Abstract
ABSTRACTMedical educators are continually looking for ways to enhance integrated learning and help students see how the material taught in their various courses is inter-related. . At Stony Brook School of Medicine, we embarked on a school-wide new curriculum called the Learning focused, Experiential, Adaptive, Rigorous and Novel (LEARN) curriculum and developed several integrated courses that were not based in specific departments. As part of this process, the pre-clinical (Phase-1) curriculum was shortened to 17 months to accommodate an expanded set of clinical offerings. The new structure called for teachers from different departments to lead and conduct the integrated blocks of pre-clinical courses. In this paper, we describe our discouraging experience with the first iteration of an integrated course in Cardiology, Pulmonology and Renal organ systems (CPR), and its transformation into a highly successful second iteration. This involved a systematic course quality improvement (QI) process within the context of a larger school wide curricular reform. As a result, student overall satisfaction with the course increased from 22% (28 of 127 responders) to 83% (111 of 134 responders); the mean score on a standardized NBME content exam increased by 6.7%. We report the systematic process we used to collect data from students and faculty that helped facilitate quality improvement in a key course in Phase-1 of our LEARN curriculum.
Highlights
In recent years, a significant number of US medical schools have reduced the time devoted to foundational sciences from 24 months to 18 months or fewer [1]
The 10-week CPR course is a required pre-clinical (Phase I) course at Stony Brook University School of Medicine (SBU SOM), directed by an overall course director, 3 clinicians who directed the individual organ segments and a basic physiologist. In both 2015 and 2016, the instructional strategies consisted of approximately 40% lectures, 20% case-based smallgroup seminars and 40% other learning activities including 3 objective structured clinical examination (OSCE) events, a clinical pathologic conference (CPC) exercise, team-based learning, several laboratory sessions and a few independent group-study hours
Starting in 2015, the LEARN curriculum allotted 22% fewer instruction days to teaching the physiology and disease manifestations of the cardiology, pulmonary and renal systems (39 days vs 50 days in the past)
Summary
A significant number of US medical schools have reduced the time devoted to foundational sciences from 24 months to 18 months or fewer [1] In general their curricula have been designed with a view toward greater horizontal integration in organ-based courses [2], in order to deliver content in a more digestible form over a shorter timeframe [3,4]. The Stony Brook University School of Medicine (SBU SOM), moved to a 17-month pre-clinical Learning focused, Experiential, Adaptive, Rigorous and Novel (LEARN) curriculum in 2015 [5] This involved merging the previously separate course in basic physiology with the organ systems courses, which already included pathophysiology, histology and pharmacology. We describe the changes made to the CPR course in response to student feedback, and highlight how a robust QI process helped us enhance horizontal integration, limit excess course material and improve consistency in teaching and assessments methods
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