Curricular

1
Curricular Revitalization of Year 1

• Frazier Stevenson, MD
• Associate Dean for Undergraduate Educational
  Education
• Stanley Nazian, PhD
• Year 1 Faculty Lead

2
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

3
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.

4
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)

5
Current Year 1
6
New Curriculum Designed March 2010
7
Proposed Realignment

• Doctoring I and II
• Evidenced Based Clinical Reasoning I and II
• Introduction to Clinical Medicine (Year 2)

• Physical Diagnosis III
• Longitudinal Clinical Experience III
• On Doctoring / Ethics
• Clinical Problem Solving
• Evidence Based Medicine (from EBCP)
• Current EBCP without the EBM formal curriculum

8
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

9
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

10
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

11
A month in Doctoring and EBCR for an MS1 during
the cardiopulmonary course
WEEK Monday Tues Wed Thursday Friday
1 AM Lecture demo on cardiac exam Free   PM Small Group in CACL examine heart PM traditional LCE
2   Free AM 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)
12
A month in Doctoring and EBCR for an MSII during
the cardiovascular block
WEEK Monday Tues Wed Thursday Friday
1 AM Lecture demo on abnormal cardiac exam Free PM Small Group in CACL simulator heart murmurs, examine heart PM Inpatient complete H and P
2 AM EBCR Lecture on Randomized Controlled Trials Free AM Humanities presentation 1 PM Ethics presentation 2 PM Small Group communication with SP PM meet inpatient preceptor to go over H and P, presentation
3 Free PM Small Group Presentations from complete H and Ps PM traditional LCE
4 Free PM Small Group CPS case PM traditional LCE