Supplemental Reference

What has been going on for the last several years, and what will the future bring?

Irby DM, Wilkerson L. Educational Innovations in Academic Medicine and Environmental Trends. JGIM; May 2003 18:370-376.

New Science of Learning, Technology and Instructional Innovations

New Science of Learning, Technology and Instructional Innovations

New theories of learningActive, constructive, social, and self-reflective process (Shuell, 1996)Learner centered and knowledge-richGuided by assessmentSituated in a community of learners

(Brown, 1996)

Presentation of content in context

New Science of Learning, Technology and Instructional Innovations

New theories of learning

Implications related to medical schools Case-based or problem-based learning Other small group instruction Collaborative organization to support student-

faculty interactions Technology enhanced educational tools Redirection of organization of basic science

materials to emphasize relevance and context

Small-group, case-based learning

Facilitates cognitive processes through engagement

Encouraged to articulate what they know and don’t know, challenge assumptions, test limits of understanding

Active rather than passive

Learning Communities

Strengthen mentoring

Career advising

Longitudinal relationships

Curricular and/or social responsibilities

Instructional Technology

Use of simulations and simulators

Multimedia cases

Access to knowledge, use of the literature

Computer based instruction

Multidisciplinary Perspectives and the Need for Integrative Structures

Multidisciplinary Perspectives and the Need for Integrative Structures

Scientific investigation and health care practice have required increased integration in design

Education and curricular design … also integrated in design?

Multidisciplinary Perspectives and the Need for Integrative Structures:

Education and curricular design

“Preclinical” educationOrgan system curricular model Block approaches, eg neuroscience

Clinical education Integrative short block experiencesLinkage of disciplinesArrangement via site of care

Shifting Views of Health and Disease and the Need for a Responsive Curriculum

Shifting Views of Health and Disease and the Need for a Responsive Curriculum

Medicine is being reshaped by changing community needs and the interplay of scientific, societal, and economic forces Human genome project Public health perspective Issues of chronic care, end-of-life care, pain

management, bioterrorism

How do we add important content to an already packed curricular program

Shifting Views of Health and Disease and the Need for a Responsive Curriculum

Weaving themes across the curriculum

Carving out intensive blocks of time

Responsiveness to the needs of the community that is served

Accountability and New Assessment Technologies

Accountability and New Assessment Technologies

Shift from simple knowledge assessment to competency evaluation, including application of knowledge and demonstration of skills

IOM report on errors in medicine has raised concern that education and assessment must do a better job

Accountability and New Assessment Technologies

Standardized patient examinations

Use of simulators

Change in the construct of examination

Development of individualized programs of learning based on comprehensive evaluation of student performance that is meant to be formative

Financial Pressures and the Need to Recapture the Educational Mission

Financial Pressures and the Need to Recapture the Educational Mission

Money is less plentiful, reimbursement going down

Expenses going up

Demands on faculty regarding clinical productivity, documentation, increased supervision of learners, reduced resident work hours

Financial Pressures and the Need to Recapture the Educational Mission

Teaching has been slowly crowded out of the schedules of faculty

“Present day market forces are rapidly destroying the learning environment of clinical education.” (Ludmerer)

Financial Pressures and the Need to Recapture the Educational Mission

Academies of Medical Educators

Mission-Based Management