A Four Year Integrated Medical Informatics Curriculum: The FSU Story Nancy B. Clark, M.Ed. Director of Medical Informatics Education Florida State University - College of Medicine STFM PreDoc – January 2008 PreDoc 20081

The FSU Model PreDoc 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 Tallahassee Daytona Ft Pierce Orlando Sarasota Pensacola

Where does Informatics live? PreDoc 20083

Philosophy PreDoc 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 1. Ethics 2. Geriatrics 3. Informatics 4. Evidence-based Medicine 5. Behavioral Science 6. Culturally-Appropriate Care 7. Professionalism 8. Rural Medicine 9. Care of the Underserved 10. Humanities

TabletPCs issued to Class of 2010 PreDoc 20085

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

The Generalists 20077

Development of Informatics Competencies PreDoc Formed Informatics Curriculum Advisory Committee 2. Reviewed AAMC MSOP, STFM Information Management, AAFP residency informatics objectives 3. Developed FSU Competencies 4. Sequenced by student year: M1, M2, M3 5. Recruited courses to include teaching and assessment

Year 1 PreDoc 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

Year 1 Informatics Integration PreDoc Anatomy: Computer based training Digital photography Audience response system Using library Resources MicroAnatomy: Presentation Skills NeuroAnatomy: Digital photography 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

Year 2 PreDoc 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 MicrobiologyMicrobiology Review Systemic Physiology Doctoring 2 Doctoring Review Medicine and Behavior Psychosocial Medicine Review Health Issues

Year 2 Informatics Integration PreDoc 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 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

Years 3 & 4 PreDoc Year 3 Curriculum Orient 6 weeks 8 weeks 6 weeks OSCE Comm Medicine 3 weeks 8 weeks 6 weeks OSCE PedsSurg 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

Year 3 Informatics Integration PreDoc 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

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

Informatics Web Site PreDoc Hits in = 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

Informatics Faculty Development PreDoc Informatics Seminar Series – Certificate Series 1. Introduction to the Maguire e-Library and PDA Resources 2. Locating and Accessing Full Text Journal Articles 3. Selecting the Best Evidence-Based Medicine Resources (Web and PDA) 4. Using Drug Resources (Web and PDA) 5. Using Disease Resources and Textbooks, Including Reference e-Books (Web and PDA) 6. Using Calculators and Quick Decision Support References (Web and PDA) Orientation to FSU CoM Information Technology

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

New Developments PreDoc 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