Curricular Reform Planning

1. Curricular Reform Planning School of Medicine 2009- 2012

2. Co-Directors • Basic Science • Alison O’Brien, PhD • Chair, Microbiology and Immunology • Clinical Science • Louis Pangaro, MD • Chair, Medicine

3. Why? • Practice of medicine has changed dramatically • Integration now a priority in accreditation • Relevance to patient • Student learning styles have changed • Adult learning; technology; life long learning • Creative curricular opportunities • MD-MPH; MClinRes; MMilMed

4. Process • Discovery (Jun 09-Nov 09) • Office of the Dean became convinced • Sought input from other SOMs • Sought the “recipe” (there is none) • Go/No Go decision has been made • We will have Curricular Reform

5. Process • Development (Dec 09-Sept 10) • Faculty must develop; Dean will execute • Faculty leadership • Alison O’Brien, PhD, Chair, Microbiology and Immunology • Louis Pangaro, MD, Chair, Medicine • Faculty, residents, students MUST participate • Broad stakeholder input will be sought • Goals must be maintained even in face of potential obstacles

6. Process • Operationalization (Oct 10-July 11) • Plan pre-clerkship curricular segments • Lecture changes • Small groups curriculum • Online and distance learning • Room schedules adjusted • Manage obstacles • Testing mechanism revised • Clinical rotations reformulated

7. Process • Implementation (Aug 11-July 12) • Evaluate • Make adjustments • Continuous evaluation and adjustment • Establish monitoring and outcomes process for continuous feedback 7

8. “Givens” • Dean • SOM Goals and Objectives • More integration • Early clerkships • No increase in contact hours • Some increase in SOM budget • Full support from Office of the Dean • Office of Curriculum Reform • Budget and personnel support

9. Discovery: June – Nov. 2009 Development: Dec. 2009 – Sept. 2010 Operationalization: Oct. 2010 – July 2011 Implementation: Aug. 2011 – July 2012 Class of 2015 Transition, early benefits for classes of 2013, 2014 New steady-state (transition completed) Continuous evaluation and adjustment Summary Timeline

11. Theme “Molecules to Military Medicine” • Working toward a goal: medical care • In the military (the educational context) • Scientifically based (the educational “driver”)

12. Educational Orientation • A switch from what teachers provide to what learners master and can demonstrate • Learners must fulfill a promise of duty and expertise • In each phase, real responsibility for real patients

13. Advisory Group • Brian Reamy, MD, Chair of Panel • Val Hemming, MD, Former Dean • Brian Cox, PhD, Former Chair • Saibal Dey, PhD, Associate Professor • Patricia McKay, MD, Commandant • Edward Mitre, MD, Assistant Professor • Michael Johns, MD, Board of Regents

14. What does success look like? • What will a USU graduate be able to do?

15. Given a Traumatic Amputee Wound Infection, a USU Grad • Will apply scientific knowledge to each aspect of the patient’s care • shock, wound healing, infection, PTSD, pain, family support, … • Will recognize and manage unexpected complexities of the case • Will develop evidence-based algorithms for other medical care personnel to follow

16. Questions to be Addressed • How tightly can basic and clinical sciences be linked? • Neuroanatomy and function learned in conjunction with care of patients with TBI and PTSD, • Will the clerkships look the same? • Same goals/assessments? • How will basic science be integrated? • Post-clerkship science • Required core for all students • Selective based on GME choice • PhD students – same classes?

17. Barriers and risks • Resources needed – to develop and sustain • Faculty time to develop new materials • Faculty - incentives and time for research • Insufficient faculty to supervise students right now • Effort wasted

18. What we Intend to Produce: • New curricular structure • Phase-in Plan: • 1 -2 year resources • Benefits for students before class of 2015 • Recommendations for system for monitoring of curriculum?

19. Curricular Impact Model Health Learning Resources Curriculum Inputs Students Teachers Patients Syllabus Process Curriculum Environment Fac. Develop Facility Product Assessments Accreditation Licensing Impact Patients GME MHS

20. Reform Process • Resources (Inputs ) • Students, Student Affairs, Commandant, Admissions • Faculty and Faculty Senate • Chairs • Hospitals & Facilities • Curriculum (Process) • Course and clerkship directors • Chairs • Students • ECC and Dean’s office • Outcomes & Impact (Products) • USU Grads • GME program directors • SGs/ MHS leaders

21. Major Committees • Pre-clerkship Group • Clerkship Group • Post-clerkship Group • Assessment : Monitoring, Outcomes, Impact

22. Overview of Efforts to do the Work Impact Outcomes Outputs Resources Inputs Activities • New curricular structure • Transition Plan • Curricular System • Committees Planned Work Intended Results

23. Summary Timeline • Discovery: June – Nov. 2009 • Development: Dec. 2009 – Sept. 2010 • Operationalization: Oct. 2010 – July 2011 • Implementation: Aug. 2011 – July 2012 • Class of 2015 • Transition for classes of 2013, 2014 • New steady-state (transition completed) • Continuous evaluation and adjustment

24. Questions?