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Curricular “Revitalization” of Year 1

Curricular “Revitalization” of Year 1. Frazier Stevenson, MD Associate Dean for Undergraduate Educational Education Stanley Nazian, PhD Year 1 Faculty Lead. Rationale for change in Year 1. Enhance integration of basic science courses Enhance compliance with LCME

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Curricular “Revitalization” of Year 1

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  1. Curricular “Revitalization” of Year 1 Frazier Stevenson, MD Associate Dean for Undergraduate Educational Education Stanley Nazian, PhD Year 1 Faculty Lead

  2. Rationale for change in Year 1 • Enhance integration of basic science courses • Enhance compliance with LCME • Desire to improve monitoring of students’ performance as the year progresses, rather than at the end of the year • Desire to provide opportunities for remediation in a more timely fashion

  3. Basic Science Education in Year 1 Actions taken: • Gross Anatomy, Physiology, Neuroanatomy, and Behavioral Science now will be taught as part of 4 organ system interdisciplinary block courses with grades issued every 8-9 weeks. • Content sequence reorganized but topics are the same. • Traditional disciplines (e.g. anatomy) tracked across the year. Students need acceptable competency to advance to Year 2. • Students have opportunity to remediate failing grade after 1-2 weeks study and re-examination.

  4. Clinical Education in Years 1 and 2 • Review of clinical skills education revealed: • fragmentation of instruction in current structure • desire to improve student readiness for the third year clerkships.   • Actions taken: • Unification of Physical Diagnosis, Longitudinal Clinical Experience, and On Doctoring into a single year-long course (“Doctoring”) • Pairing of Clinical Problem Solving and Evidence Based Medicine to create a new course: (“Evidence Based Clinical Reasoning”)

  5. Current Year 1

  6. New Curriculum: Designed March 2010 Aug w Oct Jan March 2 wks 8 wks 8 wks 8 wks 8 wks Doctoring Core Principles & Musculoskeletal System Communication: Neurologic & Endocrine Systems Cardiovascular & Pulmonary Systems Renal, Gastro-intestinal and Reproductive Systems Molecular Relationships Competency (e.g. molecular biology) Functional Relationships Competency (e.g. physiology) Structural Relationships Competency (e.g. anatomy) Human/Behavioral Relationships Competency (e.g. behavioral science) Evidence Based Clinical Reasoning

  7. Proposed Realignment • Physical Diagnosis I+II • Longitudinal Clinical Experience I+II • On Doctoring / Ethics • Clinical Problem Solving • Evidence Based Medicine (from EBCP) • Current EBCP without the EBM formal curriculum • “Doctoring I and II” • “Evidenced Based Clinical Reasoning I and II” • “Introduction to Clinical Medicine” (Year 2)

  8. “Doctoring” • Enable a smooth transition into third year by improving longitudinal skill development • Integrate small groups across multiple courses • Develop a longitudinal small group to pull together multiple competencies • Teach ethics and professionalism in clinical context • Link PD and LCE • Increase communication teaching

  9. “Evidence Based Clinical Reasoning” • Informatics, statistics (Year 1) • Clinical Problem Solving (Year 1 latter half) • Evidence Based Medicine fundamentals (literature review, types of articles) (Year 2 start) • Clinical Problem Solving (Year 2) integrating organ systems with literature review

  10. “Introduction to Clinical Medicine” • Old name = Clinical Diagnostic Reasoning • Pathophysiology not covered in Pharmacology, Pathology, PMIID • Examples: ECGs, electrolyte disorders, psychiatric disorders, liver and renal failure

  11. A month in Doctoring and EBCR for an MS1 during the cardiopulmonary course

  12. A month in Doctoring and EBCR for an MSII during the cardiovascular block

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