A New Curriculum for Community Medicine

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A New Curriculum for Community Medicine

• Don Carufel-Wert
• Kirsten Rindfleisch
• Judy Nepokroeff

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Our goal for all graduates

• Community responsive physicians
• Family doctors who
• deliver exam-room care which is culturally
  competent and recognizes the role of community
  in patients health and well-being
• facilitate connections between patients and
  appropriate community-based resources
• understand demographic, socioeconomic, and
  cultural characteristics of their practice
  community
• assess public policy proposals critically,
  using foundational knowledge of issues in public
  policy, epidemiology, and occupational health
• have the skills needed to develop, implement,
  and evaluate community-centered outreach
  projects

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Limitations of the existing curriculum
Limited content teaching cultural competence
No content teaching health policy, epidemiology,
occupational medicine Heavy emphasis on
agency visits Little structured support for
community outreach projects Limited structured
support for individual learning styles and
interests No structured opportunity for
dialogue, processing, reflection
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An overview of the proposal

• A three week R1 core curriculum combining
• ? an orientation to the R1 curriculum
• ? an orientation to the clinic community
• ? community resource/agency visits
• ? community mapping exercise
• ? web-based learning modules
• health policy
• cultural competence
• occupational health
• epidemiology
• ? structured time for online journaling
• ? introduction to the personalized learning plan

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An overview of the proposal

• A complementary longitudinal curriculum
• ? Ongoing journaling and dialogue with rotation
  preceptor
• ? Ongoing discussion of clinic projects at the
  afternoon clinic-based teaching
  conferences
• ? Protected half-days for project work and work
  related to the personalized learning plan
• 4 half-days in the R1 year
• 12 half-days in the R2 year
• 4 half-days in the R3 year

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Strengths of the new curriculum

• Expanded set of core topics including health
  policy, epidemiology, occupational medicine, and
  cultural competence
• Structured environment for dialogue,
  processing, and reflection, available online
• Principles of adult learning support for
  individual learning styles and interests built
  into curriculum content and structure
• Enhanced accountability and opportunity for
  competency-based assessment
• Longitudinal time for project work protected,
  structured, realistic, responsive to clinic needs

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The Community Medicine website - an integral tool
for the new curriculum Folders
and web links containing study materials and
course information Journaling and answering
discussion questions Communication between
rotation preceptor and residents Checklists to
track completion of assignments Room to grow
creatively Access anytime, anywhere
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The R1 curriculum1st week1st half
day- orientation with rotation preceptor orienta
tion with clinic preceptor further self-guided
exploration of web site 3 half days
- community mapping exercise3 half days -
agency visits 1 half day - processing and
writing about weeks experience
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The R1 curriculum 2nd week1 half day
- cultural competence module1 half day -
occupational health module1 half day - health
policy module4 half days - agency visits1
half day - processing and writing about weeks
experience
10
The R1 curriculum 3rd week 1 half day -
epidemiology module 4 half days - agency
visits 1 half day - exploring past and ongoing
clinic projects 1 half day - processing and
writing about weeks experience 1 half day -
rotation evaluation and introduction to the
personalized learning plan
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The R2 and R3 years An advanced, personalized,
and longitudinal experience Writing and
implementing the personalized learning plan
Participation in clinic-based community outreach
projects Discussions at quarterly clinic-based
didactic session Community Medicine home
visits Ongoing journaling and dialogue with
rotation preceptor
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The personalized learning plan .. an example

• Learn more about the relationship between health,
  health care, and the environment
• read selections from scientific, policy, and
  lay literature on pesticides, medical
  mercury waste, medical plastic waste
• meet with leaders of grass-roots organization
  working to raise local government awareness
  of environmental justice issues
• Learn more about possible roles as a
  physician-activist
• meet with Gene and Linda Farley
• research existing physician-activist
  organizations
• draft a pesticide-free DFM policy, educate
  colleagues on relevant issues, and advocate
  for policys adoption

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The Website
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Summary
New content learning modules and discussion
questions introduce a much broader range of
community medicine topics personalized
learning plans emphasize individual goals
while maintaining preceptor guidance
formalized proposals for new projects support
high- quality work and mimic real-world
processes A new tool journaling, discussion
questions, and ongoing preceptor-reside
nt contact prompt reflection and
critical thinking, enhancing learning
and satisfaction ongoing preceptor-resident
contact and checklists facilitate
accountability D2L platform allows for
creative growth
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Questions?
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Action items
Personalized learning plan for R2-R3 years
Longitudinal time allotment for R2-R3 years
Community outreach project restructuring
Job descriptions for rotation and clinic
preceptors