MEDICAL EDUCATION

School of Medicine RetreatFebruary 8-10, 2002

Strategic planning group for education

Parvati DevCharlotte JacobsLarry MathersPeter SchillingGary SchoolnikMatt ScottAl TairaDavid TerrisDick TsienDavid O’Brien

Contributors

Curriculum Reform Committee and the Faculty Senate Education retreat GALE developers Education technologies group Committee on Courses and Curriculum Dean and Senior Associate Deans Med Education Associate Deans

Mission statement

We will educate students to become outstanding clinicians who have the skills and passion to improve the health of the world’s people through research, innovation, and leadership.

Why do anything different?

It’s not “broke”. Students do well as measured by: Highly competitive admissions process

High pass rates on boards

Good reports from residency programs

High rate of academics (33%) 10 years after medical school

Why do anything different?

Our education is not primed for the future Too much emphasis on learning memorizing specific

information Not enough emphasis on:

Methods for accumulating and interpreting new information Using the most effective educational methods--i.e.,

simulations, small group interactive learning, online curricula Cross-disciplinary approaches to learning, particularly

bridging gap between clinical and basic sciences

Our curriculum does not fit our faculty or our students

Education program

The opportunities afforded students for individual innovation and cross-disciplinary work

An absence of curricular definition--what knowledge, methods and skills do students need to have?

Insufficient time devoted to fostering independent research skills and to developing clinical skills

Funds flow that neither encourages accountability nor provides incentives for teaching excellence, innovation, and interdisciplinary programs

Strengths Weaknesses

Strategic initiatives

Revise the curriculum to address weaknesses and build on strengths

Foster and facilitate teaching, advising and mentorship

Develop facilities to meet future curriculum

Develop a community service program

Strategic initiatives:Revise curriculum

Identify core knowledge and skills required for all students

Develop required majors (“scholarly tracks”) for all students to enhance independent research capabilities

Within scholarly tracks, develop a research honors programs for a subset of students

Expand the clinical curriculum—particularly in the first years of medical school—to enhance pattern recognition.

Develop a system of incentives to promote curricular change

Medscholars

Medscholars

1

2

3

4

5

Year

Q1 Q2 Q3 Q4

Clinical

Pre-clinical

TA

TA

Current curriculum

Residency and beyond

Undergraduate

Proposed curricular structure

Yea

r

Scholarly track

Basic science

Clinical

Clinical researchMolecular medicine

Community service Biotechnology

Health economics

Proposed curricular structure

Proposal for research tracks

Interdisciplinary programs compete to create scholarly tracks including:

Course work for a large number of students Honors program for smaller number of students based on resources, number of

mentors, etc.

All students required to choose a track A subset of students (at onset33%) can compete for the

“honors” program within each track and be funded for at least a year of research with or without additional degree

Number of tracks can increase with time and each track can expand

End goal: after 5-10 years, all students will want to be in honors program or MSTP

Future student body

Now

Honors research

Med scholars

Ph.D.

No independent scholarship.

Near Future 5-10 years

Obstacles and opportunities: Curriculum

Obstacles Funds flow for education Lack of central oversight of

curriculum Faculty may not be available to

teach core elements Facilities inadequate for variety

of teaching methods Insufficient mentorship and

advising programs

Opportunities Instructional technologies Intersections with university

campus Graduate programs to enhance

scholarly tracks Reputation for “flexibility” in our

curriculum Chance to give Stanford a

“distinctive” education

A certain level of teaching, advising and mentorship has to be established as a requirement for being on the faculty

Teaching needs to be honored, promoted and facilitated

The true costs of teaching courses should be established

Departments must consider their courses to be an essential component of their mission

Establish underlying principles

Strategic initiatives Enhance teaching (1)

Incentive programs for: Improvement in course performance Consistently high course performance Revising course content Developing teaching innovations, small group learning

opportunities and bridges between clinical and basic science domains

Mentorship and advising

Support for pedagogy in the areas of: Course content How to teach and how to mentor New teaching technologies Course evaluation processes

Strategic initiatives Enhance teaching (2)

Obstacles and opportunities: Teaching

Obstacles Tuition does not cover the

true costs of teaching Funds flow for education

does not directly support teaching, mentoring or advising

Teaching, advising, and mentoring are not valued

Facilities inadequate

Opportunities Tuition mechanisms are not

fixed in stone Faculty are interested in

teaching and mentorship Campus is big Instructional technologies

already strong Large number of interested

teachers in community Center for Teaching and

Learning and other pedagogical resources already exist

Strategic initiatives

Revise the curriculum to address weaknesses and build on strengths

Foster and facilitate teaching

Develop facilities to meet future curriculum Small group learning

Simulation spaces, virtual classrooms

Library

Develop a community service program

The need:

The university, from its founding, has affirmed community service among students and graduates to be a vital component of its mission

There is strong interest in community service among medical and graduate students

There is strong interest in community service among faculty

The university seeks to have better community relations

The community (local, national and international) has enormous needs

Strategic initiatives: Community service

Purpose of community service center To provide a curriculum on service for medical and graduate

students that promotes life-long commitment to action for their communities (no “amateur hour”)

To serve as a clearing house for service opportunities: International health Local health programs Arbor Free Clinic and Tully Road Clinic K-12 program

To interact with the local community Possible subsidiary of the Haas Center We are not a school of public health

Strategic initiatives: Community service

Timeline

Phase I--completed by this fall Establish mechanisms for reviewing curricular content Identify areas for scholarly track development Establish relationship with Haas Center for development of community

service program Establish the true costs of the education program, and develop a

funding system to directly support these costs

Phase II--completed by fall 2003 Five scholarly tracks in place Core knowledge and skills for basic sciences and early clinical

experience established Curriculum in first year adapted to core Community service program in place Some pedagogical programs in place to enhance teaching Incentive program begun

Timeline (2)

Phase III--completed by fall 2004 Advising, mentoring program in place Enroll first honors students, funding mechanisms in place Core knowledge base for clinical education established Clinical experience curriculum for second year class in place Lecture-based curriculum in second year adapted to core and shrunk 20%

Phase IV--completed by fall 2005 More scholarly tracks initiated, others reviewed. Basic science, scholarly track curriculum for clinical years initiated Funding mechanisms solidified Degree granting mechanisms in place (Masters in Medicine?) Enhanced incentive program in place Pedagogical evaluation of first phases of curriculum

Phase V New building in place

Balance sheet

A new vision for medical education Some components could be initiated very quickly Some component can be initiated without extensive new

resources Some components could be costly

Reviewing and revising entire curriculum Providing incentives for curricular improvements and teaching Providing funding for honors program and graduate degrees Building facilities and educational technologies Developing mentorship and advising programs

“Trade school” or MEDICAL UNIVERSITY