Curricular “Revitalization” of

Year 1

Frazier Stevenson, MDAssociate Dean for Undergraduate Educational Education

Stanley Nazian, PhDYear 1 Faculty Lead

Rationale for change in Year 1

Enhance integration of basic science courses

Enhance compliance with LCME Desire to improve monitoring of students’

performance as the year progresses, rather than at the end of the year

Desire to provide opportunities for remediation in a more timely fashion

Basic Science Education in Year 1

Actions taken: Gross Anatomy, Physiology, Neuroanatomy, and

Behavioral Science now will be taught as part of 4 organ system interdisciplinary block courses with grades issued every 8-9 weeks.

Content sequence reorganized but topics are the same. Traditional disciplines (e.g. anatomy) tracked across the

year. Students need acceptable competency to advance to Year 2.

Students have opportunity to remediate failing grade after 1-2 weeks study and re-examination.

Clinical Education in Years 1 and 2

Review of clinical skills education revealed: fragmentation of instruction in current structure desire to improve student readiness for the third year

clerkships.   Actions taken:

Unification of Physical Diagnosis, Longitudinal Clinical Experience, and On Doctoring into a single year-long course (“Doctoring”)

Pairing of Clinical Problem Solving and Evidence Based Medicine to create a new course: (“Evidence Based Clinical Reasoning”)

Current Year 1

New Curriculum: Designed March 2010

Doctoring

Evidence Based Clinical Reasoning

Core Principles &

Musculoskeletal System

Communication: Neurologic & Endocrine

Systems

Cardiovascular & Pulmonary

Systems

Renal, Gastro-intestinal and Reproductive

Systems

Molecular Relationships Competency (e.g. molecular biology)

Functional Relationships Competency (e.g. physiology)

Structural Relationships Competency (e.g. anatomy)

Human/Behavioral Relationships Competency (e.g. behavioral science)

2 wks 8 wks 8 wks 8 wks 8 wks

Aug w Oct Jan March

Proposed Realignment Physical Diagnosis I+II Longitudinal Clinical

Experience I+II On Doctoring / Ethics

Clinical Problem Solving Evidence Based Medicine

(from EBCP)

Current EBCP without the EBM formal curriculum

“Doctoring I and II”

“Evidenced Based Clinical Reasoning I and II”

“Introduction to Clinical Medicine” (Year 2)

“Doctoring”

Enable a smooth transition into third year by improving longitudinal skill development

Integrate small groups across multiple courses Develop a longitudinal small group to pull together

multiple competencies Teach ethics and professionalism in clinical

context Link PD and LCE Increase communication teaching

“Evidence Based Clinical Reasoning”

Informatics, statistics (Year 1) Clinical Problem Solving (Year 1 latter half) Evidence Based Medicine fundamentals

(literature review, types of articles) (Year 2 start)

Clinical Problem Solving (Year 2) integrating organ systems with literature review

“Introduction to Clinical Medicine”

Old name = Clinical Diagnostic Reasoning Pathophysiology not covered in

Pharmacology, Pathology, PMIID Examples: ECGs, electrolyte disorders,

psychiatric disorders, liver and renal failure

A month in Doctoring and EBCR for an MS1 during the cardiopulmonary course

WEEK Monday Tues Wed Thursday Friday

1 AM: Lecture demo on

cardiac exam

Free   PM: Small Group in CACL:

examine heart

PM: traditional LCE

2   Free AM: Humanities presentation

1 PM: Communication

presentation2 PM: Small

Group communication

with SP

PM: LCE skill visit--CV exam

in office

3   Free   PM: Small Group Ethics cases

PM: traditional LCE

4   Free   1 PM: Informatics lecture

2pm: Small Group: CPS

case

Free (pre-exam)

A month in Doctoring and EBCR for an MSII during the cardiovascular block

WEEK Monday Tues Wed Thursday Friday

1 AM: Lecture demo on abnormal cardiac exam

Free PM: Small Group in CACL: simulator heart murmurs, examine heart

PM: Inpatient complete H and P

2 AM: EBCR Lecture on Randomized Controlled Trials

Free AM: Humanities presentation

1 PM: Ethics presentation2 PM: Small Group communication with SP

PM: meet inpatient preceptor to go over H and P, presentation

3 Free PM: Small Group: Presentations from complete H and Ps

PM: traditional LCE

4 Free PM: Small Group: CPS case

PM: traditional LCE