A Four Year Integrated Medical Informatics Curriculum Nancy B. Clark, M.Ed. Director of Medical Informatics Education Florida State University - College of Medicine STFM PreDoc – January 2008 PreDoc 2008

The FSU Model Founded 2000 First 2 years at central campus Tallahassee Daytona Ft Pierce Orlando Sarasota Pensacola Founded 2000 First 2 years at central campus 120 per class Last 2 years at assigned to one of six regional campus Faculty are community physicians Paid on per week basis when have students Given access to all virtual library resources including PDA downloads Technology Emphasis PreDoc 2008

Where does Informatics live? PreDoc 2008

Philosophy Informatics is a tool best taught in the context of how it will be used: education/lifelong learning, decision support, communication, patient care, research. One of 10 integrated curriculum themes at FSU CoM Ethics Geriatrics Informatics Evidence-based Medicine Behavioral Science Culturally-Appropriate Care Professionalism Rural Medicine Care of the Underserved Humanities PreDoc 2008

TabletPCs issued to Class of 2010 PreDoc 2008

Essential Elements Standardization of equipment and software Students and faculty provided laptops and PDAs System wide resources – one network, email system, intranet, Blackboard, web site All software provided Technical support Curriculum Committee mandates Faculty support and buy-in Virtual Library PreDoc 2008

The Generalists 2007

Development of Informatics Competencies Formed Informatics Curriculum Advisory Committee Reviewed AAMC MSOP, STFM Information Management, AAFP residency informatics objectives Developed FSU Competencies Sequenced by student year: M1, M2, M3 Recruited courses to include teaching and assessment PreDoc 2008

Year 1 Year 1 Curriculum 1 Week 10 Weeks (Summer) 15 Weeks (Fall) 15 Weeks (Spring) 3 Weeks Orientation Clinical Anatomy, Embryology & Imaging Clinical Neuroscience Clinical Physiology Summer Clinical Practicum (Block clinical experience in Geriatrics, Rural Health or Urban Underserved) Clinical Microanatomy Medical Biochemistry and Genetics Doctoring 1 (Lecture, Small Group, CLC, Preceptor) Orientation: Students given laptops - 4 hours on IT survival skills. PDAs distributed in Fall with 3 hours training and loading PreDoc 2008

Year 1 Informatics Integration Anatomy: Computer based training Digital photography Audience response system Using library Resources MicroAnatomy: Presentation Skills NeuroAnatomy: Biochemistry: Medical references: Genetics databases, disease, drug, DDx Doctoring 1: Online Medical References – assessing the reliability and validity of medical information online PDA operation and maintenance Clinical Data Collection System training PDA Medical References PowerPoint skills Lifelong learning – ePortfolios EBM concepts 3 OSCEs PreDoc 2008

Year 2 Doctoring 2 Medicine and Behavior Health Issues Year 2 Curriculum 12 weeks Core Principles 22 weeks Organ Systems 3 weeks Review 4 Weeks General Pathology and Immunology Systemic Pathology & Laboratory Medicine Pathology-Radiology Review USMLE Step 1 General Medical Pharmacology Systemic Medical Pharmacology Pharmacology Review General Medical Microbiology Systemic Medical Microbiology Microbiology Review Systemic Physiology Doctoring 2 Doctoring Review Medicine and Behavior Psychosocial Medicine Review Health Issues PreDoc 2008

Year 2 Informatics Integration Medicine and Behavior Patient Education materials EMR chronic disease mgmt Pathology: Presentations Pharmacology: Presentation Drug references EBM – drug company advertising Doctoring 2: EBM Principles PDA practice Health Issues: Using MEDLINE Finding full text eJournal articles Finding health statistics online Writing a research paper using EndNote HIT systems and national initiatives Patient Safety EBM principles/ epidemiology Critical Review of the literature PreDoc 2008

Years 3 & 4 Year 3 Curriculum Orient 6 weeks 8 weeks 6 weeks OSCE Comm Medicine 3 weeks 8 weeks Peds Surg Fam Med Int Med OB/ Gyn Psych Doctoring 3 and Longitudinal Clinical Experience (1 day per week) Year 4 Curriculum 40 weeks Advanced Family Medicine – 4 weeks Emergency Medicine – 4 weeks Geriatrics – 4 weeks Advanced Internal Medicine – 4 weeks Electives – 24 weeks PreDoc 2008

Year 3 Informatics Integration Doctoring 3: Longitudinal: Using an EMR to manage chronic disease (SOAPware) Finding evidence based guidelines D3 sessions: Evidence based decision support tools Surgery Clerkship: Paper Community Medicine: Presentation All Clerkships: demonstrate ability to find information PreDoc 2008

Assessment Strategies ProveIt assess incoming skills Test questions Projects Papers, presentations, etc. Practicum OSCE stations (9 OSCEs total Yrs 1-3) Academic ePortfolio PreDoc 2008

Informatics Web Site http://www.med.fsu.edu/informatics Hits in 2006-2007 = 471,736 Average Hits per Day = 1,292 Visitors 66,843 from 170 countries Document Downloads: Writing on the Pocket PC – 56,500 Using Epocrates – 10,000 PocketPC Operation – 8,800 Decision Support – 8,700 Using Drug Resources – 8,000 PreDoc 2008

Informatics Faculty Development Informatics Seminar Series – Certificate Series Introduction to the Maguire e-Library and PDA Resources Locating and Accessing Full Text Journal Articles Selecting the Best Evidence-Based Medicine Resources (Web and PDA) Using Drug Resources (Web and PDA) Using Disease Resources and Textbooks, Including Reference e-Books (Web and PDA) Using Calculators and Quick Decision Support References (Web and PDA) Orientation to FSU CoM Information Technology PreDoc 2008

Informatics Faculty Development 2006-2007 41 workshops 10 sites: main campus, 6 regional campuses, 2 residencies, 2 remote sites 350 attended 2007-2008 Planned 50+ workshops PreDoc 2008

New Developments 2007-2008 Informatics Curriculum Directors Orlando, Pensacola and Sarasota regional campuses MD .2 FTE clinical faculty Duties - at their regional campus Deliver Faculty Development in Informatics D3 Longitudinal - EMR implementation Train, monitor and provide ongoing feedback D3 Lecture informatics integration PreDoc 2008