Curriculum for the 21st Century

Curriculum Changes for the UASOM at UAB

Curriculum for the 21st Century

Years 1-2 (Pre-Clerkship) Modular integrated/organ based Concept driven Adult/active learning

Year 3: Clerkships Will begin earlier Structure and organization to be reviewed Continue themes

Mandatory Scholarly Activity (expanded definition of scholarship) Three months Review committee

Year 4 Reevaluate all current 4th year requirements Pre-residency prep course Teaching /basic science

Guiding Principles of the Curriculum Student Centered, Active Learning, Application Based Based on Problem Solving Based on SOM Goals and Objectives Learning facilitated through clinical context Integration of modules with interdepartmental approach Appreciation of evidence as the basis for medical decision

making Appreciation of investigation as a component of medical

practice and learning Integration of Important Themes Use of evaluation methods appropriate to assess different

goal and objectives

Pre-Clerkship Phase Modules including:

Patient, Society and Doctor Fundamentals 1 (biochemistry, genetics,cell biology,

physiology) Fundamentals 2 (pathology, pharmacology,

microbiology, immunology) 8 organ-based modules 3 weeks of “Special Topics”

Blend of instructional modalities and assessments Interdisciplinary and integrated in instruction and

assessment Modules are not departmentally controlled and

are responsible to the MEC

Clerkship Phase Current Core Clerkships to be reviewed for

needed changes Start 2 months earlier than current July 1

start date Opportunity for us to consider innovation Themes will continue in longitudinal

fashion

Scholarly Activity Phase Scholarship as defined broadly as in

faculty promotion 12 weeks of an approved scholarly activity Required for graduation Appropriately mentored and supervised Defined final product for each experience Review and oversight by a faculty panel

Pre-residency Phase (4th Year) Preparation for next phase of training Individualized for each student and

approved by a recognized faculty advisor Include current acting internships and

electives Re-introduce basic sciences/teaching to

students Include a required residency prep course

for final skills to enable successful transition as a functional resident

Robert Rich, MD, VP and Dean,UASOM at UAB

Dennis Boulware, MDSenior Associate Dean

Roger Berkow, MD Assistant DeanChair of Implementation Task Force

Peter Anderson, DVM, PhD, Pre-Clerkship Coordinator

Nathanial Robin, MD, Pre-Clerkship Coordinator

Alice Goepfert, MDPDS

Tom Houston, MDThemes

Louis Justement, PhDScholarly Activity

Laura Kezar, MDPre-Residency

Johnita Dobbs, MA, EdProgram Manager

Lee Meadows, PhDConsultant

MECCheri Canon, MD

Module Directors and Co-directors

Module DirectorsPre-clerkship coordinator JHS – Pete AndersonPre-clerkship coordinator Clinical – Nat Robin

PDS Alice Goepfert (OB) aliceg@uab.edu

Fundamentals 1 Laura Cotlin (Cell Bio) lcotlin@mail.ad.uab.edu Nat Robin (Gen) nrobin@genetics.uab.edu

Fundamentals 2 Peter Anderson (Path) pga@uab.edu Clinical Ken Waites (Path) waites@path.uab.edu

Intro to Organs Erik Schwiebert (Phys) issytman@uab.edu Clinical Nancy Tofil (Peds) ntofil@peds.uab.edu

Cardiovascular Silvio Litovsky (Path) slitovsk@uab.edu Clinical Barry Rayburn (IM) brayburn@uab.edu

Pulmonary Bruce Alexander (Path) cba@uab.edu Clinical Kevin Leon, MD (IM) kleon@uab.edu

Renal Mark Bevensee (Phys) tr7o7de@uab.edu Clinical Ivan Maya (IM) imaya@uab.edu

GI Cathy Fuller (Phys) cfuller@uab.edu Clinical Douglas Heimburger (Nutrition) dheimbur@uab.edu

MS/Skin Marcas Bamman (Phys) mbamman@uab.edu Clinical W. Winn Chatham (IM)/Catherine Lucas (Derm)

wchatham@uab.edu / ctoms@uab.edu

Neuroscience Robin Lester (Neurobiol) nicotine@uab.edu Clinical Tony Nicholas (Neuro) nicholas@uab.edu

Richard Powers (Path) repowers@uab.edu Hal Thurstin (Psych) hadrian@uab.edu

Heme/Onc Vishnu Reddy (Path) vreddy@uab.edu Clinical Kimberly Whelan (Peds) kwhelan@peds.uab.edu

Endo Shawn Galin (Phys) galin@uab.edu Clinical Hussein Abdul-Latif (Peds) habdullatif@peds.uab.edu Repro Mike Conner (Path) mgconner@uab.edu Clinical Todd Jenkins (OB) aliceg@uab.edu

Integr/USMLE Erik Schwiebert (Phys) and Nancy Tofil (Peds)Nancy Hinson nhinson@uab.edu

Peter Anderson PreClerkship Coordinator (JHS)Nat Robin PreClerkship Coordinator (Clin)

Anatomy/Radiology/SurgeryShane Tubbs/Bob Stanley/Eben Rosenthal

BiochemistryTim Townes

Cell BiologyLaura Cotlin

PathologyPeter Anderson

PharmacologyDennis Pillion

PhysiologyMarcas Bamman

MicrobiologyLou Justement

GeneticsNat Robin

Themes/ICMTom Houston

NutritionDoug Heimburger

Module Director and Co-director

Module Approx. Start Date Approx Duration

Week #

PSD Jul 30, 2007-Aug 17 3 weeks 1-3

Fundamentals 1 Aug 20, 2007- Oct 12 8 weeks 4-11

Break Oct 15-21 12

Fundamentals 21 Oct 22, 2007- Dec 14 8 weeks 13-20

Winter break Dec17-Jan 1 21,22

Intro/Org systems2 Jan 2-Jan11, 2008 2 weeks 23,24

Cardiovascular Jan 14(5)-Feb 8, 2008 4 weeks 25-28

Pulmonary Feb 11- Mar 7, 2008 4 weeks 29-32

Spring Break Mar 10-16 33

Renal1 Mar 17 – Apr 11, 2008

4 weeks 34-37

Gastrointestinal Apr 14- May 9, 2008 4 weeks 38-41

MS/Skin May 12 – June 6, 2008

4 weeks 42-45

Summer Break June 9-July 20 46-51

Timing and Duration of ModulesYear 1

Timing and Duration of ModulesYear 2

Special topicsor Break

Jul 21-Aug 17, 2008

3 weeks out of total of 7

required

1-4

Neurosciences Aug 18-Oct 31, 2008

11 weeks 5-15

Fall Break Nov 1-Nov 9 16

Heme/Onc1 Nov 10– Dec 5, 2008

4 weeks 17-20Thanksgiving

Special topics/Break Dec 8- Dec 19, 2008

2 weeks 21,22

Winter Break Dec 20-Jan 4 23-24

Special topics2 Jan 5-9, 2009 25

Endocrine/Repro Jan 12- Feb 20, 2009

6 weeks 26-31

Integ/USMLE prep Feb 23- Mar 13, 2009

3 weeks 32-34

USMLE Step 1 March 16-April 24

35-40

New Curriculum: Key Differences No more than 24 (~20 is better) hours per week of student

contact <50% lectures Includes ICM, Themes, small groups, labs, independent

learning modules Anatomy:

Radiology, pro-sections, surgical anatomy Grades: <50% MCQ

Professionalism Projects Presentation/preparation/team work

Class time 10AM to 3PM (MSTP have CMB 8-10 AM) Small group/Lab times can vary

ICM usually 3-5 PM 1-2 times per weeks

Pedagogy Goals and objectives for each contact

with student (What is the expected outcome)

Core Competencies – School wide Goals and objectives, ACGME

Identify themes with ATWG Identify Special Topics - request to

the faculty (scholar’s week format)

Pedagogy Integration of material within and between modules Students will be responsible for everything that came

before (could be testable in context of current module) Students expected to prepare for concept based sessions Module teams (directors and clinical co-directors) need to

direct student preparation (text book reading, journal articles, web based learning).

Ultimate goal could be to develop a series of paper or computer “families” who students follow through the curriculum. Issues of prevention, diagnosis, treatment, compliance, culture, compliance and disease mechanism can be addressed by problems which develop based on the current module.

Integration of clinical skills and themes / PDS topics into each module.

Pedagogy

Instructional Methods Lecture Clinical correlations Discussion Groups Small Groups Problem based learning Independent learning Computer based Other

Module Structure

•Normal development •Normal processes •Abnormal processes •Diagnosis, therapeutics and disease management •Epidemiology and evidence-based medicine •Prevention and nutrition •Societal impact

Each module should be organized as follows:

Functional Anatomy and Structure (Imaging (Radiology) Gross Anatomy and Surgery)

Embryology and Post-natal Development (Embryology, Pediatrics)

Microscopic Anatomy (Histology and Pathology)

Normal Organ function (Physiology, cell biology, biochemistry, genetics, nutrition)

Organ Pathology, Pathophysiology and Pharmacotherapeutics (Pathology, Oncology, Microbes, Immunology, Nutrition problems, toxicology, environmental factors, treatment, Genetics of disease)

Prevention of disease - nutrition, toxin exposure (e.g., cigarettes, alcohol), environment (e.g. sedentary vs. active lifestyle).

Treatment of disease. Surgical (anatomy) and pharmacologic. Aging – changes in system over the life cycle.

Impact (Epidemiology, Sociology/Society, Public Health)

Clinical history and physical examination

Instructional Topic TemplateTitle of Session: _______________________________Course: ________________________________Discipline: (anatomy, biochemistry, pathology, physiology, ect)_____________Class Type: (Lecture, Small group discussion, lab, clinical encounter) __________Presenter: ____________Professional attire required: Y_____ N______Equipment required (Stethoscope, computer etc)___________Vocabulary or key words presented in session or describing session: ___________ ____________ ______________________ ____________ ______________________ ____________ ______________________ ____________ ______________________ ____________ ___________Objectives or Key teaching points: (At the end of this session the student will state, describe, contrast, list, demonstrate, distinguish, calculate, compare, review, characterize, perform, solicit, explain, correlate, determine, recognize, discuss, practice, identify):__________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Instructional Topic Template

Materials or ActivitiesPowerPoint presentation: Previous transcripts or notesTextbook readingWeb based resources

Description of Activity:

Required Preparation:Textbook chapters:Journal articles:Web based material:Hand outs:Other:

Independent learning:Web sites:Journal articles:Team based learning projectsProjectsOther

MedEdportal: AAMC resource of online computer modules (searchable by topic or browse) http://services.aamc.org/jsp/mededportal/goLinkPage.do?link=home

Health Education Asset Library: (National Library of Medicine searchable resources)http://www.healcentral.org Anatomy TV through Lister Hill Libraryhttp://www.anatomy.tv/home.aspx

Evaluation/Assessment

Number and timing of exams (formative /summative) Work with A/T WG ACGME tool box (think outside of MCQ) MCQ (local or NBME customized) <50% MCQ

NBME type with clinical stem Avoid factoid questions

Projects Small group participation and performance Problem sets Computer exercises Professionalism/Communication/Team work (SBP) Use of resources/Information (PBL)

New Curriculum ACGME 6 Core Competencies

Competency 1 – Patient Care. Competency 2 - Medical Knowledge. Competency 3 – Interpersonal and

Communications Skills. Competency 4 – Practice-based Learning

and Improvement. Competency 5 – Professionalism. Competency 6 - Systems-Based Practice.

ACGME Gen.

Competencies

UASOMG&O

Instructional Methods Assessment

Patient Care Social and Community Contexts of Health CareBiomedical Knowledge and Clinical SkillsProfessionalism and Communication

Small group (clerkships)LecturesStandardized or real patientsSimulations

MCQShort answer testsEssayFaculty observationStandardized oral exams, individual or group examsPlanned presentations (patient or project) OSCEPortfolios

Medical Knowledge

Social and Community Contexts of Health CareBiomedical Knowledge and Clinical Skills

LectureLabSmall GroupTeam-based projectsComputer assisted learning

MCQShort answer testsEssayStandardized oral exams, individual or group examsPlanned presentations (patient or project)Learning portfolios

Practice-Based Learning and Improvement

Professionalism and CommunicationClinical SkillsSocial and Community Contexts of Health Care

LectureLabSmall GroupTeam-based projectsComputer assisted learning

MCQShort answer testsEssayPortfolios Standardized oral exams, individual or group examsPlanned presentations (patient or project)

Interpersonal and Communication Skills

Professionalism and Communication

Small group (clinical)LecturesStandardized or real patients

360 evaluationsOSCEPlanned presentations (patient or project)

Professionalism Professionalism and Communication

LectureLabSmall GroupStudent-faculty interactions in all settingsRole modeling

360 evaluationsOSCEGlobal ratings

Systems-Based Practice

Biomedical Knowledge and Clinical SkillsSocial and Community Contexts of Health Care

LectureLabSmall GroupTeam based projects

MCQShort answer testsEssayFaculty observationStandardized oral exams, individual or group examsPlanned presentations (patient or project)

DISCIPLINES

ACGME COMPETEN.

Bioch Cell bio

Phys Anat Genet Micro Nutr Path Pharm ICM

KNOWLEDGE

PATIENT CARE

COMMUNICATION/INTERPERSONALSKILL

PROFESSIONALISM

SYSTEM-BASED PRACTICE

PATIENT BASED LEARNING

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Theme Cluster Theme Content Theme Directors

1 Clinical Skills Stan Massie

2

Practice-based Learning, Evidence-based MedicineInformation Management

Terry Shaneyfelt,Pat Higginbottom

3Prevention, Patient Ed, Behavioral Sciences,Substance Abuse

Hal Thurstin,Jill Billions

4Geriatrics,Palliative Care

Rick Sims, Laura KezarAmos Bailey,Christine Ritchie

5 Rural Medicine John Wheat

6

Ethics,Humanities,Cultural Competence

Greg Pence,Hughes Evans,Carlos Estrada,

Initial Courses

PDS Fundamentals 1

Fundamentals 2

Intro/Org systems

Cardio-vascula

r

Pulmonary

Theme Grades

Approx. Start Date

30-Jul-07 20-Aug-07 22-Oct-07 2-Jan-08 14-Jan-08

11-Feb-08

Approx. Duration

4 weeks 8 weeks 8 weeks 1-2 weeks 4 weeks

4 weeks

Example Themes            

Evidence-based

Medicine

Ethics andHumanities

Palliative Care

Course Grades

Adult Learning Focus is on student learning not teaching

Needs of the student rather than ease of presentation Active learning

Interactive (Audience response systems) Problem based Case based Practical Applicable New ways to make large groups interactive (consultant)

Self Directed Use prior skills or knowledge of the learner