Medical Curriculum 1995 Nijmegen

1
Prof. dr. R.S.G. Holdrinet Clinical
Hematologist and Professor in Medical
Education, UMC st Radboud
Nijmegen The Netherlands
2
Key figures UMC Nijmegen 2003
Registrated students
appr. 1.600
216
Masters certificates/yr
80
Doctorate degrees

1.200
Scientific employees (fte)

95
Allocated fte medical educat. (tot)

Allocated fte medicine
60


3
Key figures UMC-Nijmegen 2003 (million euro)
Total revenues
appr. 500


Government contribution medical education
and research


50
Primary
60
Secundary

Patient driven budget
300

Other revenues
90
4
Faculty of Medical Sciences
Care
Patient
Education
Science
5

Medical Education in The Netherlands
A Discontinuum !
Residencies en PGE
Clerkships
Predoctoraal



6
Medical Education in The Netherlands
A Continuum !

Specialisation and Postgraduate Education
Internship
Preclinical
3-6 yr
4 yr
2 yr



7
Faculty Medical Sciences
University Hospital
University Medical Centre (UMC)
8
Nijmegen Approach

A common concept
9

Knowledge
ignorance
10


Knowledge
11
Education
Performance
Skills

Kowledge

12
Didactics
Goals and Objectives
Knowledge
Skills
Attitude
13
Mode Knowledge
Teacher Transfer Student Listening Essence
Reproduction
14
Mode Cognitive Skills
Teacher Designing a learning path Student
Exercise and integrate Essence Learning by own
activities
15
Mode Performance
Teacher Focus on professionalism Student Self
reflection Essence Mastering , the art
16
Nijmegen Approach
17
Medical Curriculum Nijmegen

• Student Oriented
• Small Group Learning
• Core program/ Electives (25)
• Problem (Clinical) Oriented
• Multidisciplinary courses
• Well structured
• Mix Traditional/PBL

18
Nijmegen Approach
Goals and Objectives the faculty!!

• The Curriculum
• Curriculum Phases
• Block
• Study Assignments

19
Nijmegen Approach
Goals and objectives force you to reflect

• What do we want to learn
• How can we achieve to learn
• Did we achieve the learning goals

20
Nijmegen Approach
Goals and Objectives
1. Who 2. Will do 3. How much (how well) 4. Of
what 5. By when
21
Nijmegen Approach
Course Title (Theme)
Learning Objectives
Learning Tract
- Program - Assignments
Course book
22
Nijmegen Approach

Clinical Problems
Society and Environment
Human Individual
Cells and Molecules

23
Medicine

To think effectively about the individual most
clearly distinguishes the physician from the
medical researcher when fulfilled, it also stand
as the real source of his greatness J. Graner
Lancet 1999
24
Medicine and the Sciences
Social Sciences
MEDICINE
Natural Sciences
25
Scientific

• To wonder
• To oberve
• To measure/describe
• To analyze
• To conclude
• To discuss

Flexner 1925 So long as men strive to
transcend their native powers to rid themselves
of prejudice and preconception, to observe
phenomena in a dry light, the effort is
scientific
26
The Nijmegen Medical Curriculum

Year
1
2
3
4
5
6

27

Nijmegen Approach
Didactics
30 Teaching
70 Self learning
28
One block-course
A course
Weeks
1
2
3
4
Teaching
Assessment
Assignments
29
Teaching / week

• 2 hours main lectures
• 2 hours tutorials
• 4 hours seminars
• 4 hours, practical or CAL

30
Nijmegen Approach
Didactics
Well-structured study assignments Small
group discussions and tutorials
Monthly assessments

31

Study Assignment

• Background
• Goal
• Instruction
• Product
• Discussion

32
Nijmegen Approach
33
Clinical Education
Clinical Disciplines
Shared Professionalism
34
Clinical Education
Board of Clerkship Directors
35
Clinical Education
Clinical Disciplines
2 year rotations or clerkships
36
NMC Clinical Phase
Clinical Education
Introductary clerkship 4 wk Internal
Medicine 8 wk CENTRAL Clerkship 1 4 wk
Neurology 4 wk Psychiatry 4 wk
Pediatrics 4 wk CENTRAL Clerkship 2 4 wk
37
Clinical Education
Continued
Surgery 8 wk Gynaecology/Obestetrics 8
wk CENTRAL Clerkship 3 4wk Dermatol/ ENT/
Ophtam 4 wk Family Medicine 8 wk
38
NMC Clinical Phase
Clinical Education

Elective -clerkship 4 wk Geriatrics/Nurser
y home or Social Mecine Free clerkship
4 wk Final clerkship 4 wk
12 weeks Tropical Medicine
39
The Nijmegen Medical Curriculum

Year
1
2
3
4
5
6

40
NMC Clinical Phase
Clinical Education
Central Clerkship
reflection
training
41
Nijmegen Approach
42
Mode Performance
Teacher Focus on professionalism Student Self
reflection Essence Mastering , the art
43

Clinical Education
Theory
Practice
44
Clinical Education
Theory
Practice

45
Clinical Education
Theory
Practice

Experiential Learning
46
Clinical Education
Growing Competence (interwoven)
Knowledge
Attitude
Skills
47
Residency Training
Terminal Learning Objectives
A useful and enduring change in competence as a
result of various learning processes.
48
Clinical Education
Place for

• The Attempt
• (the mistake and the correction)
• Confidence and Responsibilty

49
Clinical Education
Time

• Thinking/Reflection
• The Demonstration
• Feedback
• In depth study
• Training

50
Klinisch Leren
Classical Instruments

• The Wardround
• The discharge letter
• The morning report
• Video/Audiotapes
• Comeback periods
• The Rolemodel

51
Clinical Education
Teacher roles

• Tutor
• Coach
• Mentor
• Supervisor
• Facilitator

52
Clinical Education

Me
The Team
The Hospital
53

Experiental Learning

Concrete Experience
Reflective Observation
Active Experimentation
Abstract Conceptualisation
54
Reflection
Education
Care
Science
55
r.holdrinet_at_hemat.umcn.nl tel. [phone]
Nijmegen The Netherlands