Curriculum Reform is Moving Forward

We are pleased to report that the EVMS MD Program Curriculum Reform movement is moving forward.   While we have been making steady progress over the last few years, the progress over the last few months has been marked.    That progress was obvious at the February Faculty Retreat held on Saturday morning, February 8th.    Over 60 faculty members gathered to dream and then plan for how curriculum reform should move forward.    

The Curriculum Reform Committee had previously identified emerging themes and so working groups were established to 1) define the key issues related to each emerging theme, 2) identify measures of success, 3) plan next steps, and 4) establish a timeframe for progress.    One of the key outcomes of this retreat was that the faculty took the conceptual emerging themes and made them real.    Below is high-level overview of the progress by theme.

  

Professionalism

Definition.  Professionalism is the decision/committment to strive for excellence and continuous improvement in knowledge and skills, education of others, altruism, communication and duty and service and to reflect a social contract with the communities served. 

Measures.  Combination of quantitative to allow students/faculty to follow development over time and identify those who deserve special recognition or individual assistance to further develop and brief narrative outlining strengths and areas for further growth. Also need method to identify/report isolated incidents to allow identification of more pervasive problems.

Timeframe.   Implement pilot program Fall 2014.

To Connect With This Team:  In Blackboard, select EVMS 2.0 – Faculty Development > Curriculum Reform Retreat > February Retreat > Professionalism

Formation of the Clinical Mind (Integrated Cases)

Definition.   Patient centered (longitudinal cases), multidisciplinary (integrating different courses and health-care professions), realistic, life-long learner, case-based learning, application of clinical knowledge to build clinical reasoning skills, encourage critical thinking.

Methods.   Representatives from more than one course and health care professions for long term cases and more clinical-based questions for our students.  We will use patient-centered cases with real patients or show videos of patient cases.

In the 3rd and 4th year: Stress students returning to foudnational sciences.

We would start integrating cases from the beginning of medical school to incorporate clinical reasoning skills with foundational science knowledge. This skill must be continued in the 3rd and 4th year, as board exams increasingly stress basic science questions.

We plan to utilize existing cases (example Mass Gen, NEJM case discussions).

Timeframe.   Now: gather data and establish baseline for clinical cases in current curriculum.  Next, create the integrated cases.   Then, start a step-wise process for integrating longitudinal cases in Fall 2014.  

To Connect With This Team:  In Blackboard, select EVMS 2.0 – Faculty Development > Curriculum Reform Retreat > February Retreat > Integrated Cases

Interprofessionalism

Definition.   Our students will learn about other health disciplines, how to provide patient centered care in a team environment and will be deployed in teams as learners to exploit cross professional expertise to benefit patient care.

Measures.    

  1. Use validated IEP tools examples like: Heartford geriatric; IEPS, RIPLES, ATHCT.  
  2. Additionally we could use the simulation center to look at how different professions evaluate the same case and patient. The teams of evaluators should be made up of the different discipline practitioners.

Timeframe.  Now: Start focus groups at EVMS, discuss possibilities with program directors, analyze current curriculum map to establish current state.   By Fall 2014, work with various departments and look to integrate interprofessional panel discussions in the curriculum. 

To Connect With This Team:  In Blackboard, select EVMS 2.0 – Faculty Development > Curriculum Reform Retreat > February Retreat > Interprofessionalism

Service Learning (The Curricular Component to Community Impact)

Definition of Community Impact.  Improving the lives of community members through involvement of students, faculty, and staff.    A community is a defined population which lives in the same place or has a characteristic in common.  We must encourage health equity as a key value.

Philosophy.   In service learning, we move the ‘big needle’ in local health challenges best through affecting the "needle movers."   Through experiences that build vision, values, and skills in doing this...  It is out students’ cumulative impact that will make the community-wide difference.  

Measures.
1. EVMS faculty/staff donated to community service.2. We measure all the student contact hours.
3. As measured by student attitude surveys, are attitudes and beliefs.
4. As measured by peer evaluations, mentor evaluations, client evaluations.
5. Student longitudinal self-reflection.
6. Measure activity participation.
7. Measure contact numbers, hours, results.
8. Does the curriculum address broadly relevant health challenges?
9. Do service learning opportunities address community needs?
10. Measure community perceptions, match to initiatives.

Timeframe:  The Service Learning Inventory Group will report findings and make recommendations this Spring.

To Connect With This Team:  In Blackboard, select EVMS 2.0 – Faculty Development > Curriculum Reform Retreat > February Retreat > Community Impact            This team meets every other Monday at noon.   Contact Don Robison at robisodg@evms.edu if you are interested in joining them. 

Capstone

Definition.   The EVMS Capstone represents the culmination of a student’s four year training journey and offers multiple methods of reassuring themselves, their peers and their mentors of their preparedness to successfully move to their next phase of their lifelong careers as passionate and competent clinicians, community health managers, leaders who will excel in excellence, collegiality and integrity.

Outline of Experience

The capstone block would occur at the end of the 4th year following the match and involves two major components:

1.  A month long post-match RIME readiness training opportunity where students can receive both general and specialty specific preparations for becoming successful residents.

2. Capstone project is a longitudinal project that would be introduced to students immediately upon matriculation and would be presented during the capstone block at the end of 4th year. This project would necessitate mentor involvements and multiple structured benchmarks throughout the 4 years as well as structured curricular time committed to the

Timeframe.   The Capstone committee meets monthly.   The next project team meeting is on March 12, 2014 at 8:00am in the conference room next to Dr. Flenner's office.  Initial implementation goal of Fall 2014-2015 start.  A great deal of planning, coordination, design, approval and implementation work is planned over the next many months.  

To Connect With This Team:  In Blackboard, select EVMS 2.0 – Faculty Development > Curriculum Reform Retreat > February Retreat > Capstone Project

 

General Progress in Curriculum Reform

In addition to the work in the reform theme groups, specific progress is being made on several other fronts, as well:

  1. Testing has successfully transitioned from paper-and-pencil to electronic formats.   This has given us the ability to conduct in-depth item by item analysis, among other benefits.
  2. We continue to make strides in moving active learning from a “sometime” event to a routine.   The Office of Medical Education has launched an Instructor Tools website that supports instructors in this movement.
  3. The Office of Medical Education is also nearing completion of the C-Map database that will make our curriculum much more ‘visible.’  That is, it will give us the ability to see how our curriculum fits together much more clearly.  
  4. In our routine audits of courses, expect to see greater integration and sharpening of objectives.    We are positioning ourselves to move away from ‘identification’ objectives to more applied and practical ones.  

Expect to see the incorporation of web-based job aids to assist instructors navigate their tasks in the near future.   

To Connect on These Issues:  Contact the MD Program instructional designers, Julie Bridges or Don Robison.