[The following notes were generated by Michele Haight, PhD.]
Presenter: Jason Walker, PhD, Assistant Dean of Transformational Learning, Associate Professor Physiology, Philadelphia College of Osteopathic Medicine South Georgia
The Off-Cycle Curriculum: Intention vs. Impact
Even though curricular change is a constant in undergraduate medical education (UME), the structure of medical education has not substantially evolved since the Flexner Report of 1910.
The 2020 Pandemic served as a catalyst for both chaos and change in UME.
Lessons Learned:
Increased interest in medical school
Increased and creative use of hybrid learning
Learning medicine takes a community (Learners felt isolated)
Struggling learners were allowed to progress (Implemented supports to advance struggling learners)
We are rebuilding our learners after the pandemic. In this process, we need to continuously ask ourselves if we are building students on sand or on bedrock.
What is a decelerated curriculum?
- Deceleration is an alternative distribution of the preclinical courses that allows student to complete the first and second year curricula in three years.
- Deceleration may allow students to decompress their curriculum or repeat a course or courses in which they have deficiencies.
- Deceleration: Mandatory vs. Voluntary (based upon student, environment, and institution)
Considerations when placing a student on academic suspension:
- What happens when a student is placed on academic suspension?
- What resources does a student have access to while on an academic suspension that are provided by the institution?
- What expectations are placed on a student when they return from academic suspension? What are the expectations and accountability faculty, administrators, the institution?
- Are there any programs in place to track or check in with a student while on academic suspension? We must remember that the student has “failed” and is deeply feeling that sense of failure.
- What is the financial impact on the student who is placed on academic suspension?
Creating an Off-Cycle Program: To provide engagement to separated students to keep them connected to the institution.
Student Needs
- Academic structure
- Improvement of Knowledge Base
- Improved Study Habits
- Confidence Rebuilding
Implementation
- ScholarRx (short bites of information)
- Creation of Modules (post Module 30-40 item quiz)
- Creation of a Book Club (all campuses; Make it Stick)
- Bi-weekly small group advising with faculty
- Monthly “authentic” small group sessions
As faculty, we need to consistently address the question of “Why am I here?” for our students in order to help them better understand how to create individual change from the inside out.
Small group interactions resulted in the creation of a strong support group for all of the off-cycle learners.
When the assessment supports that were implemented during the pandemic were removed, a new group of struggling students was identified. This prompted the following:
- Creation of an Off-Cycle Curriculum Council (OCC) to recommend candidates for the Off-Cycle curriculum.
- Provision of counseling for the candidates and review of the Off-Cycle curricular requirements: withdraw from basic science courses, stay enrolled in small credit courses to keep financial aid, fully audit all M1 courses, and engage in all labs.
- Clarification that the student makes the final decision to participate in the Off-Cycle curriculum and must agree to sign a contract.
Off-Cycle Accountability
- Off-cycle curriculum plan will be maintained in the permanent program record.
- Off-cycle students will be evaluated each term within the off-cycle curriculum plan.
- Off-cycle students must achieve an assessment average of 75% during each M1 term they are recapturing.
- Off-cycle students who fail to meet academic or professional standard while decelerated may be dismissed from the program.
Limitations of the Off-Cycle Curriculum:
- Lack of student motivation to extend medical school.
- Insufficient data on Off-Cycle student progress and outcomes.
- Lack of reliable and valid procedures for student outcomes and readiness prior to leaving the Off-Cycle curriculum.
Diagnosis of Deficiency
We make assumptions based on: MCAT scores, race/ethnicity, previous academic history, time management, study plan. We make decisions based on what we think we know.
Truth will determine the Real Impact: family issues, undiagnosed medical issues, undiagnosed disabilities, trauma, Nobody Ever Asked!!!!
Process for determining academic deficiency:
Deficiency in Assessments>Development of Remediation Strategy>Remediation with deliberate repetition, feedback and reflection>Reassessments>Reintegration into Regular Curriculum
OR
>Integration into the Off-Cycle Curriculum>Diagnosis of Deficiency
Considerations for creating a 5-year curriculum:
Identify at risk matriculants prior to first day of the first year of medical school based on the following:
- Learners’ discretion at understanding how they learn
- Socioeconomic status
- Mental Health concerns
- Non-Traditional Students
Potential external challenges: Accreditors, Institutional finances, Space accommodation
It is time to re-imagine remediation as Restructure, Integrated, Supplemental Education or RISE.