Portal de Periódicos da CAPES

University of Arkansas for Medical Sciences College of Medicine

2000; Lippincott Williams & Wilkins; Volume: 75; Issue: Supplement Linguagem: Inglês

10.1097/00001888-200009001-00006

1938-808X

Jay H. Menna, 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 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 change 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 their 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 which 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 four 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 1990s the OED has become extremely proactive in assisting the Curriculum Committee, faculty, and administration of the college in improving the curriculum. ♦ The director of the OED now serves on the Curriculum Committee as an ex officio member. Budget to Support Educational Programs ♦ The Office of Student and 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 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. ♦ The Master Teacher Award is conferred annually on 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 are also given to the faculty member who has made the most significant contribution in the area of educational research. ♦ Merit salary increases are given to faculty members with heavy educational responsibilities who are recognized as having contributed significantly to the educational mission of the college. ♦ The Promotion and Tenure Committee recognizes the educational contributions of faculty. ♦ The college has established a standard protocol for documentation of faculty educational contributions. CURRICULUM RENEWAL PROCESS Learning Outcomes ♦ Faculty are in the process of identifying learning outcomes. These outcomes must consider the requirements of the Americans with Disabilities Act. ♦ Currently students are required to pass both USMLE Step 1 and USMLE Step 2 to graduate. Changes in Pedagogy ♦ There has been an increase in the number of small-group learning sessions due to Introduction to Clinical Medicine (ICM) courses established in 1997. ♦ There are more small-group sessions in the first-year physiology and biochemistry courses. ♦ There are small-group sessions in the second-year pathophysiology courses. ♦ In the ICM course, cases are used extensively, including to teach principles of history taking as well as professionalism and ethics. ♦ A quarterly ethics forum, open to all four classes, features presentations by third- and fourth-year students on ethical and professional issues of cases, with comments by the dean, faculty, and the chairperson of the Division of Medical Humanities. ♦ Standardized patients are used in the first-year ICM course and in some clerkships for teaching. Application of Computer Technology ♦ Computer technology is integrated throughout the curriculum. ♦ Year-one students in the first- and second-year longitudinal ICM course use computers weekly to correspond with their preceptors in response to required questions generated during small-group sessions. Students also are required to offer comments of a personal nature in response to the questions. ♦ Many course examinations in years one and two are computerized. This affords more efficient data collection and better preparation of students to take the computerized USMLE Step 1 and Step 2 examinations. ♦ Students use computers in many basic science courses and in some clerkships to access required or recommended Web-based learning modules. There are also computers at the UAMS Library Learning Resource Center that can be used by our students. ♦ The Curriculum Committee is working with clerkship directors who would like to institute more computerized learning modules in their clerkships. ♦ In 1992-93, the College of Medicine established a committee that works closely with course and clerkship directors, as well as other faculty, to produce computer learning modules. This committee addresses the technical aspects of the process and acts in an advisory capacity regarding other issues attendant on the implemention of computer learning modules. ♦ The University Hospital recently adopted an E-chart program that students and residents are required to be trained on and to use. Changes in Assessment ♦ At the end of the second year, students must pass an OSCE, which uses standardized patients, that assesses their ability to perform a comprehensive physical examination, including taking a medical history. ♦ In their fourth year, students must pass a clinical practice examination (CPX), which also uses standardized patients, in order to graduate. ♦ The College of Medicine has a clinical skills center devoted exclusively to assessing student clinical skills. ♦ All assessments using standardized patients are formative as well as summative. ♦ Computers are used for students to complete the written component of their clinical skills examinations. ♦ Many of the basic science courses use computerized examinations. ♦ Faculty observe students during their preceptor sessions and in the OSCE and CPX examinations. Clinical Experiences ♦ In the second-year ICM course students are required to spend time in physicians' offices in the community. ♦ Students have the opportunity to participate in the “Day with a Doctor” program during their first year. ♦ Most students participate in the Area Health Education Center (AHEC) Preceptorship Program, between their first and second and second and third years. ♦ 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 geriatrics rotation in the third year, students spend time at nursing homes, transitional care units, the geriatric clinic, and at a hospice. Curriculum Review Process ♦ An internal standard student-evaluation protocol for courses/clerkships has been in place for over ten 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 integrated basic science courses and implemented the two-year longitudinal Introduction to Clinical Medicine course, which 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 were then analyzed to address unacceptable redundancy and areas of deficiency. The results served as the foundation for a comprehensive course-topic integration process. ♦ The ICM courses were instituted to give our students an earlier and well-structured exposure to the medical history and the physical examination and to serve as a forum in which to address important basic science principles and concepts in a clinical context. ♦ The ICM courses were added to the curriculum to address in a formal manner the issues of professionalism and ethics in medicine. In the near future, the Curriculum Committee will address the important topic of communication. ♦ The issue of cultural diversity is addressed in the curriculum of the college and will be expanded in the future. ♦ Currently, the Curriculum Committee is addressing the third- and fourth-year curricula to ascertain whether 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 these years. None of the members of this ad hoc committee is a clerkship director or departmental chairperson. ♦ In March 2000, fourth-year students will be required to pass a four-week block of instruction called the 10th Block Course. The tenth, four-week, block is the last four-week block of the fourth year. The curriculum of the 10th Block Course is as follows: Week 1—“Surviving Your Internship Year”; Week 2—“Death and Dying”; Week 3—“Nutrition and Prevention”; and Week 4—“The Law and Medicine, Informatics, and The Medical Marketplace.” The tenth-block course was instituted as a way to make more concrete topics that were taught previously in the curriculum and to discuss important issues that relate to graduate medical education. ♦ One of the challenges in the process is the inherent difficulty of change itself. The faculty at the medical school is facing the same pressures as at other medical schools, and one of the most significant is the issue of time. The climate of medical education is not optimal for effecting changes in the educational process. ♦ The Curriculum Committee, working closely with the Office of Educational Development, will develop additional effective evaluation instruments to evaluate curricular changes. These instruments will be developed while the goals and objectives of the proposed changes are being defined. ♦ All newly instituted courses will be evaluated by an external content expert every five to seven years. New courses, such as the 10th Block course, will be externally evaluated soon after initial implementation. ♦ The teaching activities of faculty will be addressed using student-based standardized evaluation instruments and a Web-based process, as is currently being done in the college. These standardized instruments have been approved by the faculty and the Promotion and Tenure Committee of the college. Future Goals ♦ The college continues to address the quality of the ICM courses, both the first-year and second-year components. Better integration is needed in the curricula of these two courses. ♦ The integration of basic science courses must continue. The quality of the educational experience of the students in the basic sciences courses has improved as a result of rather extensive integration, but this process must continue as the relative importance of topics changes and new topics are added. ♦ The use of standardized patients for assessing the clinical skills of the students will continue and will be expanded as more clerkships use them to assess students. Basic science courses more than likely will use them in the future. The OSCE and the CPX will continue and will evolve in the process. ♦ The college will address the quality of the third-year clerkships and the fourth-year curriculum.