6 28 07 SIU Curriculum Presentation

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Curriculum Revolution at the University of Kansas School of Medicine: 

Curriculum Revolution at the University of Kansas School of Medicine Giulia Bonaminio, Ph.D. Associate Dean for Medical Education

SOM Facts: 

SOM Facts Public Only medical school in Kansas 101 years old 2 clinical campuses (KC and Wichita) 8-year LCME accreditation in 2005

SOM Facts: 

SOM Facts 175 students per class ~ 90% Kansas residents F:M ratio ~ 4:5 11-13% underrepresented minorities

Curriculum from 1997-2006: 

Curriculum from 1997-2006 Organ system blocks Discipline-based, departmental courses Most courses two semesters Normal structure and function in Year 1 Abnormal structure and function in Year 2

Curriculum from 1997-2006: 

Curriculum from 1997-2006 Introduction to Clinical Medicine courses Increased small group learning Some PBL, CAI SP program and Skills Lab Office of Medical Education

Motivation for Curriculum Change: 

Motivation for Curriculum Change New administration Student feedback Grants LCME ACGME USMLE Health care expectations

KU Motivation for Curriculum Change: 

KU Motivation for Curriculum Change New dean in 2003 LCME accreditation visit in 2005 Faculty champions Desire to improve AAMC GQ feedback

KU Motivation for Curriculum Change: 

KU Motivation for Curriculum Change Completing the revisions from 1997 More PBL Integrated exams Reorganizing grading by blocks Competency-based content and assessment

How did we come up with our model?: 

How did we come up with our model? Blue Sky Committee Practical Committee Reviewed the literature Traveled to UCSF, New Mexico, Ohio State Merged the two Committees

Required Characteristics of the Curriculum Model: 

Required Characteristics of the Curriculum Model Coordinated by teaching team with one team leader Each block team would consist of a basic scientist, a clinician, and a behavioral scientist/medical ethicist Integration of basic, clinical and behavioral sciences in each block

Required Characteristics of the Curriculum Model: 

Required Characteristics of the Curriculum Model Clinical experiences integrated into each block Exams coordinated by block teams, multi-authored and integrated Emphasis on multimodal instruction with substantial student-initiated learning and small group elements

Required Characteristics of the Curriculum Model: 

Required Characteristics of the Curriculum Model Exploration of team learning Elimination of note service Requirement of tablet computers to be used for note taking, virtual microscopy, collaboration, online research in real time, etc.

Required Characteristics of the Curriculum Model: 

Required Characteristics of the Curriculum Model Grading system revision such that students receive block grades but also feedback on discipline-specific topics taught within modules Limited classroom time; no more than 3 hours of lecture per day Brief intersessions between blocks

Required Characteristics of the Curriculum Model: 

Required Characteristics of the Curriculum Model Model teamwork/professionalism Increased self-directed learning Enhanced emphasis on critical thinking skills

Desired Characteristics of Learners: 

Desired Characteristics of Learners Take responsibility for their own learning Identify their learning needs Identify and utilize good resources and learning strategies Accurately assess their achievements

Curriculum as of August, 2006: 

Curriculum as of August, 2006 Year 1 modules (wks) Foundations of Medicine (8) Genetics and Neoplasia (4) Inflammation and Immunity (4) Cardiopulmonary (8) GI and Nutrition (4) Renal and Endocrine(4) Sexuality and Reproductive Medicine (4)

Curriculum as of August, 2006: 

Curriculum as of August, 2006 Year 2 modules (wks) Musculoskeletal (4) Brain and Behavior (8) Blood and Lymph (4) Infectious Disease (6) Medicine Across the Lifespan (4) Integration and Consolidation (7)

Structure: 

Structure Year 1 implemented in 06-07 Year 2 implemented in 07-08 Each module has a team made up of at least one basic scientist and one clinician Each module is led by a basic scientist or a clinician

Structure: 

Structure Department of module leader takes ownership of module There are subject liaisons who participate in every block (ethics, clinical skills, nutrition, cultural competency, etc.)

Learning Activities: 

Learning Activities Lecture (max 3 hrs per day) Clinical correlations Small groups PBL Histopathology labs Dissection labs Clinical Skills/SP activities Preceptor visits Elearning

Support: 

Support OME Phase I Curriculum Director (new) 2 coordinators for Phase I Technology coordinator (new) 2.5 evaluation specialists (0.5 new)

Support: 

Support Teaching and Learning Technologies 2 instructional technologists (1 new) Information Resources (1 new) Dykes Library Departmental staff

Technology: 

Technology Objectives Facilitate self-directed learning Increase student collaboration Improve personal and institutional organization Provide instant wireless access to course materials and electronic textbooks and journals

Technology: 

Technology Tablets purchased by students Provided tablets to each module leader and coleader Provided tablets to staff (OME, TLT, learning specialists)

Technology: 

Technology Hardware HP Compaq TC 4200 LaCie 60Gb external hard drive LaCie Dual Layer DVD+RW with Lightscribe Targus backpack USB Flash Drive

Technology: 

Technology Software Angel Learning Management System Microsoft Office and OneNote 2003 Agilix GoBinder VitalSource Reader

Technology: 

Technology Software Microsoft Office SyncToy Aperio ImageScope Microsoft Experience and Education Pack Snipping Tool LXR Testing Software

Technology: 

Technology Angel Learning Course Management System Central repository for all materials Central calendar with links to content Discussion forums Formative quizzes Students have access to all previous module material

Technology: 

Technology O Drive Document storage Podcasting All lectures are recorded in audio and video + audio Virtual microscopy Aperio Technologies ScanScope

Technology: 

Technology Etextbooks VitalSource Reader Lippincott-Willams-Wilkins (7) Elsevier (9) AccessMedicine MacGraw Hill

Technology: 

Technology Costs Hardware = $2000 per unit Software = $300 per unit Student Fee = $2500 Electronic textbooks ~ $100,000; paid for by SOM for 2 year pilot 08-09, students will have option to purchase

Student assessment: 

Student assessment Grade given at end of each module Midterms for 8 wk modules End of module exam Anatomy practical exam “Integrated” exams 2 test system

Student assessment: 

Student assessment LXR Test Question bank and coding of items (USMLE) Student subdiscipline reports Computer testing center 2 wave testing

Student assessment: 

Student assessment Formative quizzes NBME customized exam, end-of-year 1 Faculty evaluation of students in small groups, PBL, histopathology labs, etc. Essays

Student feedback: 

Student feedback Surveys Student Advisory Group Student Curriculum Advisory Committee Students serve on educational committees Dean’s Hour Dean’s Forum Angel suggestion box

Evaluation: 

Evaluation Student evaluations of modules Organization, objectives, assessment, workload, etc. Learning activities Student evaluations of the technology Student evaluations of the learning environment

Evaluation: 

Evaluation Student evaluations of faculty Lecturers Small group leaders (small group, PBL, HP lab) Preceptors Faculty evaluations of PBL cases

Evaluation: 

Evaluation Systematic module review Comparisons of AAMC GQ results Comparisons of residency director ratings Comparisons of PGY1 ratings

So…how did Year 1 go?: 

So…how did Year 1 go? We survived! Evaluations were very positive How did the students perform? End-of-year 1 NBME custom exam “Comparison” of Year 1 module vs Year 1 course grades

So…how did Year 1 go?: 

So…how did Year 1 go? Evaluations Very positive Technology ratings Etextbooks were used by some Podcasting used by many O drive used by many

So…how did Year 1 go?: 

So…how did Year 1 go? End-of-Year 1 NBME custom exam Beta test for NBME (free) 100 questions covering all modules Items chosen by module leader and/or faculty Was not counted as part of module grade Mean = 63%

So…how did Year 1 go?: 

So…how did Year 1 go? Comparison of module vs old Year 1 course grades Tougher grading scale in modules than Year 1 courses Lower GPA in modular Year 1 curriculum Comparing old grading scale, module grades and grade point averages were comparable

Successes/Positives: 

Successes/Positives Year 1 “pioneers” were patient and resilient Sustained attendance at lectures Technology, especially podcasting Reduced amount of lecture Integration Virtual microscopy Computer testing center

Challenges: 

Challenges Communication Exam questions Too little study time Too many PPT slides

Challenges: 

Challenges Grading scale Too little pathology Faculty who don’t know module content Faculty who don’t realize the level of the learner

Changes for next year: 

Changes for next year 2nd take on midterm exams Improved communication Handbook for module leaders Grading scale Targeted item writing sessions

Changes for the future: 

Changes for the future Reallocation of dollars Robust test item banks Review sessions between tests to review items Review of course management systems Student eportfolios