Phase 2: a balanced approach to learning in Medicine

1. Phase 2: a balanced approach to learning in Medicine A/Professor Andrew M Cole

2. A New Way to Learn Medicine • Two Pillars for thinking: • Thinking like a Scientist – facts & stats • Thinking like a Doctor – people & problems • Usual way to construct these pillars: • Teach Medical Science first • Teach Clinical Studies second

3. A New Way to Learn Medicine • Standard Combinations: • Graduate MBBS Study • First degree in basic sciences • Second degree in Medicine • Undergraduate MBBS Study • First part mainly basic sciences • Second part mainly clinical studies

4. A New Way to Learn Medicine • The two parts often do not fit together well • Complete split with a graduate MBBS • UNSW MBBS integrative approach: • Phase 1 – 90:10 basic : clinical sciences • Phase 2 – 50:50 basic : clinical sciences • Phase 3 – 10:90 basic : clinical sciences

5. A New Way to Learn Medicine • How do we make Phase 2 a good bridge? • Need to have a good basic foundation • Need to have good clinical skills • Need to design the bridge carefully • The UNSW Phase 2 bridge is unique

6. A New Way to Learn Medicine • Bridge Side 1 – Independent Learning • Thinking like a Scientist • Assembling facts that are known • Asking a Research Question • Experiments to test this • Proving the new facts are true • Publishing the Research • Recognising what is true and what is not true

7. A New Way to Learn Medicine • Bridge Side 2 – Integrated Learning • Thinking like a Doctor in clinical context • A patient comes with a problem • Ask history & examine them to find abnormalities • What possible underlying basic science problems • What tests needed to make the diagnosis • What treatment principles might work

8. A New Way to Learn Medicine • Week 5 of 8: Falls in an Older Person • Basic Sciences: Balance, Standing & Walking • Clinical Sciences: Falls causes (“DAME”); Soft bones; Safe healthcare services • Examination: Joints, muscles & nerves • Tests: X-rays, blood tests, others • Communication: how to explain to the patient

9. A New Way to Learn Medicine • Week 5 of 8: Falls in an Older Person • Monday pm – Clinical & safety lectures • Tuesday am – Basic sciences prac & lecture • Rest of week – Hospital-based teaching – bed-side history-taking & examination; case-based & communication tutorials • Patients themselves are your teachers • Learning is hands-on, not reading-based

10. A New Way to Learn Medicine • Case Method Teaching • Prepared Sample Case on the week’s Topic • Each student sees similar cases at hospital • Questions to guide direction of thinking • Case Discussion • Warm calls – the lead students in the discussion • Cold calls – anyone else with ideas chimes in • Teacher – conducts orchestra, not a soloist

11. A New Way to Learn Medicine • Attendance • University requirements 80% of time • Individual responsibilities • Clinical experiences – needs hands-on time • Excused Absences • Ask well in advance • For Faculty-approved reasons

12. A New Way to Learn Medicine • Focus on how to think about 32 significant basic issues in Medicine • Each context is different • Approach, information and reasoning differs • The skill of a “Good Doctor” • Build thinking like a Doctor for Phase 3 • Training to learn for rest of your life

13. A New Way to Learn Medicine Thank you! Any Questions?