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College of Medicine Faculty of Health Sciences UGME CuRe Faculty Forum #6

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 CuReE xecutive Outline 1. Review CuRe Process & History

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College of Medicine Faculty of Health Sciences UGME CuRe Faculty Forum #6

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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 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. UGME CURRICULUM RENEWAL MAPApril2011 New UGME Curriculum 2013 that fulfills FMEC recommendations & Accreditation Standards OUTCOME> Internal Review Surveys Retreats Curriculum map Existing curriculum External Consultation Website Educational Experts Site visits Task Specific groups Stakeholder Consultations Faculty Development Process Commitment to Person, Family & Community ; Social Responsibility, Professionalism, Inclusivity; Scholarship, Excellence, Discovery, Innovation, Critical Thinking Principles Consistent Pedagogy Scholarship Outcome Based Objectives Medical Informatics Integrated ContinuousQualityImprovement Inter-Professionalism Flexible Maximize Current strengths Curriculum Renewal Goal Mission 2

  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) ReportsNov 2011 • External Review;Genevieve Moineau MD June 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. UGME CURRICULUM RENEWALOct 2012 • 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 • 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

  5. CuRe : The Journey……….. UGME Curriculum Renewal for 21stCentury • Curriculum 21st 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 • Governance • Evaluation: Student Assessment and CuRe Evaluation • AM Years 1 & 2: Preclerkship • Integrated into M0-3 • PM Years 1 & 2: Preclerkship • Clerkship AHD http://umanitoba.ca/faculties/medicine/education/undergraduate/curriculum/curriculumrenewal.html

  6. UGME CURRICULUM RENEWAL FRAMEWORK Principle: “Fully integrated spiral scaffold curriculum through 4 years” Boxes are not scaled Year 1 2 3 4 Year 1 2 3 4 Year 1 2 3 4 M0: Foundation • M6: • Med 4 Electives • CaRMS M2: Health&Disease Abnormal Processes- Clinical Integration M4TTC: Transition to Clerkship • M1: Human Biology & Health • Normal Processes- • Clinically Applied • M5: Med 3 Clinical Clerks • UGME • Academic Half Day M7 TTR:Transition to Residency M2: Health& DiseaseAbnormal Processes M3:Consolidation • Longitudinal Courses • Clinical Reasoning • Clinical Skills • Indigenous Health • Professionalism • Population Health • Scholarship in Medicine (SiMed 3 and 4) • Themes/Disciplines Incorporated into Academic time Composite Clinical Presentations (CP4)

  7. UGME CURRICULUM RENEWAL Composite Clinical Presentations (CP4) Goals to be achieved upon graduation “Composite” Clinical Presentations: • 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……. • Symptoms or Signs • Lab abnormalities • Factors Affecting Health • Health Conditions 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 7 ONE UNIVERSITY. MANY FUTURES. Undergraduate Medical Education

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

  9. UGME CURRICULUM RENEWAL GOVERNANCE UGME CuREXecutive (…..Directors) 2014 Preclerkship Keevin Bernstein ChairClerkship Merril Pauls Ira RipsteinAssociate Dean Eunice Gill Nicola Matthews Diane Moddemann Curriculum ClinicalAcademic(TTC/TTR) Rob Brown Simulation Karen KlymClinical SkillsTara 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 & M1/2Leaders Longitudinal Course Leaders Longitudinal Theme Leaders Clerkship Core Rotation Leaders

  10. UGME CURRICULUM RENEWAL GOVERNANCE • Module Courses Leaders • Foundation of Medicine MOCindy Ellison /Don Smyth • Blood and Immunology M1/M2 Don Houston • Cardiovascular M1/M2 Anita Soni • Respiratory M1/M2 Clare Ramsey • ENTAdrian Gooi • Neuroscience M1/M2 Tanya Sala(Kerri Schellenberg) • OphthLorne Bellan • Musculoskeletal M1/M2 Jason Peeler • Endocrine & Metabolism M1/M2 Carmen Hurd • Woman’s Reproductive Health M1/M2 Maggie Morris • GI, Hepatology & Nutrition M1/M2 Don Duerkson • Urinary Tract M1/M2 Keevin Bernstein • Intro to ID & Therapeutics M2 George Zhanel • Intro to Oncology M2 Gary Harding • Consolidation M3 KristelVanInvelde/Holly Hamilton • Dermatology M3 Jack Toole • Pain Management M3 Paul 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 • Professionalism MerrilPauls/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 Health DebrahMacphail * • GeneticsSandy Marles • Geriatrics Kristelvan Inevelde • Health Psychology Maxine Holmqvist....Mike Teschuk • Health Care Systems Amanda Condon • Interprofessional care Amanda Condon • Information Sciences Judy Littleford • Leadership • Pain Management Paul Daenick/ Joel Loiselle * • Palliative Care Paul Daenick • Social Accountability Anne Durcan * Recent additions

  13. UGME CuRe: Preeclerkship – targetaug 2014 • 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 (fkaCommunity Health Sciences) and 5) Professionalism maximizing community exposures linked to the morning Module courses .

  14. UGME CURRICULUM RENEWAL FRAMEWORK Principle: “Fully integrated spiral scaffold curriculum through 4 years” Boxes are not scaled Year 1 2 3 4 Year 1 2 3 4 Year 1 2 3 4 M0: Foundation • M6: • Med 4 Electives • CaRMS M2: Health&Disease Abnormal Processes- Clinical Integration M4TTC: Transition to Clerkship • M1: Human Biology & Health • Normal Processes- • Clinically Applied • M5: Med 3 Clinical Clerks • UGME • Academic Half Day M7 TTR:Transition to Residency M2: Health& DiseaseAbnormal Processes M3:Consolidation • Longitudinal Courses • Clinical Reasoning • Clinical Skills • Indigenous Health • Professionalism • Population Health • Scholarship in Medicine (SiMed 3 and 4) • Themes/Disciplines Incorporated into Academic time Composite Clinical Presentations (CP4)

  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 http://umanitoba.ca/faculties/medicine/education/undergraduate/curriculum/curriculumrenewal.html

  16. UGME CURRICULUM RENEWAL FRAMEWORK Principle: “Fully integrated spiral scaffold curriculum through 4 years” Boxes are not scaled Year 1 2 3 4 Year 1 2 3 4 Year 1 2 3 4 M0: Foundation • M6: • Med 4 Electives • CaRMS M2: Health&Disease Abnormal Processes- Clinical Integration M4TTC: Transition to Clerkship • M1: Human Biology & Health • Normal Processes- • Clinically Applied • M5: Med 3 Clinical Clerks • UGME • Academic Half Day M7 TTR:Transition to Residency M2: Health& DiseaseAbnormal Processes M3:Consolidation • Longitudinal Courses • Clinical Reasoning • Clinical Skills • Indigenous Health • Professionalism • Population Health • Themes/Disciplines • Scholarship in Medicine (SiMed 3 and 4) Incorporated into Academic time Composite Clinical Presentations (CP4)

  17. UGME CuRe 21st century: Human Biology, Health & Disease Modules Course Template March 2012 • 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

  18. UGME CuRe 21stCentury: Module 1 & 2 Course Template March 2012 Health & Disease….(“systems II” ) 2 • Introductory lecture (2 hrs) • Course objectives • Review of Systems I • Burden of illness • Epidemiology and Social • Patient illustration • Clinical Genetics • Review of embryology if relevant • *Life Cycle impacts: • Development--> pediatrics --> geriatrics • Abnormal Processes: • Specific Abnormality or Disease pathophysiology *With each entity : • Epidemiology • Scientific Basis and Anatomy review • Prevention and Screening1 • Cultural, Social and Ethical issues • Natural History & Prognosis • Diagnosis 2 • Therapeutics and Disease Management • Translational Research & Evidence Based Medicine • Health Care System *Either as part of module or parallel longitudinal course 1Includes amongst others nutrition, life style, exercise 2 Includes history, physical, labs, imaging and pathology 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 • Normal Development & Embryology • Gross Anatomy & Imaging • Histology • 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

  19. UGME CURRICULUM RENEWAL FRAMEWORK Principle: “Fully integrated spiral scaffold curriculum through 4 years” Boxes are not scaled Year 1 2 3 4 Year 1 2 3 4 Year 1 2 3 4 M0: Foundation • M6: • Med 4 Electives • CaRMS M2: Health&Disease Abnormal Processes- Clinical Integration M4TTC: Transition to Clerkship • M1: Human Biology & Health • Normal Processes- • Clinically Applied • M5: Med 3 Clinical Clerks • UGME • Academic Half Day M7 TTR:Transition to Residency M2: Health& DiseaseAbnormal Processes M3:Consolidation • Longitudinal Courses • Clinical Reasoning • Clinical Skills • Indigenous Health • Professionalism • Population Health • Scholarship in Medicine (SiMed 3 and 4) • Themes/Disciplines Incorporated into Academic time Composite Clinical Presentations (CP4)

  20. UGME CURRICULUM RENEWAL Longitudinal Courses: *CuRe TG • Clinical Reasoning CR • Critical Thinking* • Information Sciences* • “Metacognition”* • Integration* strategies - eg Case of the week • CP4 • 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*

  21. UGME CURRICULUM RENEWAL FRAMEWORK Principle: “Fully integrated spiral scaffold curriculum through 4 years” Boxes are not scaled Year 1 2 3 4 Year 1 2 3 4 Year 1 2 3 4 M0: Foundation • M6: • Med 4 Electives • CaRMS M2: Health&Disease Abnormal Processes- Clinical Integration M4TTC: Transition to Clerkship • M1: Human Biology & Health • Normal Processes- • Clinically Applied • M5: Med 3 Clinical Clerks • UGME • Academic Half Day TARGET date Aug 2014 STARTED date Aug 2013 M7 TTR:Transition to Residency M2: Health& DiseaseAbnormal Processes M3:Consolidation • Longitudinal Courses • Clinical Reasoning • Clinical Skills • Indigenous Health • Professionalism • Population Health • Scholarship in Medicine (SiMed 3 and 4) • Themes/Disciplines Incorporated into Academic time Composite Clinical Presentations (CP4)

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

  23. 4 stepUGME CuRe PreclerkshipCourse Creation: Sequential Process : Course Leader’s Presentations Principle: “Fully integrated spiral scaffold curriculum through 4 years” • CuReX- Curriculum Renewal Executive • Integration Committee- all UGME Directors & Leaders ( ~55) 4. • Leader’s Vision within CuRe Frameworkpresentation to Integration Committee •  Suggestions provided • Faculty Development- TBL and Online Learning • External Review – Dr. Charles Prober- Stanford May-June 2013 8 meetings

  24. FINAL …..V7 CuRePreclerkship M0, 1/2: Human Biology , Health and Disease Y1 • Human Biology and HealthWeeks M0 M1 • 4 ---- 2014 Aug 25 - Sept 19 • 3----------- Sept 22 - Oct 11 • 6 ----------- Oct 14 - Nov 21 • 4 ------------ Nov 24 - Dec 19 Dec break • 2------2015 Jan 5 - Jan 16 • 4------------- Jan 19 - Feb 13 • 4------------- Feb 17 - Mar 13 • TOTAL 271------------ Mar 16 – 20………. Reading week • Foundation • Blood & Immunology I • CV I and Resp(+ ET) I • NeuroScience I(Psych, Neuro+ Opth) • Musculoskeletal I • Endocrine I and Woman’sReproductive Health I • GI/Hep/Nutrition I and Urinary Tract I M2 M3 • Health and Disease • 2--------------Mar 23 - April 2 ( Good Friday April 4 ) • 7--------------April 7 - May 22 (Easter Monday April 6) • 1--------------May 25 - 29 ………..…. Rural week • 4--------------Aug 24 - Sept 18 • 7--------------Sept 21 - Nov 6 • 3--------------Nov 9 - Nov 27 • 3--------------Nov 30 - Dec 18 Dec break • 3 -----2016 Jan 4 - Jan 22 • 3--------------Jan 25 - Feb 12 • 4--------------Feb 16 - Mar 11 • 1-------------Mar 14 - 18 ……….Reading week • Intro to Infectious Disease & Therapeutics • CV 2 • Resp (+ ET) 2 • Introduction to Oncology • Blood & Immunology (+ autoimmune diseases)2 • NeuroScience(Psych, Neuro, Opth) 2 • Woman’sReproductive Health (WRH) 2 • Endocrine 2 • GI/Hep/Nutrition 2 • Urinary Tract 2 • Musculoskeletal 2 and Skin 2 Y2 • Consolidation10-------------Mar 24 - May 27

  25. Weekly Template…..Year 1 Yr 1 and Yr 2 mirror images for Clinical Skills, CR and Free time

  26. 4 Step UGME CuRe Preclerkship Course Creation Sequential Process : Course Leader’s Presentations Principle: “Fully integrated spiral scaffold curriculum through 4 years” CuReX- Curriculum Renewal Executive Integration Committee- all UGME Directors & Leaders ( 55) 4. 4. • Leader’s Course to CuReX • Objectives & Sessions • Feedback provided Oct –Dec 2013 16 meetings Total Meetings: 24 • 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 2013 8 meetings

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

  29. 4 Step UGME CuRe Preclerkship Course Creation Sequential Process : Course Leader’s Presentations Principle: “Fully integrated spiral scaffold curriculum through 4 years” CuReX- Curriculum Renewal Executive Integration Committee- all UGME Directors & Leaders ( 55) CuReX- Curriculum Renewal Executive Integration Committee- all UGME Directors & Leaders ( 55) 4. 4. 4. • Leader’s Course to Integration Committee •  Objectives & Sessions •  Suggestion & Feedback •  Faculty Development- Objectives •  Student assesssment update Jan – Feb 2014: 6 meetings • Leader’s Course to CuReX • Objectives & Sessions • Feedback provided Oct –Dec 2013: 16 meetings Total Meetings: 30 • 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 2013: 8 meetings

  30. Principle: “Fully integrated spiral scaffold curriculum through 4 years” • Longitudinal courses would interdigitate with the morning Modular courses; • Theme content would thread through module or longitudinal courses Examples: MOM1M2 • Clinical Skills Communication Normal Physical Exam Abnormal Physical • Clinical ReasoningCritical thinking Cases highlighting Cases highlighting • Metacognition Normal process in Pathophysiology and • Information science integrated fashion Diseases in integrated Clinical probabilities paralleling M1content 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

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

  32. 4 Step UGME CuRe Preclerkship Course Creation Sequential Process : Course Leader’s Presentations Principle: “Fully integrated spiral scaffold curriculum through 4 years” CuReX- Curriculum Renewal Executive Integration Committee- all UGME Directors & Leaders ( 55) CuReX- Curriculum Renewal Executive Integration Committee- all UGME Directors & Leaders ( 55) 4. 4. 4. • CuReX Review • Feedback • Student • Approval • Leader’s Course to Integration Committee •  Objectives & Sessions •  Suggestion & Feedback •  Faculty Development-Objectives •  Student asesssment update March 2014 weekly Jan – Feb 2014 6 meetings • Leader’s Course to CuReX • Objectives & Sessions • Feedback provided Total Meetings: 30 followed by weekly CuReX Oct –Dec 2013 16 meetings • 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 2013 8 meetings

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

  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. CuRe: Student assessment plan – Barry Cohen 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:

  36. UGME CURRICULUM RENEWAL FRAMEWORK Consolidation Module (Module 3) 10 weeks • 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 – egHIV, SLE ,etc. • Health Care Issues- pain, addictions, etc. • Format: small group problem solving and clinical reasoning sessions. • Leaders : Kristel Van Ineveld Holly Hamilton

  37. CuRe: Community Engagement FF#3 April 2012 • Person to Community Centered : • 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

  38. UGME Longitudinal Clinical Exposure/Engagement • 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 • 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

  39. Next Steps…..To Do List/Challenges • 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

  40. Next Steps…..To Do List/Challenges • Governance …..biggest challenge ! …. 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. UGME CURRICULUM RENEWAL • 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 http://umanitoba.ca/faculties/medicine/education/undergraduate/curriculum/curriculumrenewal.html Large… Thank You !

  42. Student and Resident participation in CuRe • Residents • Steven Promislow • AmitKaushel • Elizabeth Berg • Peter Sytnick • Students • PolDaras • Eyal Kraut • Terry Colbourne • Harold Gjerde • Anne Finlayson • Ryan Chard • Jesse Marantz • Robert Schmidt • Mark Xu

  43. Faculty Forum # 1 April 2011ALL DAY RETREAT 112 PARTICIPANTS

  44. CuRe Task group participants: Co-chairs ……………………………. 20 134 Faculty………………………………..84 Students or residents…………. 30

  45. Created: April 2011 Created: April 2011 June 2014 UGME CuRe MILESTONES Modified : Dec 2012 Modified : Oct 2012 ACHIEVED: Forum #1 Forum #2 Forum #3 Forum #4 Forum #5 Forum #6 Stakeholder Engagement : Faculty- Student-Post Graduate - Government - RHAs - Public Mar 2012 April 2012 April 2011 Oct 2011 Dec 2011 April 2011 June 2011 Oct 2011 Dec 2011 Feb 2012 June 2012 Feb 2013 Jan 2013 June 2013 Aug 2013 Aug 2013 June 2014 Aug 2014 Jan 2013 Dec 2012 Dec 2012 Jan 2013 Mar 2012 Oct 2012 Dec 2012 April 2012 Clerkship New Curriculum Content Development Appoint Curriculum “Leaders” Retreat Task Specific Groups Task Specific Reports Create Curriculum Template Present Curriculum Template Faculty Development Senate I Approval Inaugural Transformational Curriculum FEC Approval New ClerkshipLaunched 2013 Undergraduate Medical Education 47

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