OUTLINE - University of Manitoba · OUTLINE 1. Update Milestone map/ progress 2. ... Ira Ripstein MD. Associate Dean . Gary Harding MD. Director, Curriculum . Rob Brown MD . Director,

Faculty of Medicine UGME CURRICULUM RENEWAL Faculty Forum #4 Oct .11, 2012

1

OUTLINE

1. Update Milestone map/ progress

2. Curriculum 21st century Framework

Description of components

3. Faculty Impact

4. Next Steps

Undergraduate Medical Education

1

April 2011

Forum #3

Oct 2011

Forum #1

UGME CURRICULUM RENEWAL MILESTONES

Dec 2011

Stakeholder Engagement : Faculty - Student - Post Graduate Government - RHAs - Public

ACHIEVED:

April 2011

Oct 2011

June 2011

Dec 2011

Forum #2A

2 Undergraduate Medical Education

2 ONE UNIVERSITY MANY FUTURES.

Forum #2

Mar 2013

Feb 2012

Jan 2013

Dec 2012

Mar 2012 June 2012

April 2012 Oct 2012

Created: April 2011

Nov 2012

Modified : Oct 2012

Aug 2013 Aug

2013

Mar 2012

April 2012

Faculty Keevin Bernstein MD Director, CuRe

Ira Ripstein MD Associate Dean

Gary Harding MD Director, Curriculum

Rob Brown MD Director, CLSF

Don Smyth PhD Pharmacologist

Joanne Hamilton MEd Department Med Ed

Barry Cohen MD Director, Assessment

Merril Pauls MD Director, Preclerkship

Eunice Gill MD Director, Clerkship

Karen Klym MD Director, Clinical Skills

Karen Howell MBA Project Manager

Bryan Payne MBA Program Manager

“Consumers” Amit Kaushal MD PGY3* Internal Medicine

Steven Promislow MD PGY3* Internal Medicine

Elizabeth Berg MD PGY3* Surgery

Steven Montague Med IV MMSA Senior Stick

Sarah Van Galen Med III Communication Rep

Eyal Kraut Med III Academic Rep

Pol Gomez Med III Academic Rep

Jesse Marantz Med II Student

Harald Gjerde Med II Academic Rep

Anne Finlayson Med II Academic Rep

* All Task Group residents were invited to join executive

UGME CURRICULUM RENEWAL EXECUTIVE



UGME CuREXecutive:

CuRe Clinical Skills Committee Karen Klym & Rob Brown , Co-Chair Holly Hamilton Nancy Porhownik Susan Hauch Tom Klonisch TJ Grexton (Med III) Maggie Eade Greg Schmidt (Med III) (Stasa Veroukis Jeanette Edwards)

UGME CURRICULUM RENEWAL Committees



Cure Clerkship (M4-7) Committee Eunice Gill & Keevin Bernstein , Co- Chair Ira Ripstein Rob Brown Joanne Hamilton Catherine Moltzan Elizabeth Berg (PGY3) Tara Petrychko Peter Syntnik (Med IV) Current Department Clerkship Directors

UGME CuREXecutive Keevin Bernstein , Chair

CuRe Progress (Student Assessment) Subcommittee Barry Cohen, Chair Ira Ripstein Allen Kraut Brent Kvern Steven Montague (Med IV) Pol Gomez (Med III)

ACTIVE Committees:

UGME CURRICULUM RENEWAL Committees


5 .

CuRe Preclerkship (M0-M3) Committee Merril Pauls & Keevin Bernstein Co-Chairs TBD:

Preclerkship Educational Leaders Longitudinal Course Leaders

UGME CuREXecutive Keevin Bernstein , Chair

CuRe Longitudinal Course Committee Gary Harding & Keevin Bernstein Co-Chairs TBD:

Longitudinal Course Leaders

Committees not yet convened:

Principles: Physicians for 21st century: Fulfills (or exceeds) UGME global objectives, FMEC recommendations

and LCME/CCME standards

Fully integrated spiral scaffold curriculum throughout 4 years Person to Community Centered not focused on organ system or department based

Build upon existing and potential strengths

Innovative – utilizing evolving technology

Iterative and Transparent process

Faculty: More Educational leaders but fewer teachers More Faculty Development, Evaluation, Reward and Recognition

UGME CURRICULUM RENEWAL

ONE UNIVERSITY. MANY FUTURES. Undergraduate Medical Education

6

Foundation of Medicine

Year 1 2 3 4

Health & Disease Abnormal Processes- Clinical Integration

Normal Biology & Health Normal Processes- Clinically Applied

Consolidation

Health & Disease Abnormal Processes

UGME CURRICULUM RENEWAL FRAMEWORK

Incorporated into Academic time • Longitudinal Courses I. Clinical Reasoning II. Professionalism/Doctoring III.Clinical Skills ->Community Clinics IV.Community Health/Epidemiology V. Indigenous Health VI.Scholarly Activity

• Themes/Disciplines Composite Clinical Presentations (CP4)

Boxes are not scaled

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Principle: “Fully integrated spiral scaffold curriculum through 4 years”

TTR: Transition to Residency

TTC: Transition to Clerkship

“Junior” Clerks (JC) UGME Intersessions/ Academic time

“Senior”Clerks (SC) UGME Intersessions/ Academic time TTR: Transition to Residency

Presenter

Presentation Notes

“Titles” of preclerkship, clerkship, systems, year etc may not be maintained Applied Contextualized Linked Relevance


Year 1 2 3 4



Consolidation




• Themes/Disciplines Composite Clinical Presentations (CP4)

Boxes are not scaled

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Principle: “Fully integrated spiral scaffold curriculum through 4 years”





Presenter

Presentation Notes


Provide a basic science foundation relevant to the study and practice of medicine

• Focus will be on the principles, themes and overarching framework

• Not contain sessions that are simply an overview or sample of things to come

• Not dwell on specifics from clinical examples but use only clinical vignettes for illustration

Appoint Foundation Leader and curriculum committee from basic science departments who will provide most of the teaching, then continue as Department “Leader”

4 weeks

Foundation of Medicine (Module 0)

9 ONE UNIVERSITY. MANY FUTURES. Undergraduate Medical Education

9



Year 1 2 3 4



Consolidation





• Themes/Disciplines Composite Clinical Presentations (CP4) 10

Year 1 2 3 4

Boxes are not scaled Principle: “Fully integrated spiral scaffold curriculum through 4 years”




Presenter

Presentation Notes


Composite Clinical Presentations (CP4)

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:


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• 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 2009 http://www.ucalgary.ca/mdprogram/node/622

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http://www.ucalgary.ca/mdprogram/node/622



Spiral Curriculum Framework 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 2009 http://www.ucalgary.ca/mdprogram/node/622


• Symptoms or Signs • Lab abnormalities • Determinants of Health • States of Health

CCOMPOSITE CLINICAL PRESENTATIONS CP4* UGME Sept 2012 DRAFT V6 SYMPTOMS & SIGNS 34 hemoptysis ABNORMAL LABS HEALTH CONDITIONS

1 abdominal mass 35 hirsutism 67 acidosis 99 ADHD spectrum 2 abd pain: acute & chronic 36 hoarse voice 68 alkalosis 100 adrenal disorders 3 allergic reactions 37 impotence 69 hemoglobin disorders 101 arthritis 4 Anxiety 38 incontinence 70 calcium/phosphate/magnesium 102 CVD 5 Ascites 39 jaundice 71 cardiac markers/EKG 103 cirrhosis 6 blunt trauma 40 joint pain-acute & chronic 72 coagulation abnormalities 104 CNS infections 7 Burns 41 low back pain 73 creatinine: acute & chronic 105 Diabetes 8 Bleeding 42 lymphadenopathy 74 CXR abnormalities 106 Drug OD 9 cardiac murmurs 43 neck mass/thyroid 75 lipid abnormality 107 eating disorders

10 Chest pain 44 pain syndrome 76 leukocyte disorders 108 fungal infections 11 constipation 45 palpitations 77 liver enzymes/function 109 HIV/AIDS 12 cough- acute & chronic 46 prostatism 78 potassium abnormalities 110 hypertension 13 cyanosis 47 pruritus 79 platelet disorders 111 infertility 14 delirium 48 red eye 80 pulmonary function tests 112 kidney disease-chronic 15 dementia 49 paralysis 81 sodium abnormalities 113 lung disease-chronic 16 diarrhea- acute & chronic 50 pelvic pain/mass 82 urinalysis abnormalities 114 malnutrition

17 diplopia 51 seizures FACTORS AFFECTING HEALTH 115 menses/menopause 18 dysphagia 52 skin growths 83 Adverse drug reactions 116 mood disorders 19 dyspnea-acute & chronic 53 skin rashes 84 Chronic disease 117 multiple sclerosis 20 dysuria/UTI 54 sleep disorders 85 Contraception 118 osteoporosis 21 ear pain 55 somnolence 86 Culture 119 pediatric emergencies 22 edema 56 sore throat 87 WHO Determinants of Health 120 palliative care 23 extremity pain-acute & chronic 57 syncope 88 developmental pediatric delay 121 pituitary disorders 24 eye trauma 58 tendon rupture 89 Disabilities 122 pregnancy/ complications 25 fever 59 testicular swelling/pain/mass 90 neglect/abusive relationship or behavior 123 psychosis 26 fatigue 60 tinnitus 91 educational level 124 suicidal behavior 27 foot ulcers 61 vomiting 92 elderly/frail 125 shock/resuscitation 28 fracture/dislocation 62 vision loss acute & chronic 93 environmental health 126 sports injuries 29 GI bleed 63 weakness 94 infectious epidemic/prevention 127 STI 30 head injury 64 wheezing- acute & chronic 95 food and water security 128 suicidal behavior 31 headache 65 UT obstruction symptoms-lower 96 Body weight disorder 129 systemic autoimmune disorders 32 hearing loss 66 vertigo/dizziness 97 substance abuse/addiction/alcoholism 130 surgical infections 33 hematuria 98 Poverty 131 TB

Smoking 132 thyroid disorders 133 Venous thrombosis *Compiled from MCC website, UGME CD survey 2010, and UBC website

CP4: Composite Clinical Presentations Learning Outcomes or Goals to be achieved upon graduation

highlighted at different junctures at the relevant educational level ( vs Instructional objectives)

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……over 4 years.

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 2009

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Spiral Curriculum Framework 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 2009 http://www.ucalgary.ca/mdprogram/node/622


• Symptoms or Signs • Lab abnormalities • Determinants of Health • States of Health

CCOMPOSITE CLINICAL PRESENTATIONS CP4* UGME Sept 2012 DRAFT V6 SYMPTOMS & SIGNS 34 hemoptysis ABNORMAL LABS HEALTH CONDITIONS

1 abdominal mass 35 hirsutism 67 acidosis 99 ADHD spectrum 2 abd pain: acute & chronic 36 hoarse voice 68 alkalosis 100 adrenal disorders 3 allergic reactions 37 impotence 69 hemoglobin disorders 101 arthritis 4 Anxiety 38 incontinence 70 calcium/phosphate/magnesium 102 CVD 5 Ascites 39 jaundice 71 cardiac markers/EKG 103 cirrhosis 6 blunt trauma 40 joint pain-acute & chronic 72 coagulation abnormalities 104 CNS infections 7 Burns 41 low back pain 73 creatinine: acute & chronic 105 Diabetes 8 Bleeding 42 lymphadenopathy 74 CXR abnormalities 106 Drug OD 9 cardiac murmurs 43 neck mass/thyroid 75 lipid abnormality 107 eating disorders

10 Chest pain 44 pain syndrome 76 leukocyte disorders 108 fungal infections 11 constipation 45 palpitations 77 liver enzymes/function 109 HIV/AIDS 12 cough- acute & chronic 46 prostatism 78 potassium abnormalities 110 hypertension 13 cyanosis 47 pruritus 79 platelet disorders 111 infertility 14 delirium 48 red eye 80 pulmonary function tests 112 kidney disease-chronic 15 dementia 49 paralysis 81 sodium abnormalities 113 lung disease-chronic 16 diarrhea- acute & chronic 50 pelvic pain/mass 82 urinalysis abnormalities 114 malnutrition

17 diplopia 51 seizures FACTORS AFFECTING HEALTH 115 menses/menopause 18 dysphagia 52 skin growths 83 Adverse drug reactions 116 mood disorders 19 dyspnea-acute & chronic 53 skin rashes 84 Chronic disease 117 multiple sclerosis 20 dysuria/UTI 54 sleep disorders 85 Contraception 118 osteoporosis 21 ear pain 55 somnolence 86 Culture 119 pediatric emergencies 22 edema 56 sore throat 87 WHO Determinants of Health 120 palliative care 23 extremity pain-acute & chronic 57 syncope 88 developmental pediatric delay 121 pituitary disorders 24 eye trauma 58 tendon rupture 89 Disabilities 122 pregnancy/ complications 25 fever 59 testicular swelling/pain/mass 90 neglect/abusive relationship or behavior 123 psychosis 26 fatigue 60 tinnitus 91 educational level 124 suicidal behavior 27 foot ulcers 61 vomiting 92 elderly/frail 125 shock/resuscitation 28 fracture/dislocation 62 vision loss acute & chronic 93 environmental health 126 sports injuries 29 GI bleed 63 weakness 94 infectious epidemic/prevention 127 STI 30 head injury 64 wheezing- acute & chronic 95 food and water security 128 suicidal behavior 31 headache 65 UT obstruction symptoms-lower 96 Body weight disorder 129 systemic autoimmune disorders 32 hearing loss 66 vertigo/dizziness 97 substance abuse/addiction/alcoholism 130 surgical infections 33 hematuria 98 Poverty 131 TB

Smoking 132 thyroid disorders 133 Venous thrombosis *Compiled from MCC website, UGME CD survey 2010, and UBC website

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CP4: Composite Clinical Presentations Reviewed /Finalized with all UGME leaders once courses developed



Year 1 2 3 4



Consolidation





Year 1 2 3 4 Year 1 2 3 4





Presenter

Presentation Notes


Normal Biology and Health Module (formerly Systems I ) Health and Disease Module (formerly Systems II)

Contrasting Systems I and Systems II I = Normal Biology and Health Module II = Health and Disease Module

I: 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

II: 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 21st century: Normal Health & Disease Module …formerly “System” Course Template

15

Normal Biology & Health… (“systems”) I 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. Microanatomy

5. Normal Processes 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

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 Screening1

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 unit or parallel longitudinal course

1 Includes amongst others nutrition, life style, exercise

2 Includes history, physical, labs, imaging and pathology

UGME CuRe 21stCentury: Module 1 & 2 Course Template DRAFT Mar2012

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1. Introduction to Infectious Diseases/ Intro to Oncology Blood, Lymph and Immunology II 2. CV II

3. Resp II 4. Endocrine II 5. Kidney II 6. Reproduction II 7. GI & Nutrition II 8. Musculoskeletal II & Skin II 9. Neurobiology II (Psychiatry, Clinical Psychology, Neurology, Opth & ENT)

1.Blood, Lymph, Immunology & Skin I 2.Musculoskeletal I 3.Neurobiology I(Psychology, Neurosciences, & ENT) 4.CV I & 5.Kidney I & GI/ Nutrition I 6.Endocrine I & Reproduction I

UGME CuRe Preclerkship Y1/Y2: M0-M3: Normal Health and Disease Modules Y1

M0 M1

Y2

Health and Disease

Dec. break

Dec. break

Reading Week

Reading Week

Rural Week

Consolidation

M2

M3

Normal Biology & Health


DRAFT Feb 14

17

1. Introduction to Infectious Diseases/ Intro to Oncology Blood, Lymph and Immunology II 2. CV II

3. Resp II 4. Endocrine II 5. Kidney II 6. Reproduction II 7. GI & Nutrition II 8. Musculoskeletal II & Skin II 9. Neurobiology II (Psychiatry, Clinical Psychology, Neurology, Opth & ENT)

1.Blood, Lymph, Immunology & Skin I 2.Musculoskeletal I 3.Neurobiology I(Psychology, Neurosciences, & ENT) 4.CV I & 5.Kidney I & GI/ Nutrition I 6.Endocrine I & Reproduction I

UGME CuRe Preclerkship Y1/Y2: M0-M3: Normal Health and Disease Modules Y1

M0 M1

Y2

Health and Disease

Dec. break

Dec. break

Reading Week

Reading Week

Rural Week

Consolidation

M2

M3

Normal Biology & Health

Foundation of Medicine CREATION of M1 and M2 course sequencing & allocation 1. Logical sequencing of systems

2. Commence with Immunology and Blood

3. Logical anatomy instruction – dissection and student comprehension

4. Ensure all systems completed before spring year 1

5. Separated current topics into M1 and M2 equivalents & allocated 90 %

6. Ensure M1 course schedule doesn’t overlap with respective M2 schedule. 7. Accommodate student assessment and remediation Accommodate remediation of M1 Y1 courses before M2Y1 i.e. CV 2 days for Student assessment per course All courses end on Fridays with final course/unit exams that day

7. Accommodate natural holidays ( eg Dec break, Reading week and summer)

8. Accommodate national scientific meetings

……………….Numerous iterations >>>>> 18

Normal Biology and Health wks.days ( w. 2 days eval ) Approximate dates

UGME CuRe Preclerkship M1/2: Health and Disease Modules Y1

M1

Y2

Health and Disease

• FOUNDATION 1.Blood & Immunology I (+ Skin I) 2.CV I & Resp (+ ET) I 3.Neurobiology I(Psych, Neuro + Opth) 4.Musculoskeletal I 5.Endocrine I & Reproduction I 6.GI/ Nutrition I & Renal I

M2

M3

JULY 23 2012

4 ---- 2013 Aug 26 - Sept 20 3------------ Sept 23 - Oct 11

5 ------------ Oct 14 - Nov 15 4.6 --------- Nov 18 - Dec 18… Dec break 2------2014 Jan 6 - Jan 17 4------------- Jan 20 - Feb 14

4------------- Feb 17 - Mar 14 TOTAL 26.6 ……………….Mar 17 - 21 ………Reading week

2-------------Mar 24 - April 4 3-------------Apri 7 - April 25 4-------------Apri 28 - May 23 -----------May 26 - 30 …………. Rural week 4--------------Aug 25 - Sept 19 3--------------Sept 22 - Oct 10 3--------------Oct 13 - Oct 31 3 -------------Nov 3 - Nov 21 3 +3d------- -Nov 24 - Dec 18…… Dec break 6 -----2015- Jan 5 - Feb 13 4--------------Feb 16 - Mar13 ----------------Mar 16 - 20 ……. Reading week

1. Intro to ID/Intro Oncology 2. Blood & Immunology (+ autoimmune diseases) II 3. CV II

4. Resp + ET II 5. Endocrine II 6. Reproduction II 7. GI & Nutrition II 8. Renal II 9. Neurobiology II (Psych, Neuro, Opth) 10. Musculoskeletal II & Skin II 19 Consolidation 10-------------Mar 23 - May 29

5

UGME CuRe 21st century: Pedagogical Approach

Pedagogical approach and weekly template Ensure consistency amongst courses CuRex debated based upon Task Groups recommendation

However….. Needed buy in from all course leaders

……………Awaiting governance reorganization and Appointment of educational leaders :

Commence Faculty Development Organized by Joanne Hamilton (MEd) In person and online ; 13 modules 1st module: Pedagogical approach &

weekly template Course structure and organization Creation of objectives Creation of exam questions with MCC

Appointed Course leaders : Create curriculum committees

Membership to reflect requirements for course from all relevant departments

Submit course outline to CuRex /CuRe Preclerkship cte for approval

20

UGME CuRe 21st century: Pedagogical Template DRAFT Normal Health & Disease Modules : 17 hrs /week- AMs Lectures: Introductions; interdisciplinary ; summaries

Proportion & Number of lecturers TBD

Independent learning: role Assigned studies – Directed Self Learning

Small group learning: Tutorials:

o cases or questions o apply content o apply critical thinking o evidence based with references

Case Base Learning Team Based Learning

Online learning Peer teaching Link to Clinical skills/simulation/early exposure Student Assessment- formative & summative

Longitudinal Courses : 11hrs /week- PMs Clinical Skills - 3 hrs ( 4 hrs in Year 2) Clinical Reasoning - 3 hrs Others - 5 hrs

DRAFT Feb 2012

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9-10

10-11

UGME MODULE 2 or Year 2 AM Labs: anatomy

or Sim. Small group 180 minutes divided by 2, 3 or 4

Monday Tuesday Wednesday Thursday Friday

Whole group sessions: 160 minutes divided by 2, 3 or 4

Didactic, TBL, T1 with Iclickers

11-12

12-13

Break

Break

Whole group sessions

Unit specific Activity ( 2hrs)


Course specific Activity

Small group sessions: ( 2hrs)




9-10

10-11

Labs: anatomy or Sim.

Small group 180 minutes divided by 2, 3 or 4

Whole group sessions:

Whole group sessions: 160 minutes divided by 2, 3 or 4

Didactic, TBL, T1 with Iclickers

11-12

12-13



Break




Break


Course specific Activity ( 2hrs)

UGME MODULE 1 & MODULE 2 Year 1 AM

Year 1 & 2 : Noon hours for joint sessions: Tues & Thursday; 1300 Wed

Break

Break

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SAMPLE UGME WEEKLY TEMPLATE AM: Module 1 and 2

Longitudinal courses:

3 hrs (<1 hr didactic

lecture)

UGME PM/Longitudinal Courses Year 1 and 2


Clinical Reasoning (1hr)

Clinical Reasoning (2 hrs) Longitudinal

courses 2hrs

13-14

14-15

15-16

16-17

Break

Break

Break

Break

Clinical Skills (3 hrs)

Break

12-13

Year 1

Clinical Skills (4 hrs)

Clinical Reasoning (2 hrs)

Longitudinal

courses 2hrs

Break

Break

Break

Break

Break

Longitudinal courses:

3 hrs (<1 hr didactic

lecture)

13-14

14-15

15-16

16-17

12-13

Clinical Reasoning (1hr)

Year 2

UGME M 1

UGME M 1

UGME M 2

UGME M 2


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Year 1 & 2 unscheduled : Monday and Friday PM


Year 1 2 3 4



Consolidation





Year 1 2 3 4 Year 1 2 3 4





Presenter

Presentation Notes


Purpose: Ensure all the content from the previous modules are assimilated Applied to patient care in a complex health care environment Ensure ~130 Composite Clinical Presentations have been covered

(if not covered elsewhere) at appropriate level.

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.

Duration: 10 weeks


Consolidation Module (Module 3)

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Year 1 2 3 4



Consolidation





Year 1 2 3 4 Year 1 2 3 4





Presenter

Presentation Notes


Longitudinal Courses: Names TBA

Clinical Reasoning CR ( formerly Problem Solving) Information Sciences* Integration* strategies - eg Case of the week Pathology ( eg mini hospitals) CP4

Community Health Epidemiology Public health Health care systems * (includes Law & Med) Global Health Occupational Environmental

Clinical Skills * Communication skills Physical exam skills/diagnosis Community Clinics & Distributed Learning

contexts* Procedural skills Self reflection

Professionalism*/Doctoring Social accountability/equity* Cultural safety/diversity Humanities/Ethics/History Life Skills ( formerly Survival tactics) Narrative or Arts and Medicine Decorum Interprofessional Leadership/Health advocacy

Indigenous Health*

Scholarly Activity Basic or clinical science research Educational research Health Care system or Leadership Community research

UGME CURRICULUM RENEWAL *CuRe TG

27

Longitudinal Themes: Themes: Not individual courses but thread throughout curriculum with a designated leader:

Generalism * Information Science* Leadership Geriatrics Pediatrics Palliative Care Health Care Systems/Safety* Interprofessional Education

UGME CURRICULUM RENEWAL *CuRe TG

28

CuRe: STUDENT ASSESSMENT PLAN – Barry Cohen

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PRECLERKSHIP: 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 • 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 may occur during other mandatory curricular time

i.e Wed + Fri aft if unscheduled

Longitudinal Courses: Separate assessments • Clinical Reasoning: Integrated cases; based upon on both prior and

concurrent CR and Modular material; short answer questions • Year 1 : 6 exams for year 1 with proportional increase in value:

Percent: 5% / 5% / 20% / 20% / 20% / 30%

CURRICULUM RENEWAL: Community Engagement

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

30

Person to Community Centered :

UGME CURRICULUM RENEWAL –CLINICAL SKILLS

Service Learning ( Currently Co-Curricular ) • WISH clinic • Jacob Penner Park • Global Health Concentration Program

Learning in the Community ( Curricular):

•Urban ( eg WRHA Access or others) •Emergency departments •Rural Health care clinics •First Nation Communities •Health Care Agencies •Personal Care Homes

Foster Interest or Careers: - Urban primary care - Rural primary care - Indigenous /global health - Public Health/Equity - Geriatrics

31

UGME CURRICULUM RENEWAL –Clinical skills

New Clinical Skills Course: Following introduction to communication skills (early Module 1)….

Longitudinal clinics follow assigned families: Address community needs Range of engagement:

• Appreciate social diversity>>> manage chronic disease • Interprofessional care and /or education

Self reflection Commenced engagement with WRHA Primary Care Network

• Intended for communication skills • provide student exposure to various chronic diseases, and their

impact on both individual and family, • utilization of other care professionals, and how they navigation

through community services and resources

32

Service Learning ( Currently Co-Curricular or becomes curricular) Learning in the Community ( Curricular)


Year 1 2 3 4



Consolidation





Year 1 2 3 4 Year 1 2 3 4





Presenter

Presentation Notes


CLERKSHIP >2015: Year 3 ( M4 & M5)

ECP and CP4 Don’t need to be rotation specific - tracked electronically

TTC

9 days

Block 1 Surgery /Anesthesia

Block 2 Peds and OG

Block 3 Adult Medicine

Block 4 FM and Psych

12 weeks 6 weeks each 12 weeks 6 weeks each 3 groups 9 2 groups 14 2 groups 14 2 groups 14

34

???

3 weeks

Academic time: UGME qThursday PM- once developed determine if time required or qoThursday

Mandatory attendance Policy no “call” past 2300

Block specific academic time Maintain central oversight Developed jointly by 2 departments Commence each block 1-2 days academic time

Longitudinal Courses: Community Health Sciences (Public health & Health care system), Professionalism & Social Equity and Indigenous Health Incorporated into clinical rotation or UGME Academic half day

Block 1 Surgery /Anesthesia: 3 groups- NO overlaps- 9 students /group Segment 1 Segment 2 Segment 3

# Weeks 2 2 2 2 2 2 Group 1 General Surgery Subspecialty

Surgery Orthopedic /MSK Med

Anesthesia Perioperative Care

General Surgery : 4 weeks all students do GS; include community hospitals

Surgery subspecialty: 2 weeks limited to Urology or Plastics

Orthopedic medicine: 2 weeks

• Called MSK include joint & soft tissue management w. Sports & Physical Med

Anesthesia: 2 weeks Perioperative care: 2 weeks

• Follow a patient through perioperative experience in PAC & in surgery clinics • Non-operative ENT ( may change to LC) and ophthalmology ( and include in EM ) • Pain management curriculum: to include Non-pharmacologic pain management-

psychology, acupuncture and complimentary med Miscellaneous: Incorporate public health into surgery in collaboration with CHS,

and some component of pediatrics in collaboration with Peds


35

Block 1 Surgery /Anesthesia: 3 groups- NO overlaps- 9 students /group Segment 1 Segment 2 Segment 3

# Weeks 2 2 2 2 2 2 Group 1 General Surgery Subspecialty

Surgery Orthopedic /MSK Med


Group 2 Subspecialty Surgery

Orthopedic /MSK Med


General Surgery

Group 3 Anesthesia Perioperative Care

General Surgery Subspecialty Surgery

Orthopedic /MSK Med

12 week overall rotation called Block IM–EM – ACUTE MEDICINE 4 weeks Emergency Medicine

• ~ 15 emergency medicine shifts, plus optional EMS ride along • Incorporate internal medicine ambulatory care exposure (number of and type of clinics

are TBD; aim for 2 per week 1 GIM and 1 specialty ); • Develop continuity between ER and IM (ex. fast track clinic, urgent consult/follow up). • Incorporate General Internal Med Consult service if possible 6 weeks general internal medicine (CTU)

2 weeks of internal medicine selective

Miscellaneous: • Incorporate public health into block in collaboration with CHS


36

Block 2 Internal & Emergency Medicine: 2 grps- 14 students / grp #

Weeks 6 6

4 2 4 2 Group1

CTU Emergency Medicine Outpatient Internal

Subspecialty Medicine

Group2

Emergency Medicine Outpatient Internal

Subspecialty Medicine

CTU

TO DO LIST: Appointment of Academic Clerkship Director

Redevelop TTC Develop overview for UGME academic half time Develop TTR M7

Develop Four M5 ( core or junior )Blocks Family Med & Psych and Peds & Obs/gyn…….. add something novel Each block to develop objectives and work out academic time Appoint Block Coordinators

Develop 3 weeks “post TTC” ….Options: • Selectives ….different than traditional (s)electives- create catalogue of Selectives

which could to include anatomy, health care systems, leadership, palliative care, etc • 1- 2 weeks of Community clinics- urban..as continuation of preclerkship Clinical skills

Develop Year 4 ( M6 & M7) M6 – Electives pre CaRMS ( 17 weeks including interviews) ie no Change Develop M7 with academic time, LMCC review and concept of senior clerk:

Mandatory additional Core rotations ie selective IM/ surgery / Community care Selectives – palliative care, care of elderly, indigenous health, etc Program tailored to specific residencies

CLERKSHIP >2015: Year 3 (M4/M5) and Year 4 (M6/M7)

37

Governance: Modified to enhance & facilitate transparent communication

Maintain quality assurance and curricular stability Recognize faculty – remuneration or time


Appointed Educational leaders to oversee/ensure continuum for each: • Module or Course within modules (“unit”) • Longitudinal Course • Discipline/Department or “Theme”

With job description and appropriate recognition & reward

Formal Faculty Development & Evaluation All Educational leaders understand the curriculum framework Each educational “unit” with leader will have a curriculum

committee with relevant representation

Fewer teachers…..in particular lectures

38

UGME CURRICULUM RENEWAL: Faculty

UGME CURRICULUM RENEWAL NEXT STEPS:

1. Finalize Governance: Attaching remuneration and source

2. Appointment of new educational unit leaders Who will then develop their committees and course content

3. Commence Faculty Development

4. Revised overarching UGME objective – Gary Harding

Mission statement

5. Formalizing the Longitudinal Courses, and Theme threads

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Presenter

Presentation Notes


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QUESTIONS

Thank you.


Documents

OUTLINE - University of Manitoba · OUTLINE 1. Update Milestone map/ progress 2. ... Ira Ripstein MD. Associate Dean . Gary Harding MD. Director, Curriculum . Rob Brown MD . Director,