Clinical Curriculum Proposal

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Clinical Curriculum Proposal

• Clinical Curriculum Committee ¾

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Essential Needs For Effective Implementation of
New Clinical Curriculum

• Improved advising system
• Good communication/coordination across courses
• Electronic scheduling
• All core courses completed by 12/31 of year 4
• 2-week and 4-week elective options

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MS3 CURRICULUM
MS4 CURRICULUM
Complete the following Core Courses (32 weeks) by
July 1 of MS4 year Inpatient medicine (8
weeks) Surgery (8 weeks) OB/Gyn (6
weeks) Psychiatry (6 weeks) Inpatient
Pediatrics (4 weeks) (32 weeks)
Complete the remaining Core Courses (listed
above) by December 31 of MS4 year
Complete the Advanced Curriculum by
graduation AHEC Acting Internship (4
weeks) Critical Care Selective (4
weeks) Advanced Practice (4 weeks) Integration
Selective (4 weeks) Elective (4
weeks) Capstone (2 weeks) (22 weeks)
Complete at least three of the following Core
Courses (12-14 weeks) by July 1 of MS4 year
Family medicine (6 weeks) Outpatient Medicine
(4 weeks) Outpt Peds (3) FAC (1) (4
weeks) Neurology (4 weeks) Elective (4
weeks) (22 weeks)
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Sample Scheduling
July
Oct
Neurology
Pediatrics Outpatient, with FAC
Optional Elective
Jan
April
Pediatrics Inpatient
IM Outpatient
Optional Elective
July
Oct
Optional Elective
AHEC Acting Internship (Core Curriculum)
Critical Care Selective (IM and Surg)
Optional Away Elective
Step 2CK
Jan
April
Advanced Care Selective (Core Curriculum)
Integration Selective (Core Curriculum)
Interview
Total
Inpatient
AHEC Acting Internship (Core Curriculum)
Advanced Care Selective (Core Curriculum)
Integration Selective (Core Curriculum)
Critical Care Selective (IM and Surg)

• 3rd and 4th years are a continuum
• Courses of varying lengths

Core Curriculum
Advanced Curriculum
By Quarter 4-2
By Quarter 3-4
Optional Elective
Optional Elective
Optional Elective
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Questions to Address

• Can we get a list of the people making these
  decisions?
• How has the curriculum recently changed and why?
• What motivated the current proposal?
• In what metrics do we compare negatively to peer
  institutions?
• What about losing electives?
• What is the Integration Selective?
• What is the Advanced Practice Selective?
• Why offer 2 Week Electives?
• How do we know the proposed changes will help?
• Are the changes congruent with exiting MS4
  feedback?
• What's the hurry?

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Clinical Curriculum Committee

• Co-chairs
• Julie Byerley, Pediatrics
• Tim Farrell, Surgery
• Jim Yankaskas, Medicine, Director of Critical
  Care Selective
• Christopher Klipstein, Medicine
• Amy Shaheen, Outpatient Medicine
• Tony Lindsey, Psychiatry

• Bob Gwyther, Family Medicine
• Alice Chuang, OB/Gyn
• Cheryl McNeil, Neurology
• Charles Murphy, FAC
• Deb Bynum, Medicine, Director of AHEC AI
• Student Representatives
• AHEC Representatives
• Others

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How Has the Curriculum Recently Changed?
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Comparing Proposed to Recent Curricula
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Comparing Proposed to Recent Curricula
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Comparing Proposed to Recent Curricula
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Why has the curriculum changed?

• Students demanded improved flexibility in review
  for LCME visit
• Old curriculum (class of 2007) allowed no
  flexibility in 3rd year
• Students needed potential exposure to non-core
  fields
• Students requested, and LCME supported, improved
  Neurology exposure
• Change for Class of 2008
• Neuro added as 2 weeks combined with 6 weeks
  psych
• OB/Gyn and Family Medicine shortened from 6 to 4
  weeks to allow for scheduling in blocks of 8
  weeks
• Medicine divided into 84 to allow room for
  elective

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Why has the curriculum changed?

• Change for the Class of 2009
• 62 of Psych / Neuro was not working well
• Changed to 44
• Push for basic science integration and increased
  rigor into 4th year led to Integration Selective

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What is the rationale for the current proposal
for the Class of 2010?

• Protect and increase flexibility for students
• Neuro is well received as a 4 week experience
• OB/Gyn, Psych, and Family Medicine can not cover
  material well in 4 weeks
• Some concerns about shelf test performance
• Some concerns about national standards
• Pediatrics can be split like Medicine to allow
  increased flexibility
• Blending FAC into another rotation is a more
  efficient use of student time
• Effectively that adds another possibility for a
  rotation

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Concerns

• See graph of shelf test data
• See chart of national trends in lengths of
  clerkships

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What about losing electives?

• Students are allowed (and encouraged) to take
  additional electives
• Selectives are electives with guidelines
• Selectives allow students choice in what they do
  clinically and, in addition, have threads of
  overarching content
• AHEC AI
• Critical Care
• Advanced Practice
• Integration

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What is the Integration Selective?

• Students will have choices for clinical content
• Basic science integration will be the thread that
  runs through, with Practiced Based Learning
• Example possibilities
• Clinical Anatomy
• Womens Health
• Surgical Oncology
• Radiology
• Genetics
• Details will be outlined on Feb. 25 Class Meeting
  with Current Third Year Students

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What is the Advanced Practice Selective?

• Students will have choices for clinical content
• Systems based practice will be the thread that
  runs through
• Example possibilities
• Native American Health
• ENT
• Emergency Medicine
• Genetics
• Global health
• Details will be outlined on Feb. 25 Class Meeting
  with Current Third Year Students

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Why Two Week Electives?

• Career exploration opportunities
• Opportunity to broaden education
• Credit in smaller chunks allows time for step 2
  studying, vacationing, or interviewing
• National trend
• Students would not be required to take two week
  electives

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Will the proposed changes help?

• Curriculum evaluation and improvement is an
  ongoing process
• Data we will watch
• Shelf test scores
• Student feedback
• Faculty feedback
• National trends
• The curriculum will change again
• Phase two of this evaluation is intended for
  implementation for the class of 2011
• Are the changes congruent with exiting MS4
  feedback?
• Student feedback varies

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What's the hurry?

• The importance of improvement
• Curriculum calendar changes can be made only once
  per year
• This can be accomplished by July, 2008
• Scheduling is done early for student convenience

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Summary

• Clinical curriculum changes are intended as
  improvements with the students best interest in
  mind
• Preserve flexibility
• Expose students to core and non-core fields
• Allow adequate time to cover core material
• Prepare for national benchmark testing
• Curriculum improvement is an ongoing process