Preclinical Competency Based Curriculum A Multidisciplinary Approach Carol

Pre-clinical Competency Based Curriculum: A Multidisciplinary Approach Carol Motley MD, Allen Perkins MD, Amanda Mc. Bane MD University of South Alabama Dept of Family Medicine

Objectives �Upon conclusion of this talk the participant will: �Be familiar with the process of curriculum change in a medical school �Be knowledgeable regarding creation of a pre-clinical service learning requirement �Be able to discuss the risks and benefits of multidisciplinary instruction

Allopathic Medical School Curriculum �Traditional vs Problem Based Learning vs Competency Based �Biomedical vs Biopsychosocial �Role of ACGME Outcomes Project �Concept of the continuum �Pre-med �Medical school �Residency �CME

Hidden agenda �Learning environment �Role of faculty �Role of peers �How clinical care is valued �Concept of professionalism

Why this is important when…

Pre-clinical “clinical” curriculum �LCME �Collaborative Curriculum Project �ACGME Outcomes Project �AMA Initiative to Transform Medical Education

Process of curriculum change �Formal process �Curriculum committee �External mandates � LCME � Other external influences �Informal process

Process of curriculum change

Fundamentals of Doctoring �Multidisciplinary course �COM I and COM II years �Replaced Medical Practice in Society, Behavioral Medicine, Medical Ethics �Added professionalism �Did not incorporate ICM course �Service-learning requirement � 8 hours per semester �Experiences chosen off pick list

Fundamentals of Doctoring �Format �Lecture-discussion � Physician(Psychiatry, Family Medicine, Pediatrics, Ob/Gyn, Internal Medicine, Pathology, Critical care, Palliative care) � Non-physician(IRB director, hospital administrator, patients, sociology, psychology, counselor education, Migrant worker clinic, COM administration, ministers, others) �Small group �Essay �Online case studies �Panel discussions �Multimedia �Service learning

Fundamentals of Doctoring �Overarching themes �Medical professionalism �Doctor-patient communication �Biopsychosocial model of patient care �Normal and abnormal development �Physicians at risk �Medical ethics

Problem solving �Multidisciplinary instruction �Scheduling �Commitment �Maintaining integrity of instruction �Use of clinical resources �Use of non-medical outside resources � Cultural competence of learners and instructors �Process �Creating a multidisciplinary milieu

Leadership �Creative process �Maintenance �Handling changes inherent in Medical Education �Incorporation of new resources �Leadership changes at Dean level �Political issues

Problem solving �Service-learning project �Clarifying goals �Faculty goals vs student agenda �Specific experiences � Involved much initial contact � “We’re from the medical school and here to help you” � Assessment of value of experience � Changes in value over time

Outcomes �Ability to create and maintain multidisciplinary course �Working through Dean of Students office as opposed to departmental silo �Many departments willing to participate �Leadership team created and meeting regularly �Effect on clinical knowledge

Outcomes �Changes in professionalism educational experience �Ongoing monitoring and discussion of effect of course �Use of surrogate measures of professionalism � Attendance � Participation � Using essay to assess class needs �Identification of students with professionalism deficits

Outcomes �Service learning experience �Clinical vs non-clinical �Variety of exposures important (? ) �Emphasis on intent of experience � Found to be rewarding

Future directions �Expand service learning into 3 rd year clerkship �Longitudinal emphasis on professionalism over all 4 years �Assess impact on specialty choice �Improve evaluation process �Ongoing review of content �Spirituality and cultural competence