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
Professional Development
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:
Professional Development
Hans Arora
Phase 1
Phase 2
Phase 3
Science in Medicine Clinical Medicine
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?
Phase 1 Phase 2 Phase 3
Science in Medicine Clinical Medicine
Health & Society
Professional Development
CURRICULUM RENEWAL March 2011 Update
HEALTH & SOCIETY
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
Phase 1 Phase 2 Phase 3
Science in Medicine Clinical Medicine
Health & Society
Professional Development
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.
Receptors& membranes
2nd messengers, signal term., kinases, phosphatases
Membrane transport
Receptors& membranes
Membrane potentials
Ion channels and pharmacology
Receptors& membranes
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
21201918
3 7654
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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4 5
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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19 23222120
26 30292827
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
Science in Medicine Clinical Medicine
Professional Development
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?
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