2014 Fall: Evolution and Revolution in Medical Education

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September 11, 2014 at 12:00 pm

Changes to Medical School Admissions: The Holistic Review

Presenter: Steve Case and David Jones

Jones HeadshotDr. Jones received his B.S. in Pharmacy in 1968 followed by an M.S. in Pharmacology/Toxicology in 1970 from UT Austin. He completed his Ph.D. in Pharmacology in 1974 at the University of Texas Health Science Center at San Antonio and joined the faculty in Anesthesiology at that time with a cross appointment in Pharmacology. He is a tenured professor in both departments and has been recognized as a Distinguished Teaching Professor. He currently serves as the Senior Associate Dean for Admissions for the School of Medicine. Other responsibilities include serving as the Executive Director for Pipeline Programs in the Health Sciences (including the South Texas Med Ed Program and Facilitated Admissions for South Texas Scholars program),and as a Council member for the Joint Admissions Medical Program (JAMP). He previously was the Chair of the AAMC Southern Group on Student Affairs, a facilitator for the AAMC Holistic Admissions Workshop and currently serves on two AAMC committees validating the MCAT2015.

Holistic review medical school admissions affords each applicant balanced consideration of life experiences that are valued by the school, personal attributes, and metrics that predict academic success. The goal is to select applicants who can not only succeed, but those who can best fulfill a school’s mission and diversity interests. This session will review the rationale for implementation and four core principles of holistic review admissions noting the multiple dimensions of diversity that contribute to educational excellence of a medical school class and future physician workforce. An example will be presented of how one medical school implemented holistic review. Another example will be presented of the diversity outcomes that resulted from another school’s long term implementation of holistic review.

Seminar Archive
September 18, 2014 at 12:00 pm

Pre-matriculation Programs

Presenter: John Pelley

Prematriculation programs, like all programs, are a collection of coordinated activities designed to correct deficiencies in needed skills. In particular, prematriculation programs address competencies needed by students for rapid adjustment to the medical curriculum so that their education can be maximally effective. This raises the immediate question, “Why isn’t premedical education an adequate prematriculation program?” The simple, perhaps oversimplified, answer is “heterogeneity.” On the surface, it would appear that the important heterogeneity is in content background in spite of standard admissions prerequisites. This is evident in many prematriculation programs that provide exposure to content specifically designed to familiarize the student with early courses in medical school. Dig a little deeper and you find heterogeneity in the capacity of new students to adapt from the relatively flexible premedical environment to the less flexible medical curriculum. However, both of these types of heterogeneity exist as effects and not causes of successful skill acquisition in medical education. The heterogeneity that exists as a “cause” is the level of understanding of what a “learning skill” really is. Without this understanding, awareness is absent and in the absence of awareness, skill acquisition is impossible. Such skill areas would include problem analysis, visual recognition, communication, motor (both fine and gross), and procedural skills. Perhaps we need to address more than cognitive performance in prematriculation programs if they are to provide a lasting effect.

In this one-hour Web Audio Seminar, Dr. Pelley will provide a sampling of the various general approaches that he has experienced at his own institution and as a participant at other institutions. The discussion period may bring out additional program designs for comparison. The purpose is to illustrate the nature of the problems that are addressed and the general expectations of faculty for new medical students. A suggested prioritization of skill development will be suggested using the Expert Skills Program at Texas Tech as an example of a low resource, time efficient strategy to start the student on the path to Mastery Learning. The objective will be to help participants compose a program that can develop the student while they are in the premedical education environment that continues to scaffold their experience throughout medical school. Issues in measuring program effectiveness will be addressed. We can tell our students, “Our goal is not just to help you survive, but to help you match well for a residency!”

Seminar Archive
October 2, 2014 at 12:00 pm

Longitudinal Integrated Clerkships: Challenges of Expanding to All Campuses and all Students

Presenter: Janet Linderman, Lori Hansen, Ed Simanton

Janet_LindemannJanet Lindemann, M.D., MBA, is professor of family medicine and dean of medical student education at the University of South Dakota Sanford School of Medicine. Following private practice, she joined the faculty at the Medical College of Wisconsin where she completed a faculty development fellowship in medical education. In 1997, she received the Family Medicine Educator of the Year award from the Wisconsin Academy of Family Physicians. Following a move to South Dakota in 1997, she served as Director of Introduction to Clinical Medicine and co-director of the Primary Care Ambulatory Program. In 2001, she was appointed dean of medical student education where she oversees the 4-year medical student curriculum. In 2009, she completed an MBA in healthcare management. Her publications have focused on medical education, especially in the areas of ambulatory education, educator’s portfolios, and professionalism.

Lori_HansenLori Hansen, MD, received her Doctor of Medicine degree from the University of Nebraska College of Medicine and completed a fellowship in Pulmonary Medicine at Mayo Graduate School of Medicine in Rochester, Minnesota. In July 1989, Dr. Hansen joined the University of South Dakota Sanford School of Medicine and Yankton Medical Clinic in Yankton, South Dakota. Dr. Hansen was involved in planning and implementing the Yankton Ambulatory Program – the oldest yearlong integrated, ambulatory clinical clerkship. She is a professor of Medicine and is Avera Sacred Heart Yankton Campus Dean of the Sanford School of Medicine of the University of South Dakota. Dr. Hansen and her husband, Michael Waid, D.V.M., have three children: Michael, Matthew and Leah.

Edward_SimantonEdward Simanton, PhD, is assistant professor of family medicine and director of evaluation and assessment at Sanford School of Medicine of the University of South Dakota. He holds bachelors and masters degrees in music education and taught music for 12 years at colleges and universities in various Latin American countries. In 2000, he received a PhD in education research from the University of North Dakota and began working in education research as Director of the Bureau of Educational Services and Applied Research at the University of North Dakota. In 2002 he began his medical education career as Senior Statistician in the Office of Medical Education at the University of North Dakota School of Medicine and Health Sciences. In 2006, he moved to South Dakota to become the director of evaluation and assessment. He completed the Leadership and Education Development [LEAD] certificate program in 2013. His publications cover a broad range of medical education topics including professionalism, radiology education, evidence-based medicine, and retention of knowledge.

Longitudinal integrated clerkships (LIC) as a clerkship format have been in use at medical schools for over twenty years. The format of immersion in multiple simultaneous clerkships as opposed to block clerkships originally met the needs of smaller campuses and rural settings. Evidence for comparable test scores, increased retention, increased patient centeredness, and the ability to make an earlier career choice selection is leading more schools to consider implementing the LIC at large as well as small campuses. The University of South Dakota Sanford School of Medicine initiated an LIC at its Yankton campus in 1991. In 2013, the school implemented LICs on all clinical campuses. Steps in implementation included significant program and curriculum design, overcoming change angst, and faculty development. Presenters will describe challenges in implementation and suggest strategies to address the challenges.

Following this session, participants will be better able to:

  • Identify the Longitudinal Integrated Clerkship (LIC) model
  • Describe the evidence about advantages of the LIC as compared to block clerkships
  • Anticipate potential challenges to implementation of a multi-campus LIC, and
  • Identify strategies to address these challenges

October 9, 2014 at 12:00 pm

Crossing the Synapse: Integrating Basic Science and Clinical Medicine at the Cognitive Level to Improve Medical Decision Making

Presenter: Leslie Fall
Leslie Fall MD

Dr. Fall serves as the Associate Dean for Faculty Development at the Geisel School of Medicine at Dartmouth, and is an inaugural member of Geisel’s Academy of Master Educators. She is a Professor of Pediatrics (Hospital Medicine) as also serves as the Vice Chair for Education in the Department of Pediatrics. Dr. Fall has been deeply involved in the continuum of medical education serving as a pediatric clerkship director and residency program director, as well as leading many faculty development efforts throughout her career. A Geisel graduate herself, she completed a medical education fellowship at Michigan State University (1995) and the Executive Leadership in Academic Medicine (ELAM) program for women (2013). Her innovative approach to teaching clinical skills using a developmental coaching paradigm (www.doctor-coach.org), co-developed with Dr. Kim Gifford, has resulted in numerous invited national workshops, visiting professorships and recent publications.

Dr. Fall is also the co-founder, President and Executive Medical Director of MedU (www.med-u.org). Founded in 2006, MedU is a non-profit social enterprise with a mission to advance medical education through collaborative development, dissemination and research of technology-enabled medical education programs. The majority of US and Canadian medical schools subscribe to at least one of MedU’s virtual patient courses (CLIPP, SIMPLE, fmCASES, CORE) with over 30,000 registered new users per year and over 1,000,000 case sessions completed annually – a success which far exceeds that of any other e-learning program in medical education anywhere in the world. Dr. Fall and her fellow co-founder, Dr. Norm Berman, have received numerous national medical education awards for their work developing MedU. Dr. Fall lives in Hanover, NH with her husband and three children.

Over 100 years ago Abraham Flexner disrupted American medical education by asserting that the sciences must play a foundational role in the intellectual development of a physician, thus setting the standard for the traditional curricular “2×2” model of concentrated basic science education followed by clinical training. Since then additional reforms have led to improved contextual integration of clinical education into the basic science curriculum through earlier clinical exposure and implementation of problem-based learning programs. Unfortunately, similar integration of advanced basic science education into the core clinical curriculum remains elusive, and the promise of meaningful curricular time for science educators unmet.

This web seminar will focus on newer approaches to advancing IAMSE’s core mission – to integrating science into the heart of medical practice. The session will overview a variety of current approaches, describing the benefits and challenges of each. Newer research describing how novice physicians integrate their basic science knowledge into their clinical reasoning will be reviewed, and methods to leverage this new understanding will be discussed. The session will conclude with an overview of the MedU Science project. This collaborative effort is teaming basic science and clinical educators together to develop an innovative national curriculum for advanced medical science education. The teaching and learning resources built from the curriculum will promote cognitive integration of students’ basic science understanding into their everyday medical decision-making for the purpose of improving their patients’ care.

Seminar Archive
October 16, 2014 at 12:00 pm

Pros and Cons of Compressed Medical Schools

Presenter: Stanley Goldfarb and Steven Abramson

goldfarb-stanleyStanley Goldfarb, MD

Dr Goldfarb, a graduate of Princeton University and the University of Rochester School of Medicine, is a nephrologist and Professor of Medicine and Associate Dean for Curriculum at the Perelman School of Medicine at the University of Pennsylvania in Philadelphia, Pennsylvania. In that role he supervises all aspects of the medical student curriculum, chairs the curriculum committee, supervises the medical student scholarly pursuit program in clinical investigation, and serves on the Student Standards Committee and chairs the School of Medicine Teaching Awards Committee. He supervises the Medical Student Course in Health Care Systems.

From 1992 to 1997,Dr. Goldfarb was the Chief Medical Officer of the Graduate Health System in Philadelphia, a 7 hospital system with a 100,000 member HMO and a 100 physician primary care network. In that capacity he developed a clinical trial network, an office of quality improvement and outcome measures, and a multi-site closed circuit video system to provide cross institutional education.

Dr. Goldfarb has served as program director of the NIH sponsored General Clinical Research Center at Penn and was the interim chair of the Department of Medicine at Penn for 2 1/2 years. He has also served on the ABIM subspecialty board on Nephrology and been a member of the Board of Regents of the American College of Physicians. He is a member of the American Society of Clinical Investigation.

He has been the recipient of numerous awards, including the Laureate Award from the Pennsylvania Chapter of the American College of Physicians and the Christian and Mary Lindback award for distinguished teaching from Penn.

Dr Goldfarb has over 100 original publications and has edited 2 books.. He served on the editorial board of the Journal of Clinical Investigation, American Journal of Kidney Disease, Diabetes, Journal of the American Society of Nephrology, and Clinical Nephrology and is the immediate past Editor in Chief of NephSAP, an official journal of the American Society of Nephrology.

StevenAbramsonSteven Abramson

I will propose that widespread acceptance of the suitability of a 3 year medical undergraduate education would be a profound error for three main reasons. First, it has been attempted before by many U.S. medical schools and it was an abysmal failure and abandoned by the beginning of the 21st century. Second, in an era of an explosion in biomedical research and knowledge, the idea that less education is sufficient flies in the face of simple logic and echoes the mistakes of the past in such an attempt. In fact, residency program directors have bemoaned the poor preparation found in many of their recent trainees. Third, the prediction that a shortened medical school duration would lead to increased numbers of primary care physicians is not supported by past evidence and ignores the dualistic nature of primary care medicine: the provision of preventative medical advice and the management of complex, typically chronic, medical problems. The former does not require utilizing physicians to accomplish the task and the latter requires a broadly trained and expert physician who likely needs even more training than is currently the norm.

I will also propose, in response to the deficiencies of current training, a renewed focus on the curricular goals of the fourth year of medical school as a means of corrected current deficiencies in training.

Seminar Archive