CURRICULUM RENEWAL
May 2011 Update
May 2011 Update
TIMELINE
100 faculty
15students
Sept 2009
Retreat
200faculty
40students
Oct 2010
Kick-Off
Sept 2011
Aug 2012
Phase 1
Plan Completed
Phase 1
Implementation
~April 2013
Phase 2
Implementation
Curriculum Development
organization, content
113faculty
25students
Instructional Design
Faculty Development
Assessment Design
Ongoing Curriculum Evaluation
~April 2014
Phase 3
Implementation
CURRICULUM RENEWAL
May 2011 Update
Continuity
Organizing principles
PROPOSED FRAMEWORK
Competency-Based
Science in Medicine
M1/M2
Learner-Centered
Inquiry-Driven
M3/M4
Professional Development
Current Curriculum
Year 2
Year 1
SF
Year 3
SBM
Normal
Year 4
Clinical Medicine
Abnormal
Patient, Physician, Society
Proposed Curriculum
Phase 1
Science in Medicine
Phase 2
Phase 3
Clinical Medicine
Health & Society
Professional Development
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
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
Curricular Model
Professional Development
Hans Arora
CURRICULUM RENEWAL
March 2011 Update
PROFESSIONAL DEVELOPMENT
Phase 1
Science in Medicine
Phase 2
Phase 3
Clinical Medicine
Health & Society
Professional Development
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)
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
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.
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)
…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)
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)
…Pilot Projects for 2011
3. Personal Awareness and Self-Care:
- Develop guidelines for mentor/student 4
year plan for personal awareness and selfcare.
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.
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
Questions/Comments?
CURRICULUM RENEWAL
March 2011 Update
HEALTH & SOCIETY
Phase 1
Science in Medicine
Phase 2
Phase 3
Clinical Medicine
Health & Society
Professional Development
Health & Society CEG
Healthy People 2020 www.healthypeople.gov
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
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
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
Northwestern University Feinberg School of Medicine
Science in Medicine
Committee
Andy Reese
Nick Macpherson
May 2, 2010
Current Curriculum
Year 2
Year 1
SF
Year 3
SBM
Normal
Year 4
Clinical Medicine
Abnormal
Patient, Physician, Society
Proposed Curriculum
Phase 1
Science in Medicine
Phase 2
Phase 3
Clinical Medicine
Health & Society
Professional Development
Phase 1 Overview
• 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 Sequence of Science in Medicine Modules: YEAR 1
1 week
6 weeks
4 weeks
4 weeks
13-AUG-12
to
9-NOV-12
12-NOV-12
to
17-DEC-12
2-JAN-13
to
1-FEB-13
4-FEB-13
to
1-MAR-13
Prologue
CardioVascul
ar
Pulmonar
y
Renal
V
VI
VII
3 weeks
2 weeks
4 weeks
11-MAR-13 8-APR-13 22-APR-13
to
to
to
29-MAR-13 19-APR-13 17-MAY-13
Muscul Derm. Head
&
o
Neck
Skeletal
Competency-Based, Gateway Assessments with Portfolio Reviews
4 weeks
20-MAY-13
to
14-JUN-13
Summer Break
13 weeks
Si
M
CM
H&S
PD
IV
Area of Concentration
III
Spring Break
II
Integration & Synthesis Module
I
Holiday Break
Orientation
4-MAR-13
to
8-MAR-13
Phase 1 Sequence of Science in Medicine Modules: YEAR 2
XIII
3 weeks
5 weeks
5 weeks
21-OCT-13
to
8-NOV-13
11-NOV-13
to
13-DEC-13
6-Jan-14
to
7-FEB-14
1 week
1 week
17-MAR-14
to
21-MAR-14
24-MAR-14
to
28-MAR-14
XIV
5 weeks
10-Feb-14
to
14-MAR-14
Oncology
XII
Break
Integration & Synthesis Module
Psychiatry
26-AUG-13
to
27-SEP-13
Neurology
Pharmacology / ANS
5 weeks
XI
Reproductive
Urogenital
X
Holiday Break
IX
Endocrine
VIII
30-SEP-13 14-OCT-13
to
to
11-OCT-13 18-OCT-13
GastroIntestinal
19-AUG-13
to
23-AUG-13
1 week
Integration & Synthesis Module
2 weeks
Hematology
1 week
END
Of
Phase One
28-MAR-14
Competency-Based, Gateway Assessments with Portfolio Reviews
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
MONDAY
TUESDAY
AUGUST
2012
WEDNESDAY
THURSDAY
FRIDAY
1
2
3
6
7
8
9
10
13Introduction
14 The Cell
15 The Cell
16 The Cell
17 The Cell
Themes, Threads
The Cycle: Determinants,
Mechanisms, Presentation,
Treatment, Prevention
20 Receptors
Structure, function,
organelles
Macromolecules,
carbohydrate, lipids, A & N
acids, inorganics
The nucleus
Enzyme mechanisms,
kinetics, regulation
21 Receptors
22 Receptors
Membranes and their
molecules
Molecules of organelles,
Golgi complex and ER
Localization of proteins to
organelles
Endocytosis, lysosomes
23 Receptors
& membranes
& membranes
& membranes
& membranes
Ligands, locations,
classification
2nd messengers, signal
term., kinases, phosphatases
Membrane potentials
Ion channels and
pharmacology
7 trans-membrane
receptors, G proteins, Gs, Gi,
Go, etc.
Membrane transport
27 Genetics
28 Genetics
Ion channels and
pharmacology
29 Genetics
Cytoskeleton, actin, myosin
30 Genetics
Cell cycle, stem cells,
mitosis, meiosis, DNA
replication, crossing over
Control of gene expression,
transcription, regulation,
homeobox
Regulation and posttranslational modification,
methylation
Mendelian inheritance:
segregation, assortment,
Hardy-Weinberg, linkage
Fertilization and early
embryogenesis
Protein translation
Mutation, misfolded protein
response
Haplotypes, linkage
disequilibrium, linkage
24 Genetics
Structure & elements of
genes
Chromosomes, telomeres,
repeat seq.s, non-coding,
sRNA, transposable
elements
Multifactorial & complex
traits, population genetics
31 Genetics
Genetic variation
MONDAY
3
Genetics
Pedigree analysis
Autosomal recessive
disorders
10 Genetics
TUESDAY
4
SEPTEMBER 2012
Genetics
Autosomal recessive
disorders
Autosomal dominant
disorders
11 Genetics
WEDNESDAY
5
Genetics
Congenital anomalies
Trinucleotide repeats and
diseases (includes fragile X)
12 Genetics
Approaches to treatment of
genetic disorders
Prenatal diagnosis
Approaches to treatment of
genetic disorders
Development and pattern
formation (incl. homeobox)
Contiguous gene deletions
18 Genetics
Genetic screening, prenatal
& cancer risk screening
X chromosome, inactivation,
pseudoautosomal regions,
Turner syndrome
Behavioral genetics
24Human Body
The cadaver
Epithelium: classification,
apical domain; microvilli,
stereocilia, cilia
Diseases: neurofibromatosis,
Marfan, hemoglobinopath,
PKU
25Human Body
6
Genetics
Chromosome abnormalities
(non-dysjunction, meiosis I
vs. meiosis II errors,
translocation)
FRIDAY
7
Genetics
Gene therapy
Genetic counseling
Developmental toxicology
Genetic counseling
17 Genetics
THURSDAY
13 Genetics
Imprinting/uniparental
disomy
14 Genetics
Newborn screening
Pharmacogenetics
Mitochondrial genetics and
diseases
19
Cell Metabolism 20
Cell Metabolism 21
Cell Metabolism
ATP-ADP cycle, glycolysis
TCA cycle, ketone bodies,
oxidative phosphorylation
26Human Body
Epithelium: lateral domain,
cell-cell adhesion, basal
domain, glands, epithelial
cell renewal
Histology of cartilage;
hyaline, elastic,
fibrocartilage. Organization,
development.
Connective tissue
(less on collagen, please)
Histology of bone,
compact/trabecular, osteo
-blasts, -cytes, -clasts
Synthetic pathways,
gluconeogenesis
Mitochondria
27Human Body
Mitochondrial mutations and
defects
Human Body
The four tissue types
28Human Body
Bone metabolism and
development
Muscle: mechanism of
contraction
Muscle types: striated
(skeletal, cardiac), smooth
Blood and circulation
MONDAY
1 Human Body
Arteries, veins, lymphatics
Somatic nervous system,
neurons, development,
subdivisions, dorsal and
ventral roots, dermatomes
8 Pathology
Introduction to oncology
TUESDAY
2 Human Body
Autonomic nervous system:
sympathetic/parasympathet
icenteric, cell locations
Embryogenesis:
gastrulation, placenta
9 Pathology
Functional properties of
tumors
Tumor growth
OCTOBER 2012
WEDNESDAY
THURSDAY
3Human Body
4 Pathology
Embryogenesis: vertebrate
body plan
Cell adaptation, injury, death
Pathology
Introduction to pathology
10 Pathology
Hyperplasia, hypertrophy,
etc. oxidative stress, reactive
oxygen species, free radicals
11 Pathology
FRIDAY
5 Pathology
Response to hypoxia, heat
shock proteins
Mechanisms of cell injury,
necrosis, apoptosis, aging
12 Pathology
Carcinogenic agents
Chemotherapy 2
Radiation therapy
Chemotherapy 1
Radiation biology
Biologic modifiers
Molecular basis of cancer
15
Pharmacology
16
Pharmacology
17
Pharmacology
18
Pharmacology
19Microbiology
Absorption and transport
Excretion
Drug metabolism 2
Pharmacokinetics 2
Introduction to microbiology,
virology, parasitology
Distribution
Drug metabolism 1
Pharmacokinetics 1
(keep Dr. Yeh’s organization)
Pharmacokinetics 3
(keep Dr. Yeh’s organization)
24Microbiology
25Microbiology
RNA viruses: flu, polio, HCV,
SARS, HIV, rubella,
rotaviruses
22Microbiology
23Microbiology
DNA viruses: CMV, HSV,
VZV, parvoviruses, HBV
Bacterial structure,
physiology, genetics,
therapeutics, antimicrobials 1
Viral oncogenesis and
immune evasion
Bacterial structure,
physiology, genetics,
therapeutics, antimicrobials 2
29Immunology
Antibody and T cell receptor
structure & function
HLA and antigen
presentation
30Immunology
Fungal structure, laboratory
diagnosis, therapeutics 1
Fungal structure, laboratory
diagnosis, therapeutics 2
31Immunology
Lymphocyte activation
Effector functions in cell
mediated immunity
Cytokines
Effector functions in humoral
immunity
Features of parasites,
morbidity & mortality,
therapeutics 1
26Immunology
Introduction
Innate immunity
Features of parasites,
morbidity & mortality,
therapeutics 2
MONDAY
TUESDAY
NOVEMBER 2012
WEDNESDAY
THURSDAY
1 Immunology
5 Immunology
6 Immunology
FRIDAY
2 Immunology
Host defense against
pathogens
Transplantation immunology
Immunological tolerance and
principles of autoimmunity
Immunopathology:
amyloidosis
7
8
9
Prologue Exam
13
14
15
16
19
20
21
22
23
26
27
28
29
30
Hypersensitivity
Cell and molecular
mechanisms of inflammation
Immune deficiencies
Resolution of inflammation
and tissue repair
12
Cardiovascular
Module begins
(6 weeks duration)
Learning Cycle
33
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
34
35
Thank you for your
attention. Questions?
CLINICAL MEDICINE
Phase 1
Science in Medicine
Phase 2
Phase 3
Clinical Medicine
Professional Development
* 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
Panel of 100
Patients
1-2 Faculty
Facilitators
Team of 10
Students
(2-3 per class)
Proposed Curriculum
Phase 1
F
C
E
Science in Medicine
Phase 2
Phase 3
Clinical Medicine
PCMH
Health & Society
Professional Development