curriculum renewal
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FSM will mentor and educate students to become exceptional, compassionate and innovative physicians , educators, and researchers We expect our students to be inquiry-driven team leaders who will serve patients , society and the profession. Curriculum renewal. March 2011 Update. - PowerPoint PPT PresentationTRANSCRIPT
CURRICULUM RENEWAL
March 2011 Update
FSM will mentor and educate students to become exceptional, compassionate and innovative physicians, educators, and researchers
We expect our students to be inquiry-driven team leaders who will serve patients, society and the profession
Sept 2009 Retreat
Aug 2012Phase 1Implementation
Sept 2011 Phase 1 Plan Completed
~April 2013 Phase 2 Implementation
Instructional Design to deliver contentFaculty Development to facilitate content deliveryAssessment Design to evaluate student learning outcomes
Curriculum Evaluation and Continuous Quality Improvement
100 faculty
15students
Oct 2010 Kick-Off
200faculty
25students
Curriculum Developmentorganization, content
113faculty
25students
CURRICULUM RENEWAL March 2011 Update
~April 2014 Phase 3 Implementation
Competency-BasedActive LearningPBL
Collaborative
Colleges
ContentPPS , MDM
Evidence-Based LearningPBL, TBL, Simulation, Virtual Reality
Science in Medicine
Personal - Adaptive
Learner-Centered
Professional Development
ContentAOC, Competency, PPS , MDM
Integrated
Collaborative Multidisciplinary & Inter-professional Teams, Societies, Colleges
Inquiry-Driven
Curricular Model
Health & Society• Biopsychosocial determinants of Health and Disease
(Healthy People 2020)• Health Disparities, Equity and Advocacy• Health Economics and Health Systems• Global, Community and Public Health Perspectives• Patient Safety and Quality Improvement
Professional Development • Area of Scholarly Concentration, “Pathways”, Professional
Goals• Personal Awareness and Self-Care• Professional Behavior and Moral Reasoning• Teamwork & Leadership
Clinical Medicine• Prevention, Diagnosis, Treatment, Rehabilitation, Palliation (Prevention includes nutrition, lifestyle medicine, behavioral change, wellness (Diagnosis includes Hx & PE, laboratory medicine, imaging) (Treatment includes therapeutics and technical skills) (Rehab includes transitions of care) (Palliation includes end of life care)• Medical Decision-Making & Clinical Reasoning
(MDM includes Info Acquisition & Management, EBM, Cost- Effectiveness)
• Communication (oral, written, counseling, teaching)
Science in Medicine• Foundational Sciences (cellular processes,
genetics, metabolism inflammation and infection)• Normal Structure and Function• Mechanisms of Disease, Diagnosis, Therapeutic
Interventions, Disease Prevention• Organ-based, lifecycle / developmental framework
4 Curricular Elements content threads
CURRICULUM RENEWAL March 2011 Update
Continuity
Organizing principles
Current Curriculum
Year 1 Year 3 Year 4
Clinical Medicine
Patient, Physician, Society
SF
Normal Abnormal
Year 2
SBM
Phase 1 Phase 2 Phase 3
Science in Medicine Clinical Medicine
Health & Society
Professional Development
Proposed Curriculum
CURRICULUM RENEWAL March 2011 Update
CURRICULUM RENEWAL March 2011 Update
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Competency-Based, Gateway Assessments with Portfolio ReviewsGa
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I II III IV V VI VII VIII IX X XI XII XIII XIV
SiM
Sept 2009 Retreat
Aug 2012Phase 1Implementation
Sept 2011 Phase 1 Plan Completed
~April 2013 Phase 2 Implementation
Instructional Design to deliver contentFaculty Development to facilitate content deliveryAssessment Design to evaluate student learning outcomes
Curriculum Evaluation and Continuous Quality Improvement
Oct 2010 Kick-Off
Curriculum Developmentorganization, content
CURRICULUM RENEWAL March 2011 Update
~April 2014 Phase 3 Implementation
Phase 1 Phase 2 Phase 3
Science in Medicine Clinical Medicine
Health & Society
Professional Development
CURRICULUM RENEWAL March 2011 Update
SCIENCE IN MEDICINE
Inte
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Syn
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Prologue CV
Pulm
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Phase 1 Sequence - Science in Medicine Modules
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CM
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September October November
Prologue - Sequence of Science in Medicine (Weeks) Fall 2012
Mon Tue FriThuWed
LABOR DAY CELLS, ORGANELLES, MACROMOLECULES
CELLS, CONT. RECEPTORS, G PROTEINS, MEMBRANE TRANSPORT, CHANNELS
INTRO,THEMES,THREADS
CHROMOSOMES, CELL CYCLE, STEM CELLS, MUTATION, INHERITANCE
GENETIC VARIATION, PEDIGREE, AUTOSOMAL & CHROMOSOMAL DISORDERS
Mon Tue FriThuWed
GENETIC DISORDER DIAGNOSIS, SCREENING & THERAPEUTICS, SPECIFIC DISEASES
METABOLISM, PATHWAYS, MITOCHONDRIA
HUMAN BODY: EPITHELIUM, CONNECTIVE TISSUE
HUMAN BODY: BONE, MUSCLE BLOOD,CIRCULATION
AUTONOMIC,SOMATIC
NERVOUS SYS.
EMBRYO-GENESIS
CELL ADAPTATION & INJURY, APOPTOSIS, TUMORS, CANCERPHARMACOLOGY:
ABSORPTION,TRANSPORT
PHARM: DISTRIBUTION, EXCRETION, METABOL., KINETICS
Mon Tue FriThuWed
PHARMACOLOGY:KINETICS
INTROMICROBIOLOGY
RNA & DNA VIRUSES, BACTERIA, FUNGI, PARASITES, THERAPEUTICS INTROIMMUNOLOGY
ANTIBODIES, T CELLS, EFFECTOR FUNCTIONS, AUTOIMMUNITY, TRANSPLANTS
IMMUNOPATHOLOGY,INFLAMMATION
THANKSGIVING
PROLOGUEEXAM
CARDIOVASCULAR MODULE
September 2012 Calendar
October 2012 Calendar
November 2012 Calendar
December 2012 CalendarMon Tue FriThuWed
3 7654
10 14131211
17 21201918
24 28272625
1 5432
8 1211109
15 19181716
22 26252423
29 3130
21
5 9876
12 16151413
19 23222120
26 2827 3029
3 7654
10 14131211
17 21201918
24 28272625
31
CARDIOVASCULAR MODULE
CARDIOVASCULAR MODULE
CARDIOVASCULAR MODULE
CHRISTMAS<===============HOLIDAY BREAK===============>
<===============HOLIDAY BREAK===============>
CELLS, RECEPTORS, MEMBRANES
GENETICS
GENETICS
HUMAN BODY
CELL INJURY
PHARMACOLOGY
MICROBIOLOGY
IMMUNOLOGY
EXAM
CARDIOVASCULAR MODULE
Prologue Sequence of SiM - Weekly Calendar
3 7654
September 2012 CalendarMon Tue FriThuWed
10 14131211
17 21201918
24 28272625
LABOR DAY CELLS, ORGANELLES, MACROMOLECULES
CELLS, CONT. RECEPTORS, G PROTEINS, MEMBRANE TRANSPORT, CHANNELS
INTRO,THEMES,THREADS
CHROMOSOMES, CELL CYCLE, STEM CELLS, MUTATION, INHERITANCE
GENETIC VARIATION, PEDIGREE, AUTOSOMAL & CHROMOSOMAL DISORDERS
October 2012 CalendarMon Tue FriThuWed
1 5432
8 1211109
15 19181716
22 26252423
29 3130
GENETIC DISORDER DIAGNOSIS, SCREENING & THERAPEUTICS, SPECIFIC DISEASES
METABOLISM, PATHWAYS, MITOCHONDRIA
HUMAN BODY: EPITHELIUM, CONNECTIVE TISSUE
HUMAN BODY: BONE, MUSCLE BLOOD,CIRCULATION
AUTONOMIC,SOMATIC
NERVOUS SYS.
EMBRYO-GENESIS
CELL ADAPTATION & INJURY, APOPTOSIS, TUMORS, CANCERPHARMACOLOGY:
ABSORPTION,TRANSPORT
PHARM: DISTRIBUTION, EXCRETION, METABOL., KINETICS
November 2012 CalendarMon Tue FriThuWed
21
5 9876
12 16151413
19 23222120
26 2827 3029
PHARMACOLOGY:KINETICS
INTROMICROBIOLOGY
RNA & DNA VIRUSES, BACTERIA, FUNGI, PARASITES, THERAPEUTICS INTROIMMUNOLOGY
ANTIBODIES, T CELLS, EFFECTOR FUNCTIONS, AUTOIMMUNITY, TRANSPLANTS
IMMUNOPATHOLOGY,INFLAMMATION
THANKSGIVING
PROLOGUEEXAM
CARDIOVASCULAR MODULE
December 2012 CalendarMon Tue FriThuWed
3 7654
10 14131211
17 21201918
24 28272625
31
CARDIOVASCULAR MODULE
CARDIOVASCULAR MODULE
CARDIOVASCULAR MODULE
CHRISTMAS<===============HOLIDAY BREAK===============>
<===============HOLIDAY BREAK===============>
Prologue Sequence of SiM - Weekly Topics
Approaches to genetics disorders
Development, pattern
formation, homeobox genes
Contiguous gene deletions,
uniparental disomy
Genetic screening,
prenatal, cancer risk
X chromosome: inactivation,
pseudoautosomal regions, Turner
syndrome
Treatment of genetic disorders
Prenatal diagnosis
Mitochondrial genetics & diseases
Behavioral genetics
Neurofibromatosis Marfan syndrome, hemiglobinopathy,
PKU
Example: Prologue SiM Week 5, Hourly Topics Fall 2012
MondayOctober 1
TuesdayOctober 2
WednesdayOctober 3
ThursdayOctober 4
FridayOctober 5
Tasks ahead: 1. Improve coordination and communication across SiM topics2. Integrate the daily and weekly schedule with other curricular
elements - clinical medicine, health and society, professional development
3. Develop stimulating, interactive learning experiences that engage students in large and small groups
Phase 1 Phase 2 Phase 3
Science in Medicine Clinical Medicine
Professional Development
CURRICULUM RENEWAL March 2011 Update
CLINICAL MEDICINE
TUESDAY 5PM : CLINICAL MED STEERING COMMITTEE• Ben Singer• Julia Corcoran• John Butter• Warren Tourtelotte• Rama Gourenini• Jen Trainor• Stephanie Kerns• Nicholas Volpe• Donna Woods• Margaret Duggan• Kristine Gleason
• Bob Tanz• John Vozenelik• Jay Thomas• Michael Fleming• Alex Korutz• Daniel Katz• Joseph Brown• Kate Kinner• Kelly Walker• Aarati Didwania• Amanda Zick
TUESDAY 12NOON : CLINICAL MED SUBCOMITTEE #1• Eric Terman• Arv Vanagunas• Lori Goodhartz• Cristine Park• Toshi Uchida• Boye Ogunseitan• Stevie Mazyck• Gary MacVicar• Marie Crandall• Jen Bierman
• Todd Davis• Karen Mangold• Alexander Sandu• Sharon Unti• Mike Moore• Susan Santacaterina• Nicole Wysolcki• Cherina Cyborski• Donald-Lloyd Jones
THURSDAY 8AM : CLINICAL MED SUBCOMMITEE #2• Bob Brannigan• Tania Saroli• Michael Angarone• Rick Lee• Amer Aldeen• Jyothy Puthumana• Edgar Black• Darius Loghmanee• Danielle Smith• Julie Stamos
• Tina Tan• Melissa Brown• Natasha Wheaton • Allison Hammer• Stephanie Miller• Jay Sarthy• Jared Mendelson
CLINICAL MEDICINE ELEMENT GROUP:• Tuesday 12noon subcommittee:
– Task: organize the clinical medicine curriculum horizontally almost done mapping broad goals, assessment methods, & learning strategies
• Thursday 8am subcommittee:– Task: integrate clinical medicine vertically into the CV
unit Focused Clinical Experience (FCE) initiative
• Tuesday 5pm steering committee:– Task: think tank for “big picture” & reactor panel
developing a longitudinal student/patient experience
Current Curriculum
Year 1 Year 3 Year 4
Clinical Medicine
Patient, Physician, Society
SF
Normal Abnormal
Year 2
SBM
Phase 1 Phase 2 Phase 3
Science in Medicine Clinical Medicine
Health & Society
Professional Development
Proposed Curriculum FCE
SINGLE DOSESOF EARLY CLINICAL MEDICINE…
THE FCE CONCEPT:
• Find a lecture • https://fsmweb02.northwestern.edu/emerg/
• Pick 2-3 objectives
• Find real-world examples where the lecture content is applicable• Embed students in a clinical area. Aims: provide context, apply & synthesize knowledge and inspire
PROVIDE THE “WHY” & INSPIRE INQUIRY
COULD IT WORK?
First FCE pilot Dr. Puthumana’s echo lab experience…
• “Experience was wonderful”• “the lecture material really
came together”• “Cardiac echo, E/A & E’
definitely seemed more relevant after the exercise”
• “It was certainly inspiring and I would definitely do it again- for other units”
What’s up next:
• NMH valve surgery (R. Lee)• CMH heart biopsy (T.Saroli)• Heart transplant (E.Black)• Cardiac cath lab (J.Flaherty)• CCU pharmacist (K. Gleason)• ED ecg’s (Aldeen, Wheaton)• CCU nurse shadow (M.Duggan)• Cardiac MRI imaging (A.Korutz)• Stress test lab (J.Puthumana)• Cardiac autopsy (J.Lomasney)• Any volunteers?
A MAINTENANCE DOSE OF CLINICAL MEDICINE…
Because understanding the social/environmental determinants of disease & the chronic care model requires… more than 4 weeks!
CONTINUITYPatients
(continuity of care)
Peers (continuity
of teamwork
& collaborati
on)
Preceptors
(continuity of
supervision)
SO WE NEED TO CREATE AN EDUCATIONAL EXPERIENCE WHERE:
• A team of health professionals, coordinated by a longitudinal physician, working collaboratively to provide high levels of care, access and communication, care coordination and integration, and working to improve care quality and safety.
• This is the AAFP, ACP, AAP, AOA 2007 consensus definition of a Patient-Centered Medical Home
SIMPLE & ELEGANT
ALL RESIDENTS & ATTENDINGS CAN UNDERSTAND A CONTINUITY CLINIC CONCEPT
CONTINUITY Panel of 100
Patients
Team of 10
Students(2-3 per class)
1-2 Faculty
Facilitators
Recruit vulnerable patients with one or more of 20 core
conditions such as: heart disease, cancer, stroke,
COPD, obesity, trauma/SCI, dementia, DM, ESRD, mood disorders, asthma, HIV, SLE, cirrhosis, CHF, high-risk OB,
cystic fibrosis, sickle cell, chronic pain, and OA
Panel of 100 patients with Q4 mth visits
would be ~6 patients/wk, +add 1-2 acute slots as needed
SIMPLE DESIGN, INFINITE FLEXIBILITY• All students have a clinic (simple concept)• But within their clinic- many chances for
“layered individualization” & adaptability:
• Panel of 100 patients allows students to focus (“own”) the patients with conditions they find most interesting
• Multiple visits with 1 patient over 4 years allows for “deep learning” rather than just superficial initial encounters
• Multiple levels of learners allows students to operate at exactly their “true” level. M1’s who are ahead of the curve can start doing more DDx and M3’s who are struggling can work more on PEx skills or Hx
• M3 students could recruit the inpatients that inspire them
NEW RESOURCES SINCE 1993:• Ability to track patient
progress when not physically at the clinic
• And increasing ease of data-mining to assess quality across sites
Epic.lnk
PowerChart.lnk
OTHER SCHOOLS CAN MEASURE THEIR CURRICULAR REFORM EFFORTS WITH STUDENT SATISFACTION SURVEYS
Our educational outcomes could be:
97% of student CAD patients on B-Blkrs & Aspirin
Average Hgb A1c dropped 1.0% compared to entry80% patients up to date with cancer screening metrics
No racial disparities detectable in screening rates
Mean BMI of patient panel dropped over 4 years
RHINOCEROS– WHY WERE YOU SO INSPIRING?
• Students owned the project• Students worked as a team and had a goal• The project was simple but yet integrated
everything they had been learning in class (reading, writing, math, art, weather, geography, biology, health/nutrition)
• The project inspired inquiry & deep learning• Professionalism, responsibility were required• Can’t we aspire to compete with 1st graders??
Current Curriculum
Year 1 Year 3 Year 4
Clinical Medicine
Patient, Physician, Society
SF
Normal Abnormal
Year 2
SBM
Phase 1 Phase 2 Phase 3
Science in Medicine Clinical Medicine
Health & Society
Professional Development
Proposed Curriculum FCE
PCMH
• Imagine working with these 4 FSM students over 4 years and seeing what they could do with a panel of their OWN patients
• Imagine the PR campaign & recruitment impact…
• Improving Medical Education by Improving Chicago’s Health
Phase 1 Phase 2 Phase 3
Science in Medicine Clinical Medicine
Health & Society
Professional Development
CURRICULUM RENEWAL March 2011 Update
HEALTH & SOCIETY
Prologue:Students learn about themselves
• Health Risk Appraisal (HRA)– Lifestyle factors and readiness to change • Biometric
and laboratory results • Compliance with recommended preventive screenings • Existing chronic conditions • Future disease risk factor • Personal environment
– Personal and group results• Behavior Change Plan (BCP)
– Reanalysis of HRA results– Personal and group results
Prologue:Students learn about others
• Textbook Chicago – Chicago bus tour of 6 communities to assess the 4
determinants of health (social environment, physical environmental, health services, individual behavior)
– SES • Racial/ethnic demographics • Built environment • Health care access & delivery • Prevalence of selected health conditions
– Presentations and discussion of health outcome disparities regarding determinants of health
Overarching themes
• Determinants of health• Disparities in health
outcomes• Public health• Community and global
health• Health service delivery• Physician roles• Professional well-being
• Advocacy• Communication /
motivational interviewing/ behavior change
• Interdisciplinary learning
• Lifestyle Medicine Thread
Phase 1 Phase 2 Phase 3
Science in Medicine Clinical Medicine
Health & Society
Professional Development
CURRICULUM RENEWAL March 2011 Update
PROFESSIONAL DEVELOPMENT
Professional Development
Curriculum Renewal UpdateMarch 2011
OverviewA curricular element that encompasses:
– An Area of Scholarly Concentration (AOSC)
– Professional Behavior and Moral Reasoning/Medical Ethics (PBMR)
– Personal Awareness and Self-Care (PASC)
– Teamwork and Leadership (TL)
Accomplishments: November 2010- Area of Scholarly Concentration task force:
Report on activities of other schools and recommendations for FSM
- Professional Behavior and Moral Reasoning Competency Committee: Education and assessment blueprint
- Personal Awareness and Self-Care Competency Committee: Education and assessment blueprint
Progress: November 2010-March 2011
1. Convened sub-committees for four areas of Professional Development.
2. Agreement on goals, teaching activities and assessment strategies for Prologue/Phase 1.
3. Development of Pilot projects for Fall, 2011.
Broad Goals for Prologue/Phase 1... • DISCUSS basic theories of teamwork and leadership (TL).
• ANALYZE team structure and roles for a team that they are currently on (TL).
• UNDERSTAND basic research designs in biomedical research (AOSC).
• DEVELOP a 4 year plan for an area of scholarly concentration in research, education or community service (AOSC)
• IDENTIFY, ANALYZE and JUSTIFY appropriate ethical and legal choices in the care of patients and their families (PBMR)
…Broad Goals for Prologue/Phase I• IDENTIFY, ANALYZE, and JUSTIFY ethical choices in the
healthcare systems in which they work, including issues of access to care and conflicts of interest (PBMR)
• BEHAVE with honesty, integrity, respect, and compassion toward all patients, families, students, faculty, and other healthcare professionals (PBMR)
• CREATE a 4 year plan for personal awareness and self-care (PASC)
Pilot Projects for 2011…
1. Teamwork and Leadership: - Course with Northwestern Center for
Leadership on teamwork & leadership for medical students
- Develop structure/ framework for team analysis of a current team
2. Professional Behavior and Moral Reasoning: - Develop new assessment for current ethics and values course (M1)
…Pilot Projects for 20113. Personal Awareness and Self-Care:
- Develop guidelines for mentor/student 4 year plan for personal awareness and self-care.
4. Area of Scholarly Concentration: - Update medical decision-making (MDM) course to reflect goal of developing a research project/plan with a preceptor. - Convene one regular AOSC interest group to meet monthly.
Ongoing challenges and opportunities
• Integrate with Clinical Medicine and the Patient Centered Medical Home:– Opportunities for PBMR, TL, PASC
• Integrate with Health and Society: PASC
• Make one assessment “count” for multiple competencies/curricular elements
Sept 2009 Retreat
Aug 2012Phase 1Implementation
Sept 2011 Phase 1 Plan Completed
~April 2013 Phase 2 Implementation
Instructional Design to deliver contentFaculty Development to facilitate content deliveryAssessment Design to evaluate student learning outcomes
Curriculum Evaluation and Continuous Quality Improvement
100 faculty
15students
Oct 2010 Kick-Off
200faculty
25students
Curriculum Developmentorganization, content
113faculty
25students
CURRICULUM RENEWAL March 2011 Update
~April 2014 Phase 3 Implementation
Steering
Clinical Medicine
ProfessionalDevelopment
Science in Medicine
Health& Society
Synthesis & Application
Modules
Prologue / Foundations
Steering Committee
Patient Safety
MDM & Laboratory MedicineLifestyle MedicineTe
amwor
kLe
ader
ship
Instructional Design& Technology
AWO
ME
GHSL
FAM
E
Student Assessment
Com
pete
ncy
Com
mitt
ee
Faculty Development
FAM
E
Curriculum Outcomes &Evaluation
Curr
icul
umCo
mm
ittee
Reactor Panels
Curr Element Groups
Thread Subcommittees
Subcommittees
Thanks for your contributions toward a shared vision
the imagination to createthe courage to change
the excitement and resolve to continue into uncharted areas
the resilience to recover from a mistake
http://goo.gl/L5oZK
http://twitter.com/#!/FSM_curr
Inte
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