Curricular Change Factors to Consider October 24, 2012 Dan Hunt, MD, MBA Senior Director, Accreditation Services Association of American Medical Colleges.
Download ReportTranscript Curricular Change Factors to Consider October 24, 2012 Dan Hunt, MD, MBA Senior Director, Accreditation Services Association of American Medical Colleges.
Curricular Change Factors to Consider October 24, 2012 Dan Hunt, MD, MBA Senior Director, Accreditation Services Association of American Medical Colleges Thanks! • College of Medicine, Florida International University – George Damback, PhD, Associate Dean for Curriculum and Medical Education – Pedro “Joe” Greer, MD, Assistant Dean for Academic Affairs • University of Central Florida College of Medicine – Deborah C. German, M.D., Vice President for Medical Affairs and Dean – Juan Carlos Cendan, M.D., Assistant Dean • Paul Foster School of Medicine, Texas Tech University Health Sciences, El Paso – Jose Manuel de la Rosa, M.D., Founding Dean and Vice President for Health Affairs – David J. Steele, PhD, Senior Associate Dean for Medical Education • Hofstra North Shore-LIJ School of Medicine at Hofstra University – Larry Smith, MD, Dean and Chief Medical Officer – Veronica M. Catanese, MD, MBA , Vice Dean and Dean for Academic Affairs • Northern Ontario School of Medicine – Roger Strasser, MD, Founding Dean Factors to Consider • Patterns of dysfunction: Why did all of those schools go on probation? • New school innovations: – Social accountability – “Real” integration – IT innovations: Have you met your avatar? – Starting off with a bang! • Alignment with Post-Grad: Milestones Patterns of Severe Action • N = 143 full survey reports • 8-year review cycle (October 2004 – June 2012) • Includes four schools that had two full surveys reviewed in the 8-year cycle • Excludes three new schools Patterns • Numbers count, but not always • Educational core • Scatter shot • Chronicity • Responsiveness Noncompliance Citations Severe Action Schools (n = 41) Non-Severe Action Schools (n = 102) Mean 11 5 Median 10 5 Mode 8, 10, 11, and 15 3 and 4 Min; Max 4; 18 0; 14 St. Dev. 3.5 2.7 Noncompliance Patterns ED Core Cluster Pattern Severe Action Schools Non-Severe Action Schools 66% 30% •ED-33 - curriculum management •ED-35 - systematic review and revision of the curriculum •ED-37 - monitoring curriculum content Scattershot (Non-ED Core) Pattern • MS-19 – Career Counseling • Mixed Noncompliance areas for all schools • ED-30 - formative and summative assessment • ED-2 - required clinical experiences and monitoring • ER-9 - affiliation agreements Additional Variables Insufficient Response With Database/Self-study • 39% of all severe action schools • 14% of all non-severe action schools Chronicity • 22% of all severe action schools • 2% of all NON-severe action schools No courses: Integrated 6 week modules Training Health Care Workforce for Rural Shortages • Selection of people from small communities • Training students in small communities • Providing the skill set needed for practice in small communities • Using teachers and role models from small communities Thunder Bay Sudbury Aboriginal Community Sites Spring of the First Year Toronto Thunder Bay Sudbury Integrated Community Experience Sites Fall and Winter of Second Year Toronto Thunder Bay Sudbury Comprehensive Community Clerkship Sites Third year for 30 weeks Toronto NeighborhoodHELP™ Household Visits: September 2010 – August 2012 Total number of student visited households: 233* Total number of visits: 931 Total number of students : 648 • Nursing: 322 • Medical: 166 • Social Work: 138 • Law: 22 *Additionally, the Community Outreach Team supports 450 potential replacement households. This ensures that all households receive services whether or not a student team is assigned. NeighborhoodHELP™: Having an Impact The effect on emergency room visits after one year of household visits by the third cohort of students and the outreach team (control) Integration of Content The Paul Foster School of Medicine, Texas Tech University Health Sciences Center, El Paso. Curriculum Overview: Year 1 July SCI Aug SPM Unit 1 Health & Disease SPM Unit 2 Musculo-skeletal/ Derm Dec SPM Unit 3 GI System Jan SPM Unit 4 Liver and Hematology SPM Unit 5 Cardio/ Pulmonary Medical Skills Master’s Colloquium Society, Community and the Individual SPM SCI CEYE Scientific Principles of Medicine Society, Community, and Individual Comprehensive End of the Year Exam May C E Y E Big Picture First The “Scheme” Concept • Branching diagram illustrating how experts organize (“chunk”) information to create coherent pattern – big picture • Illustrates major decision-points in diagnostic reasoning • Content-specific to particular presentation UNIT 1 – SORE THROAT RHINORRHEA Sore Throat Rhinorrhea < 2wks Viral URTI Rhinorrhea Sore Throat Predominant Predominant > 2wks Allergic/Vasomotor /Sinusitis Viral < 2wks > 2wks Infection Other Bacterial Copyright - Paul L Foster School of Medicine Clinical Presentation Sore Throat Clinical Presentations 1. Periodic health exam (adult) 2. Period health exam (child) 3. Sore throat 4. Fever 5. Wound Basic Science Disciplines Of the 12 basic sciences, 9 disciplines are contained in 1. 2. 3. 4. 5. 6. 7. 8. 9. “Sore Throat” Neuroscience Cell Biol/Histology Immunology Anatomy Embryology Biochemistry Microbiology Pathology Pharmacology Typical Week = Formative Assessment = SPM - Clinical = SCI = Medical Skills = SPM – Basic Science = Self Study = Masters Colloquium Research – VP constructivism • Build-a-VP Potential benefit is the underlying game engine technology • Newallows platform with Unity distribution platform wide distribution • Minimizes dialogue Inexpensive open source technology http://vel.engr.uga.edu/fullnerves/nerveauthor.html What is your patient’s name? Betty Lou May Assigned cranial nerve deficit: Left CN III palsy Underlying pathology causing the presentation: uncontrolled diabetes The story line in 5 sentences will eventually be shown in the textbox “Patient History.” Betty Lou May is a 66yo Caucasian female who presents with headaches and double vision. She states that she is having difficulty reading the cards at her bridge club, and the images are all mixed up, both up and down and side to side. She adds that when she goes out into the sun, her left eye hurts. Her vitals are all normal except for an elevated blood pressure (150/90). She has a history of diabetes and states that she sometimes forgets to take her medicine. She also states that she had chicken pox as a child, which resolved without treatment. She is currently taking Metformin, and is not allergic to anything. Describe the findings you would expect in the examination. Patient’s left eye is facing down and out, and there is slight ptosis of the left eyelid. She has a disconjugate gaze and enlarged left pupil that is unresponsive to light. When she covers one eye, she states that the double vision resolves. Teams of 3 vs. independent learners Mean quiz scores by training sequence group across time of assessment*. Post-hoc WebManikin group improved, p<0.001 ManikinWeb group did not, p=0.06 Cendan J C , Johnson T R Advan in Physiol Edu 2011;35:402-407 ©2011 by American Physiological Society First 100 Weeks: Years 1 & 2 Keep an Eye on “Milestones” • Pediatrics Milestone Project http://www.acgme.org/acgmeweb/Portals/0/PFAssets/Progra mResources/320_PedsMilestonesProject.pdf • ACGME Milestones