Title: CORE COMPETENCIES: WHAT DO MEDICAL STUDENTS REALLY NEED TO KNOW ABOUT PATHOLOGY WHAT, WHEN, BY WHOM,
1CORE COMPETENCIESWHAT DO MEDICAL STUDENTS
REALLY NEED TO KNOW ABOUT PATHOLOGY?WHAT, WHEN,
BY WHOM, HOW MUCH?
Chuck Hitchcock, Ohio State University Regina
Gandour-Edwards, UC Davis Vinay Kumar, University
of Chicago
2POINTS OF DISCUSSION
- What
- What does core competency mean in undergraduate
medical education? - Why core competencies?
- Subject material
3What Does Core Competency Mean In Undergraduate
Medical Education?
- Development of core competencies will alter the
overall design of the curriculum. - Problems with implementation
- Lack of interest
- Too many myths
- Ineffective assessment tools
4WHY CORE COMPETENCIES
5CORE COMPENTENCIES IN PATHOLOGY
- Effective communication
- Basic clinical skills data interpretation
- Basic science knowledge
- Life-long learning
- Problem-solving
- Professionalism and role recognition
6CORE COMPENTENCIES IN PATHOLOGY
- Well defined objectives
- Well defined assessment criteria
7SUBJECT MATERIAL
- Basic mechanisms of disease
- Communicate with depts. of genetics,
biochemistry, cell biology, immunology,
microbiology, and medicine - Vocabulary of disease
- Prioritize subject material how?
8AP - SUBJECT MATERIAL
- Normal vs. Abnormal Morphology
- Lectures
- Lab / small group exercises
- Microscopes vs. images (virtual slides)
- Gross specimens
- Autopsy experience
9CP - SUBJECT MATERIAL
- Normal vs. Abnormal Lab results
- Lectures
- Lab / small groups
- Morphologic features blood smear, CSF,
cultures, etc. - Interpretation of clinical tests
10EFFECTIVE COMMUNICATION
- Patients
- Patients family
- Colleagues
11BASIC CLINICAL SKILLS DATA INTERPRETATION
- Identification of the most frequent clinical,
laboratory and pathologic manifestations of
common diseases. UNC
12BASIC SCIENCE KNOWLEDGE
- Clear objectives
- National core pathology curriculum
13OTHERS
- Life-long learning
- Problem-solving
- Professionalism and role recognition
- TBL as a possible mode
14CURRICULAR CHANGESASSESSMENT
- Assessment methods must match the learning
modality. - Students are entitled to learning experiences
that will adequately represent the assessment
methods.
15CURRICULAR CHANGESWHERE TO ASSESS
- Audience response systems
- Exams
- MCQ
- Practical exams
- Small group exercises
- Team Based Learning (TBL) exercises
- Problem Based Learning (PBL) exercises
- Case based
- Information presentation
- Autopsy exercise
- USMLE
16CORE COMPENTENCIES IN PATHOLOGY
DO
KNOW HOW TO DO
KNOW HOW
KNOW(LEDGE)
17POINTS OF DISCUSSION
- When
- Preclinical years 1 and 2
- Years 3 and 4
- Clinical elective
- Required clerkship
18POINTS OF DISCUSSION
- By Whom
- Pathology faculty
- MD
- PhD
- Non-pathology clinical faculty
- Residents
- Fellows
19WHO ELSE HAS CORE COMPETENCIES
- Assoc. Professors of Gynecology and Obstetrics
- Association of Professors of Human of Medical
Genetics 1998
20WHO ELSE HAS CORE COMPETENCIES
- UNC entire curriculum
- Detailed pathology participation in each of the
competencies - UF Path Dept. knowledge, problem-solving and
professional behavior - Etiology, pathogenesis, structural
manifestations, and natural course of various
diseases. - Vocabulary
- Role of the pathologist
- Skill in ordering lab tests
- Skill in developing ddx
21POINTS OF DISCUSSION
- Do core competencies equal objectives?
22HOW MUCH?
23From an address by Eugene F. Dubois to medical
students of Cornell University Medical College at
the beginning of the college year, 1923
"...as...facts have increased in number, the
teachers of medicine have increased the rate of
cramming the students. This has developed the
method of 'spoon feeding.' Our students resemble
domestic fowls fattening for the market,
expecting their food to be served to them on
trays. We should prefer to have game birds who
know how to find their own food. You can take
all the courses listed in the catalogue, work
hard, pass all your examinations, and yet make an
utter failure of your course in the medical
school. The best that we can teach you now will
be hopelessly inadequate in another decade.
24From an address by Eugene F. Dubois to medical
students of Cornell University Medical College at
the beginning of the college year, 1923 cont.
You must teach yourself to study the medicine
of this decade in such a manner that you can
teach yourself the medicine of the next decade.
You must learn to do your own searching for
knowledge. You must develop your own powers of
observation and critical judgment. You must
learn how to use the literature and must prepare
yourself to substitute your own wards, your own
laboratories, and your own libraries for those of
this medical school..."
25Core Competency In Pathology
- PATHOLOGY SPECIFIC
- A data base of facts that form the foundation of
medicine, selected from basic disease mechanisms
and common and illustrative disorders - PATHOLOGY FACILITATED
- Ability to integrate information from diverse
sources to build on the data base and apply it to
solve problems - Acquire the tools to manage the ever-growing
databases
26The Current State
- Excessive attention to impart an ever increasing
data base cramming of new information into
progressively shorter schedules (we teach too
many facts) - Insufficient attention to tools of data gathering
, synthesis, and application (we do not teach
how to acquire facts and to apply them) -
27The Solution
- Reduce the content and define it by clearly
spelled out and accomplishable objectives - Introduce data gathering and analytic skills
(Text books,Pub Med searches, Journal clubs, yes
I do mean journal clubs) - Devise objective driven exercises that require
the application of the above to solve problems