1. Medbiquitous Competency Working Group January 11, 2013 Co-Chairs: Steve Lieberman, MD Vice Dean for Academic Affairs, UTMB Pedro Reyes, PhD Executive Vice Chancellor for Academic Affairs, UT System A multi-institution initiative within the UT System

2. TIME Initiative Mission Statement The UT System TIME initiative is a student-centered, clinically focused program designed to increase the effectiveness of medical education while shortening its duration. TRANSFORMATION in MEDICAL EDUCATION

3. TIME Initiative Initial Strategies Line-up Ten institutions in the U.T. System 6 general academic institutions (GAIs) 4 medical schools at health-related institutions (HRIs) Four partnerships, each with > 1 GAI & > 1 med school Short-term Four pilot programs Integrated & shortened Scalable and generalizable Mid-term Identify best practices  refine the model Expansion across partnerships (and beyond?!) TRANSFORMATION in MEDICAL EDUCATION

4. Pre-Health Professions Program Students interested in multiple health professions learn in teams Competency-Based Education Assessment and academic advancement rely on demonstration of specified levels of performance (milestones) Professional Identity Formation Intentional approach to the personal and professional maturation of students “Non-traditional” Topics Medical and non-medical subjects not historically emphasized TIME Initiative Four Principal Elements of Model TRANSFORMATION in MEDICAL EDUCATION

5. TIME Initiative General Curriculum Model Physician Competencies Professional Formation “Non-traditional” topics Non-medical Medical TRANSFORMATION in MEDICAL EDUCATION Activities, reflection, mentorship Transition Milestones Pre- Health Professions Program Graduation Milestones Provisional admission to medical school College campusMedical campus

6. Common competency framework adopted Synthesis of ACGME & CanMEDS Six competency domains  Communication Skills and Collaboration  Professionalism  Medical Knowledge and Scholarship  Patient Care  Practice-based Learning and Improvement  Systems-based Practice and Management Common “transition milestones” identified Required before moving to medical campus 6 TRANSFORMATION in MEDICAL EDUCATION TIME Initiative Competency-based education

7. Specifying Milestones Derived from Dutch model 2009 (baccalaureate + med school) I. Decontextualized skills, knowledge, behaviors. II. Ability to apply knowledge, skills, behavior to relevant health care problems. III. Demonstrates the given competency in simulated environments. IV. Demonstrates the competency in a clinical setting under direct supervision. V. Demonstrates the competency in a clinical setting with supervision immediately available. VI. Consistently demonstrates the given competency in independent practice without need for supervision (entrustment). Competence For each competency or sub-competency: TRANSFORMATION in MEDICAL EDUCATION

8. TRANSFORMATION in MEDICAL EDUCATION Knowledge Competence Application Simulation Full Supervision Available Supervision TIME transition milestones (end of college) Specifying Milestones Derived from Dutch model 2009 (baccalaureate + med school)

9. Application of foundational science to human biology & exemplar conditions Social & behavioral sciences Complete history and physical (H&P) Focused H&P on patient with:  Normal pregnancy  A well-controlled chronic condition (e.g., diabetes, hypertension) Evidence-based medicine (literature searching) Health care system Systems science, quality improvement Interprofessional teams 9 TIME Transition Milestones Examples TRANSFORMATION in MEDICAL EDUCATION

10. Special recognition and thanks to Dr. Kenneth Shine Executive Vice Chancellor for Health Affairs University of Texas System

11. TIME Initiative Ten Schools, Four Pilot Partnerships 11 PACT UT Dallas UT Southwestern APRIME UT Pan American UT Brownsville UT El Paso UTHSC-H UTMB FAME UT San Antonio UTHSC-SA SHAPE UT Austin UTSWMS UTHSC-H TRANSFORMATION in MEDICAL EDUCATION Facilitated Acceptance to Medical Education Southwestern Houston Austin Partnership in Education Partnership for Advanced Clinical Training Accelerated Professional Relevant Innovative Medical Education Southwestern Houston Austin Partnership in Education