Finding the ‘Goldilocks’ Solution to the Problem of Choosing a

Curriculum Content Framework

SGEA 2015

Charlotte, NC

April 26, 2015

Hugh A. Stoddard, MEd, PhD

Gordon Churchward, PhD

Mia S. White, MILS, AHIP

Erica D. Brownfield, MD

COI Statement

• No conflicts of interest to declare

Session Agenda

a) Introduce topic and format 5 minb) Problem statement 10 minc) Small group discussion 25 mind) Report back 20 mine) Present case study 10 minf) Large group discussion 15 ming) Take-home points 5 min

Background (1)

1. LCME emphasis on curriculum management2. Trend towards integrated curricula

– Less departmental ownership

3. Metrics for CQI– Comparative data for topics taught and time/effort

allocated

Background (2)

• AAMC– Curriculum Inventory and Reports (CIR)– MedAPS

• Local v. Aggregate– Common good?– Mandate?– Benefits?

• Magnitude? To whom?

Background (3)

• Trade-offs in choosing a framework– Precision

v.

– Utility

Illustration of aMeSH Tree:“cardiovascular system”

• Cardiovascular System [A07] – Blood-Air Barrier [A07.025] – Blood-Aqueous Barrier [A07.030] – Blood-Brain Barrier [A07.035] – Blood-Nerve Barrier [A07.037] – Blood-Retinal Barrier [A07.040] – Blood-Testis Barrier [A07.045] – Blood Vessels [A07.231] – Glomerular Filtration Barrier [A07.500] – Heart [A07.541]

• Endocardium [A07.541.207] • Fetal Heart [A07.541.278] • Heart Atria [A07.541.358] • Heart Conduction System [A07.541.409]

– Atrioventricular Node [A07.541.409.147] – Bundle of His [A07.541.409.273] – Purkinje Fibers [A07.541.409.683] – Sinoatrial Node [A07.541.409.819]

• Heart Septum [A07.541.459] • Heart Valves [A07.541.510] • Heart Ventricles [A07.541.560] • Myocardium [A07.541.704] • Papillary Muscles [A07.541.749] • Pericardium [A07.541.795]

Activity Outline

• Divide into small groups (4-5 people)• Discuss your question and choose an answer• Report back to other groups

Discussion Questions1. There is a standardized vocabulary for instructional methods and

assessment methods. Should there also be a national, standardized content framework?– Would a standardized reporting framework be antecedent to a “national

curriculum?” What would be the benefits/drawbacks of a national curriculum?

2. Which is more important to a medical school, having a national database of content or a locally defined framework?– What are the local uses of a content framework? What are the national uses?

3. How does the choice of curriculum framework affect the usability of the results?– How does the choice of framework affect various groups (e.g. students,

faculty, school administrators, LCME, AAMC)? Are there ‘winners’ and ‘losers’ in this decision?

Report Back from Small Groups1. There is a standardized vocabulary for instructional methods and

assessment methods. Should there also be a national, standardized content framework?– Would a standardized reporting framework be antecedent to a “national

curriculum?” What would be the benefits/drawbacks of a national curriculum?

2. Which is more important to a medical school, having a national database of content or a locally defined framework?– What are the local uses of a content framework? What are the national uses?

3. How does the choice of curriculum framework affect the usability of the results?– How does the choice of framework affect various groups (e.g. students,

faculty, school administrators, LCME, AAMC)? Are there ‘winners’ and ‘losers’ in this decision?

Emory Framework

• EUSOM developed own framework1. School outcomes2. ICD-9 organ systems3. USMLE principles4. LCME topics5. Common patient problems

– Plus 3 standardized vocabulary categories

Emory Framework

SPA System Principle Topic Problem Instruction Assessment Resource

Emory Framework

SPA System Principle Topic Problem Instruction Assessment Resource

28 15 18 13 138 (SV) (SV) (SV)

Emory FrameworkSPA System Principle Topic Problem Instruction Assessment Resource

SPA01: Take a patient-centered history (focused and complete)

Sys00: NA Prin00: NA Top00: NA Pt000: NA Case-Based Instruction/Learning

Clinical Documentation Review

Audience Response System

SPA02: Perform a physical examination (focused and comprehensive) and recognize normal and abnormal findings

Sys01: Blood & Lymphoreticular System

Prin01: Biochemistry and molecular biology

Top01: Primary Care

Pt001: abdominal pain

Clinical Experience - Ambulatory

Clinical Performance Rating/Checklist

Audio

SPA03: Apply principles of medical science to interpret clinical information

Sys02: Cardiovascular System

Prin02: Tissue response to disease(Pathophysiology)

Top02: Wellness, Prevention and Health Promotion

Pt002: accidents Clinical Experience - Inpatient

Exam - Institutionally Developed, Clinical Performance

Cadaver

SPA04: Apply principles of medical science to patient care to develop a problem list, working diagnosis, etiologic evaluation, and management plan

Sys03: Endocrine System

Prin03: Normal structure and function(Gross anatomy & physiology)

Top03: Behavioral and Social Determinants of Health

Pt003: acid base imbalance

Concept Mapping Exam - Institutionally Developed, Written/ Computer-based

Clinical Correlation

SPA05: Develop a patient care plan

Sys04: Female Reproductive & Breast

Prin04: Histology and Biology of cells

Top04: Healthcare Disparities

Pt004: acute coronary syndromes

Conference Exam - Institutionally Developed, Oral

Distance Learning - Asynchronous

Emory FrameworkSPA System Principle Topic Problem Instruction Assessment Resource

SPA01: Take a patient-centered history (focused and complete)

Sys00: NA Prin00: NA Top00: NA Pt000: NA Case-Based Instruction/Learning

Clinical Documentation Review

Audience Response System

SPA02: Perform a physical examination (focused and comprehensive) and recognize normal and abnormal findings

Sys01: Blood & Lymphoreticular System

Prin01: Biochemistry and molecular biology

Top01: Primary Care

Pt001: abdominal pain

Clinical Experience - Ambulatory

Clinical Performance Rating/Checklist

Audio

SPA03: Apply principles of medical science to interpret clinical information

Sys02: Cardiovascular System

Prin02: Tissue response to disease(Pathophysiology)

Top02: Wellness, Prevention and Health Promotion

Pt002: accidents Clinical Experience - Inpatient

Exam - Institutionally Developed, Clinical Performance

Cadaver

SPA04: Apply principles of medical science to patient care to develop a problem list, working diagnosis, etiologic evaluation, and management plan

Sys03: Endocrine System

Prin03: Normal structure and function(Gross anatomy & physiology)

Top03: Behavioral and Social Determinants of Health

Pt003: acid base imbalance

Concept Mapping Exam - Institutionally Developed, Written/ Computer-based

Clinical Correlation

SPA05: Develop a patient care plan

Sys04: Female Reproductive & Breast

Prin04: Histology and Biology of cells

Top04: Healthcare Disparities

Pt004: acute coronary syndromes

Conference Exam - Institutionally Developed, Oral

Distance Learning - Asynchronous

Critique of Emory Approach

• Advantages/drawbacks of this framework?• Does this advance national goals for CI?• What are you doing at your schools?

– Can one framework work at multiple schools?

Summary

• Balance local and national value– Trade-offs

• No one is ever completely satisfied

• Any framework must support local goals to be successful

Thanks for Attending!

Questions or follow-up:

• Hugh Stoddard hugh.stoddard@emory.edu

• Gordon Churchward gordon.churchward@emory.edu

• Mia White mia.s.white@emory.edu

• Erica Brownfield ebrownf@emory.edu