National Standards In Pathology Education

Barbara Knollmann-Ritschel, M.D.

• The opinions expressed herein are those of the author, and are not necessarily representative of those of the Uniformed Services University of the Health Sciences (USUHS), the Department of Defense (DOD); or, the United States Army, Navy, or Air Force.

Evolution of Medical School Education

• 1910 Flexner report• Traditional Format

– Two years lecture– Two years Clinical

apprenticeship

New Reforms• Carnegie Foundation

Report:“ Learner centered”

• Learners learn in a variety of ways and may benefit from a learning environment different than the traditional format

• Learning outcomes must be carefully assessed and tied to competencies

AAMC and Howard Hughes Medical Institute

“specific competencies in the sciences fundamental to medicine that all medical students should demonstrate before receiving the M.D. degree”

New Reforms

Moving from didactic lectures in isolated disciplines to horizontal integration with small group discussion and case presentation as well as earlier clinical interaction.

-Online lectures

-Patient simulators

-Shared study material

-Interdisciplinary teams

How does this affect Pathology Teaching?

• Elimination of Pathology as a course– Reduced visibility– Not reduced importance

• Increased the need to identify the essential contributions of pathology to understanding and treating disease.

Competencies for Pathology

• LCME ED-11 (Element 7.1)– “The Curriculum of a medical education program

must include content for the biomedical sciences that supports students' mastery of the contemporary scientific knowledge, concepts, and methods fundamental to acquiring and applying science to the heath of individuals and populations and to the contemporary practice of medicine”

– Pathology was specifically named

Competencies for Pathology

• ED 17: educational opportunities must be available in clinical pathology– Must learn basic mechanisms of disease– Disease manifestation in organs– Application of disease mechanisms to clinical

practice for diagnosis and management

• Requested information in medical education database, not an Element

ED -1Element 8.2

• The faculty of an institution the offers a medical education program must define the objectives of its program. The objectives must serve as guides of establishing curriculum content and provide the basis for evaluation the effectiveness of the program.

Why National Standards?

• Concern that with integrated curriculum that pathology is appropriately represented in curriculum committee to ensure full integration for teaching pathologic processes from disease mechanism to organ system pathology to laboratory diagnosis.

Three Basic Pathology Competencies

• Disease mechanism• Organ system pathology• Application of pathology in diagnostic

medicine

Disease MechanismsLearning Objective: Inflammation

• Apply knowledge of the histology and molecular biology of inflammation to the clinical presentation of disease.– Compare and contrast the cellular components of

acute and chronic inflammation to include their primary function and the molecules and mediators responsible for cellular recruitment and interactions.

– Describe the appearance and mechanism of the 5 cardinal signs of inflammation…..

Why the Effort?

• LCME requirements• Improved teaching/ assessment (learner

centered – small group)• Use for leverage to get time for pathology

UMED• Share objectives/cases

Next Steps

• Feedback• Develop Cases

Acknowledgements

• Mike Prystowski• Moshe Sadofsky• Richard Conran• Mike Borowitz• Dan Regula• Margret Magid