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1 College of Medicine Faculty of Health Sciences UGME CuRe Faculty Forum #6 June 19, 2014 LAUNCHING NEW PRECLERKSHIP CURRICULUM AUGUST 2014 Dr. Keevin.

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Presentation on theme: "1 College of Medicine Faculty of Health Sciences UGME CuRe Faculty Forum #6 June 19, 2014 LAUNCHING NEW PRECLERKSHIP CURRICULUM AUGUST 2014 Dr. Keevin."— Presentation transcript:

1 1 College of Medicine Faculty of Health Sciences UGME CuRe Faculty Forum #6 June 19, 2014 LAUNCHING NEW PRECLERKSHIP CURRICULUM AUGUST 2014 Dr. Keevin Bernstein Director, Curriculum Renewal on behalf of CuReExecutive Outline 1. Review CuRe Process & History 2. Preclerkship Curriculum and its creation 3. Evaluation 4. Next Steps…..To Do List….Challenges

2 2 Consistent Pedagogy Scholarship Outcome Based Objectives Medical Informatics Integrated Continuous Quality Improvement Inter-Professionalism Flexible Maximize Current strengths Consistent Pedagogy Scholarship Outcome Based Objectives Medical Informatics Integrated Continuous Quality Improvement Inter-Professionalism Flexible Maximize Current strengths New UGME Curriculum 2013 that fulfills FMEC recommendations & Accreditation Standards New UGME Curriculum 2013 that fulfills FMEC recommendations & Accreditation Standards Task Specific groups Task Specific groups External Consultation Website Educational Experts Site visits External Consultation Website Educational Experts Site visits Internal Review Surveys Retreats Curriculum map Existing curriculum Internal Review Surveys Retreats Curriculum map Existing curriculum Commitment to Person, Family & Community ; Social Responsibility, Professionalism, Inclusivity; Scholarship, Excellence, Discovery, Innovation, Critical Thinking UGME CURRICULUM RENEWAL MAP April 2011 OUTCOME> Process Principles Curriculum Renewal Goal Mission Stake holder Consultations Stake holder Consultations Faculty D evelopment Faculty D evelopment

3 UGME CURRICULUM RENEWAL University of Manitoba UGME Review  CuRe UGME Faculty Survey Dec 2010  CuRe Faculty Retreat and Report April 2011  CuRe UGME Course & Clerkship Director Survey June 2011  CuRe Department Representative Focus Group July 2011  LCME/CACMS Accreditation Oct 2011 Student surveys Report  CuRe Task Group (11) Reports Nov 2011  External Review; Genevieve Moineau MDJune 2008 Associate Dean, UGME University of Ottawa  Internal Review ; Oscar Casiro MD Associate Dean UGME 2002 Cheryl Kristjanson PhD Director ED Development  CuRe UGME Faculty Survey Dec 2010  CuRe Faculty Retreat and Report April 2011  CuRe UGME Course & Clerkship Director Survey June 2011  CuRe Department Representative Focus Group July 2011  LCME/CACMS Accreditation Oct 2011 Student surveys Report  CuRe Task Group (11) Reports Nov 2011  CuRe UGME Faculty Survey Dec 2010  CuRe Faculty Retreat and Report April 2011  CuRe UGME Course & Clerkship Director Survey June 2011  CuRe Department Representative Focus Group July 2011  LCME/CACMS Accreditation Oct 2011 Student surveys Report  CuRe Task Group (11) Reports Nov 2011

4 PRINCIPLES:  Physicians for 21 st century:  Fulfills (or exceeds) UGME global objectives, FMEC recommendations and LCME/CCME standards  Fully integrated spiral scaffold curriculum throughout 4 years  Enhance communication between faculty, and continuity with students  Person to Community Centered  Not focused on organ system or department based  Fewer Lectures…Lecturers ….more small group/interactive sessions  Build upon existing or potential strengths  Innovative – utilizing evolving technology  Iterative and Transparent process  Address Governance and Faculty Recognition UGME CURRICULUM RENEWAL Oct

5 CuRe : The Journey……….. UGME Curriculum Renewal for 21 st Century 1.Curriculum 21 st century Framework :  Separated into 8 Modules (M0-M7)  Human Biology, Health & Disease Modules (Modules 0-3 )  Foundation of Medicine Module (M0)  Human Biology & Health Module (M1)  Health & Disease Module (M2)  Consolidation Module (M3)  Clerkship (Modules 4-7)  Integrated across all 4 years  CP4s  Longitudinal Courses/Themes 2.Governance 3.Evaluation : Student Assessment and CuRe Evaluation  AM Years 1 & 2: Preclerkship  Integrated into M0-3  PM Years 1 & 2: Preclerkship  Clerkship AHD

6 Year Incorporated into Academic time Longitudinal Courses I.Clinical Reasoning II.Clinical Skills III.Indigenous Health IV.Professionalism V.Population Health  Scholarship in Medicine (SiMed 3 and 4) Themes/Disciplines 6 Year Boxes are not scaled M0: Foundation M2: Health & Disease Abnormal Processes- Clinical Integration M1: Human Biology & Health Normal Processes- Clinically Applied M2 : Health & Disease Abnormal Processes M5: Med 3 Clinical Clerks  UGME Academic Half Day M6:  Med 4 Electives  CaRMS UGME CURRICULUM RENEWAL FRAMEWORK M4 TTC : Transition to Clerkship M3: Consolidation Principle: “Fully integrated spiral scaffold curriculum through 4 years” M7 TTR: Transition to Residency Composite Clinical Presentations (CP 4 )

7 Goals to be achieved upon graduation Derived from combination : MCC objectives UBC modified MCC Objectives–clinical presentations (~130) Suggestions from UGME PreClerkship and Clerkship Directors survey ( June 2011) ……Then divided into 4 color coded groups……. Spiral Curriculum Framework “Composite” Clinical Presentations: ONE UNIVERSITY. MANY FUTURES. Undergraduate Medical Education 7 Symptoms or Signs Lab abnormalities Factors Affecting Health Health Conditions Clinical Presentations “must represent a common or important way in which a patient, group of patients, community or population actually presents to the physician and which a graduate would be expected to handle” UC UGME CURRICULUM RENEWAL

8 8 *Complied from MCC objectives, UGME CD survey 2010, UBC website

9 UGME CURRICULUM RENEWAL GOVERNANCE UGME CuREXecutive (…..Directors) 2014 PreclerkshipKeevin Bernstein Chair Clerkship Merril PaulsIra Ripstein Associate Dean Eunice Gill Nicola Matthews Diane Moddemann Curriculum Clinical Academic(TTC/TTR) Rob Brown Simulation Karen Klym Clinical Skills Tara Petrychko - Administrator Adrian GooiOnline Learning Barry Cohen Student Evaluation Joanne Hamilton Educ. Development Don Smyth Basic Science rep Bryan Payne Program Manager Shawna Klapecki Administrative Asst. Preclerkship M0 & M1/2 Leaders Longitudinal Course Leaders Clerkship Core Rotation Leaders Longitudinal Theme Leaders

10 UGME CURRICULUM RENEWAL GOVERNANCE Module Courses Leaders  Foundation of Medicine MOCindy Ellison /Don Smyth  Blood and Immunology M1/M2Don Houston  CardiovascularM1/M2Anita Soni  RespiratoryM1/M2Clare Ramsey  ENT Adrian Gooi  NeuroscienceM1/M2Tanya Sala (Kerri Schellenberg)  Ophth Lorne Bellan  Musculoskeletal M1/M2 Jason Peeler  Endocrine & MetabolismM1/M2Carmen Hurd  Woman’s Reproductive Health M1/M2Maggie Morris  GI, Hepatology & NutritionM1/M2 Don Duerkson  Urinary TractM1/M2Keevin Bernstein  Intro to ID & Therapeutics M2George Zhanel  Intro to OncologyM2Gary Harding  ConsolidationM3 Kristel VanInvelde/Holly Hamilton  DermatologyM3Jack Toole  Pain Management M3Paul Daenick/Joel Loiselle

11 UGME CURRICULUM RENEWAL GOVERNANCE  Longitudinal CoursesLeaders  Critical ReasoningMartha Ainslie  Clinical SkillsKaren Klym/Rob Brown  Indigenous HealthBarry Lavallee ( Linda Diffey)  Population HealthJoss Reimer  ProfessionalismMerril Pauls/Aviva Goldberg

12 UGME CURRICULUM RENEWAL GOVERNANCE  Longitudinal Theme Thread throughout curriculum with a designated leader; differs from Course as no designated exam:  Diagnostic Imaging Jeff Mottola…>James Kippen  Generalism  Gender & Sexual HealthDebrah Macphail *  GeneticsSandy Marles  GeriatricsKristel van Inevelde  Health PsychologyMaxine Holmqvist....Mike Teschuk  Health Care SystemsAmanda Condon  Interprofessional careAmanda Condon  Information SciencesJudy Littleford  Leadership  Pain ManagementPaul Daenick/ Joel Loiselle *  Palliative CarePaul Daenick  Social Accountability Anne Durcan * Recent additions

13 UGME CuRe: PreECLERKSHIP – Target AUG Content presented in the context of a Person, Family & Community: Human Biology, Health & Disease Modules (AM)  After the first 4 weeks of basic science foundation relevant to the study of medicine ( M0), the following 62 weeks ( separated by breaks) provides a system-based, spiral, scaffold, integrated approach to normal (M1) and abnormal function(M2).  There are 9 system based units each with 2 separate courses per system scaffolding from the application of basic science to normal function (M1) evolving to clinical practice (M2). M2 starts with an introduction to Infectious Disease and Oncology.  Year 2 concludes with a 10 week Consolidation Module (M3) to ensure all the content from the previous modules and Longitudinal courses are assimilated.  All individual courses will have a separate evaluation each requiring a minimum mastery with scaffold content. Longitudinal Courses and Themes (PM)  Focus will be a Person to Community Centered curriculum highlighting principles of professionalism, social accountability & responsibility helping to contextualize health issues  Presented in the afternoon in one of the 5 Longitudinal courses of 1) Clinical Reasoning, 2) Clinical Skills, 3) Indigenous Health, 4) Population Health (fka Community Health Sciences) and 5) Professionalism maximizing community exposures linked to the morning Module courses.

14 Year Incorporated into Academic time Longitudinal Courses I.Clinical Reasoning II.Clinical Skills III.Indigenous Health IV.Professionalism V.Population Health  Scholarship in Medicine (SiMed 3 and 4) Themes/Disciplines 14 Year Boxes are not scaled M0: Foundation M2: Health & Disease Abnormal Processes- Clinical Integration M1: Human Biology & Health Normal Processes- Clinically Applied M2 : Health & Disease Abnormal Processes M5: Med 3 Clinical Clerks  UGME Academic Half Day M6:  Med 4 Electives  CaRMS UGME CURRICULUM RENEWAL FRAMEWORK M4 TTC : Transition to Clerkship M3: Consolidation Principle: “Fully integrated spiral scaffold curriculum through 4 years” M7 TTR: Transition to Residency Composite Clinical Presentations (CP 4 )

15 UGME CURRICULUM RENEWAL GOVERNANCE Foundation of Medicine MOCindy Ellison /Don Smyth  Provide basic science foundation relevant to the study & practice of medicine  Focus will be on the principles, themes and overarching framework  4 weeks …58 hours: mostly WGS ( Whole Group Sessions) with relevant illustrative clinical scenarios  Premier instructors from the basic science departments  Course created with components : Cells: Structure & Function, Communication, Metabolism, Intake/Output, Reproduction and Environment Protein: Tissues: Biology, Imaging and Sampling Altered cells: Inflammation & Neoplasia Roles in Health & DiseaseGenetics,Immunity, Pathogens, Toxins Pharmacology and Human Development

16 Year Incorporated into Academic time Longitudinal Courses I.Clinical Reasoning II.Clinical Skills III.Indigenous Health IV.Professionalism V.Population Health Themes/Disciplines  Scholarship in Medicine (SiMed 3 and 4) 16 Year Boxes are not scaled M0: Foundation M2: Health & Disease Abnormal Processes- Clinical Integration M1: Human Biology & Health Normal Processes- Clinically Applied M2 : Health & Disease Abnormal Processes M5: Med 3 Clinical Clerks  UGME Academic Half Day M6:  Med 4 Electives  CaRMS UGME CURRICULUM RENEWAL FRAMEWORK M4 TTC : Transition to Clerkship M3: Consolidation Principle: “Fully integrated spiral scaffold curriculum through 4 years” M7 TTR: Transition to Residency Composite Clinical Presentations (CP 4 )

17  Human Biology and Health Module (I )  Health and Disease Module (2) Contrasting Module I and Module 2 I = Human Biology and Health…Module 1 2 = Health and Disease…………....Module 2 1: Normal development, anatomy and processes  Provide overview of burden of illness / diseases related to system  Predominantly basic sciences with clinical cases (normal or abnormal) to contrast or help illustrate normal 2 : Abnormal processes  Provide overview of burden of illness & societal impact of diseases  With each specific abnormality or disease cover all “9” elements  Predominantly clinical cases with review of basic science UGME CuRe 21 st century: Human Biology, Health & Disease Modules Course Template March

18 Human Biology & Health…(“systems I”) 1 1. Introductory lecture (2hrs)  Course objectives  Overview of system/organ function  Overview of anatomy and relevant structures  Overview of Burden of illness  Patient illustration 2.Normal Development & Embryology 3.Gross Anatomy & Imaging 4.Histology 5.Normal Processes including impact of aging  Physiology  Biochemistry & Molecular biology  Pharmacology * All material ( where possible) will be presented as normal contrasting to illustrations of abnormal providing clinical relevance Health & Disease….(“systems II” ) 2 1.Introductory lecture (2 hrs) Course objectives Review of Systems I Burden of illness  Epidemiology and Social Patient illustration 2.Clinical Genetics Review of embryology if relevant 3.*Life Cycle impacts: Development--> pediatrics --> geriatrics 4.Abnormal Processes: Specific Abnormality or Disease pathophysiology *With each entity : 1)Epidemiology 2)Scientific Basis and Anatomy review 3)Prevention and Screening 1 4)Cultural, Social and Ethical issues 5)Natural History & Prognosis 6)Diagnosis 2 7)Therapeutics and Disease Management 8)Translational Research & Evidence Based Medicine 9)Health Care System * Either as part of module or parallel longitudinal course 1 Includes amongst others nutrition, life style, exercise 2 Includes history, physical, labs, imaging and pathology UGME CuRe 21 st Century: Module 1 & 2 Course Template March

19 Year Incorporated into Academic time Longitudinal Courses I.Clinical Reasoning II.Clinical Skills III.Indigenous Health IV.Professionalism V.Population Health  Scholarship in Medicine (SiMed 3 and 4) Themes/Disciplines 19 Year Boxes are not scaled M0: Foundation M2: Health & Disease Abnormal Processes- Clinical Integration M1: Human Biology & Health Normal Processes- Clinically Applied M2 : Health & Disease Abnormal Processes M5: Med 3 Clinical Clerks  UGME Academic Half Day M6:  Med 4 Electives  CaRMS UGME CURRICULUM RENEWAL FRAMEWORK M4 TTC : Transition to Clerkship M3: Consolidation Principle: “Fully integrated spiral scaffold curriculum through 4 years” M7 TTR: Transition to Residency Composite Clinical Presentations (CP 4 )

20 Longitudinal Courses:  Clinical Reasoning CR  Critical Thinking*  Information Sciences*  “Metacognition”*  Integration* strategies - eg Case of the week  CP 4  Clinical Skills *  Communication skills  Physical exam skills/diagnosis  Community Clinics & Distributed Learning contexts*  Procedural skills  Self reflection*  Professionalism  Social accountability/equity*  Cultural safety/diversity*  Humanities/Ethics/History  Physician wellness (formerly Survival Tactics)  Narrative or Arts and Medicine  Decorum  Interprofessional  Leadership/Health advocacy*  Population Health Formerly KA Community Health Sciences Temporarily KA Public Health, Prevention & Scholarship  Epidemiology  Public health  Prevention  Health care systems *  Global Health  Occupational  Environmental  Specific or Key populations  Scholarship in Medicine *  SiMed3 - Clerkship AHD  SiMed4 - TTR  Indigenous Health* UGME CURRICULUM RENEWAL * CuRe TG 20

21 Year Incorporated into Academic time Longitudinal Courses I.Clinical Reasoning II.Clinical Skills III.Indigenous Health IV.Professionalism V.Population Health  Scholarship in Medicine (SiMed 3 and 4) Themes/Disciplines 21 Year Boxes are not scaled M0: Foundation M2: Health & Disease Abnormal Processes- Clinical Integration M1: Human Biology & Health Normal Processes- Clinically Applied M2 : Health & Disease Abnormal Processes M5: Med 3 Clinical Clerks  UGME Academic Half Day M6:  Med 4 Electives  CaRMS UGME CURRICULUM RENEWAL FRAMEWORK M4 TTC : Transition to Clerkship M3: Consolidation Principle: “Fully integrated spiral scaffold curriculum through 4 years” M7 TTR: Transition to Residency Composite Clinical Presentations (CP 4 ) TARGET date Aug 2014 STARTED date Aug 2013

22 Step UGME CuRe Preclerkship Course Creation: Sequential Process : Course Leader’s Presentations 4. UGME CURRICULUM RENEWAL FRAMEWORK Principle: “Fully integrated spiral scaffold curriculum through 4 years”

23 Leader’s Vision within CuRe Framework presentation to Integration Committee  Suggestions provided  Faculty Development- TBL and Online Learning  External Review – Dr. Charles Prober- Stanford May-June meetings  CuReX- Curriculum Renewal Executive  Integration Committee- all UGME Directors & Leaders ( ~55) Principle: “Fully integrated spiral scaffold curriculum through 4 years” 4 step UGME CuRe Preclerkship Course Creation: Sequential Process : Course Leader’s Presentations

24 M0 M1  Health and Disease FOUNDATION 1.Blood & Immunology I 2.CV I and Resp (+ ET) I 3.NeuroScience I( Psych, Neuro + Opth) 4.Musculoskeletal I 5.Endocrine I and Woman’s Reproductive Health I 6.GI/Hep/Nutrition I and Urinary Tract I M2 M3 24  Consolidation Mar 24 - May Mar 23 - April 2 ( Good Friday April 4 ) April 7 - May 22 (Easter Monday April 6 ) May ………..…. Rural week Aug 24 - Sept Sept 21 - Nov Nov 9 - Nov Nov 30 - Dec 18 Dec break Jan 4 - Jan Jan 25 - Feb Feb 16 - Mar Mar ……….Reading week Aug 25 - Sept Sept 22 - Oct Oct 14 - Nov Nov 24 - Dec 19 Dec break Jan 5 - Jan Jan 19 - Feb Feb 17 - Mar 13 TOTAL Mar 16 – 20 ………. Reading week 1.Intro to Infectious Disease & Therapeutics 2.CV 2 3.Resp (+ ET) 2 4.Introduction to Oncology 5.Blood & Immunology (+ autoimmune diseases )2 6.NeuroScience ( Psych, Neuro, Opth ) 2 7.Woman’s Reproductive Health (WRH) 2 8.Endocrine 2 9.GI/Hep/Nutrition 2 10.Urinary Tract 2 11.Musculoskeletal 2 and Skin 2 Y2  Human Biology and Health Weeks Y1 CuRe Preclerkship M0, 1/2: Human Biology, Health and Disease FINAL …..V7

25 25 Weekly Template…..Year 1 Yr 1 and Yr 2 mirror images for Clinical Skills, CR and Free time M1 week 1 MondayTuesdayWednesdayThursdayFriday WGS or WGS/A 9:00 WGS or WGS/ASGS/TAS SGS/T 10:00 WGS or WGS/ASGS/TWGS or WGS/ASGS/LP SGS/T SGS/LP 11:00 WGS or WGS/A SGS/T AS 12:00 ASLunch Clinical Skills 50% 13:00 Lunch Clinical Reasoning Lunch Clinical Reasoning Clinical Skills-50% Free time -50% Free time 50% 14:00 Longitudinal Course Clinical Reasoning Clinical Skills-50% 15:00 Longitudinal Course Longitudinal Courses Free time- 50% 16:00 Longitudinal Course Free

26 Leader’s Course to CuReX Objectives & Sessions Feedback provided May-June meetings Oct –Dec meetings Total Meetings: CuReX- Curriculum Renewal Executive Integration Committee- all UGME Directors & Leaders ( 55) Principle: “Fully integrated spiral scaffold curriculum through 4 years” Leader’s Vision within CuRe Framework presentation to Integration Committee  Suggestions provided  Faculty Development- TBL and Online learning  External Review – Dr. Charles Prober- Stanford 4 Step UGME CuRe Preclerkship Course Creation Sequential Process : Course Leader’s Presentations

27 27 Principle: “Fully integrated spiral scaffold curriculum through 4 years” Module Courses …..Longitudinal Courses………Selected Themes  Scaffolding Module content ………  Longitudinal courses interdigitating with the morning Modular courses  Theme content thread through module or longitudinal courses  Ensuring scaffolded into, and within clerkship !

28 28 Longitudinal Courses………………242 Hours through M0-M2.  Professionalism (Merril Pauls/Aviva Goldberg) 92 1.Clinical Ethics 41 CE PR-CE 2.Professionalsim: 14Pro PR-Pro 3.Medical Humanities: 3MH PR-MH 4.Physician Wellness:13*PW PR-PW 5.History of Medicine: 6HM PR-HM 6.Health Law: 13HL PR-HL 7.Spirituality: 2SP PR-SP  Population Health ( Joss Reimer) 114 (including M3 127) 1.Concepts of Health and its Determinants: 21HD PH-HD 2.Assessing and Measuring Health Status: 29AM PH-AM 3.Interventions at the Population Level: 16IP PH-IP 4.Administration of effective health programs: 7Adm PH-Adm 5.Infectious Disease & outbreak Management : 9ID PH-ID 6.Environment: 8Env PH-Env 7.Health of Key Populations: 35KP PH-KP  Indigenous Health (Barry Lavellee/Linda Diffey) 37 1.Indigenous Health and Ethics : 10IHE IH- IHE 2.Health Systems and Policy: 6HSP IH-HSP 3.Issues in Indigenous Health: 10IIH IH-IIH 4.Community Based: 8CB IH-CB 5.Family & Development: 3FD IH-FHD 6.Integrated Sessions Principle: “Fully integrated spiral scaffold curriculum through 4 years”

29 Leader’s Course to CuReX Objectives & Sessions Feedback provided May-June 2013: 8 meetings Oct –Dec 2013: 16 meetings Jan – Feb 2014: 6 meetings CuReX- Curriculum Renewal Executive Integration Committee- all UGME Directors & Leaders ( 55) Total Meetings: 30 Leader’s Course to Integration Committee  Objectives & Sessions  Suggestion & Feedback  Faculty Development- Objectives  Student assesssment update CuReX- Curriculum Renewal Executive Integration Committee- all UGME Directors & Leaders ( 55) Principle: “Fully integrated spiral scaffold curriculum through 4 years” Leader’s Vision within CuRe Framework presentation to Integration Committee  Suggestions provided  Faculty Development- TBL and Online learning  External Review – Dr. Charles Prober- Stanford 4 Step UGME CuRe Preclerkship Course Creation Sequential Process : Course Leader’s Presentations

30 30  Clinical Skills Communication Normal Physical Exam Abnormal Physical  Longitudinal courses would interdigitate with the morning Modular courses;  Theme content would thread through module or longitudinal courses Principle: “Fully integrated spiral scaffold curriculum through 4 years”  Clinical Reasoning Critical thinkingCases highlighting Cases highlighting MetacognitionNormal process in Pathophysiology and Information scienceintegrated fashion Diseases in integrated Clinical probabilitiesparalleling M1 content fashion paralleling M2 Heuristics  Population Health Determinants of health Critical appraisal of linked to M1 course Evaluating treatment eg disabilities in NS1 in each M2 course  Professionalism Principles of Clinical Clinical Ethic cases Ethics (CE) in each M2 course MOM1M2 Examples:

31 Leader’s Course to CuReX Objectives & Sessions Feedback provided May-June 2013: 8 meetings Oct –Dec 2013: 16 meetings Jan – Feb 2014: 6 meetings CuReX- Curriculum Renewal Executive Integration Committee- all UGME Directors & Leaders ( 55) Leader’s Course to Integration Committee  Objectives & Sessions  Suggestion & Feedback  Faculty Development  Student assessment update 4.4. CuReX- Curriculum Renewal Executive Integration Committee- all UGME Directors & Leaders ( 55) Principle: “Fully integrated spiral scaffold curriculum through 4 years” CuReX Review Feedback Student Approval March 2014 weekly and continue ! Leader’s Vision within CuRe Framework presentation to Integration Committee  Suggestions provided  Faculty Development- TBL and Online learning  External Review – Dr. Charles Prober- Stanford Total Meetings: 30 followed by weekly CuReX 4 Step UGME CuRe Preclerkship Course Creation Sequential Process : Course Leader’s Presentations

32 Leader’s Course to CuReX Objectives & Sessions Feedback provided CuReX Review Feedback Student Approval May-June meetings Oct –Dec meetings Jan – Feb meetings March 2014 weekly CuReX- Curriculum Renewal Executive Integration Committee- all UGME Directors & Leaders ( 55) Total Meetings: 30 followed by weekly CuReX Leader’s Course to Integration Committee  Objectives & Sessions  Suggestion & Feedback  Faculty Development-Objectives  Student asesssment update Step UGME CuRe Preclerkship Course Creation Sequential Process : Course Leader’s Presentations 4.4. CuReX- Curriculum Renewal Executive Integration Committee- all UGME Directors & Leaders ( 55) Principle: “Fully integrated spiral scaffold curriculum through 4 years” Leader’s Vision within CuRe Framework presentation to Integration Committee  Suggestions provided  Faculty Development- TBL and Online learning  External Review – Dr. Charles Prober- Stanford

33 PreClerkship System Courses Only Pedagogical Approaches : current curriculum by % 2009/2010 PreClerkship System Courses Only Pedagogical Approaches : current curriculum by % 2009/2010 M1/2 TARGET for lectures: <30% with all having some interactive component

34 34 UGME Pedagogical Approaches Preclerkship  WGS : Whole Group Session …lecture  WGS/A: Whole Group Session – interActive  audience response – top hat  team based learning  flipped classroom  SGS/T# :Small Group Sessions – Tutorial ideally >6 groups  SGS/LP: Small Group Sessions -Lab Practical  AS:Assigned Study with designated assignment

35 35 PRECLERKSHIP: PRINCIPLE: Multiple assessments per course; Frequent spiral assessments per year  Module (M0-M3) Courses: Each M1 and M2 course evaluated and passed separately i.e. No cumulative single block exam 30% MCQ midterm, with strugglers flagged and assisted ; 70% MCQ final; Course leader may modify with non MCQ evaluation Faculty Development from M.C.C. for exam questions Do not have to pass M0 to proceed to M1 but must pass M1 course to proceed to its respective M2 course Remediation to occur during other mandatory curricular time i.e Wed + Fri aft if unscheduled  Longitudinal Courses: CuRe: STUDENT ASSESSMENT PLAN – Barry Cohen

36 Purpose:  Ensure all the content from the previous modules are assimilated  Applied to patient care in a complex health care environment  Ensure ~137 Composite Clinical Presentations have been covered (if not covered elsewhere) at appropriate level. First 2 weeks:  Incorporate Derm (10 Hr) & Pain Management (10hrs) Subsequent 8 weeks include:  Single symptom presentations with broad differential diagnosis  Multisystem Disease – eg complicated diabetes  “Themes” or Disciplines such as pediatrics, geriatrics  Systemic diseases – eg HIV, SLE,etc.  Health Care Issues- pain, addictions, etc. Format : small group problem solving and clinical reasoning sessions. Consolidation Module (Module 3) 10 weeks 36 UGME CURRICULUM RENEWAL FRAMEWORK  Leaders : Kristel Van Ineveld Holly Hamilton

37 CuRe: Community Engagement FF#3 April 2012  Social Responsibility and Accountability Population Health and determinants of health framework Health Advocacy Interprofessional education and care Contextualize health issues – quality, equity and cost effectiveness  Curriculum needs to be based upon priority health needs of community and province:  We need to engage government, agencies and public  Longitudinal Courses: Clinical Skills Professionalism Community Health Indigenous Health Scholarly activity with community 37  Person to Community Centered :

38 38 UGME Longitudinal Clinical Exposure/Engagement Four Domains: 1. Longitudinal Clinical Experience – preclerkship over 2 years  Attach students to a community clinic to follow patients/family as they navigate health care system with chronic disease.  Pair Med 1 with Med 2 to incorporate peer teaching/learning 2. Clinical Exposures – visiting various community agencies 3. Rural week for Med 1…ongoing 4. Community exposures TTC….initiated in Aug 2013  Facilitated by engagement with WRHA……Jeanette Edwards…Director, Primary Care Committee: Co-chaired by Anne Durcan and Amanda Condon Dianne Moddemann, Karen Klym, Rob Brown, Nicola Matthews Jose Francois, Barry Lavalee, Keevin Bernstein Tara Petchrynko, Linda Diffey

39  Course schedules – fine tuned !  Objectives :  UGME Global – revised and approved by CEX  Course - Developed by course leaders and instructors Reviewed, modified and approved by CuReX  Session - Being reviewed by Dianne Moddemann & Joanne Hamilton  Mapping curriculum – objectives and course exam questions  Evaluation:  Student….Course Exam creation  Course and Faculty……mandatory ?  Opal:  Awaiting update to accommodate new curriculum  Upload: Course schedules & syllabi, and session objectives & materials  Restructuring admin support:  All preclerkship and non departmental clinical activities will be centralized under UGME  Clerkship development:  Formal academic integration – UGME AHD and core rotations  TTR and TTC revisions Next Steps…..To Do List/Challenges

40  Governance …..biggest challenge ! …. Next Steps…..To Do List/Challenges Principle: “Fully integrated spiral scaffold curriculum through 4 years” Examples:  Clerkship launched in 2013….. Ensure Clerkship curriculum including AHD, and core rotations leading into TTR is fully integrated to prevent curricular slide and silos  Integration within new preclerkship curriculum ….ensuring: Relevant basic science is integrated into M1/M2 Longitudinal Courses are integrated All themes are appropriately represented Diagnostic Imaging incorporated with anatomy and clinical cases ( as it is in new GiN, UT & MSK courses) Sessions are interactive

41 41

42 42 WEBSITE……UM/Faculties/Medicine:  all CuRe Information  Spreadsheet with each course outline, weekly schedules (M0-M2) …90+ tabs..today !  Spreadsheet – uploading all course and session objectives ….once finalized Large… Thank You ! UGME CURRICULUM RENEWAL

43 43 Student and Resident participation in CuRe Residents  Steven Promislow  Amit Kaushel  Elizabeth Berg  Peter Sytnick Students  Pol Daras  Eyal Kraut  Terry Colbourne  Harold Gjerde  Anne Finlayson  Ryan Chard  Jesse Marantz  Robert Schmidt  Mark Xu

44 44 Faculty Forum # 1 April 2011 ALL DAY RETREAT 112 PARTICIPANTS

45 45 CuRe Task group participants: Co-chairs…………………………… Faculty………………………………..84 Students or residents………….30

46 46

47 April 2011 Forum #4 Oct 2011 Forum #1 UGME CuRe MILESTONES Dec 2011 Stakeholder Engagement : Faculty- Student-Post Graduate - Government - RHAs - Public ACHIEVED: April 2011 Oct 2011 June 2011 Dec 2011 Forum #2 Undergraduate Medical Education 47 Forum #3 Feb 2012 Jan 2013 Dec 2012 Mar 2012 June 2012 Aug 2013 Mar 2012 April 2012 Dec 2012 April 2012 Oct 2012 Dec 2012 Jan 2013 June 2013 Feb 2013 Jan 2013 Forum #5 New Clerkship Launched 2013 New Clerkship Launched 2013 Aug 2013 Aug 2014 Created: April 2011 Modified : Oct 2012Modified : Dec 2012 June 2014 Forum #6 June 2014


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