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Curricular “Revitalization” of Year 1 Frazier Stevenson, MD Associate Dean for Undergraduate Educational Education Stanley Nazian, PhD Year 1 Faculty Lead
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Rationale for change in Year 1 Enhance integration of basic science courses Enhance compliance with LCME Desire to improve monitoring of students’ performance as the year progresses, rather than at the end of the year Desire to provide opportunities for remediation in a more timely fashion
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Basic Science Education in Year 1 Actions taken: Gross Anatomy, Physiology, Neuroanatomy, and Behavioral Science now will be taught as part of 4 organ system interdisciplinary block courses with grades issued every 8-9 weeks. Content sequence reorganized but topics are the same. Traditional disciplines (e.g. anatomy) tracked across the year. Students need acceptable competency to advance to Year 2. Students have opportunity to remediate failing grade after 1-2 weeks study and re-examination.
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Clinical Education in Years 1 and 2 Review of clinical skills education revealed: fragmentation of instruction in current structure desire to improve student readiness for the third year clerkships. Actions taken: Unification of Physical Diagnosis, Longitudinal Clinical Experience, and On Doctoring into a single year-long course (“Doctoring”) Pairing of Clinical Problem Solving and Evidence Based Medicine to create a new course: (“Evidence Based Clinical Reasoning”)
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Current Year 1
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New Curriculum: Designed March 2010 Doctoring Evidence Based Clinical Reasoning Core Principles & Musculoskelet al System Core Principles & Musculoskelet al System Communicatio n: Neurologic & Endocrine Systems Cardiovascular & Pulmonary Systems Renal, Gastro- intestinal and Reproductive Systems Molecular Relationships Competency (e.g. molecular biology) Functional Relationships Competency (e.g. physiology) Structural Relationships Competency (e.g. anatomy) Human/Behavioral Relationships Competency (e.g. behavioral science) 2 wks 8 wks 8 wks 8 wks 8 wks Aug w Oct Jan March
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Proposed Realignment Physical Diagnosis I+II Longitudinal Clinical Experience I+II On Doctoring / Ethics Clinical Problem Solving Evidence Based Medicine (from EBCP) Current EBCP without the EBM formal curriculum “Doctoring I and II” “Evidenced Based Clinical Reasoning I and II” “Introduction to Clinical Medicine” (Year 2)
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“Doctoring” Enable a smooth transition into third year by improving longitudinal skill development Integrate small groups across multiple courses Develop a longitudinal small group to pull together multiple competencies Teach ethics and professionalism in clinical context Link PD and LCE Increase communication teaching
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“Evidence Based Clinical Reasoning” Informatics, statistics (Year 1) Clinical Problem Solving (Year 1 latter half) Evidence Based Medicine fundamentals (literature review, types of articles) (Year 2 start) Clinical Problem Solving (Year 2) integrating organ systems with literature review
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“Introduction to Clinical Medicine” Old name = Clinical Diagnostic Reasoning Pathophysiology not covered in Pharmacology, Pathology, PMIID Examples: ECGs, electrolyte disorders, psychiatric disorders, liver and renal failure
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A month in Doctoring and EBCR for an MS1 during the cardiopulmonary course WEEKMondayTuesWedThursdayFriday 1AM: Lecture demo on cardiac exam Free PM: Small Group in CACL: examine heart PM: traditional LCE 2 FreeAM: Humanities presentation 1 PM: Communication presentation 2 PM: Small Group communication with SP PM: LCE skill visit--CV exam in office 3 Free PM: Small Group Ethics cases PM: traditional LCE 4 Free 1 PM: Informatics lecture 2pm: Small Group: CPS case Free (pre- exam)
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A month in Doctoring and EBCR for an MSII during the cardiovascular block WEEKMondayTuesWedThursdayFriday 1AM: Lecture demo on abnormal cardiac exam FreePM: Small Group in CACL: simulator heart murmurs, examine heart PM: Inpatient complete H and P 2AM: EBCR Lecture on Randomized Controlled Trials FreeAM: Humanities presentation 1 PM: Ethics presentation 2 PM: Small Group communication with SP PM: meet inpatient preceptor to go over H and P, presentation 3FreePM: Small Group: Presentations from complete H and Ps PM: traditional LCE 4FreePM: Small Group: CPS case PM: traditional LCE
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