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Clinically Centered Education, with Reinforced Foundations. Members: Marc Pizzimenti, Charles Clark, Jeff Emrich, Jill Endres, Paul Leonard, Marygrace Elson, Erwin Shibata, Jack Stapleton, Michael Takacs, Kelly Thormodson, Jerry Weiss, Jaci Haugsdal, Mara Determan, Joshua Fischer, Eric Kaiser

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clinically centered education with reinforced foundations

Clinically Centered Education, with Reinforced Foundations

Members:

Marc Pizzimenti, Charles Clark, Jeff Emrich, Jill Endres, Paul Leonard, Marygrace Elson, Erwin Shibata, Jack Stapleton, Michael Takacs, Kelly Thormodson, Jerry Weiss, Jaci Haugsdal, Mara Determan, Joshua Fischer, Eric Kaiser

Steering Committee Liaisons: Kristi Ferguson, Mark C Wilson, Tim Thomsen

primary idea
Primary Idea
  • Move students from discipline overviews/concepts to experiencing the multifacets of medicine (and back) throughout the curriculum
    •  Reliance on lecture (traditionally defined)
    • Independent/group learning fostered
    • Distribution of foundational and clinical sciences across the continuum of curriculum
    • Experiences are content relevant and demonstrate integration across disciplines
lecture use
 Lecture Use
  • CCOM has large percentage of lecture use
  • CCOM also effectively uses small group exercises
  • Expand activites
    • Module learning
    • Online learning
    • Large Lecture “Discussions”

Barzansky, 2009; CCOM database, AAMC database

ccom curriculum renewal year i sem 1
CCOM Curriculum Renewal Year I, Sem. 1

Macro Medicine (Anatomy (with lab), Embryology, Imaging)

Clinical links in the curriculum

Cellular and Molecular Medicine (Biochem, Genetics, Cell Bio)

Clinical Continuity Experience

FCP I: CBL and PPD

The ‘Well Patient Visit’ - Interviewing, history, and comprehensive PE

Restructure the Foundational Sciences:  independent/group learning,  lecture ,  discussion oriented small/large group meetings

well patient visit
Well-Patient Visit
  • Year I Semester 1
    • Focus on Interviewing and basic skills
      • Clinical Observation
      • Simulated Patient
        • Interview, Hx
        • PE
  • Year I Semester 2
    • Focus on comprehensive PE
      • Participate in clinical visits
      • Practice
  • Limitations
      • Available visits
      • Student travel
      • Scheduling
clinical links in the curriculum
Clinical Links in the Curriculum
  • Self/Group directed learning modules
    • simulation, cases, interactive on-line, procedural observation and reflection, etc.)
    • Faculty guidance, debriefing
  • Promote understanding of basic science concepts and illustrate clinical relevance
    • Example: Chest-Tube Insertion
ccom curriculum renewal year i sem 2
CCOM Curriculum Renewal Year I, Sem. 2

HOS

Clinical links in the curriculum

Mind, Brain, Behavior

Clinical Continuity Experience

FCP II: CBL and PPD

The ‘Well Patient Visit’ - Interviewing, history, and comprehensive PE

  • Allows for participation and integration of other student teams
    • PT, Dentistry, Graduate Students
ccom curriculum renewal year 1 summer track distinctions
CCOM Curriculum Renewal Year 1 SummerTrack Distinctions

Mentored Independent Scholarly Project

Global Health Project

Teaching and Learning Project

Community Service Project

10-week project that contributes to successful completion of a distinction track

  • Large % of student currently participate
  • Formal part of the curriculum?
  • Limitations
    • Opportunities for all
    • Funding issues
  • Assessment
    • Portfolio - ifolio
ccom curriculum renewal year ii sem 1
CCOM Curriculum Renewal Year II, Sem.1

Common Core Problem Visits - Unit visits to observe and practice focused Hx and PE components

Pathobiology - pathology focused with elements of Anatomy, Immunology, PID, and Pharmacology

Intersession

Integrated blocks based upon common clinical presentations:

Carcinogenesis, Headache, Diabetes, Hypertension, Smoking, Obesity, Geriatrics, Pain, Orthopaedic Issues, Respiratory infection, etc.

Track Distinctions

Clinical Skills Workshops

  • Provides opportunity for PA program students to participate
intersession
Intersession
  • Modeling of Year structure
    • Case studies, simulations focus on disease process and mechanisms
      • Review skills, foundational concepts
      • Interdisciplinary approaches
      • Ethics
      • Patient safety, human Factors
      • Communication
integrated blocks and core problem visits
Integrated Blocks and Core Problem Visits
  • Disease process, clinical presentation focus
    • Focal shift of FCP III-IV
      • Carcinogenesis
      • Chest Pain
      • Diabetes
    • Permits review of foundational material in conjunction with parallel studies in pathobiology
    • Demonstrate variety of clinical settings
    • Introduction to specific issues of team function, patient safety, human factors, ethics
carcinogenesis block
Carcinogenesis Block
  • Foundations
    • Genetics > inheritance, counseling
    • Pathology> presentation, mechanisms, biochem
    • Pharmacology> neoplastic drugs
    • Anatomy > lymphatics, circulatory
    • PID> opportunistic infections
    • Immunology > mounted responses, drug pathways
    • FCP > bad news, screening, economics, social, legal
    • Health policy
  • Clinical Areas
    • Dermatology
    • OB/GYN
    • Urology
    • Surgery > GI, Breast
    • ENT > Head & Neck
    • FM & IM > Screening, Dx
    • HemOnc
    • Psychiatry > mental health
    • Ortho
    • Anesthesia > pain management
    • Radiology >
ccom curriculum renewal year ii sem 2
CCOM Curriculum Renewal Year II, Sem. 2

Common Core Problem Visits - Unit visits to observe and practice focused Hx and PE components

Pathobiology - pathology focused with elements of Anatomy, Immunology, PID, and Pharmacology

Intersession

Integrated blocks based upon common clinical presentations:

Carcinogenesis, Headache, Diabetes, Hypertension, Smoking, Obesity, Geriatrics, Pain, Orthopaedic Issues, Respiratory infection, etc.

Track Distinctions

Clinical Skills Workshops

USMLE preparation and vacation time

ccom curriculum renewal year iii starts july 1
CCOM Curriculum Renewal Year III (Starts July 1)

Intersession: Clinical Beginnings Theme (2)

Intern. Med (6 IP + 4 OP)

  • Surgical Selectives (examples)
  • Orthopaedics (2)
  • Ophthalmology (2)
  • Urology (2)
  • Anesthesia (2)
  • Radiology (2)
  • Dermatology (2)
  • Otolaryngology (2)

Surgery (6 + 2 +2 )

OB/GYN (3 + 3)

Foundation Modules

Peds (3 IP + 3 OP)

Fam. Pract., CBPC (6)

Adv. Electives (12)

If two-site delivery model is maintained programs must be consistent. Required rotations reflect areas of needed competency for graduation. These areas must demonstrate programs that reflect foundations content, clinical case exposure, clinical skills opportunities to fulfill competencies.

foundation modules
Foundation Modules
  • Integration of foundational material across and in light of clinical experiences
    • Foundational sciences/concepts
    • Focal exposure to issues of interdisciplinary team work, patient safety, human factors, ethics
    • Skills (re)assessment
  • Delivery
    • Distance education
    • Online, CAI modules
    • Simulation
    • Case presentation
    • Large/Small group discussion
electives
Electives
  • ‘New’ Clinical experiences that provide multi or cross discipline exposure
    • Orthopedics
      • Working with Peds, Family Medicine, Emerg. Med., PM&R
      • Opportunities to evaluate and treat common MSK injuries
      • Develop rehab. plans
    • Women’s Health
      • Working in an Adolescent clinic (Peds or OBG), Family Medicine, Geriatrics
    • Other ideas: Perioperative Medicine, Infectious Disease, Research, Foundational Science, Health Law/Policy
ccom curriculum renewal year iv starts july 1
CCOM Curriculum Renewal Year IV (Starts July 1)

Neurology (4)

Capstone (4)

Psychiatry (4)

M4 Sub-I (4)

Foundation Modules

Emerg. Med or CCM (4)

Adv. Electives (12)

If two-site delivery model is maintained programs must be consistent. Required rotations reflect areas of needed competency for graduation. These areas must demonstrate programs that reflect basic science content, clinical case exposure, clinical skills opportunities to fulfill competencies.

scholarly project
Scholarly Project
  • Opportunities to participate and develop a longitudinal plan of study
    • M1 Summer experience
    • Year II
    • Advanced Elective
capstone
Capstone
  • 4(2?) weeks
  • Organized similar to scientific meeting
    • Plenary sessions, focus groups/ themes
    • Skills workshops
    • Foundational science reviews in light of clinical experience
    • Research presentations
    • Residency prep topics
    • Ethics issues
    • Systems medicine, patient safety and human factors
    • ACLS certification and Neonatal resuscitation
    • Social activities (Community challenges, ‘olympics’, etc.)
charge
Charge
  • Provide curricular flexibility for integration and change
  • Address patient and societal needs
  • Provide earlier clinical experience and appropriate skill development to support that experience
  • Encompass existing collegiate educational competencies for students
  • Promote student-centered education, student well-being, engagement, and active learning
  • Maximize use of education and information technologies
  • Enable individualized progress through the curriculum as appropriate