Dept. of General Practice Medical University of Vienna

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DO WE NEED NEW MODELS OF TEACHING?

• Manfred Maier

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CHARACTERISTICS OF TRADITIONAL MEDICAL CURRICULA

• structured as sequence of disciplines
• teaching content defined by the disciplines
• cumulative growth of teaching content
• examinations in each discipline (currently 23)
• late patient contact (Vienna 4.year)
• no reflection of the current health care system

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PROBLEMS WITH TRADITIONAL MEDICAL CURRICULA

• no relevance to practice situations
• overloaded with theory, cumulative factual
  knowledge
• knowledge cannot be implemented in daily work
• frequent and important problems not taught at all
• basic medical education unsatisfactory
• vocational training unsatisfactory

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Medical education will not change medical
practice, medical practice will change medical
education
Georg Silver
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THE BLOCK-LINE-MODEL
Theme 1
Theme 2
integrated themes knowledge
integrated assessment

• Morphology
• Function
• Diagnosis
• Therapy etc.

Morphology Function Diagnosis Therapy etc.
knowledge
knowledge
respective clinical examples POL line-element
clinical skills
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PROFILE OF GRADUATES

• knowledge and understanding
• clinical skills
• communicative competences
• attitudes
• professional competences

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PROFILE OF GRADUATES - EXCERPTS

• knowledge and understanding
• ...detailed knowledge and understanding of
  frequent and urgent health problems or illnesses
  and concepts for their treatment
• clinical skills
• ability to recognize and correctly judge
  emergency situations and to initiate first aid
  measures
• ability to propose a reasonable concept for
  treatment of frequent illnesses under hospital-
  and outpatient conditions

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BASIS FOR THE TEACHING CONTENTLIST OF DIAGNOSES

• frequent and typical symptoms
• illnesses/diagnoses/problems in primary health
  care and in hospitals (frequency gt 0,25)
• supplemented by conditions according to
• - frequency
• - urgency
• - exemplaricity

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ARGUMENTS FOR THE LIST OF DIAGNOSES

• based on epidemiological data
• guarantees relevant content
• fulfils didactic requirements
• helps to limit teaching content
• supports importance of relevant content for all
  students (basic medical education)
• selects content on a rational basis
• supports integrated teaching and learning
• does not support discipline oriented approach

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INCLUSION OF COMMUNITY BASED AMBULATORY CARE
FACILITIES

• 1. section
• block 1(orientation)
• observation of various aspects of the occupation
• block 6 (environment, family and society)
• 2. section
• several blocks (specific themes, frequent
  problems)
• 3. section
• attachment to a GP practice once a week for one
  semester
• elective

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GENERAL PRACTICE IN THE NEW CURRICULUM

• sections 1-3
• special study module (SSM, training in science
  and research methodology)
• clerkship 4 weeks obligatory (among 24 weeks
  total)
• diploma
• thesis
• final examination by faculty commission

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GENERAL PRACTICE AND THE NEW CURRICULUM

• block line model
• horizontal and vertical integration
• teaching content based on epidemiological data
  from primary health care
• GP contributes to each of 3 sections of the
  curriculum

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STILL PROBLEMS?

• staff development (teaching, research)
• hidden curriculum driven by exams
• exams / assessment in GP? (BME PD CME)
• clinical electives, tutorials
• medical universities medical colleges
• do we attract the best students?

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NEW MODELS?

• no, but we need
• to have a good structure for what and how we
  teach
• to aim at the best (learning, training,
  retraining)
• to be omnipresent in exams / assessments with
  fair but difficult problems
• to contribute to the goals of the university in
  teaching and research

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• Die Studenten sollen
• Denken und nicht
• Gedanken lernen.
• K. Jaspers

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USEFUL LINKS

• www.lcme.org