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A New Curriculum for Community Medicine. Don Carufel-Wert Kirsten Rindfleisch Judy Nepokroeff. Our goal for all graduates. Community responsive physicians… Family doctors who :

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A new curriculum for community medicine

A New Curriculum for Community Medicine

Don Carufel-Wert

Kirsten Rindfleisch

Judy Nepokroeff


Our goal for all graduates

Our goal for all graduates

Community responsivephysicians…

Family doctors who :

•deliver exam-room care which is culturally competent and recognizes the role of community in patients’ health and well-being

• facilitate connections between patients and appropriate community-based resources

•understand demographic, socioeconomic, and cultural characteristics of their practice community

• assess public policy proposals critically, using foundational knowledge of issues in public policy, epidemiology, and occupational health

• have the skills needed to develop, implement, and evaluate community-centered outreach projects


Limitations of the existing curriculum
Limitations of the existing curriculum

• Limited content teaching cultural competence

• No content teaching health policy, epidemiology, occupational medicine

• Heavy emphasis on agency visits

• Little structured support for community outreach projects

• Limited structured support for individual learning styles and interests

• No structured opportunity for dialogue, processing, reflection


An overview of the proposal

An overview of the proposal

A three week R1 core curriculum combining:

⇛ an orientation to the R1 curriculum

⇛ an orientation to the clinic community

⇛ community resource/agency visits

⇛ community mapping exercise

⇛ web-based learning modules

•health policy

• cultural competence

• occupational health

• epidemiology

⇛ structured time for online journaling

⇛ introduction to thepersonalized learning plan


An overview of the proposal1

An overview of the proposal

A complementary longitudinal curriculum:

⇛ Ongoing journaling and dialogue with rotation preceptor

⇛ Ongoing discussion of clinic projects at the afternoon clinic-based teaching conferences

⇛ Protected half-days for project work and work related to the personalized learning plan

• 4 half-days in the R1 year

• 12 half-days in the R2 year

• 4 half-days in the R3 year


Strengths of the new curriculum

Strengths of the new curriculum

• Expanded set of core topics: including health policy, epidemiology, occupational medicine, and cultural competence

• Structured environment for dialogue, processing, and reflection, available online

• Principles of adult learning – support for individual learning styles and interests – built into curriculum content and structure

• Enhanced accountability and opportunity for competency-based assessment

• Longitudinal time for project work – protected, structured, realistic, responsive to clinic needs


The Community Medicine website - an integral tool for the new curriculum

• Folders and web links containing study materials and course information

• Journaling and answering discussion questions

• Communication between rotation preceptor and residents

• Checklists to track completion of assignments

• Room to grow creatively

• Access anytime, anywhere


The R1 curriculum:1st week1st half day- orientation with rotation preceptor orientation with clinic preceptor further self-guided exploration of web site 3 half days - community mapping exercise3 half days - agency visits 1 half day - processing and writing about week’s experience


The R1 curriculum: 2nd week1 half day - cultural competence module1 half day - occupational health module1 half day - health policy module4 half days - agency visits1 half day - processing and writing about week’s experience


The R1 curriculum:

3rd week

1 half day - epidemiology module

4 half days - agency visits

1 half day - exploring past and ongoing clinic projects

1 half day - processing and writing about week’s experience

1 half day - rotation evaluation and introduction to the personalized learning plan


The R2 and R3 years:

An advanced, personalized, and longitudinal experience

• Writing and implementing the personalized learning plan

• Participation in clinic-based community outreach projects

• Discussions at quarterly clinic-based didactic session

• Community Medicine home visits

• Ongoing journaling and dialogue with rotation preceptor


The personalized learning plan an example

The personalized learning plan ….. an example

Learn more about the relationship between health, health care, and the environment

• read selections from scientific, policy, and lay literature on pesticides, medical mercury waste, medical plastic waste

• meet with leaders of grass-roots organization working to raise local government awareness of environmental justice issues

Learn more about possible roles as a physician-activist

• meet with Gene and Linda Farley

• research existing physician-activist organizations

• draft a “pesticide-free DFM” policy, educate colleagues on relevant issues, and advocate for policy’s adoption



Summary
Summary

New content

• learning modules and discussion questions introduce a much broader range of community medicine topics

• personalized learning plans emphasize individual

goals while maintaining preceptor guidance

• formalized proposals for new projects support high- quality work and mimic real-world processes

A new tool

• journaling, discussion questions, and ongoing preceptor-resident contact prompt reflection and critical thinking, enhancing learning and satisfaction

• ongoing preceptor-resident contact and checklists facilitate accountability

• D2L platform allows for creative growth



Action items
Action items:

• Personalized learning plan for R2-R3 years

• Longitudinal time allotment for R2-R3 years

• Community outreach project restructuring

• Job descriptions for rotation and clinic preceptors


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