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					MEDICAL EDUCATION



   School of Medicine Retreat
      February 8-10, 2002
          Strategic planning
         group for education

Parvati Dev
Charlotte Jacobs
Larry Mathers
Peter Schilling
Gary Schoolnik
Matt Scott
Al Taira
David Terris
Dick Tsien
David O’Brien
                                       Contributors


   Curriculum Reform Committee and the Faculty Senate
   Education retreat
   GALE developers
   Education technologies group
   Committee on Courses and Curriculum
   Dean and Senior Associate Deans
   Med Education Associate Deans
                               Mission statement

   We will educate students to become outstanding
    clinicians who have the skills and passion to improve
    the health of the world’s people through research,
    innovation, and leadership.
                                                Why do anything
                                                  different?


   It’s not “broke”. Students do well as measured by:
       Highly competitive admissions process

       High pass rates on boards

       Good reports from residency programs

       High rate of academics (33%) 10 years after medical school
                                         Why do anything
                                           different?

   Our education is not primed for the future
       Too much emphasis on learning memorizing specific
        information
       Not enough emphasis on:
            Methods for accumulating and interpreting new information
            Using the most effective educational methods--i.e.,
             simulations, small group interactive learning, online curricula
            Cross-disciplinary approaches to learning, particularly
             bridging gap between clinical and basic sciences
   Our curriculum does not fit our faculty or our students
                                      Education program


          Strengths                          Weaknesses
   The opportunities afforded      An absence of curricular
    students for individual          definition--what knowledge,
                                     methods and skills do students
    innovation and cross-
                                     need to have?
    disciplinary work
                                    Insufficient time devoted to
                                     fostering independent research
                                     skills and to developing clinical
                                     skills
                                    Funds flow that neither
                                     encourages accountability nor
                                     provides incentives for teaching
                                     excellence, innovation, and
                                     interdisciplinary programs
                                Strategic initiatives


   Revise the curriculum to address weaknesses and build
    on strengths

   Foster and facilitate teaching, advising and mentorship

   Develop facilities to meet future curriculum

   Develop a community service program
                                     Strategic initiatives:
                                     Revise curriculum


   Identify core knowledge and skills required for all students

   Develop required majors (“scholarly tracks”) for all students
    to enhance independent research capabilities

   Within scholarly tracks, develop a research honors programs
    for a subset of students

   Expand the clinical curriculum—particularly in the first years
    of medical school—to enhance pattern recognition.

   Develop a system of incentives to promote curricular change
                                Current curriculum


            Q1       Q2          Q3        Q4
                                          Med
       1         Pre-clinical
                                        scholars

       2           Med
                 scholars          TA
Year
       3
           TA

       4            Clinical

       5
                                   Proposed curricular
                                   Proposed curricular
                                       structure
                                        structure
                             Undergraduate

                                                  Basic science
                                Molecular medicine
         Clinical research
Year




                  Community service          Biotechnology


       Clinical                   Health economics


                      Residency and beyond
                                              Proposal for research
                                                    tracks

   Interdisciplinary programs compete to create scholarly tracks
    including:
        Course work for a large number of students
        Honors program for smaller number of students based on resources, number of
         mentors, etc.
   All students required to choose a track
   A subset of students (at onset33%) can compete for the
    “honors” program within each track and be funded for at least a
    year of research with or without additional degree
   Number of tracks can increase with time and each track can
    expand
   End goal: after 5-10 years, all students will want to be in honors
    program or MSTP
                       Future student body


Now               Near Future           5-10 years




Honors research            Ph.D.
Med scholars               No independent scholarship.
                                        Obstacles and opportunities:
                                                Curriculum


   Obstacles                                  Opportunities
       Funds flow for education                   Instructional technologies
       Lack of central oversight of               Intersections with university
        curriculum                                  campus
       Faculty may not be available to            Graduate programs to enhance
        teach core elements                         scholarly tracks
       Facilities inadequate for variety          Reputation for “flexibility” in our
        of teaching methods                         curriculum
       Insufficient mentorship and                Chance to give Stanford a
        advising programs                           “distinctive” education
                                Strategic initiatives
                               Enhance teaching (1)

    Establish underlying principles

   A certain level of teaching, advising and mentorship has
    to be established as a requirement for being on the
    faculty

   Teaching needs to be honored, promoted and facilitated

   The true costs of teaching courses should be
    established

   Departments must consider their courses to be an
    essential component of their mission
                                      Strategic initiatives
                                     Enhance teaching (2)

   Incentive programs for:
       Improvement in course performance
       Consistently high course performance
       Revising course content
       Developing teaching innovations, small group learning
        opportunities and bridges between clinical and basic science
        domains
       Mentorship and advising
   Support for pedagogy in the areas of:
       Course content
       How to teach and how to mentor
       New teaching technologies
       Course evaluation processes
                                     Obstacles and
                                 opportunities: Teaching

   Obstacles                           Opportunities
       Tuition does not cover the          Tuition mechanisms are not
        true costs of teaching               fixed in stone
                                            Faculty are interested in
       Funds flow for education
                                             teaching and mentorship
        does not directly support
                                            Campus is big
        teaching, mentoring or
        advising                            Instructional technologies
                                             already strong
       Teaching, advising, and
                                            Large number of interested
        mentoring are not valued             teachers in community
       Facilities inadequate               Center for Teaching and
                                             Learning and other
                                             pedagogical resources
                                             already exist
                                        Strategic initiatives

   Revise the curriculum to address weaknesses and build
    on strengths

   Foster and facilitate teaching

   Develop facilities to meet future curriculum
       Small group learning
       Simulation spaces, virtual classrooms
       Library

   Develop a community service program
                                     Strategic initiatives:
                                     Community service

   The need:
       The university, from its founding, has affirmed community
        service among students and graduates to be a vital component
        of its mission

       There is strong interest in community service among medical
        and graduate students

       There is strong interest in community service among faculty

       The university seeks to have better community relations

       The community (local, national and international) has enormous
        needs
                                     Strategic initiatives:
                                     Community service

   Purpose of community service center
       To provide a curriculum on service for medical and graduate
        students that promotes life-long commitment to action for their
        communities (no “amateur hour”)
       To serve as a clearing house for service opportunities:
           International health

           Local health programs

           Arbor Free Clinic and Tully Road Clinic

           K-12 program

       To interact with the local community
   Possible subsidiary of the Haas Center
   We are not a school of public health
                                                  Timeline

   Phase I--completed by this fall
       Establish mechanisms for reviewing curricular content
       Identify areas for scholarly track development
       Establish relationship with Haas Center for development of community
        service program
       Establish the true costs of the education program, and develop a
        funding system to directly support these costs

   Phase II--completed by fall 2003
       Five scholarly tracks in place
       Core knowledge and skills for basic sciences and early clinical
        experience established
       Curriculum in first year adapted to core
       Community service program in place
       Some pedagogical programs in place to enhance teaching
       Incentive program begun
                                                  Timeline (2)

   Phase III--completed by fall 2004
        Advising, mentoring program in place
        Enroll first honors students, funding mechanisms in place
        Core knowledge base for clinical education established
        Clinical experience curriculum for second year class in place
        Lecture-based curriculum in second year adapted to core and shrunk 20%
   Phase IV--completed by fall 2005
        More scholarly tracks initiated, others reviewed.
        Basic science, scholarly track curriculum for clinical years initiated
        Funding mechanisms solidified
        Degree granting mechanisms in place (Masters in Medicine?)
        Enhanced incentive program in place
        Pedagogical evaluation of first phases of curriculum
   Phase V
        New building in place
                                                Balance sheet

   A new vision for medical education
   Some components could be initiated very quickly
   Some component can be initiated without extensive new
    resources
   Some components could be costly
       Reviewing and revising entire curriculum
       Providing incentives for curricular improvements and teaching
       Providing funding for honors program and graduate degrees
       Building facilities and educational technologies
       Developing mentorship and advising programs

   “Trade school” or MEDICAL UNIVERSITY

				
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