curricular “revitalization” of year 1
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Curricular “Revitalization” of
Year 1
Frazier Stevenson, MDAssociate Dean for Undergraduate Educational Education
Stanley Nazian, PhDYear 1 Faculty Lead
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
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.
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”)
Current Year 1
New Curriculum: Designed March 2010
Doctoring
Evidence Based Clinical Reasoning
Core Principles &
Musculoskeletal System
Communication: Neurologic & Endocrine
Systems
Cardiovascular & Pulmonary
Systems
Renal, Gastro-intestinal and Reproductive
Systems
Molecular Relationships Competency (e.g. molecular biology)
Functional Relationships Competency (e.g. physiology)
Structural Relationships Competency (e.g. anatomy)
Human/Behavioral Relationships Competency (e.g. behavioral science)
2 wks 8 wks 8 wks 8 wks 8 wks
Aug w Oct Jan March
Proposed Realignment Physical Diagnosis I+II Longitudinal Clinical
Experience I+II On Doctoring / Ethics
Clinical Problem Solving Evidence Based Medicine
(from EBCP)
Current EBCP without the EBM formal curriculum
“Doctoring I and II”
“Evidenced Based Clinical Reasoning I and II”
“Introduction to Clinical Medicine” (Year 2)
“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
“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
“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
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
presentation2 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)
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 presentation2 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
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