Improving Public Health Content and Related Problem-Based Practice in XSM Medical Education Curriculum Chen Lv CSU Craig S. Scott UW September 19, 2006

Content Part 1……Context and Setting Part 2……Rationale for Improving Disease Prevention and Surveillance in Medical Education Part 3……Project Goal Part 4……Development and Implementation Plan Part 5……Evaluation

Part 1…… Context and Setting  Effects of the new developments in science and technology  Increased commerce, travel and communication capability  Public health and preventive medicine are playing more and more important role in medicine

Part 1…… Context and Setting  Medical science and health care are facing serious challenges in the first decade of the 21st Century. Many problems related to medical education need attention: ☻ new and emerging infectious disease ☻ environmental pollution ☻ unhealthy lifestyles…… Physicians must be better prepared to participate in protecting the health of the public

In 2001, IIME aimed to promote globalization of medical education, and published the GMER in medical education The GMER covers: 7 domains 60 competences required “Population health and health systems” is one of the 7 GMER domains

Part 1…… Context and Setting  “Population Health and Health Systems (PHHS)” states that medical students should come to: ☻ understand their role in protecting and promoting the health of a whole population and be able to take appropriate action ☻ understand the principles of health systems organization and their economic and legislative foundations ☻ have a basic understanding of the efficient and effective management of the health care system

Part 1…… Context and Setting  XSM has set up many public health and preventive medicine courses for medical students: ☻ preventive medicine ☻ medical statistics ☻ epidemiology ☻ social medicine ☻ health policy

Part 2… Rationale for Improving Disease Prevention and Surveillance in Medical Education  The outbreak of SARS in 2003 imperiled people’s health and life security. The crisis was due, in part, to the fact that physicians were not more aware of the importance of: ☻ reporting unusual disease states ☻ their public health responsibilities ☻ how to protect themselves and their patients from public health threats

Part 2… Rationale for Improving Disease Prevention and Surveillance in Medical Education  During the SARS outbreak, China had: ☻ quickly revised the “Law of Prevention and Cure of Infectious Disease of the P.R China” ☻ quickly published the “Guideline of Public Health Event Emergency Measures” ☻ Invested 8 billion Yuan to improve the public health system after SARS outbreak the nation’s increased recognition of public health and disease prevention.  At the same time, the Ministry of Education required all medical schools to reinforce the preventive medicine education

Part 2… Rationale for Improving Disease Prevention and Surveillance in Medical Education  However, post-SARS surveys (WCMS) showed (1,2): ☻ the understanding of the importance of PHHS was not sufficiently enhanced by the SARS experience ☻ the PHHS’s importance rating remains the lowest of the GMER’s 7 domains medical students need to know more about their roles and responsibilities relative to population health

Part 2… Rationale for Improving Disease Prevention and Surveillance in Medical Education  A study by University of Queensland reported (3) : poor role modeling by the faculty of population and preventive health issues in their school of medicine faculty attitudes towards population health and preventive medicine likely influence the attitudes of medical students. The attitudes and knowledge of both faculty and students need to be improved  Therefore, the reform of the education of preventive medicine must be a priority

Part 3…… Project Goal  To better prepare medical school faculty to teach future medical students about: ☻ their public health responsibilities and roles ☻ disease surveillance and reporting including how to protect vulnerable individual and groups from contacting or spreading new and emerging diseases in their communities

Part 4…… Development and Implementation Plan 1 Faculty Development Faculty Development 2 Curriculum DevelopmentCurriculum Development 3 Teaching method reformationTeaching method reformation 4 Community practice site developmentCommunity practice site development 5 Collaboration involving CMB CentersCollaboration involving CMB Centers

Part 5 …… Evaluation Document, v ia performance assessments and surveys : ☻ How well medical students understand the relative importance of ratings for PHHS within the 7 GMER domains ☻ How well medical students understanding their responsibilities and roles in protecting and promoting the health of their community and nation These assessments will consist of 3 phases: ☻ Baseline assessments of knowledge (K), attitudes (A) & practice intentions (PI) ☻ Documentation of preventive medicine curriculum improvements ☻ Post implementation assessments of K, A & PI

References 1. Xiaolan Zhang, Craig S. Scott, Douglas C. Schaad, et al. Pre/Post SARS Attitudes towards the Global Minimum Essential Requirements: A Call to Action for Population Health for Medical Educators. (submitted for publication) 2. Xiaolan Zhang, Craig S. Scott, Douglas C. Schaad, et al. Attitudes of Chinese Medical Students Toward the Global Minimum Essential Requirements Established by the Institute for International Medical Education. Teaching and Learning in Medicine, 2004;16(2): Patricia M Rego, Marie-Louise Dick. Teaching and learning population and preventive health: challenges for modern medical curricula. Medical Education, 2005; 39:

Attachments  Attachment 1: The timeline for the project The timeline for the project  Attachment 2: Questionnaire --- students SurveyQuestionnaire --- students Survey  Attachment 3: Questionnaire --- faculty SurveyQuestionnaire --- faculty Survey

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1 Faculty Development  A needs assessment survey of faculty: to determine their understanding of the population health GMER domain and to determine where improvements are needed  Steps will be taken to improve medical school faculty knowledge of public health principles and physician responsibilities ☻ workshop ☻ seminar ☻ training

1 Faculty Development  Retain experts in public health and disease prevention as part-time instructors who will give updates to medical school faculty and students on: ☻ infectious disease outbreaks and epidemic, emergency measures and procedures ☻ responsibilities and obligations of clinicians The intent will be to: ☻ build an atmosphere wherein increased attention to preventive medicine and public health across the campus ☻ increase students’ sense of obligation to incorporate preventive medicine principles into their medical practice

2 Curriculum Development  Curriculum development will be undertaken to attain the PHHS.  We will focus on enhancement of course content related to: ☻ preventive medicine Outdated content will be identified and deleted New content will be added

3 teaching method reformation  Integrate lecture, case-based and PBL methods to improve the students’: ☻ preventive medicine problem recognition ☻ self-learn abilities ☻ interest in studying staying up-to-date with their public health obligations

4 Community Practice Site Development  Identify centers for community health care in which community/public health practice sites can be established  Arrange for medical students to practice in community sites, and focus on: ☻ disease prevention ☻ health education ☻ infectious diseases reporting ☻ chronic diseases management Learning-in-service Understanding-in-experience

5 Collaboration Plan  Establish Consortium (September 2006): XSM (lead school) + WCMS & CMU  5-Year Collaboration Plan (see Timeline)