1. Finding the ‘Goldilocks’ Solution to the Problem of Choosing a Curriculum Content Framework SGEA 2015 Charlotte, NC April 26, 2015 Hugh A. Stoddard, MEd, PhD Gordon Churchward, PhD Mia S. White, MILS, AHIP Erica D. Brownfield, MD

2. COI Statement No conflicts of interest to declare

3. Session Agenda a)Introduce topic and format5 min b)Problem statement10 min c)Small group discussion25 min d)Report back20 min e)Present case study10 min f)Large group discussion15 min g)Take-home points5 min

4. Background (1) 1.LCME emphasis on curriculum management 2.Trend towards integrated curricula – Less departmental ownership 3.Metrics for CQI – Comparative data for topics taught and time/effort allocated

5. Background (2) AAMC – Curriculum Inventory and Reports (CIR) – MedAPS Local v. Aggregate – Common good? – Mandate? – Benefits? Magnitude? To whom?

6. Background (3) Trade-offs in choosing a framework – Precision v. – Utility

7. Illustration of a MeSH Tree: “cardiovascular system” Cardiovascular System [A07] – Blood-Air Barrier [A07.025] – Blood-Aqueous Barrier [A07.030] – Blood-Brain Barrier [A07.035] – Blood-Nerve Barrier [A07.037] – Blood-Retinal Barrier [A07.040] – Blood-Testis Barrier [A07.045] – Blood Vessels [A07.231] – Glomerular Filtration Barrier [A07.500] – Heart [A07.541] Endocardium [A07.541.207] Fetal Heart [A07.541.278] Heart Atria [A07.541.358] Heart Conduction System [A07.541.409] – Atrioventricular Node [A07.541.409.147] – Bundle of His [A07.541.409.273] – Purkinje Fibers [A07.541.409.683] – Sinoatrial Node [A07.541.409.819] Heart Septum [A07.541.459] Heart Valves [A07.541.510] Heart Ventricles [A07.541.560] Myocardium [A07.541.704] Papillary Muscles [A07.541.749] Pericardium [A07.541.795 ]

8. Activity Outline Divide into small groups (4-5 people) Discuss your question and choose an answer Report back to other groups

9. Discussion Questions 1.There is a standardized vocabulary for instructional methods and assessment methods. Should there also be a national, standardized content framework? – Would a standardized reporting framework be antecedent to a “national curriculum?” What would be the benefits/drawbacks of a national curriculum? 2.Which is more important to a medical school, having a national database of content or a locally defined framework? – What are the local uses of a content framework? What are the national uses? 3.How does the choice of curriculum framework affect the usability of the results? – How does the choice of framework affect various groups (e.g. students, faculty, school administrators, LCME, AAMC)? Are there ‘winners’ and ‘losers’ in this decision?

10. Report Back from Small Groups 1.There is a standardized vocabulary for instructional methods and assessment methods. Should there also be a national, standardized content framework? – Would a standardized reporting framework be antecedent to a “national curriculum?” What would be the benefits/drawbacks of a national curriculum? 2.Which is more important to a medical school, having a national database of content or a locally defined framework? – What are the local uses of a content framework? What are the national uses? 3.How does the choice of curriculum framework affect the usability of the results? – How does the choice of framework affect various groups (e.g. students, faculty, school administrators, LCME, AAMC)? Are there ‘winners’ and ‘losers’ in this decision?

11. Emory Framework EUSOM developed own framework 1.School outcomes 2.ICD-9 organ systems 3.USMLE principles 4.LCME topics 5.Common patient problems – Plus 3 standardized vocabulary categories

12. Emory Framework SPASystemPrincipleTopicProblemInstructionAssessmentResource

13. Emory Framework SPASystemPrincipleTopicProblemInstructionAssessmentResource 28151813138(SV)

14. Emory Framework SPASystemPrincipleTopicProblemInstructionAssessmentResource SPA01: Take a patient-centered history (focused and complete) Sys00: NAPrin00: NATop00: NAPt000: NACase-Based Instruction/Learnin g Clinical Documentation Review Audience Response System SPA02: Perform a physical examination (focused and comprehensive) and recognize normal and abnormal findings Sys01: Blood & Lymphoreticular System Prin01: Biochemistry and molecular biology Top01: Primary Care Pt001: abdominal pain Clinical Experience - Ambulatory Clinical Performance Rating/Checklist Audio SPA03: Apply principles of medical science to interpret clinical information Sys02: Cardiovascular System Prin02: Tissue response to disease (Pathophysiology) Top02: Wellness, Prevention and Health Promotion Pt002: accidentsClinical Experience - Inpatient Exam - Institutionally Developed, Clinical Performance Cadaver SPA04: Apply principles of medical science to patient care to develop a problem list, working diagnosis, etiologic evaluation, and management plan Sys03: Endocrine System Prin03: Normal structure and function (Gross anatomy & physiology) Top03: Behavioral and Social Determinants of Health Pt003: acid base imbalance Concept MappingExam - Institutionally Developed, Written/ Computer-based Clinical Correlation SPA05: Develop a patient care plan Sys04: Female Reproductive & Breast Prin04: Histology and Biology of cells Top04: Healthcare Disparities Pt004: acute coronary syndromes ConferenceExam - Institutionally Developed, Oral Distance Learning - Asynchronous

15. Emory Framework SPASystemPrincipleTopicProblemInstructionAssessmentResource SPA01: Take a patient-centered history (focused and complete) Sys00: NAPrin00: NATop00: NAPt000: NACase-Based Instruction/Learnin g Clinical Documentation Review Audience Response System SPA02: Perform a physical examination (focused and comprehensive) and recognize normal and abnormal findings Sys01: Blood & Lymphoreticular System Prin01: Biochemistry and molecular biology Top01: Primary Care Pt001: abdominal pain Clinical Experience - Ambulatory Clinical Performance Rating/Checklist Audio SPA03: Apply principles of medical science to interpret clinical information Sys02: Cardiovascular System Prin02: Tissue response to disease (Pathophysiology) Top02: Wellness, Prevention and Health Promotion Pt002: accidentsClinical Experience - Inpatient Exam - Institutionally Developed, Clinical Performance Cadaver SPA04: Apply principles of medical science to patient care to develop a problem list, working diagnosis, etiologic evaluation, and management plan Sys03: Endocrine System Prin03: Normal structure and function (Gross anatomy & physiology) Top03: Behavioral and Social Determinants of Health Pt003: acid base imbalance Concept MappingExam - Institutionally Developed, Written/ Computer-based Clinical Correlation SPA05: Develop a patient care plan Sys04: Female Reproductive & Breast Prin04: Histology and Biology of cells Top04: Healthcare Disparities Pt004: acute coronary syndromes ConferenceExam - Institutionally Developed, Oral Distance Learning - Asynchronous

16. Critique of Emory Approach Advantages/drawbacks of this framework? Does this advance national goals for CI? What are you doing at your schools? – Can one framework work at multiple schools?

17. Summary Balance local and national value – Trade-offs No one is ever completely satisfied Any framework must support local goals to be successful

18. Thanks for Attending! Questions or follow-up: Hugh Stoddardhugh.stoddard@emory.edu Gordon Churchward gordon.churchward@emory.edu Mia Whitemia.s.white@emory.edu Erica Brownfield ebrownf@emory.edu