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Curriculum renewal

Curriculum renewal. May 2011 Update. May 2011 Update. 100 faculty 15 students. 2 00 faculty 40 students. Sept 2009 Retreat. Oct 2010 Kick-Off. Sept 2011 Phase 1 Plan Completed. Aug 2012 Phase 1 Implementation. ~ April 2013 Phase 2 Implementation. ~ April 2014

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Curriculum renewal

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  1. Curriculumrenewal May 2011 Update

  2. May 2011 Update 100 faculty 15students 200faculty 40students Sept 2009 Retreat Oct 2010 Kick-Off Sept 2011 Phase 1 Plan Completed Aug 2012 Phase 1 Implementation ~April 2013 Phase 2 Implementation ~April 2014 Phase 3 Implementation Curriculum Development organization, content Timeline Instructional Design Faculty Development Assessment Design 113faculty 25students Ongoing Curriculum Evaluation

  3. May 2011 Update Curriculum renewal Continuity Organizing principles

  4. Competency-Based Science in Medicine Integrated Structure Function Personal - Adaptive M1/M2 M3/M4 Health & Society Scientific Basis of Medicine Learner-Centered Inquiry-Driven Clinical Medicine Proposed framework Professional Development

  5. Year 2 Year 1 Year 3 Current Curriculum Year 4 SF SBM Clinical Medicine Normal Abnormal Patient, Physician, Society Proposed Curriculum Phase 1 Phase 2 Phase 3 Science in Medicine Clinical Medicine Health & Society Professional Development

  6. 4 Curricular Elements: • Clinical Medicine • Prevention, Diagnosis, Treatment, Rehabilitation, Palliation • (Diagnosis includes Hx & PE, laboratory medicine, imaging) • (Treatment includes therapeutics and technical skills) (Rehab includes transitions of care) (Palliation includes end of life care) • Medical Decision-Making & Clinical Reasoning • (MDM includes Info Acquisition & Management, EBM, Cost- Effectiveness) • Communication (oral, written, counseling, teaching) • Patient Safety and Quality Improvement • Professional Development • Area of Scholarly Concentration, “Pathways”, Professional Goals • Personal Awareness and Self-Care • Professional Behavior and Moral Reasoning • Teamwork & Leadership • Curricular Model • Health & Society • Biopsychosocial determinants of Health and Disease (Healthy People 2020) • Health Disparities, Equity and Advocacy • Health Economics and Health Systems • Global, Community and Public Health Perspectives • (Prevention includes nutrition, lifestyle medicine, behavioral change, wellness • Science in Medicine • Foundational Sciences (cellular processes, genetics, metabolism • inflammation and infection) • Normal Structure and Function • Mechanisms of Disease, Diagnosis, Therapeutic Interventions, • Disease Prevention • Organ-based, lifecycle / developmental framework

  7. Professional Development Hans Arora

  8. March 2011 Update Professional development Phase 1 Phase 2 Phase 3 Curriculum renewal Science in Medicine Clinical Medicine Health & Society Professional Development

  9. Overview A curricular element that encompasses: • An Area of Scholarly Concentration (AOSC) • Professional Behavior and Moral Reasoning/Medical Ethics (PBMR) • Personal Awareness and Self-Care (PASC) • Teamwork and Leadership (TL)

  10. Accomplishments: November 2010 • Area of Scholarly Concentration task force: Report on activities of other schools and recommendations for FSM • Professional Behavior and Moral Reasoning Competency Committee: Education and assessment blueprint • Personal Awareness and Self-Care Competency Committee: Education and assessment blueprint

  11. Progress: November 2010-March 2011 1. Convened sub-committees for four areas of Professional Development. 2. Agreement on goals, teaching activities and assessment strategies for Prologue/Phase 1. 3. Development of Pilot projects for Fall, 2011.

  12. Broad Goals for Prologue/Phase 1... • DISCUSS basic theories of teamwork and leadership (TL). • ANALYZE team structure and roles for a team that they are currently on (TL). • UNDERSTAND basic research designs in biomedical research (AOSC). • DEVELOP a 4 year plan for an area of scholarly concentration in research, education or community service (AOSC) • IDENTIFY, ANALYZE and JUSTIFY appropriate ethical and legal choices in the care of patients and their families (PBMR)

  13. …Broad Goals for Prologue/Phase I • IDENTIFY, ANALYZE, and JUSTIFY ethical choices in the healthcare systems in which they work, including issues of access to care and conflicts of interest (PBMR) • BEHAVE with honesty, integrity, respect, and compassion toward all patients, families, students, faculty, and other healthcare professionals (PBMR) • CREATE a 4 year plan for personal awareness and self-care(PASC)

  14. Pilot Projects for 2011… 1. Teamwork and Leadership: - Course with Northwestern Center for Leadership on teamwork & leadership for medical students - Develop structure/ framework for team analysis of a current team 2. Professional Behavior and Moral Reasoning: - Develop new assessment for current ethics and values course (M1)

  15. …Pilot Projects for 2011 3. Personal Awareness and Self-Care: - Develop guidelines for mentor/student 4 year plan for personal awareness and self- care. 4. Area of Scholarly Concentration: - Update medical decision-making (MDM) course to reflect goal of developing a research project/plan with a preceptor. - Convene one regular AOSC interest group to meet monthly.

  16. Ongoing challenges and opportunities • Integrate with Clinical Medicine and the Patient Centered Medical Home: • Opportunities for PBMR, TL, PASC • Integrate with Health and Society: PASC • Make one assessment “count” for multiple competencies/curricular elements

  17. Questions/Comments?

  18. March 2011 Update Health & Society Phase 1 Phase 2 Phase 3 Curriculum renewal Science in Medicine Clinical Medicine Health & Society Professional Development

  19. Health & Society CEG Healthy People 2020 www.healthypeople.gov

  20. Prologue:Students learn about themselves • Health Risk Appraisal (HRA) • Lifestyle factors and readiness to change • Biometric and laboratory results • Compliance with recommended preventive screenings • Existing chronic conditions • Future disease risk factor • Personal environment • Personal and group results • Behavior Change Plan (BCP) • Reanalysis of HRA results • Personal and group results

  21. Prologue:Students learn about others • Textbook Chicago • Chicago bus tour of 6 communities to assess the 4 determinants of health (social environment, physical environmental, health services, individual behavior) • SES • Racial/ethnic demographics • Built environment • Health care access & delivery • Prevalence of selected health conditions • Presentations and discussion of health outcome disparities regarding determinants of health

  22. Overarching themes • Determinants of health • Disparities in health outcomes • Public health • Community and global health • Health service delivery • Physician roles • Professional well-being • Advocacy • Communication / motivational interviewing/ behavior change • Interdisciplinary learning • Lifestyle Medicine Thread

  23. Science in Medicine Committee Andy Reese Nick Macpherson May 2, 2010

  24. Year 2 Year 1 Year 3 Current Curriculum Year 4 SF SBM Clinical Medicine Normal Abnormal Patient, Physician, Society Proposed Curriculum Phase 1 Phase 2 Phase 3 Science in Medicine Clinical Medicine Health & Society Professional Development

  25. Still an organ based approach, but with normal/abnormal taught simultaneously • Long Prologue (13 weeks) at the beginning to introduce fundamental concepts • Lasts from August 13, 2012 to March 28, 2014 • Shortened summer between M1 and M2 year • 5 weeks of MDM are no longer blocked out • Includes three 1-week Integration and Synthesis Modules Phase 1 Overview

  26. Phase 1 Sequence of Science in Medicine Modules: YEAR 1 1 week 4-MAR-13 to 8-MAR-13 VII I II III IV V VI 4 weeks 20-MAY-13 to 14-JUN-13 4 weeks 22-APR-13 to 17-MAY-13 2 weeks 8-APR-13 to 19-APR-13 13 weeks 13-AUG-12 to 9-NOV-12 6 weeks 12-NOV-12 to 17-DEC-12 4 weeks 2-JAN-13 to 1-FEB-13 4 weeks 4-FEB-13 to 1-MAR-13 3 weeks 11-MAR-13 to 29-MAR-13 Integration & Synthesis Module Head & Neck Prologue Cardio- Vascular Pulmonary Renal Musculo Skeletal Derm. Area of Concentration Summer Break Holiday Break SiM Spring Break Orientation CM H & S PD Competency-Based, Gateway Assessments with Portfolio Reviews

  27. Phase 1 Sequence of Science in Medicine Modules: YEAR 2 1 week 19-AUG-13 to 23-AUG-13 2 weeks 30-SEP-13 to 11-OCT-13 1 week 14-OCT-13 to 18-OCT-13 1 week 17-MAR-14 to 21-MAR-14 1 week 24-MAR-14 to 28-MAR-14 VIII IX X XI XII XIII XIV Break 5 weeks 26-AUG-13 to 27-SEP-13 3 weeks 21-OCT-13 to 8-NOV-13 5 weeks 11-NOV-13 to 13-DEC-13 5 weeks 6-Jan-14 to 7-FEB-14 5 weeks 10-Feb-14 to 14-MAR-14 Pharmacology / ANS END Of Phase One 28-MAR-14 Integration & Synthesis Module Integration & Synthesis Module GastroIntestinal Holiday Break Reproductive Urogenital Hematology Neurology Psychiatry Endocrine Oncology Competency-Based, Gateway Assessments with Portfolio Reviews

  28. Prologue • Concepts that are fundamental to understanding every organ system • Synthesis of first two units from Structure Function and Scientific Basis of Medicine • SF: Fundamentals of Cellular Function, Intro to the Human Body • SBM: Toolbox 1 and 2 • Distilled ~20 weeks of material into 13 weeks

  29. AUGUST 2012 MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY 1 2 3 6 7 8 9 10 Introduction Themes, Threads The Cycle: Determinants, Mechanisms, Presentation, Treatment, Prevention 13 14 The Cell Structure, function, organelles The nucleus The Cell Macromolecules, carbohydrate, lipids, A & N acids, inorganics Enzyme mechanisms, kinetics, regulation 15 16 The Cell Membranes and their molecules Localization of proteins to organelles The Cell Molecules of organelles, Golgi complex and ER Endocytosis, lysosomes 17 Receptors & membranes Ligands, locations, classification 7 trans-membrane receptors, G proteins, Gs, Gi, Go, etc. 20 21 22 23 24 Receptors & membranes Membrane potentials Ion channels and pharmacology Receptors & membranes 2nd messengers, signal term., kinases, phosphatases Membrane transport Receptors & membranes Ion channels and pharmacology Cytoskeleton, actin, myosin Genetics Structure & elements of genes Chromosomes, telomeres, repeat seq.s, non-coding, sRNA, transposable elements Genetics Cell cycle, stem cells, mitosis, meiosis, DNA replication, crossing over Fertilization and early embryogenesis Genetics Control of gene expression, transcription, regulation, homeobox Protein translation Genetics Regulation and post-translational modification, methylation Mutation, misfolded protein response Genetics Mendelian inheritance: segregation, assortment, Hardy-Weinberg, linkage Haplotypes, linkage disequilibrium, linkage studies Genetics Multifactorial & complex traits, population genetics Genetic variation 27 28 29 30 31

  30. SEPTEMBER 2012 MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY Genetics Pedigree analysis Autosomal recessive disorders 3 Genetics Autosomal recessive disorders Autosomal dominant disorders 4 Genetics Congenital anomalies Trinucleotide repeats and diseases (includes fragile X) 5 Genetics Chromosome abnormalities (non-dysjunction, meiosis I vs. meiosis II errors, translocation) Developmental toxicology 6 Genetics Gene therapy Genetic counseling 7 10 11 12 13 14 Genetics Approaches to treatment of genetic disorders Development and pattern formation (incl. homeobox) Genetics Prenatal diagnosis Contiguous gene deletions Genetics Imprinting/uniparental disomy Mitochondrial genetics and diseases Genetics Newborn screening Pharmacogenetics Genetics Genetic counseling Approaches to treatment of genetic disorders 18 19 20 21 17 Genetics X chromosome, inactivation, pseudoautosomal regions, Turner syndrome Diseases: neurofibromatosis, Marfan, hemoglobinopath, PKU Cell Metabolism ATP-ADP cycle, glycolysis TCA cycle, ketone bodies, oxidative phosphorylation Cell Metabolism Synthetic pathways, gluconeogenesis Mitochondria Cell Metabolism Mitochondrial mutations and defects Genetics Genetic screening, prenatal & cancer risk screening Behavioral genetics Human Body The four tissue types Human Body Epithelium: lateral domain, cell-cell adhesion, basal domain, glands, epithelial cell renewal Connective tissue (less on collagen, please) Human Body Histology of cartilage; hyaline, elastic, fibrocartilage. Organization, development. Histology of bone, compact/trabecular, osteo -blasts, -cytes, -clasts Human Body Bone metabolism and development Muscle types: striated (skeletal, cardiac), smooth Human Body Muscle: mechanism of contraction Blood and circulation Human Body The cadaver Epithelium: classification, apical domain; microvilli, stereocilia, cilia 24 25 26 27 28

  31. OCTOBER 2012 MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY 1 Human Body Arteries, veins, lymphatics Somatic nervous system, neurons, development, subdivisions, dorsal and ventral roots, dermatomes 2 Human Body Autonomic nervous system: sympathetic/parasympatheticenteric, cell locations Embryogenesis: gastrulation, placenta Human Body Embryogenesis: vertebrate body plan 3 Pathology Cell adaptation, injury, death Hyperplasia, hypertrophy, etc. oxidative stress, reactive oxygen species, free radicals 4 Pathology Response to hypoxia, heat shock proteins Mechanisms of cell injury, necrosis, apoptosis, aging 5 Pathology Introduction to pathology 8 9 10 11 12 Pathology Functional properties of tumors Molecular basis of cancer Pathology Carcinogenic agents Chemotherapy 1 Pathology Chemotherapy 2 Radiation biology Pathology Radiation therapy Biologic modifiers Pathology Introduction to oncology Tumor growth 15 16 17 18 19 Pharmacology Excretion Drug metabolism 1 Pharmacology Drug metabolism 2 Pharmacokinetics 1 (keep Dr. Yeh’s organization) Pharmacology Pharmacokinetics 2 Pharmacokinetics 3 (keep Dr. Yeh’s organization) Microbiology Introduction to microbiology, virology, parasitology RNA viruses: flu, polio, HCV, SARS, HIV, rubella, rotaviruses Pharmacology Absorption and transport Distribution Microbiology DNA viruses: CMV, HSV, VZV, parvoviruses, HBV Viral oncogenesis and immune evasion Microbiology Bacterial structure, physiology, genetics, therapeutics, antimicrobials 1 Bacterial structure, physiology, genetics, therapeutics, antimicrobials 2 Microbiology Fungal structure, laboratory diagnosis, therapeutics 1 Fungal structure, laboratory diagnosis, therapeutics 2 Microbiology Features of parasites, morbidity & mortality, therapeutics 1 Features of parasites, morbidity & mortality, therapeutics 2 Immunology Introduction Innate immunity 22 23 24 25 26 Immunology Lymphocyte activation Cytokines Immunology Effector functions in cell mediated immunity Effector functions in humoral immunity Immunology Antibody and T cell receptor structure & function HLA and antigen presentation 29 30 31

  32. NOVEMBER 2012 MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY 1 Immunology Host defense against pathogens Immunological tolerance and principles of autoimmunity Immunology Transplantation immunology Immunopathology: amyloidosis 2 5 6 7 8 9 Immunology Cell and molecular mechanisms of inflammation Resolution of inflammation and tissue repair Prologue Exam Immunology Hypersensitivity Immune deficiencies 12 13 14 15 16 Cardiovascular Module begins (6 weeks duration) 19 20 21 22 23 26 27 28 29 30

  33. Learning Cycle

  34. Challenges Ahead • Content delivery (lecture, TBL, simulation, etc.) • Maximize efficiency of instruction • Anatomy/histology labs • Assessment of student progress • Expectations of students (preparation) • Integration and synthesis modules

  35. Thank you for your attention. Questions?

  36. Clinical medicine Phase 1 Phase 2 Phase 3 Science in Medicine Clinical Medicine Professional Development

  37. Injecting clinical exposure into the science curriculum • Scenario • CV Unit • Menu of Clinical Experiences Available Online • Your interests guide your exposure • Defined educational objectives with focused preparation and engagement The Focused Clinical Experience

  38. Continuity

  39. Current Curriculum PCMH FCE Proposed Curriculum Phase 1 Phase 2 Phase 3 Science in Medicine Clinical Medicine Health & Society Professional Development

  40. Questions/Comments?

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