Innovating and Updating the Medical School Curriculum

Innovating and Updating the Medical School Curriculum

Wednesday, June 23, 2010

The New York Academy of Sciences

Presented By

Presented by the Josiah Macy, Jr. Foundation and The New York Academy of Sciences

 

Despite vast advances in biomedical research and technology, the medical school curriculum has remained mostly static for the past half century. However, a select group of medical schools have begun to implement innovative curricula based on new methods of physician training and technologies for learning that integrate basic science with clinical medicine (e.g., Patient-Based Learning, Organ Modules, Computer Simulation of Procedures, and E-Learning). This conference will convene medical school deans, medical students, new physicians, senior physicians, governing boards, accrediting institutions, and health profession educators to discuss these curricula and new technologies in medical school education. The goals of this conference are to highlight new models for physician training motivated by advances in science and technology, to consider how to more closely link science and clinical training in the medical school curriculum, and to make this information available for dissemination to the public.

This conference is the inaugural meeting of our Translational Medicine Initiative.

Presented by

Gold Sponsor 


This event is funded in part by the Life TechnologiesTM Foundation.

 

For a complete list of sponsors, please click on the Sponsor tab.

Agenda

*Presentation times are subject to change.


Wednesday, June 23, 2010

8:15 am

Registration and Breakfast

9:00 am

Opening Remarks
Stacie Bloom, PhD, The New York Academy of Sciences
George Thibault, MD, The Josiah Macy, Jr. Foundation

Session I: Linking Science and Clinical Training in Medical School

9:30 am

Linking Science and Clinical Training in Medical School - Mount Sinai’s Perspective
Erica Friedman, MD, Mount Sinai School of Medicine

10:00 am

A New Paradigm for Teaching and Training Medical Students for the 21st Century: University of Pennsylvania School of Medicine Thirteen Years After Implementation
Gail Morrison, MD, University of Pennsylvania School of Medicine

10:30 am

Biomedical Science: A Critical Component of the Weill Cornell Medical College Educational Program
Carol Storey-Johnson, MD, Weill Cornell Medical College

11:00 amCoffee Break

11:30 am

Innovating and Updating the Medical School Curriculum: Time for a Paradigm Change
Charles Wiener, MD, Johns Hopkins School of Medicine

12:00 am

Panel Discussion: Integrating the teaching of science and clinical medicine to make science relevant in clinical practice

12:45 pm

Lunch

Session II: Incorporating New Technologies in Medical School Teaching

2:00 pm

Can Technology-Enhanced Patient Simulation Enhance the Flexnerian Ideal
Nancy E. Oriol, MD, Harvard Medical School

2:30 pm

The Promise and Peril of Technology in Medical Education
Clarence H. Braddock, MD, Stanford School of Medicine

3:00 pm

Transformative Educational Technologies and the Curriculum for the 21st Century
Marc M. Triola, MD, NYU School of Medicine

3:30 pm

Coffee Break

4:00pmCritical Issues to Model for 21st Century Physicians
Gerald Healy, MD, Harvard Medical School

4:30 pm

Panel Discussion: How to use technology as an educational tool

5:30 – 6:45 pm

Networking Reception

Speakers

Clarence Braddock III, MD

Stanford School of Medicine

Dr. Braddock is Professor of Medicine and Associate Dean for Medical Education at Stanford University School of Medicine and Director of Clinical Ethics at the Stanford Center for Biomedical Ethics. His main research interests include in physician-patient communication and informed decision-making, having developed an assessment scale of the quality of informed decision making in clinical practice and applying it in published studies of informed decision making in a number of areas, such as intensive care units, orthopedic surgical practice, and preventive and screening services. His work in this area has extended into cultural competence, and he is currently leading an effort among eighteen medical schools to developing curriculum in cultural competence and healthcare disparities.

Dr. Braddock received his undergraduate degree from Stanford University, his M.D. degree from the University of Chicago, internal medicine training in the US Navy and his MPH in Health Care Ethics from the University of Washington. He moved to Stanford in 2003, as Director of “Practice of Medicine,” a new curriculum effort at Stanford to integrate ethics, professionalism, evidence-based medicine, doctor-patient communication, and clinical practice into the first two years of the medical school curriculum. He has served as Associate Dean for Medical Education at Stanford since 2007, one of a number of institutional leadership roles in medical education that he has filled over his career.

Dr. Braddock is Director of Clinical Ethics at the Stanford Center for Biomedical Ethics, a role that spans clinical ethics consultation, institutional policy, and health professions education in bioethics. He has twenty years of experience in bioethics education, including development of a web-based ethics curriculum, interactive on-line case discussion tools, and several new clerkship-based ethics case discussion experiences

Erica Friedman, MD

Mount Sinai School of Medicine

Dr. Erica Friedman is the Associate Dean for Undergraduate Medical Education at the Mount Sinai School of Medicine (MSSM).  In that capacity, she oversees the curriculum and assessment for the entire medical school.  In addition, she is the Medical Director of the Morchand Center for Clinical Competence, which is a state of the art Standardized Patient (SP) Center that assesses clinical skills including history taking, physical examination, communication and cultural competency.

She has created two comprehensive assessment exercises that occur at the end of the second and third years of medical school that use written and SP cases to assess medical students' clinical skills in patient management, ethical issues and evidence-based medicine. She has written multiple SP cases including cases requiring communication of an error to a patient, and obtaining consent for an autopsy; and she also has created written assessments that are linked to the SP cases to assess residents' ability to recognize a medical error, propose a solution and communicate with the patient.

She received a grant from the AAMC "Enhancing Education about Chronic Illness" to implement a longitudinal curriculum around caring for patients with chronic illness, and the Mannix Award from the Medical, Educational and Scientific Foundation of New York for a project entitled "Recognition and Communication of Medical Errors: A Three-Year Curriculum for Internal Medicine Residents", and is Co-Investigator on the Attorney General's Prescriber Education Program Grant, "Data Smog and Marketing Fog: A Critical Skills Curriculum to Educate Health Professionals about Rational Prescribing". She is a co-chair of the Cultural Competency Curriculum and Evaluation Committee for the Center for Multicultural Affairs and in that role, has developed curricular goals and assessment tools for addressing cultural competency at MSSM. In addition, she is an Internist and Rheumatologist who runs the Mount Sinai Arthritis Clinic and teaches medical students, Internal Medicine residents, and Rheumatology fellows. Her interests include enhancing physician-patient communication, promoting effective health care teamwork, and educating people about osteoporosis and chronic illness management.

Gerald Healy, MD

Harvard Medical School

Gerald B. Healy, M.D., was born in Boston, Massachusetts and received his undergraduate degree with honors from Boston College in 1963 and his M.D. degree from Boston University in 1967. Dr. Healy is the Emeritus Gerald B. Healy Chair in Otolaryngology at Children's Hospital Boston and is currently Professor of Otology and Laryngology at Harvard Medical School. He is the former Surgeon-in-Chief at The Children’s Hospital, Boston. Currently he is a Senior-Fellow at the Institute for Healthcare Improvement, Cambridge, Massachusetts.

Dr. Healy is a member of numerous honorary societies, including the American Academy of Otolaryngology-Head and Neck Surgery, American College of Surgeons, the Triological Society, the American Laryngological Association, the American Society of Pediatric Otolaryngology and the American Society of Head and Neck Surgery. He has served as President of the Massachusetts Chapter of the American College of Surgeons, the American Society of Pediatric Otolaryngology, the American Bronchoesophageal Association, and the Triological Society (the leading academic society in the specialty of Otolaryngology-Head and Neck Surgery). He has served as Secretary and President of the American Laryngological Association. He is an Honorary Fellow of the Royal College of Surgeons of Ireland and the Royal College of Surgeons of England. He has served as a Chairman of the Board of Regents of the American College of Surgeons and is the immediate past-President of the American College. He was the first Otolaryngologist to be elected President. In 1986, Dr. Healy was elected to the Board of Directors of the American Board of Otolaryngology and served as its Executive Vice-President until 2004. He has also served as a Director of the American Board of Emergency Medicine. Dr. Healy has served as a Trustee of the Children’s Hospital Boston.

An active scholar and lecturer, Dr. Healy publishes extensively in professional journals, books, and editorials. He has been the principal investigator of NIH funded research addressing diseases affecting infants and children and has been cited for his pioneering work with laser surgery in children. In addition, Dr. Healy is the author of several books and book chapters and/or monographs, and is extensively published in peer-reviewed journals. He has lectured in North America, Asia and Europe on Health Care Reform, patient safety, the need to restructure medical education and international medical collaboration.

Gail Morrison, MD

University of Pennsylvania School of Medicine

Dr. Gail Morrison, Professor of Medicine, is the present Vice Dean for Education (1995-present), and Director of the Office of Academic Programs at the University of Pennsylvania School of Medicine. For over 25 years, she has been actively involved in directing educational programs in the Department of Medicine, the School of Medicine and nationally, in the Clerkship Directors in Internal Medicine (CDIM) organization. She has served as the Associate Chairman of the Department of Medicine for Medical Student Education (1986-1995), and the Associate Dean for Clinical Curriculum (1991-1995), in the School of Medicine. Dr. Morrison earned her medical degree from the University of Pennsylvania and completed her internship/residency at Beth Israel Hospital in Boston and Georgetown University Hospital. After serving as Staff Associate at the NIH in the NHLBI (National Heart Lung and Blood Institute) for one year, she completed a fellowship in nephrology at the University of Pennsylvania. She was appointed Assistant Professor of Medicine in 1976, was promoted to Associate Professor in 1982 and to Professor in 1994. Prior to her appointment as Vice Dean for Education she was responsible for overseeing the End Stage Renal Disease Program for University of Pennsylvania Health System, was an attending physician in the Nephrology Department and then became the Associate Chair in the Department of Medicine for Medical Education.

In her role as Vice Dean for Education since 1995, she was responsible for the successful implementation (in 1997) of an innovative, horizontally and vertically integrated 4-year curriculum (Curriculum 2000™) and the Virtual Curriculum 2000™ that allows students access to all their lectures (audio & video), images and slides on demand, seven days a week, 24 hours a day via the internet. Since 2004, Dr. Morrison, has been the PI or Co/PI on educational grants/contracts totaling over $4 million. Her nutrition textbook, Medical Nutrition & Disease: A Case-Based Approach, innovative for its case-based approach, was the result of grants from the Heinz Endowment and National Cancer Institute and is being used by more than 50 medical schools in the U.S. to teach their nutrition curriculum and is now in its 4th edition. Dr. Morrison was also funded by the Health Resources and Services Administration (HRSA), to develop the handbook: Core Competencies and Training Problems for the Internal Medicine Clerkship. Completed in 1995, over 100 departments of medicine use the resulting manual for their core medicine clerkship curriculum. She is presently the PI for a 5-year NHLBI Cultural Competence Health Disparities Training Program grant (2004-2009) and Co-PI for the Donald W. Reynolds Foundation Geriatric Training Grant (2009-2013) for geriatric education. She received the Christian R. & Marcy F. Lindback Award in 1988; the Clerkship Directors in Internal Medicine Award (CDMI) for outstanding program development in 1999, and the Daniel C. Tosteson Award for Leadership in Medical Education in 2006. Dr. Morrison also serves as a peer reviewer for five prominent journals and has close to 76 papers and abstracts, as well as 50 chapters and reviews, and 11 books and manuals.

Nancy E. Oriol, MD

Harvard Medical School

Dr. Nancy Oriol is Dean for Students and Associate Professor of Anesthesia at Harvard Medical School and Director of Faculty Development for the Department of Anesthesia and Critical Care at the Beth Israel Deaconess Medical Center. From 1984 -1997 she was the director of the Division of Obstetric Anesthesia where her research included pioneering the walking epidural, a technique for pain relief for women in labor, designing a device to resuscitate newborns, and inventing a data processing system that detects fetal distress. Since 1997, Dr. Oriol has devoted 80% of her time to administrative and teaching responsibilities at HMS where she has helped design and implement several new courses including: the Healer’s Art Course, The Transition to the Wards Course, and The Mentored Clinical Casebook Project.

She was instrumental in introducing simulation onto the HMS Campus and into the undergraduate curriculum, and, with Dr James Gordon, built the Classroom of the Future. She serves as chair of the steering committee of the HMS Gilbert Program in Medical Simulation and is a member of the executive board for the Center for Medical Simulation.

Dr. Oriol is co-founder and former Executive Director of the Family Van, a public health outreach program of Harvard Medical School that serves the communities of Roxbury, Dorchester and Mattapan and co-creator of MobileHealthMap.org and the Mobile Health Clinic Return-on-Investment Calculator.

Dr. Oriol has been awarded several Harvard Medical Student Teaching Awards, The YMCA Black Achiever’s Award, The Massachusetts Medical Society Special Award for Public Service, The Dr. Louis Sullivan Award for contributions to the delivery of quality health care to black men, The New England Women’s Leadership Award in Health, and The AMA Pride of the Profession Award.

Carol Storey-Johnson, MD

Weill Cornell Medical College

Carol Storey-Johnson, M.D. is the Senior Associate Dean (Education) at the Weill Cornell Medical College (WCMC). She is a graduate of Yale University, where she received her Bachelor of Science Degree in Chemistry in 1973, and a graduate of Cornell University Medical College where she received her M.D. degree in 1977. She is currently an Associate Professor of Clinical Medicine and an Associate Attending Physician at New York Presbyterian Hospital. Dr. Storey-Johnson has a special interest in medical education and in the past has served in a number of leadership roles at the medical center including Associate Dean for Curricular Affairs. In the past, her leadership roles at the Weill Cornell – New York Presbyterian Hospital center have been numerous, spanning medical undergraduate and graduate training, and have included serving as Director of: the Medicine, Patients, and Society I course for first year medical students; the Clinical Education Unit in the Weill Cornell Division of General Internal Medicine; the Ambulatory Selective for fourth year medical students; the New York Presbyterian Hospital Primary Care Residency Track in Internal Medicine; and the Ambulatory Block Rotation for interns and residents in the Department of Medicine.

In addition to her current activities as Senior Associate Dean, she is the Chair of the Medical Education Council at the Medical College and the Chair of the Strategic Planning Initiatives for the education mission at WCMC. Dr. Storey-Johnson is a graduate of the Stanford Faculty Development Program in Clinical Teaching (1995) and is now teaching faculty and fellows how to teach using the Stanford techniques. She is also a graduate of the Harvard-Macy Program for Clinician Educators (1999). Dr. Storey-Johnson is an active member of the Society of General Internal Medicine (SGIM) where she has served as a reviewer for the Journal of General Internal Medicine, and of the Association of Academic Medical Colleges (AAMC). She has been an invited speaker at national and regional professional meetings of SGIM, AAMC, and other specialty organizations giving presentations on enhancing teaching and other professional skills.

Currently she provides leadership and oversight for the education mission at the Weill Cornell Medical College, building the infrastructure to support ongoing curricular innovation and education scholarship. She is regularly involved in reviewing program evaluations to discern whether learning objectives and content are consistent with projected educational outcomes. Her research interests are in the areas of curriculum evaluation, student assessment, and faculty development.

Marc M. Triola, MD

NYU School of Medicine

Dr. Triola is Director of the Division of Educational Informatics at NYU School of Medicine, one of the largest Educational Informatics laboratories in the country. He is also the Chief of the Section of Medical Informatics at NYU School of Medicine, an academic research group focused on both educational and clinical Informatics. Dr. Triola's research experience and expertise includes computer-based medical education, the use of Virtual Patients, factors affecting the usability and impact of clinical information systems, and the assessment of change in knowledge and attitudes resulting from computer assisted instruction.

Dr. Triola is the Principal Investigator of a grant from the Josiah H. Macy, Jr. Foundation to support the development of NYU 3T: Teaching, Technology, Teamwork, which will provide NYU medical and nursing students with longitudinal exposure to a diverse patient population and systematic interdisciplinary education in the competencies of team-based care. This program will foster collaborative learning between our nursing and medical students, and generate the evidence base needed to inform the use of a technology-enhanced, interdisciplinary curriculum to efficiently teach a large and diverse group of healthcare learners. He has also been the PI of two NIH/NLM funded grants evaluating the use of technology in medical education of health care providers and has participated in several multi-center trials evaluating both clinical and educational Informatics interventions. He is a national expert on Virtual Patients and serves on the national advisory board for creating standards for Virtual Patients, and co-Chairs a national task force on databases in medical education.

George Thibault, MD

The Josiah Macy, Jr. Foundation

George E. Thibault, M.D. became the seventh president of the Josiah Macy, Jr. Foundation in January 2008. He graduated summa cum laude from Georgetown University in 1965 and magna cum laude from Harvard Medical School in 1969. He completed his internship and residency in Medicine and fellowship in Cardiology at Massachusetts General Hospital (MGH). He also trained in Cardiology at the National Heart and Lung Institute in Bethesda and at Guys Hospital in London, and served as Chief Resident in Medicine at MGH. In 1977, he founded and became the first director of the Medical Practices Evaluation Unit, and was named director of the Medical ICU/CCU at the MGH. In 1978, he became the Director of the Training Program in Internal Medicine and Assistant Chief (subsequently Associate Chief) of the Department of Medicine, MGH. In 1988, he was named Chief of the Medical Services at Brockton/West Roxbury VA Medical Center and Vice Chairman of Medicine at Brigham and Women’s Hospital (BWH). In 1990, he was also named Director of Health Services Research at the Brockton/West Roxbury VA Medical Center. In 1995, Dr. Thibault was named the Chief Medical Officer at the BWH. Since January 1999, he has been Vice President of Clinical Affairs at Partners HealthCare System, Inc. He is a Professor of Medicine at Harvard Medical School (HMS). In September 2001 he was chosen as the first Director of The Academy at HMS. The Academy has been created to recognize teaching excellence and to promote curriculum innovation at HMS. In 2005, he was named the first Daniel D. Federman Professor of Medicine and Medical Education at HMS.

His research has focused on the evaluation of practices and outcomes of medical intensive care units and variations in the use of cardiac technologies. In addition to an active research and clinical career, Dr. Thibault has served in many capacities at Harvard Medical School, including leadership roles in the New Pathway Project and in the current medical education reform effort. He has also served on, and has chaired, numerous committees of national organizations, including the Institute of Medicine, the Department of Veteran’s Affairs, the National Institutes of Health, and the American College of Physicians. He is past President of the Harvard Medical School Alumni Association and was recently named Director of Alumni Relations for HMS.

Dr. Thibault has been the recipient of numerous awards and honors from Georgetown (Ryan Prize in Philosophy, Alumni Prize, and Cohongaroton Speaker) and Harvard (Alpha Omega Alpha, Henry Asbury Christian Award and Society of Fellows). He has been a visiting Scholar both at the Institute of Medicine and Harvard’s Kennedy School of Government and a Visiting Professor of Medicine at many medical schools in the U.S. and abroad.

Charles Wiener, MD

Johns Hopkins University School of Medicine

Additional biographies coming soon

Sponsors

For sponsorship opportunities please contact Sonya Dougal at sdougal@nyas.org or 212.298.8662.

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This event is funded in part by the Life TechnologiesTM Foundation.

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Abstracts

Session I: Linking Science and Clinical Training in Medical School

Linking Science and Clinical Training in Medical School: Mount Sinai’s Perspective

Erica Friedman, MD, Mount Sinai School of Medicine

Our approach to teaching the art and science of medicine is being transformed in order to facilitate deep learning and to instill a scientific approach to patient management and disease prevention. Students learning must be shifted from dualism to relativism, so that rather than memorizing and regurgitating material that is presented, they can transform it into constructs that have meaning. Mount Sinai School of Medicine curriculum is evolving and students work in teams to generate explanations from their scientific and clinical questions and to find creative solutions. Our students follow a patient with chronic disease longitudinally for two years, using science to explain the patient’s symptoms, findings, disease progression and treatment rationale. Simulation is used to demonstrate the relevance of physiology, anatomy and pharmacology to patient treatment. Geriatricians, surgeons, EM physicians, etc. demonstrate the relevance of anatomy to patient care. Students witness procedures and surgery on their cadavers. Patient presentations are part of the teaching in every science course, and science is revisited in the clerkships through simulation or blended content, such as Anatomic Radiology. Future changes may include longitudinal standardized patient cases, translational and clinical researchers co-facilitating discussions about patient management, as well as delaying teaching in-depth molecular and cellular biology until after students have completed systems courses and appreciate disease processes. Our goal is to promote deep learning, a lifelong appreciation of the relevance of science to the profession of medicine and the acquisition of analytical tools to create new solutions to patient management and disease prevention.

A New Paradigm for Teaching and Training Medical Students for the 21st Century: University of Pennsylvania School of Medicine Thirteen Years after Implementation

Gail Morrison, MD, University of Pennsylvania School of Medicine

From 1995 to 1997, University of Pennsylvania School of Medicine underwent a process of curricular revision that resulted in the design, planning and implementation of a four year horizontally and vertically integrated curriculum, Curriculum 2000®. The four principles of CU-2000® were (1) medical education should be a continuum; (2) integration of basic sciences and clinical medicine should occur throughout the curriculum; (3) curricular model should maintain maximum flexibility and (4) self-directed, life-long learning should be emphasized. The curriculum content and pedagogy was designed using the “blank sheet” approach (the idealized redesign) often used in the corporate world. Curriculum design first identified competencies across three broad themes: science of medicine, technology and practice of medicine, and humanism and professionalism. Curriculum content, pedagogy, and assessment outcomes for the four years of medical school were designed and planned simultaneously by interdisciplinary teams of basic science and clinical medicine faculty. Pedagogy for integrating basic science and clinical medicine included both interactive and self-directed small group case-based workshops, journal clubs, virtual labs, and team activities precepted by basic science and clinical faculty (and included population and preventative medicine, personalized medicine, biostatistics and epidemiology, clinical decision-making, evidence-based medicine, and healthcare systems). Faculty approval for this integrated curriculum resulted from an innovative process to achieve buy-in. Simultaneously, a central curriculum administrative structure that monitored and facilitated implementation, an evaluation and assessment online system for curriculum, students and faculty, and a faculty development program was designed and implemented. Results after 13 years include increased interdisciplinary education grants, ongoing basic science and clinical faculty collaboration, increased number of students presenting abstracts/posters/original papers at national/international meetings and completing dual degrees, year out experiences or certificate programs.

Biomedical Science: A Critical Component of the Weill Cornell Medical College Educational Program

Carol Storey-Johnson, MD, Weill Cornell Medical College

Biomedical science is viewed as a critical component of the educational program for medical students at WCMC. It is important for medical schools to promote the underpinnings of biomedical science to inform clinical knowledge, practice, and decision-making. The presentation will outline several methods of explicit inclusion of biomedical science in the WCMC curriculum including: basic science—clinical course connections in years one and two; the mandatory Advanced Biomedical Science Requirement; the promotion and recognition of excellence in biomedical science for medical students; and the mandatory Advanced Biomedical Course. In addition, the presentation will share recent ideas for future linkages between biomedical and clinical sciences from our curriculum reform efforts and an examination of the challenges that need to be met to ensure success in these efforts.

Innovating and Updating the Medical School Curriculum: Time for a Paradigm Change

Charles Wiener, MD, Johns Hopkins School of Medicine

Medicine is arguably in the midst of a paradigm change from the Age of Modern Medicine to the Science of the Individual. Medical educators must train future physicians for a future that incorporates this paradigm change into their research and practice. The next generation of scientists and clinicians should be prepared apply rapidly changing knowledge extending from biology to global health. For these reasons, the Johns Hopkins SOM instituted the Genes to Society (GTS) curriculum in August 2009. The new medical curriculum reframes the context of health and illness in a broader view that encourages students to explore the biologic properties of an individual’s health in the light of a larger integrated system that includes social, cultural, psychological and environmental variables. It adopts a systems approach presenting the patient’s phenotype as the sum of internal (genes, molecules, cells, organs) and external (environment, family, society) factors within a defined system. Unique genotype and societal factors highlight individuality and variability to the student. The GTS curriculum rejects the phenotypic dichotomy of health and illness; preferring to view patients along a continuum of asymptomatic and latent on one end to critically ill on the other. We view GTS as the foundation for future physicians’ scientific and clinical career development.

Session II: Incorporating New Technologies in Medical School Teaching

Can Technology-Enhanced Patient Simulation Enhance The Flexnerian Ideal

Nancy E. Oriol, MD, Harvard Medical School

Flexner championed the integration of basic medical sciences with clinical medicine. However, limitations imposed by concerns for patient safety require the novice build a foundation of medical science before being allowed to integrate that knowledge into the care of patients. Since 1997 Harvard Medical School has allowed novice clinical students to practice real medicine on physiologically-realistic patient-simulators. And since 2005 we have integrated this technology throughout the entire curriculum: starting from the first week of medical school with a fully immersive introduction to the profession; during preclinical tutorials to bring paper cases to life; and during the clinical years to allow students to diagnosis and manage complex clinical cases. Simulation does not replace interacting with real patients - it is an adjunct permitting students to "practice physiology on their feet". It does not replace didactics but rather adds emotional valance to lessons in preclinical sciences and it does not replace tutorial but rather allows students to follow their own logic and elicit the facts of a case rather than have the case evolve along a predetermined storyline. In our experience, an average of one hour per week appears optimal to engender the proper balance between familiarity with the technology and the excitement of practicing "real" medicine. Our experiences with different ways to incorporate this technology into the curriculum have helped identify, and suggest solutions to, the logistical challenges of: finding time and blending into the ongoing curriculum, identifying resources and space, and enlisting and developing the faculty.

The Promise and Peril of Technology in Medical Education

Clarence Braddock III, MD, Stanford School of Medicine

Advances in educational technologies hold great promise for stimulating the attention of current generation learners and better aligning teaching methods with theories of pedagogy. Current learners have a thirst for teaching methods that incorporate the various electronic media to which they have become accustomed, and much of the increased emphasis on quality relies on electronic media as a tool to guide patient care. New methods of instruction, such as high-fidelity simulation, can enhance learning and inter-professional teamwork in ways that more traditional methods cannot. At the same time, the public yearns for clinicians that can truly practice patient-centered care, and many commentators have lamented the erosion of bedside clinical skills, seeing them as a victim of an obsession in medicine with technology. Reconciling the promise and peril of education technologies is one of the most important challenges of the next decade.

Transformative Educational Technologies and the Curriculum for the 21st Century

Marc M. Triola, MD, New York University School of Medicine

Growing challenges to traditional medical education and dramatic changes in the health care delivery system are prompting curricular reform projects at many medical schools. NYU School of Medicine is engaged in a curricular transformation effort entitled C21, the Curriculum for the 21st Century. C21 aims to produce dramatic changes in the structure, content, and methods with which we teach tomorrow’s healthcare providers. A distinct feature of C21 is the emphasis on recent innovations in educational technology and the implementation of seminal digital applications to drive curricular evolution. Teaching and learning technologies offer several advantages such as anytime/anywhere availability, economies of scale, personalized teaching based on individual performance, and the ability to assess learners in novel ways. This presentation will highlight several uses of educational technology to meet the pedagogical and organizational challenges of our new curriculum and will discuss the issues and opportunities involved with the introduction of these empowering but sometimes disruptive solutions. Examples will include the use of virtual patients, visualizing surgical procedures using 3D models, online teaching labs for histopathology, electronic portfolios for mastery-based assessment, and teacher-learner collaboration tools. The current evidence for effectiveness and pedagogical use will be presented as a synthesis of the literature and summarized to provide guidance on the features associated with improved learning outcomes.

Critical Issues to Model for 21st Century Physicians

Gerald B. Healy, MD, FACS, Harvard Medical School

The recent report of the Lucien Leape Institute, UNMET NEEDS: Teaching Physicians to Provide Safe Patient Care, provides a thoughtful analysis and roadmap for modeling critical 21st Century recommendations for the training of physicians (1). The report begins by reaffirming the centuries-old admonition- First do no harm. Our inability to take this admonition seriously has led to less than ideal outcome for generations. The culmination of this inattention led to the IOM report- To Err Is Human.

The call to leaders in medical education is clear. We must assure that student physicians are properly equipped with the skills, attitudes, knowledge and behaviors (i.e. patient safety competencies) that will make them capable of becoming part of the patient safety solution. Some medical schools have initiated aggressive and elaborate patient safety courses using simulation and other teaching models. However the progress is uneven and in some schools non-existent. In addition the selection process for medical school should place greater emphasis on selecting for attributes that reflect concepts of professionalism and an orientation to patient safety. We must examine these issues and consider a corrective process going forward.


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