A new curriculum for community medicine
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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

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A New Curriculum for Community Medicine

Don Carufel-Wert

Kirsten Rindfleisch

Judy Nepokroeff

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

• 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

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 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

• 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 preceptororientation with clinic preceptorfurther self-guided exploration of web site3 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

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

The Website……


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:

• 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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