Portal de Periódicos da CAPES

University of Arkansas for Medical Sciences College of Medicine

2010; Lippincott Williams & Wilkins; Volume: 85; Linguagem: Inglês

10.1097/acm.0b013e3181e869dd

1938-808X

Bruce W. Newton, Richard P. Wheeler,

Medical Education and Admissions

Curriculum Management and Governance Structure ♦ Management of the curriculum is the responsibility of the faculty of the College. ♦ Major teaching departments in the College elect representatives to the Curriculum Committee for a three-year term. They can be re-elected by their departmental faculty. ♦ All course and clerkship directors, as well as representatives from the Library, Center for Clinical Skills Education, and Office of Educational Development, are ex officio members. ♦ For clinical departments without responsibility for a clerkship, a single member is elected to represent several departments. ♦ The Curriculum Committee is responsible for monitoring the curriculum of the College, for making recommendations for changes based on results of standard course and clerkship student evaluations, and on the results of external evaluations. ♦ The Curriculum Committee is responsible for staying abreast of contemporary changes in health care delivery and its impact on defining the appropriate educational experiences for students; in so doing, the Committee considers contemporary changes in the curricula of other medical schools. ♦ The Committee has endorsed Operating Guidelines for the management of the curriculum that have resulted in a much more expedient process for effecting curricular change and, as a result, has invigorated the curriculum of the College. Office of Education ♦ The College of Medicine is one of five colleges on campus supported by the Office of Educational Development (OED). ♦ The OED was established in 1975 and is staffed by education professionals who are assigned to one or more of the colleges on campus. ♦ During the 2000s, the OED has become proactive in assisting the Curriculum Committee, faculty, and administration of the College in improving the curriculum. ♦ The Director of the OED, and some of the OED staff, serve on the Curriculum Committee as ex officio members. Financial Management of Educational Programs ♦ The Office of Academic Affairs has a separate budget. Funds from that budget support some of the educational activities of the College. ♦ The Dean's Office funds required educational activities that are outside the domain of a department or division. ♦ All departments and divisions in the College entrusted with responsibility for a course and/or clerkship receive supporting funds from the Dean's Office. Valuing Teaching ♦ Faculty whose primary responsibility is medical student education receive recognition for their efforts. ♦ A Master Teacher Award is conferred annually to the most outstanding teacher in the College, based on nominations from peers and committee selection. The winner receives a $2,500 check and a plaque. ♦ The College confers an award of $1,000 and a plaque on the faculty member who has made the most significant contribution to the area of educational innovation. ♦ An award of $1,000 and a plaque is given to the faculty member who has made the most significant contribution in the area of educational research. ♦ Merit salary increases are given to some faculty members with heavy educational responsibilities (e.g., course or clerkship directors) that have been recognized as having contributed significantly to the educational mission of the College. ♦ The newly revised (2009) Promotion and Tenure Document instructs the Promotion and Tenure Committee to give increased consideration to the educational contributions of faculty. ♦ The College has established a standard protocol for documentation of faculty educational contributions, and $500,000 will be distributed to faculty demonstrating teaching excellence. Curriculum Renewal Process Learning outcomes ♦ Faculty have identified learning outcomes for all courses and clerkships. These outcomes must consider the tenets of the Americans with Disabilities Act. ♦ Currently, students are required to pass both Step 1 and Step 2 USMLE to graduate. Changes in pedagogy ♦ There has been a steady increase in the number of clinically-based small group learning sessions because of the steadily increasing emphasis on the clinical aspects of the basic sciences. ♦ There are small group sessions in first-year physiology, biochemistry, cell biology, introduction to clinical medicine, and neuroscience courses that use a variety of formats for content delivery (e.g., PBL, TBL) and hybrids of those methodologies. CPCs are presented in several of the second-year courses. ♦ Clinical Applications of Professional Experience (CAPE) sessions are used in the second year to help the students consolidate material from several disciplines. Faculty from three to five second-year courses contribute to the clinical cases students solve in a large group setting. These sessions are very interactive. ♦ In the ICM course, cases are used extensively to teach principles of history taking, the physical examination, as well as professionalism and ethics. ♦ A monthly ethics forum, open to the entire campus, features presentations of ethical and professional issues of cases, with discussion by the Dean, faculty, and the chairperson and faculty of the Division of Medical Humanities. ♦ Standardized patients are used in the freshman ICM course and in some clerkships for teaching. ♦ Self-directed learning (SDL) modules are being used in the curriculum to reduce the amount of in-class time, with the goal of having at least 10% of the lectures converted to SDLs. ♦ Starting in 2010, many courses are now recording their lectures for synchronous or asynchronous delivery. ♦ The traditional approach to the first- and second-year curriculum has been changed to an integrated, organ-system-based curriculum for each of the first two years. This organ-system approach to the basic sciences has increased student satisfaction and resulted in a decrease in didactic hours, since unnecessary redundancies were removed from the curriculum. ♦ All first- and second-year courses place their materials into a Blackboard 8 shell. The master calendar is also kept on Blackboard 8 and can be immediately updated if there is a change in the schedule. ♦ Many first- and second-year courses use an audience response system during lecture to keep the students engaged in the material and for the faculty to assess, in real time, if the students are grasping the concepts being presented. Application of computer technology ♦ Computer technology is integrated throughout the curriculum. ♦ Students in first- and second-year longitudinal Introduction to Clinical Medicine (ICM) course use computers weekly to correspond with their preceptors concerning required questions generated during small group sessions. Students also are required to offer comments of a personal nature to the questions. ♦ Computers are used by students in many basic science courses and in some clerkships to access required or recommended web-based learning modules, other course content, and archived lectures. ♦ There are also computers at the UAMS Library and education buildings that can be used by our students. ♦ The Curriculum Committee continues to work with clerkship directors who would like to institute more computerized learning modules in their clerkships. ♦ The University Hospital has an e-chart program that students and residents are required to be trained on and to use. Changes in assessment since 2000 ♦ The College of Medicine has an excellent Center for Clinical Skills Education devoted exclusively to assessing student clinical skills. ♦ All assessments using standardized patients are formative as well as summative. ♦ With the advent of integrated first- and second-year curricula, the examinations are also integrated. Three or four questions are asked from each lecture in a particular block, and those questions are gathered into a single examination and presented in a random fashion to the students. Computers are used to take the examination that can last up to 3.5 hours and contain 160 questions. ♦ Many questions on the integrated examinations start with a clinical scenario. Both the integrated nature of the examination and the use of clinical stems are valued by the students since it prepares them for Steps I and II. Clinical experiences ♦ In the second year, ICM course students are required to spend time in a physician's office in the community. ♦ Students have the opportunity to participate in the “Day with a Doctor Program” during their first year. ♦ Many students volunteer at the recently established Harmony Health Clinic, providing basic medical care (under supervision) to the community. ♦ Most students participate in the Area Health Education Center (AHEC) Preceptorship Program. ♦ During their third- and fourth-years, students spend time in numerous clinics and the hospital wards at the University Hospital, Arkansas Children's Hospital, the Little Rock VA Hospital, and the North Little Rock VA Hospital. ♦ During the four-week Geriatric rotation in the fourth year, students spend time at nursing homes, transitional care units, the geriatric clinic, and a hospice setting. Curriculum review process ♦ An internal standard course/clerkship student evaluation protocol has been in place for over 15 years. The system is now web based as a means of receiving evaluation data more efficiently. ♦ The College continues to use an external course/clerkship evaluation system employing content educational experts. The data accrued from both the student internal standard evaluation process and the external evaluation process have been invaluable in effecting recent curricular changes. ♦ The central theme of the curricular reformation process is, and has been, a cohesive presentation of basic science course principles and concepts in a clinical context and better integration of our clinical curriculum. ♦ The College has significantly increased the integration of the basic science courses with the use of an organ-system-based curriculum. ♦ The two-year longitudinal Introduction to Clinical Medicine Course addresses the important topics of professionalism and humanism in the practice of medicine, as well as the clinical importance of the sciences basic to medicine. ♦ The overarching theme of the curriculum is the optimal preparation of our students to competently enter graduate programs armed with the scientific basics and an understanding of the importance of humanism and professionalism in medicine. ♦ The Curriculum Committee carried out a comprehensive survey of the topics addressed in the basic science courses using the topic analysis of the USMLE Step 1 examination as a template. All basic science course directors were asked to complete this exhaustive survey. The results of this survey were then analyzed to address unacceptable redundancy and areas of deficiency. The results of the survey served as the foundation for a comprehensive course topic integration process. ♦ Currently, the Curriculum Committee is addressing the junior and senior curricula to ascertain if they are educationally sound. ♦ An ad hoc committee consisting of some of the best clinical instructors in the College has been appointed and charged by the Curriculum Committee to critique the curricula of the junior and senior years. ♦ Fourth-year students are required to pass a one-week block of instruction called the “Residency Preparation Week Course.” This block is the last week of the fourth year. ♦ The curriculum of the Residency Preparation Week Course covers topics important for the internship year (e.g., teaching at the bedside, death and dying, the law and medicine, medical informatics, basic statistics used for evidence-based medicine, and surviving your internship year). ♦ The Residency Preparation Week Course has numerous sessions in the Center for Clinical Skills Education where basic clinical skills are honed for adult and pediatric patients. ♦ The Residency Preparation Week Course was instituted as a means of consolidating topics that were taught previously in the curriculum and to discuss important issues that relate to graduate medical education and is highly valued by the students. New topics in the curriculum ♦ Patient Safety has been incorporated in to the Introduction to Clinical Medicine course as well as being emphasized in many of the clerkships. ♦ Team-based learning (TBL) and problem-based learning (PBL), and hybrids of those two methods, are used in all four years of the curriculum. ♦ Self-directed learning modules continue to be developed in all four years. ♦ Expansion of the simulation center is currently underway. ♦ The process has started to place material concerning electronic health records, evidence-based medicine, medical informatics, and basic biostatistics/epidemiology into all four years of the curriculum. Regional Campus ♦ The first six medical students started their junior year in July 2009 at our newly established Regional Campus in Fayetteville, Arkansas. ♦ It is anticipated that, in the future, 30-40 students per year will complete their junior and senior years at the Regional Campus. ♦ The first two years of medical school will continue to be taught at UAMS in Little Rock. ♦ The Regional Campus junior year uses a longitudinal curriculum that provides the students with the same educational experiences as those students at UAMS. ♦ The senior year consists of mainly elective courses. Highlights of the Program/School ♦ The first two years now use an integrated curriculum that is organ-system based. ♦ The examinations in the first two years are integrated, such that questions from each course in a block are compiled into a single examination and presented to the students in a random order. This emulates, in part, the Step I examination. ♦ The process of introducing an even greater clinical emphasis on the basic science material by having clinician advisors for the basic scientists has been started. ♦ Increasing the emphasis on electronic health records, evidence-based medicine, medical informatics, and basic biostatistics/epidemiology in the curriculum will better prepare the students for residency and private practice.