Fsm3.0 march update

CURRICULUM RENEWAL

March 2011 Update

FSM will mentor and educate students to become exceptional, compassionate and innovative physicians, educators, and researchers

We expect our students to be inquiry-driven team leaders who will serve patients, society and the profession

Sept 2009 Retreat

Aug 2012Phase 1Implementation

Sept 2011 Phase 1 Plan Completed

~April 2013 Phase 2 Implementation

Instructional Design to deliver contentFaculty Development to facilitate content deliveryAssessment Design to evaluate student learning outcomes

Curriculum Evaluation and Continuous Quality Improvement

100 faculty

15students

Oct 2010 Kick-Off

200faculty

25students

Curriculum Developmentorganization, content

113faculty

25students

CURRICULUM RENEWAL March 2011 Update


Competency-BasedActive Learning

PBL

Collaborative

Colleges

ContentPPS , MDM

Evidence-Based LearningPBL, TBL, Simulation, Virtual Reality

Science in Medicine

Personal - Adaptive

Learner-Centered

Professional Development

ContentAOC, Competency, PPS , MDM

Integrated

Collaborative Multidisciplinary & Inter-professional Teams, Societies, Colleges

Inquiry-Driven

Curricular Model

Health & Society• Biopsychosocial determinants of Health and Disease

(Healthy People 2020)• Health Disparities, Equity and Advocacy• Health Economics and Health Systems• Global, Community and Public Health Perspectives• Patient Safety and Quality Improvement

Professional Development • Area of Scholarly Concentration, “Pathways”, Professional

Goals• Personal Awareness and Self-Care• Professional Behavior and Moral Reasoning• Teamwork & Leadership

Clinical Medicine• Prevention, Diagnosis, Treatment, Rehabilitation, Palliation (Prevention includes nutrition, lifestyle medicine, behavioral change, wellness (Diagnosis includes Hx & PE, laboratory medicine, imaging) (Treatment includes therapeutics and technical skills) (Rehab includes transitions of care) (Palliation includes end of life care)• Medical Decision-Making & Clinical Reasoning

(MDM includes Info Acquisition & Management, EBM, Cost- Effectiveness)

• Communication (oral, written, counseling, teaching)

Science in Medicine• Foundational Sciences (cellular processes,

genetics, metabolism inflammation and infection)• Normal Structure and Function• Mechanisms of Disease, Diagnosis, Therapeutic

Interventions, Disease Prevention• Organ-based, lifecycle / developmental framework

4 Curricular Elements content threads


Continuity

Organizing principles

Current Curriculum

Year 1 Year 3 Year 4

Clinical Medicine

Patient, Physician, Society

SF

Normal Abnormal

Year 2

SBM

Phase 1 Phase 2 Phase 3

Science in Medicine Clinical Medicine

Health & Society


Proposed Curriculum



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Competency-Based, Gateway Assessments with Portfolio ReviewsG

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SiM

Sept 2009 Retreat






Oct 2010 Kick-Off






Health & Society



SCIENCE IN MEDICINE

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Phase 1 Sequence - Science in Medicine Modules

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September October November

Prologue - Sequence of Science in Medicine (Weeks) Fall 2012

Mon Tue FriThuWed

LABOR DAY CELLS, ORGANELLES, MACROMOLECULES

CELLS, CONT. RECEPTORS, G PROTEINS, MEMBRANE TRANSPORT, CHANNELS

INTRO,THEMES,THREADS

CHROMOSOMES, CELL CYCLE, STEM CELLS, MUTATION, INHERITANCE

GENETIC VARIATION, PEDIGREE, AUTOSOMAL & CHROMOSOMAL DISORDERS

Mon Tue FriThuWed

GENETIC DISORDER DIAGNOSIS, SCREENING & THERAPEUTICS, SPECIFIC DISEASES

METABOLISM, PATHWAYS, MITOCHONDRIA

HUMAN BODY: EPITHELIUM, CONNECTIVE TISSUE

HUMAN BODY: BONE, MUSCLE BLOOD,CIRCULATION

AUTONOMIC,SOMATIC

NERVOUS SYS.

EMBRYO-GENESIS

CELL ADAPTATION & INJURY, APOPTOSIS, TUMORS, CANCERPHARMACOLOGY:

ABSORPTION,TRANSPORT

PHARM: DISTRIBUTION, EXCRETION, METABOL., KINETICS

Mon Tue FriThuWed

PHARMACOLOGY:KINETICS

INTROMICROBIOLOGY

RNA & DNA VIRUSES, BACTERIA, FUNGI, PARASITES, THERAPEUTICS INTROIMMUNOLOGY

ANTIBODIES, T CELLS, EFFECTOR FUNCTIONS, AUTOIMMUNITY, TRANSPLANTS

IMMUNOPATHOLOGY,INFLAMMATION

THANKSGIVING

PROLOGUEEXAM

CARDIOVASCULAR MODULE

September 2012 Calendar

October 2012 Calendar

November 2012 Calendar

December 2012 CalendarMon Tue FriThuWed

3 7654

10 14131211

17 21201918

24 28272625

1 5432

8 1211109

15 19181716

22 26252423

29 3130

21

5 9876

12 16151413

19 23222120

26 2827 3029

3 7654

10 14131211

17 21201918

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31




CHRISTMAS<===============HOLIDAY BREAK===============>

<===============HOLIDAY BREAK===============>

CELLS, RECEPTORS, MEMBRANES

GENETICS

GENETICS

HUMAN BODY

CELL INJURY

PHARMACOLOGY

MICROBIOLOGY

IMMUNOLOGY

EXAM


Prologue Sequence of SiM - Weekly Calendar

3 7654

September 2012 CalendarMon Tue FriThuWed

10 14131211

17 21201918

24 28272625

LABOR DAY CELLS, ORGANELLES, MACROMOLECULES

CELLS, CONT. RECEPTORS, G PROTEINS, MEMBRANE TRANSPORT, CHANNELS

INTRO,THEMES,THREADS

CHROMOSOMES, CELL CYCLE, STEM CELLS, MUTATION, INHERITANCE

GENETIC VARIATION, PEDIGREE, AUTOSOMAL & CHROMOSOMAL DISORDERS

October 2012 CalendarMon Tue FriThuWed

1 5432

8 1211109

15 19181716

22 26252423

29 3130

GENETIC DISORDER DIAGNOSIS, SCREENING & THERAPEUTICS, SPECIFIC DISEASES

METABOLISM, PATHWAYS, MITOCHONDRIA

HUMAN BODY: EPITHELIUM, CONNECTIVE TISSUE

HUMAN BODY: BONE, MUSCLE BLOOD,CIRCULATION

AUTONOMIC,SOMATIC

NERVOUS SYS.

EMBRYO-GENESIS

CELL ADAPTATION & INJURY, APOPTOSIS, TUMORS, CANCERPHARMACOLOGY:

ABSORPTION,TRANSPORT

PHARM: DISTRIBUTION, EXCRETION, METABOL., KINETICS

November 2012 CalendarMon Tue FriThuWed

21

5 9876

12 16151413

19 23222120

26 2827 3029

PHARMACOLOGY:KINETICS

INTROMICROBIOLOGY

RNA & DNA VIRUSES, BACTERIA, FUNGI, PARASITES, THERAPEUTICS INTROIMMUNOLOGY

ANTIBODIES, T CELLS, EFFECTOR FUNCTIONS, AUTOIMMUNITY, TRANSPLANTS

IMMUNOPATHOLOGY,INFLAMMATION

THANKSGIVING

PROLOGUEEXAM


December 2012 CalendarMon Tue FriThuWed

3 7654

10 14131211

17 21201918

24 28272625

31




CHRISTMAS<===============HOLIDAY BREAK===============>

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Prologue Sequence of SiM - Weekly Topics

Approaches to genetics disorders

Development, pattern

formation, homeobox genes

Contiguous gene deletions,

uniparental disomy

Genetic screening,

prenatal, cancer risk

X chromosome: inactivation,

pseudoautosomal regions, Turner

syndrome

Treatment of genetic disorders

Prenatal diagnosis

Mitochondrial genetics & diseases

Behavioral genetics

Neurofibromatosis Marfan syndrome, hemiglobinopathy,

PKU

Example: Prologue SiM Week 5, Hourly Topics Fall 2012

MondayOctober 1

TuesdayOctober 2

WednesdayOctober 3

ThursdayOctober 4

FridayOctober 5

Tasks ahead: 1. Improve coordination and communication across SiM topics2. Integrate the daily and weekly schedule with other curricular

elements - clinical medicine, health and society, professional development

3. Develop stimulating, interactive learning experiences that engage students in large and small groups





CLINICAL MEDICINE

TUESDAY 5PM : CLINICAL MED STEERING COMMITTEE

• Ben Singer• Julia Corcoran• John Butter• Warren Tourtelotte• Rama Gourenini• Jen Trainor• Stephanie Kearns• Nicholas Volpe• Donna Woods• Margaret Duggan• Kristine Gleason

• Bob Tanz• John Vozenelik• Jay Thomas• Michael Fleming• Alex Korutz• Daniel Katz• Joseph Brown• Kate Kinner• Kelly Walker• Aarati Didwania• Amanda Zick

TUESDAY 12NOON : CLINICAL MED SUBCOMITTEE #1

• Eric Terman• Arv Vanagunas• Lori Goodhartz• Cristine Park• Toshi Uchida• Boye Ogunseitan• Stevie Mazyck• Gary MacVicar• Marie Crandall• Jen Bierman

• Todd Davis• Karen Mangold• Alexander Sandu• Sharon Unti• Mike Moore• Susan Santacaterina• Nicole Wysolcki• Cherina Cyborski• Donald-Lloyd Jones

THURSDAY 8AM : CLINICAL MED SUBCOMMITEE #2

• Bob Brannigan• Tania Saroli• Michael Angarone• Rick Lee• Amer Aldeen• Jyothy Puthumana• Edgar Black• Darius Loghmanee• Danielle Smith• Julie Stamos

• Tina Tan• Melissa Brown• Natasha Wheaton • Allison Hammer• Stephanie Miller• Jay Sarthy• Jared Mendelson

CLINICAL MEDICINE ELEMENT GROUP:

• Tuesday 12noon subcommittee:– Task: organize the clinical medicine curriculum

horizontally almost done mapping broad goals, assessment methods, & learning strategies

• Thursday 8am subcommittee:– Task: integrate clinical medicine vertically into the CV

unit Focused Clinical Experience (FCE) initiative

• Tuesday 5pm steering committee:– Task: think tank for “big picture” & reactor panel

developing a longitudinal student/patient experience

Current Curriculum


Clinical Medicine


SF

Normal Abnormal

Year 2

SBM



Health & Society


Proposed CurriculumFCE

SINGLE DOSESOF EARLY CLINICAL MEDICINE…

THE FCE CONCEPT:

• Find a lecture • https://fsmweb02.northwestern.edu/emerg/

• Pick 2-3 objectives

• Find real-world examples

where the lecture content

is applicable• Embed students in a clinical area. Aims: provide context, apply & synthesize knowledge and inspire

https://fsmweb02.northwestern.edu/emerg/

https://fsmweb02.northwestern.edu/emerg/

PROVIDE THE “WHY” & INSPIRE INQUIRY

COULD IT WORK?

First FCE pilot Dr. Puthumana’s echo lab experience…

• “Experience was wonderful”• “the lecture material really

came together”• “Cardiac echo, E/A & E’

definitely seemed more relevant after the exercise”

• “It was certainly inspiring and I would definitely do it again- for other units”

What’s up next:

• NMH valve surgery (R. Lee)• CMH heart biopsy (T.Saroli)• Heart transplant (E.Black)• Cardiac cath lab (J.Flaherty)• CCU pharmacist (K. Gleason)• ED ecg’s (Aldeen, Wheaton)• CCU nurse shadow (M.Duggan)• Cardiac MRI imaging (A.Korutz)• Stress test lab (J.Puthumana)• Cardiac autopsy (J.Lomasney)

• Any volunteers?

A MAINTENANCE DOSE OF CLINICAL MEDICINE…

Because understanding the social/environmental determinants of disease & the chronic care model requires… more than 4 weeks!

CONTINUITYPatients

(continuity of care)

Peers (continuity

of teamwork

& collaborati

on)

Preceptors

(continuity of

supervision)

SO WE NEED TO CREATE AN EDUCATIONAL EXPERIENCE WHERE:

• A team of health professionals, coordinated by a longitudinal physician, working collaboratively to provide high levels of care, access and communication, care coordination and integration, and working to improve care quality and safety.

• This is the AAFP, ACP, AAP, AOA 2007 consensus definition of a Patient-Centered Medical Home

SIMPLE & ELEGANT

ALL RESIDENTS & ATTENDINGS CAN

UNDERSTAND A CONTINUITY CLINIC CONCEPT

CONTINUITYPanel of

100 Patients

Team of 10

Students(2-3 per class)

1-2 Faculty

Facilitators

Recruit vulnerable patients with one or more of 20 core

conditions such as: heart disease, cancer, stroke,

COPD, obesity, trauma/SCI, dementia, DM, ESRD, mood disorders, asthma, HIV, SLE, cirrhosis, CHF, high-risk OB,

cystic fibrosis, sickle cell, chronic pain, and OA

Panel of 100 patients with Q4 mth visits

would be ~6 patients/wk, +add 1-2 acute slots as needed

SIMPLE DESIGN, INFINITE FLEXIBILITY• All students have a clinic (simple concept)• But within their clinic- many chances for

“layered individualization” & adaptability:

• Panel of 100 patients allows students to focus (“own”) the patients with conditions they find most interesting

• Multiple visits with 1 patient over 4 years allows for “deep learning” rather than just superficial initial encounters

• Multiple levels of learners allows students to operate at exactly their “true” level. M1’s who are ahead of the curve can start doing more DDx and M3’s who are struggling can work more on PEx skills or Hx

• M3 students could recruit the inpatients that inspire them

NEW RESOURCES SINCE 1993:• Ability to track patient

progress when not physically at the clinic

• And increasing ease of data-mining to assess quality across sites

Epic.lnk

PowerChart.lnk

http://nmh-ctx-nfuse1.nmh.org/ica/ssodesktop.ica

http://pacsweb.nmh.org/ami/html/

http://nmhpaging.nmh.org/cgi-bin/cgiip.exe/WService=webmessaging/webmessaging.html

OTHER SCHOOLS CAN MEASURE THEIR CURRICULAR REFORM EFFORTS WITH STUDENT SATISFACTION SURVEYS

Our educational outcomes could be:

97% of student CAD patients on B-Blkrs & Aspirin

Average Hgb A1c dropped 1.0% compared to entry

80% patients up to date with cancer screening metrics

No racial disparities detectable in screening rates

Mean BMI of patient panel dropped over 4 years

RHINOCEROS– WHY WERE YOU SO INSPIRING?

• Students owned the project• Students worked as a team and had a goal• The project was simple but yet integrated

everything they had been learning in class (reading, writing, math, art, weather, geography, biology, health/nutrition)

• The project inspired inquiry & deep learning• Professionalism, responsibility were required• Can’t we aspire to compete with 1st graders??

Current Curriculum


Clinical Medicine


SF

Normal Abnormal

Year 2

SBM



Health & Society


Proposed Curriculum FCE

PCMH

• Imagine working with these 4 FSM students over 4 years and seeing what they could do with a panel of their OWN patients

• Imagine the PR campaign & recruitment impact…

• Improving Medical Education by Improving Chicago’s Health



Health & Society



HEALTH & SOCIETY

Health & Society CEG

Healthy People 2020 www.healthypeople.gov

http://www.healthypeople.gov/

Prologue:Students learn about themselves

• Health Risk Appraisal (HRA)– Lifestyle factors and readiness to change • Biometric

and laboratory results • Compliance with recommended preventive screenings • Existing chronic conditions • Future disease risk factor • Personal environment

– Personal and group results• Behavior Change Plan (BCP)

– Reanalysis of HRA results– Personal and group results

Prologue:Students learn about others

• Textbook Chicago – Chicago bus tour of 6 communities to assess the 4

determinants of health (social environment, physical environmental, health services, individual behavior)

– SES • Racial/ethnic demographics • Built environment • Health care access & delivery • Prevalence of selected health conditions

– Presentations and discussion of health outcome disparities regarding determinants of health

Overarching themes

• Determinants of health• Disparities in health

outcomes• Public health• Community and global

health• Health service delivery• Physician roles• Professional well-being

• Advocacy• Communication /

motivational interviewing/ behavior change

• Interdisciplinary learning

• Lifestyle Medicine Thread



Health & Society



PROFESSIONAL DEVELOPMENT


Curriculum Renewal UpdateMarch 2011


Curriculum Renewal UpdateMarch 2011

Overview

A curricular element that encompasses:

– An Area of Scholarly Concentration (AOSC)

– Professional Behavior and Moral Reasoning/Medical Ethics (PBMR)

– Personal Awareness and Self-Care (PASC)

– Teamwork and Leadership (TL)

Accomplishments: November 2010- Area of Scholarly Concentration task force:

Report on activities of other schools and recommendations for FSM

- Professional Behavior and Moral Reasoning Competency Committee: Education and assessment blueprint

- Personal Awareness and Self-Care Competency Committee: Education and assessment blueprint

Progress: November 2010-March 2011

1. Convened sub-committees for four areas of Professional Development.

2. Agreement on goals, teaching activities and assessment strategies for Prologue/Phase 1.

3. Development of Pilot projects for Fall, 2011.

Broad Goals for Prologue/Phase 1... • DISCUSS basic theories of teamwork and leadership (TL).

• ANALYZE team structure and roles for a team that they are currently on (TL).

• UNDERSTAND basic research designs in biomedical research (AOSC).

• DEVELOP a 4 year plan for an area of scholarly concentration in research, education or community service (AOSC)

• IDENTIFY, ANALYZE and JUSTIFY appropriate ethical and legal choices in the care of patients and their families (PBMR)

…Broad Goals for Prologue/Phase I

• IDENTIFY, ANALYZE, and JUSTIFY ethical choices in the healthcare systems in which they work, including issues of access to care and conflicts of interest (PBMR)

• BEHAVE with honesty, integrity, respect, and compassion toward all patients, families, students, faculty, and other healthcare professionals (PBMR)

• CREATE a 4 year plan for personal awareness and self-care (PASC)

Pilot Projects for 2011…

1. Teamwork and Leadership: - Course with Northwestern Center for

Leadership on teamwork & leadership for medical students

- Develop structure/ framework for team analysis of a current team

2. Professional Behavior and Moral Reasoning: - Develop new assessment for current ethics and values course (M1)

…Pilot Projects for 20113. Personal Awareness and Self-Care:

- Develop guidelines for mentor/student 4 year plan for personal awareness and self-care.

4. Area of Scholarly Concentration: - Update medical decision-making (MDM) course to reflect goal of developing a research project/plan with a preceptor. - Convene one regular AOSC interest group to meet monthly.

Ongoing challenges and opportunities

• Integrate with Clinical Medicine and the Patient Centered Medical Home:– Opportunities for PBMR, TL, PASC

• Integrate with Health and Society: PASC

• Make one assessment “count” for multiple competencies/curricular elements

Sept 2009 Retreat






100 faculty

15students

Oct 2010 Kick-Off

200faculty

25students


113faculty

25students



Steering

Clinical Medicine

ProfessionalDevelopment

Science in Medicine

Health& Society

Synthesis & Application

Modules

Prologue / Foundations

Steering Committee

Patient Safety

MDM & Laboratory MedicineLifestyle MedicineTe

amwor

kLe

ader

ship

Instructional Design& Technology

AWO

ME

GH

SLFA

ME

Student Assessment

Com

pete

ncy

Com

mitt

ee

Faculty Development

FAM

E

Curriculum Outcomes &Evaluation

Curr

icul

umCo

mm

ittee

Reactor Panels

Curr Element Groups

Thread Subcommittees

Subcommittees

Thanks for your contributions toward a shared vision

the imagination to

createthe courage to change

the excitement and resolve to continue into

uncharted areas

the resilience to recover from a mistake

http://goo.gl/L5oZK

http://twitter.com/#!/FSM_curr

http://twitter.com/#!/FSM_curr

http://goo.gl/L5oZK

http://goo.gl/L5oZK

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AOCD/int

D/int

D/int

D/int

D/intH/Onc

H/Onc

H/Onc

H/Onc

H/OncRe/UG

Re/UG

Re/UG

Re/UG

Re/UGEndoc

Endoc

Endoc

Endoc

Endoc

Endoc = EndocrineRe/UG = Reproductive/UrogenitalH/Onc = Hematology/OncologyD/Int = Dermatology/Phase 1 Integration

CM

PDH & S

SiM