Medical School Objectives Project Research Articles

Loyola University Chicago Stritch School of Medicine.

Loyola University Chicago Stritch School of Medicine.

Loma Linda University School of Medicine.

Loma Linda University School of Medicine.

The University of Texas Health Science Center at San Antonio, Joe R. and Teresa Lozano Long School of Medicine.

The University of Texas Health Science Center at San Antonio, Joe R. and Teresa Lozano Long School of Medicine.

Competency 1. Communicate effectively with patients, families, and the public, as appropriate, across a broad range of socioeconomic and cultural backgrounds

The ability to communicate effectively with patients, families, and the public is a critical skill for the medical professional and has been directly related to the outcomes of clinical care. 1 Stewart M. Effective physician–patient communication and health outcomes: a review. Can Med Assoc J. 1995; : 152-159 Google Scholar The importance of this is reflected in the medical education literature in consensus statements on essential elements of communication, 2 Simpson M. Buckman R. Stewart M. et al. Doctor–patient communication: the Toronto consensus statement. BMJ. 1991; 303: 1385-1387 Crossref PubMed Scopus (599) Google Scholar , 3 Participants in the Bayer-Fetzer Conference on Physician–Patient Communication in Med Educ Essential elements of communication in medical encounters: the Kalamazoo consensus statement. Acad Med. 2001; 76: 390-393 Crossref PubMed Scopus (584) Google Scholar in guidelines for medical school curriculum development, 4 Association of American Medical Colleges Medical School Objectives Project, Report III. Contemporary Issues in Medicine: Communication in Medicine. Association of American Medical Colleges, Washington, DC1999 Google Scholar , 5 General Medical Council Tomorrow's Doctors: Recommendations on Undergraduate Med Educ. General Medical Council, London, UK1993 Google Scholar and through increased emphasis placed on communication skills by professional practice organizations and accrediting bodies. 6 Communications Self-Evaluation Process (COM-SEP) Committee Minutes. American Board of Internal Medicine, Philadelphia, Pa1999 Google Scholar , 7 Tate P. Foulkes J. Neighbour R. et al. Assessing physicians' interpersonal skills via videotaped encounters: a new approach for the Royal College of General Practitioners membership examination. J Health Commun. 1999; 4: 143-152 Crossref PubMed Scopus (43) Google Scholar

Spirituality and Health

Spirituality has played a role in health care for centuries, but by the early 20th century, technological advances in diagnosis and treatment overshadowed the more human element of medicine. In response, a core group of medical academics and practitioners launched a movement to reclaim medicine's spiritual roots, defining spirituality broadly as a search for meaning, purpose, and connectedness. This commentary describes the history of the field of spirituality and health-its origins, its furtherance through the Medical School Objectives Project, and its ultimate incorporation into the curricula of over 75% of U.S. medical schools. The diverse efforts in developing this field within medical education and in national and international organizations created a need for a cohesive framework. The National Competencies in Spirituality and Health-created at a consensus conference of faculty from seven medical schools and reported here for the first time-answered that need.Also reported are some of the first applications of these competencies-competency-linked curricular projects. This issue of Academic Medicine features articles from three of the participating medical schools as well as one from an additional medical school. This commentary also describes another competency application: the George Washington Institute of Spirituality and Health-Templeton Reflection Rounds initiative, known as G-TRR, which has provided clerkship students with the opportunity, through reflection on their patient encounters, to develop their own inner resources to address the suffering of others. This commentary concludes with the authors' proposals for future directions for the field.

Educating Medical Students in Musculoskeletal Surgery and Medicine—How to Get a Course Up and Running at Your Institution

Approximately 15% to 30% of visits to primary care physicians in the United States and Canada1, 20% of emergency room visits in the U.S.2, and 20% of nonroutine pediatric visits to physicians in Europe3 are for the purpose of addressing musculoskeletal complaints and injuries. In 2004, the National Ambulatory Medical Care Survey indicated that musculoskeletal conditions composed the number-one reason for visits to physicians’ offices, with approximately 92.1 million visits reported annually4. Two years later, in 2006, the Centers for Disease Control and Prevention (CDC) reported that an estimated 7.9 million (15%) of the 53.3 million surgical and nonsurgical procedures performed during visits for ambulatory surgery in the U.S. were related to the musculoskeletal system, a percentage that is second only to that of procedures related to the digestive system (27%)5. With the current system of managed care and the prevalence of musculoskeletal disease, knowledge of musculoskeletal medicine must not only be mastered by specialists but should also be well understood by practitioners across a wide range of fields, including internal medicine, family practice, emergency medicine, pediatrics, and surgery. Nevertheless, relatively little attention is devoted to musculoskeletal medicine in most medical school curricula. Of the 122 medical schools in the U.S. in 2003, fewer than 50% required preclinical courses in musculoskeletal medicine, fewer than 25% required a clinical course in that subject area, and nearly 50% had no required course, preclinical or clinical6. In 2005, the Association of American Medical Colleges (AAMC) published a report highlighting this deficiency as part of its Medical School Objectives Project. In this report, entitled “Contemporary Issues in Medicine: Musculoskeletal Medicine Education,” the AAMC stated that “Medical schools may not be accomplishing this educational goal (i.e., preparing doctors to care for patients with musculoskeletal …

Aligning Education and Assessment: Improving Medical Education through Assessment

Nearly all levels of medical education and training are currently examining traditional methodologies to assess learner knowledge and competence. Medical science educators are keys to introducing students to the integration of the basic and clinical sciences and to providing relevant, integrated assessments that support the educational outcomes they seek. Perhaps nowhere else is medical education changing as quickly as in the sciences basic to medicine and the assessments we use must accompany that change. The recent report from the Association of American Medical Colleges and the Howard Hughes Medical Institute, “Scientific Foundations for Future Physicians” illustrates this profound change and presents a blueprint of principles, objectives, and competencies and “...represents the beginning of a broad dialogue within the undergraduate and medical education communities to reinvigorate the scientific preparation of physicians.”1 Organizations and countries have defined competencies, in the U.S.: the Medical School Objectives Project (MSOP), the Accreditation Council for Graduate Medical Education (ACGME); in Canada, the CanMeds; and Tomorrow’s Doctors in the United Kingdom. While there is no universally accepted definition of “competency”, there is general agreement that converges around the idea that competency is the integration of knowledge, skills, and professionalism or attitudes.

An Interprofessional Educational Approach to Teaching Spiritual Assessment

Spirituality is an essential aspect of a patient's health that can and should be integrated into routine health care. Despite recommendations of accrediting organizations such as the Association of American Medical Colleges, the National Association of Social Workers, and the Association of Professional Chaplains, there is little well defined curriculum focusing on interprofessional spiritual assessment. This article explores one program's use of an interprofessional approach in teaching spiritual assessment to students from medicine, social work, and chaplaincy. Learning objectives were adapted from the Association of American Medical Colleges Medical School Objectives Project. Workshop evaluations show that students can learn key concepts of spirituality and the basics of spiritual assessment while developing an understanding and respect for the role of chaplains, social workers, and physicians.

The Challenges and Impact of Evolving Competency-based Medical Education and Practice

In clinical care, much of the emphasis is appropriately focused on evidence-based practice, atient safety, and quality outcomes. However, a closely related evolving dynamic is aimed at ssessing, attaining, and maintaining competence in practice. This evolution has the potential for ajor, even revolutionary, changes in medical education and practice at all levels. Medical education in the United States has undergone a significant transformation over he past several decades, ranging from medical school (undergraduate medical education UME]), to residency training (graduate medical education [GME]), and continuing medical ducation (CME). In some respects, this evolution has occurred in each area independent of he others, but clearly there are overlapping themes, with significant impact on the rofessional activities of both experienced and neophyte physicians. Each of these arenas of education is governed by separate professional accrediting rganizations, ostensibly independent of each other but, again, coordinated in regard to ertain strategies and policies. UME is directed and monitored by the Liaison Committee on edical Education (LCME), which governs U.S. medical school curriculum content and tructure to ensure standards of basic education and training of physicians. GME is ontrolled by the Accreditation Council on Graduate Medical Education (ACGME), which ets institutional standards for organizations that sponsor GME, as well as common program equirements, which govern the structure and function of all ACGME-accredited residency raining programs. In addition, the ACGME is organized into 26 residency review commitees (RRC), which set standards for training in each medical specialty (including physical edicine and rehabilitation [PM&R]), as well as first postgraduate year training programs. he Accreditation Council on Continuing Medical Education (ACCME) in turn sets policies nd accrediting standards for any organization that desires to designate educational activiies for the American Medical Association Physicians’ Recognition Award category 1 CME redits. Each of these organizations periodically surveys its constituents regarding complince with established standards (the LCME surveys medical schools, the ACGME RRCs urvey residency programs, and the ACCME surveys CME providers), with varying cycle urations, depending on the degree of compliance. Another organization with roles in both UME and GME, the Association of American edical Colleges (AAMC), initiated a debate regarding learning objectives for medical tudents, which culminated in the Medical School Objectives Project in 1998, which dentified the following attributes of medical school graduates: altruistic, knowledgeable, killful, and dutiful [1]. More or less concurrently, the ACGME undertook a process to better define and haracterize physician “competence,” and, in 1999, evolved a 4-phase “Outcome Project” 2], with goals for assessing resident performance and instilling specific knowledge, skills, nd attitudes in 6 “core” or “general competencies”:

Louisiana State University Health Sciences Center School of Medicine at New Orleans

Louisiana State University Health Sciences Center School of Medicine at New Orleans

Wayne State University School of Medicine

Wayne State University School of Medicine

University of Vermont College of Medicine

University of Vermont College of Medicine

Medical Education in the United States and Canada, 2010

The authors present an overview of the educational programs, infrastructure to support them, and the assessment strategies of 128 medical schools in the United States and Canada, based on reports submitted by those schools and published in this supplement to Academic Medicine. The authors explore many important changes that have occurred since the publication of the Flexner Report in 1910 as well as the progress that is evident since a similar collection of medical school reports was published in September 2000, also as a supplement to Academic Medicine. Drawing on the reports, the authors summarize, among other topics, the advances that have taken place in the support for faculty, the funding of medical student education, changes in pedagogy and assessment, and the expansion of medical education to distributed models and regional campuses.The authors observe that the reports from the 128 schools illustrate that medical student education has undergone and continues to undergo substantive change, has advanced markedly since the reforms stimulated by the Flexner Report, and has continued to evolve during the past decade. The reports illustrate the strength of support for the educational programs, even in a time of financial constraints, and the increasing recognition of the scholarly contributions of faculty through teaching. The authors provide examples of the changes in pedagogy and new topics in the required curriculum in the past decade and describe selected highlights of the 128 educational programs.

Foundations of Database Searching: Integrating Evidence-Based Medicine into the Medical Curriculum

Library integration into the medical school curriculum is a crucial aspect of meeting Liaison Committee on Medical Education (LCME) Accreditation Standards and the Association of American Medical Colleges (AAMC) Medical School Objectives Project (MSOP) guidelines. To accomplish this, academic health sciences libraries seek to develop evidence-based medicine (EBM) literature searching classes within the medical school curriculum. Establishing a basic understanding of the fundamental concepts behind health sciences database searching among medical students is a prerequisite for a more demanding evidence-based literature searching curriculum. The George T. Harrell Health Sciences Library, Penn State College of Medicine, sought to incorporate an evidence-based medicine literature searching structure by working within the existing problem-based learning system during the preclinical years. Students in the clinical years will participate in evidence-based assignments during their rotations. A fourth-year EBM elective will be created to reinforce and round out students' exposure to these concepts.

Musculoskeletal Preclinical Medical School Education: Meeting an Underserved Need

Musculoskeletal problems including both rheumatologic and orthopaedic pathologies are the primary reason for physician office visits across the United States, with approximately 92.1 million encounters reported annually, according to the 2004 National Ambulatory Medical Care Survey1. Despite the impact that musculoskeletal diseases have on society and the wide range of medical practitioners who treat these conditions, there is compelling evidence that undergraduate medical curricula do not adequately prepare physicians in musculoskeletal medicine2-5. In 2005, the Association of American Medical Colleges (AAMC) issued a Medical School Objectives Project Report on musculoskeletal medicine highlighting the need for medical schools to improve the education of future physicians in this area6. The report outlined educational guidelines to establish a more coherent undergraduate musculoskeletal curriculum. We conducted a study at our medical school during the 2005-2006 academic year that substantiated the need for improving the musculoskeletal curriculum. Students lacked cognitive mastery, demonstrated low clinical confidence, and were dissatisfied with the amount of time spent learning musculoskeletal medicine. Findings of the study suggested the need to improve the integration of musculoskeletal medicine into the curriculum3. Data from the 2005 Step-1 United States Medical Licensing Examination at our institution also revealed that performance on the musculoskeletal section was the lowest of all the subsections. Thus, both national as well as institutional concerns prompted us to lobby for, develop, and begin implementation of a four-year integrated musculoskeletal curriculum. We focused our initial reform endeavors on the preclinical (first and second-year) curriculum. The process of curriculum reform and development differs among various medical schools. As such, the purpose of this study was to provide a framework that may assist educators in achieving the adoption of an integrated musculoskeletal curriculum into the preclinical curriculum at their own school. We offer …

Assessment of the Integration of AAMC Medical Informatics Objectives into the Medical School Curriculum

ABSTRACT The School of Medicine at the Medical College of Virginia Campus of Virginia Commonwealth University examined the 2005/2006 medical school curriculum to ensure that students were prepared to meet the informatics objectives put forward by the AAMC Medical School Objectives Project published in 1998. The AAMC Medical Informatics Objectives Survey, issued in 2005, led the VCU School of Medicine to investigate the points of integration between informatics objectives and course syllabi for the first three years of the medical school curriculum. This analysis raised awareness of the informatics objectives with SOM faculty and staff and showed that more than 74% of the informatics objectives have been integrated into the curriculum.

Professionalism, Medical Humanism, and Clinical Bioethics: The New Wave-Does Psychiatry Have a Role?

In medicine, and especially in medical school education, there is growing interest in and emphasis on professionalism, humanism, and clinical bioethics, as reflected in the Medical School Objectives Project of the American Association of Medical Colleges and the core competencies developed by the American Committee for Graduate Medical Education and the American Board of Medical Specialties. The authors first discuss the reasons for the increasing emphasis on this area. They then discuss specific areas related to professionalism, humanism, and clinical bioethics where psychiatrists are especially well fitted to play a role because of their training and experience. Finally, they suggest ways in which psychiatrists can play a more active role in this new direction in medical care and education.

Objectives of Undergraduate Medical Education in Musculoskeletal Surgery and Medicine

The Medical School Objectives Project is an initiative of the Association of American Medical Colleges (AAMC) that is designed to reach a general consensus within the American medical education community on the “skills, attitudes, and knowledge” that students graduating from accredited American medical schools should possess before beginning postgraduate training. Since its inception in 1997, the Medical School Objectives Project has published special reports addressing specific topics in medical education. The goal of these reports is to outline these learning objectives and the educational and assessment strategies that might be put to use in their implementation. Titles of previous reports issued by the Medical School Objectives Project include “Medical Informatics and Population Health,” “Communication in Medicine,” “Basic Science and Clinical Research,” “Quality of Care,” and “Genetics Education.” These reports are available online at www.aamc.org/meded/msop/start.htm. The underlying philosophical thrust of the reports, and of the Medical School Objectives Project, is the belief that mastery of their content might result in physicians who are altruistic, knowledgeable, skillful, and dutiful. In order that the critical importance of the mastery of musculoskeletal medicine and surgery would be appreciated by medical educators, the Committee on Medical Student, Resident and Fellow Education …

Spirituality and Medicine: Idiot-Proofing the Discourse

The field of spirituality and medicine has seen explosive growth in recent years, due in part to significant private support for the development of curricula in more than half of all U.S. medical schools, and for related residency training programs and research centers. While there is no single definition of "spirituality" in use across these initiatives, this article examines the definitions and learning objectives relevant to spirituality that are addressed in a 1999 report of the Medical School Objectives Project (MSOP), with special attention to their ethical implications. It concludes with several "diagnostic" case studies of religious consciousness from the medical literature and in literary texts, again with attention to ethical concerns.

Superior student chart notes challenge Medicare documentation policies.

Superior student chart notes challenge Medicare documentation policies.