Curriculum renewal

CURRICULUM RENEWAL

May 2011 Update

Sept 2009 Retreat

Aug 2012Phase 1Implementation

Sept 2011 Phase 1 Plan Completed

~April 2013 Phase 2 Implementation

Instructional DesignFaculty DevelopmentAssessment Design

Ongoing Curriculum Evaluation

100 faculty

15students

Oct 2010 Kick-Off

200faculty

40students

Curriculum Developmentorganization, content

113faculty

25students

TIMELINEMay 2011 Update

~April 2014 Phase 3 Implementation

CURRICULUM RENEWAL May 2011 Update

Continuity

Organizing principles

Competency-Based

Science in Medicine

Personal - Adaptive

Learner-Centered

Professional Development

Integrated

Inquiry-Driven

PROPOSED FRAMEWORK

M1/M2

M3/M4

Current Curriculum

Year 1 Year 3 Year 4

Clinical Medicine

Patient, Physician, Society

SF

Normal Abnormal

Year 2

SBM

Phase 1 Phase 2 Phase 3

Science in Medicine Clinical Medicine

Health & Society


Proposed Curriculum

Curricular Model

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

Professional Development •Area of Scholarly Concentration, “Pathways”, Professional Goals•Personal Awareness and Self-Care•Professional Behavior and Moral Reasoning•Teamwork & Leadership

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

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

4 Curricular Elements:


Hans Arora

Phase 1

Phase 2

Phase 3


Health & SocietyProfessional Development

CURRICULUM RENEWAL March 2011 Update

PROFESSIONAL DEVELOPMENT

OverviewA 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 20113. Personal Awareness and Self-Care:

- Develop guidelines for mentor/student 4 year plan for personal awareness and self-care.

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?



Health & Society


CURRICULUM RENEWAL March 2011 Update

HEALTH & SOCIETY

Health & Society CEG

Healthy People 2020 www.healthypeople.gov

http://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 CommitteeAndy Reese

Nick Macpherson

May 2, 2010

Current Curriculum

Year 1 Year 3 Year 4

Clinical Medicine

Patient, Physician, Society

SF

Normal Abnormal

Year 2

SBM



Health & Society


Proposed Curriculum

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

Inte

grat

ion

& S

ynth

esis

Mod

ule

Cardio-Vascul

ar

Are

a of

Con

cent

ratio

n

Spr

ing

Bre

ak

II III IV V VI

CM

PDH & S

Prologue

I

SiM

13 weeks

13-AUG-12to

9-NOV-12

Sum

mer

Bre

ak

Competency-Based, Gateway Assessments with Portfolio Reviews

Phase 1 Sequence of Science in Medicine Modules: YEAR 1

Pulmonary

Renal Musculo

Skeletal

Derm.

6 weeks

12-NOV-12to

17-DEC-12

4 weeks

2-JAN-13to

1-FEB-13

4 weeks

4-FEB-13to

1-MAR-13

1 week

4-MAR-13to

8-MAR-13

3 weeks

11-MAR-13to

29-MAR-13

2 weeks

8-APR-13to

19-APR-13

Hol

iday

Bre

ak

Orie

ntat

ion

VII

Head&

Neck

4 weeks

22-APR-13to

17-MAY-13

4 weeks

20-MAY-13to

14-JUN-13

Phase 1 Sequence of Science in Medicine Modules: YEAR 2

Inte

grat

ion

& S

ynth

esis

Mod

ule Bre

ak

Rep

rodu

ctiv

eU

roge

nita

l

Onc

olog

y

Hem

atol

ogy

IX X XII XIII XIV

Pha

rmac

olog

y / A

NS

VIIIN

euro

logy

Psy

chia

try

Gas

troIn

test

inal

1 week

19-AUG-13to

23-AUG-13

5 weeks

26-AUG-13to

27-SEP-13

2 weeks

30-SEP-13to

11-OCT-13

1 week

14-OCT-13to

18-OCT-13

3 weeks

21-OCT-13to

8-NOV-13

Competency-Based, Gateway Assessments with Portfolio Reviews

XI

End

ocrin

e

5 weeks

11-NOV-13to

13-DEC-13

1 week

17-MAR-14to

21-MAR-14

Hol

iday

Bre

ak

5 weeks

6-Jan-14to

7-FEB-14

Inte

grat

ion

& S

ynth

esis

Mod

ule

5 weeks

10-Feb-14to

14-MAR-14

1 week

24-MAR-14to

28-MAR-14

ENDOf

Phase One28-MAR-14

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

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AUGUST 2012MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY

IntroductionThemes, Threads

The Cycle: Determinants, Mechanisms, Presentation,

Treatment, Prevention

The CellStructure, function,

organelles

The nucleus

The CellMacromolecules,

carbohydrate, lipids, A & N acids, inorganics

Enzyme mechanisms, kinetics, regulation

The CellMembranes and their

molecules

Localization of proteins to organelles

The CellMolecules of organelles, Golgi complex and ER

Endocytosis, lysosomes

Receptors& membranes

Ligands, locations, classification

7 trans-membrane receptors, G proteins, Gs, Gi,

Go, etc.


2nd messengers, signal term., kinases, phosphatases

Membrane transport


Membrane potentials

Ion channels and pharmacology


Ion channels and pharmacology

Cytoskeleton, actin, myosin

GeneticsStructure & elements of

genes

Chromosomes, telomeres, repeat seq.s, non-coding,

sRNA, transposable elementsGenetics

Cell cycle, stem cells, mitosis, meiosis, DNA

replication, crossing over

Fertilization and early embryogenesis

GeneticsControl of gene expression,

transcription, regulation, homeobox

Protein translation

GeneticsRegulation and post-

translational modification, methylation

Mutation, misfolded protein response

GeneticsMendelian inheritance:

segregation, assortment, Hardy-Weinberg, linkage

Haplotypes, linkage disequilibrium, linkage

studies

GeneticsMultifactorial & complex

traits, population genetics

Genetic variation

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10 14131211

17

24 28272625

SEPTEMBER 2012MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY

GeneticsPedigree analysis

Autosomal recessive disorders

GeneticsAutosomal recessive

disorders

Autosomal dominant disorders

GeneticsCongenital anomalies

Trinucleotide repeats and diseases (includes fragile X)

GeneticsChromosome abnormalities (non-dysjunction, meiosis I

vs. meiosis II errors, translocation)

Developmental toxicology

GeneticsGene therapy

Genetic counseling

GeneticsGenetic counseling

Approaches to treatment of genetic disorders

GeneticsApproaches to treatment of

genetic disorders

Development and pattern formation (incl. homeobox)

GeneticsPrenatal diagnosis

Contiguous gene deletions

GeneticsImprinting/uniparental disomy

Mitochondrial genetics and diseases

GeneticsNewborn screening

Pharmacogenetics

GeneticsGenetic screening, prenatal

& cancer risk screening

Behavioral genetics

GeneticsX chromosome, inactivation, pseudoautosomal regions,

Turner syndrome

Diseases: neurofibromatosis, Marfan, hemoglobinopath,

PKU

Cell MetabolismATP-ADP cycle, glycolysis

TCA cycle, ketone bodies, oxidative phosphorylation

Cell MetabolismSynthetic pathways,

gluconeogenesis

Mitochondria

Cell MetabolismMitochondrial mutations and

defects

Human BodyThe cadaver

Epithelium: classification, apical domain; microvilli,

stereocilia, cilia

Human BodyThe four tissue types

Human BodyEpithelium: lateral domain,

cell-cell adhesion, basal domain, glands, epithelial cell

renewal

Connective tissue (less on collagen, please)

Human BodyHistology of cartilage;

hyaline, elastic, fibrocartilage. Organization,

development.

Histology of bone, compact/trabecular, osteo

-blasts, -cytes, -clasts

Human BodyBone metabolism and

development

Muscle types: striated (skeletal, cardiac), smooth

Human BodyMuscle: mechanism of

contraction

Blood and circulation

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OCTOBER 2012MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY

Human BodyArteries, veins, lymphatics

Somatic nervous system, neurons, development, subdivisions, dorsal and

ventral roots, dermatomes

Human BodyAutonomic nervous system: sympathetic/parasympatheti

centeric, cell locations

Embryogenesis: gastrulation, placenta

Human BodyEmbryogenesis: vertebrate

body plan

PathologyCell adaptation, injury, death

Hyperplasia, hypertrophy, etc. oxidative stress, reactive oxygen species, free radicals

PathologyIntroduction to pathology

PathologyResponse to hypoxia, heat

shock proteins

Mechanisms of cell injury, necrosis, apoptosis, aging

PathologyIntroduction to oncology

Tumor growth

PathologyFunctional properties of

tumors

Molecular basis of cancer

PathologyCarcinogenic agents

Chemotherapy 1

PathologyChemotherapy 2

Radiation biology

PathologyRadiation therapy

Biologic modifiers

PharmacologyAbsorption and transport

Distribution

PharmacologyExcretion

Drug metabolism 1

PharmacologyDrug metabolism 2

Pharmacokinetics 1(keep Dr. Yeh’s organization)

PharmacologyPharmacokinetics 2

Pharmacokinetics 3(keep Dr. Yeh’s organization)

MicrobiologyIntroduction to microbiology,

virology, parasitology

RNA viruses: flu, polio, HCV, SARS, HIV, rubella,

rotavirusesMicrobiologyDNA viruses: CMV, HSV, VZV, parvoviruses, HBV

Viral oncogenesis and immune evasion

MicrobiologyBacterial structure,

physiology, genetics, therapeutics, antimicrobials 1

Bacterial structure, physiology, genetics,

therapeutics, antimicrobials 2

MicrobiologyFungal structure, laboratory

diagnosis, therapeutics 1

Fungal structure, laboratory diagnosis, therapeutics 2

MicrobiologyFeatures of parasites, morbidity & mortality,

therapeutics 1

Features of parasites, morbidity & mortality,

therapeutics 2

ImmunologyIntroduction

Innate immunity

ImmunologyAntibody and T cell receptor

structure & function

HLA and antigen presentation

ImmunologyLymphocyte activation

Cytokines

ImmunologyEffector functions in cell

mediated immunity

Effector functions in humoral immunity

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NOVEMBER 2012MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY

ImmunologyHost defense against

pathogens

Immunological tolerance and principles of autoimmunity

ImmunologyTransplantation immunology

Immunopathology: amyloidosis

ImmunologyHypersensitivity

Immune deficiencies

ImmunologyCell and molecular

mechanisms of inflammation

Resolution of inflammation and tissue repair

Prologue Exam

CardiovascularModule 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

Thank you for your attention. Questions?

35

Phase 1

Phase 2

Phase 3



CLINICAL MEDICINE

The Focused Clinical Experience

*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

ContinuityPanel of

100 Patients

Team of 10

Students(2-3 per class)

1-2 Faculty

Facilitators

Phase 1

Phase 2

Phase 3

Science in Medicine

Clinical Medicine

Health & SocietyProfessional Development

Proposed Curriculum FCE

PCMH

Questions/Comments?

Curriculum renewal

Documents

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