Transcript Pre-curriculum Review Advisory Committee Report

Pre-curriculum Review
Advisory Committee
Report
Suzanne Allen, MD, MPH
Michael Ryan, MD
Overview
Background
 Process
 Findings
 Recommendations
 Next steps
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Background
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Successful LCME accreditation June 2010
Last curriculum review 1998-2001
Expansion of class size for workforce needs
Pre-curriculum review advisory committee
charged September 2010
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Curricular strengths and areas for improvement
Approaches to expand class size
Engage with all constituents across the region
Develop rationale and proposed approach to a
curriculum review
Committee Members
Co-Chairs:
 Suzanne Allen, M.D., M.P.H., Vice Dean for Regional Affairs
Michael J. Ryan, M.D., Associate Dean for Curriculum
Committee Members:
 David Acosta, M.D., Associate Dean for Multicultural Affairs
 Daniel Benedetti, Fourth-year medical student
 Courtney Boulton, Fourth-year medical student
 Jan Carline, Ph.D., Professor, Medical Education & Biomedical Informatics
 Kellie Engle, Program Operations Manager, Regional Affairs
 Yogesh Khanal, Fourth-year medical student
 Dennis Kirby, Fourth-year medical student
 Andrew Luks, M.D., Assistant Professor, Medicine
 Ramoncita Maestas, M.D., Associate Professor, Family Medicine
 Kathleen Mulligan, Ph.D., Senior Lecturer, Biological Structure
 Kenneth Roberts, Ph.D., Assistant Dean, WWAMI-Spokane
 Lorna Shanks, Fourth-year medical student
 Roger Tatum, M.D., Associate Professor, Surgery
 Marjorie Wenrich, Chief of Staff, UW Medicine
 Mark Whipple, M.D., Associate Professor, Otolaryngology-Head & Neck Surgery
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Information Reviewed
Past curriculum reviews
 Current curriculum
 Curricula at other medical schools
 Current literature on curricula in medical
schools
 LCME self-study
 AAMC graduation study results
 Internal end-of-year program evaluation
 USMLE Step 1 and Step 2 Board scores
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Meetings Held
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Curriculum committees
Educational leaders
Educational program leaders
Teaching faculty: basic science and clinical region-wide
Medical students
Community physicians and leaders
Residency program directors
Medical school finance administrators
Technology specialists
ISIS leadership
Other health science disciplines
UW Medicine senior leaders
Town Hall and open forum meetings
Catalyst website
Findings
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Strengths:
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ICM course/Colleges program/mentoring
Small classes/unique opportunities at 1st year sites
The few current active learning/small groups in
2nd year classes
Diversity and quality of clinical offerings across
the region
Dedicated and enthusiastic faculty
Many opportunities for unique, rural learning
Findings
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Areas identified for improvement:
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Governance
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Large, growing content without clear mechanisms to
decrease content
Departmentally based curricula do not foster
integration of basic science and clinical, horizontally
or vertically
Lack of flexibility in the curriculum to adapt to
changes
Decline in USMLE Step 1 scores
Inadequate standardization across regional
sites
Reliance on lecture-based instruction
Findings
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Areas identified for improvement:
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Insufficient instruction in critical thinking
and evaluation of the medical literature
Insufficient emphasis on life-long learning
Emphasis on memorization instead of
clinical thinking
Insufficient instruction in biomedical
informatics and population-based medicine
Lack of opportunities for career
exploration
Findings
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Areas identified for improvement:
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Insufficient time carved out for faculty to
teach and lack of acknowledgement of
teaching as core activity
Difficulty in attracting and retaining clinical
community teaching sites due to clinical
productivity demands
Insufficient attention to the continuum of
education from pre-med to practice
Continued need for physician workforce
development
Applicants comments who declined
admission to UWSOM
“I decided to go to Columbia University
because I was accepted into the ColumbiaBassett program--a new program that
focuses on longitudinal care….Plus, I really
liked the 18-month curriculum at
Columbia, which gets me into clinicals
earlier.”
Applicants comments who declined
admissions to UWSOM
“Strengths of UCSF include ….systems
based curriculum, pass/fail for 2 years,
more small group work, emphasis on early
clinical experience, and more innovative
and adaptive curriculum.”
Applicants comments who declined
admissions to UWSOM
“UCLA has a non-traditional curriculum
with a systems-based approach, PBL and
doctoring minimizing the number of hours
spent in a lecture hall to 2 hours/day. This
was a HUGE difference when compared to
the traditional curriculum that UW has and
was one of the major factors influencing
my decision.”
Applicant comments who declined
admissions to UWSOM
“I did not like the curriculum at the
University of Washington. I am an active
learner and I felt that the curriculum had
too much lecture time. Also, I prefer
curriculum that are more integrated and
after talking to students the curriculum at
the UW is not that integrated.”
“A good hockey player plays where the puck is.
A great hockey player plays where the puck is
going to be.”
Wayne Gretsky
Time for change
Explosion of medical and scientific
information
 Explosion of information technology
 Enhanced patient knowledge and
understanding
 Generational characteristics of students
 Changes in learning styles
 National movement to active learning
modalities
 Changes in the roles of physicians in rapidly
evolving healthcare system
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Areas for change
 Increase
active learning
 Increase curricular flexibility
 Integrate the curriculum vertically and
horizontally
 Allow students to individualize their
training
 Integrate critical thinking, information
management, techniques for lifelong
learning throughout the curriculum
Specific Recommendations
Continuous curriculum improvement process
 Governance structure
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Convene a “visioning committee”
Develop and define the “product” i.e.
overarching curricular goals, objectives and
outcomes
 Adjust and redesign the curriculum to meet
these goals, objectives and outcomes
 Improve USMLE Step 1 and 2 scores to
increase successful residency matches for
students
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Specific Recommendations
 Focus
on continuum of education and lifelong learning
 Maintain focus on contextual learning
opportunities and needs through
horizontal and vertical integration
 Incorporate new training foci and
modalities into the curriculum, including
simulation, IPE, information management
 Support faculty through faculty
development, funding, sufficient time for
teaching and acknowledgement of value of
teaching and curriculum involvement
Specific Recommendations
 Continue
working to meet workforce
needs across the WWAMI region
 Expand class size to help meet workforce
needs
 Will require all of basic sciences to be
taught in the region
Next Steps
Share findings and recommendations
 Charge and appoint the visioning
committee
 Establish interactive web site for
ongoing curriculum improvement and
communication
 Pilot teaching all of the basic sciences
in the region
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Questions?