Purpose

1. CAn CLINICAL CASES DRIVE ALL components of a medical curriculum? Stephen Charles and Dennis Valenzeno,  Department of Medical Sciences, University of Kansas School of Medicine – Wichita, Wichita, KS, 67214, USA SAMPLE CASE: A 43-year-old woman with obesity and a 7-year history of diabetes complains of fatigue, difficulty losing weight, and lack of initiative. She notes a marked Purpose Can learning be driven entirely by clinical case scenarios, structured so that all curricular components are organized around cases and still provide broad scope/depth in the requisite basic medical sciences and traditional pre-clinical curricula? MethodsRepresentative medical school curricula primarily in the US and Canada were reviewed, during the past year. Selected model campuses were visited and representatives from others were invited to present at the KU School of Medicine – Wichita. A small faculty group used these experiences to draft a curriculum designed to drive all components from clinical cases. ResultsCase-based/PBL/patient-centered curricula frequently engage only part of a program of study, e.g. 10-h/wk of PBL paralleled by a similar number of lecture hours that may not be directly tied to the PBL. A draft curriculum composed of weekly cases and independent study mini-cases appears capable of driving all elements needed in a full medical curriculum that uses adult learning principles to provide content through text, video, podcasts, web pages, selected lectures, small group sessions and live patient presentations. Achievement of objectives can be tracked digitally for each case and reviewed to assess remedial needs on an organ system or disciplinary basis, facilitating review for summative examinations and NBME tests. The curriculum transcends the traditional basic/clinical science divide allowing for a cohesive curriculum across 4 years. ConclusionsA fully case-driven curriculum can be constructed based on adult learning principles using educational technology. With digital tracking of the mastery of learning objectives on a case-by-case basis student learning can be documented and interventions implemented when needed. decrease in her energy level, particularly in the afternoons. She is tearful and states that she was diagnosed with depression and prescribed an antidepressant that she chose not to take. Her health care practitioners have repeatedly advised weight loss and exercise to improve her health status. She complains that the pain in her knees and ankles makes it difficult to do any exercise. She denies polyuria, polydipsia, polyphagia, blurred vision, or vaginal infections . . . Objectives an be examined in alternate views. • SAMPLE LEARNING RESOURCES: • Web sites: Calorie King • Wikipedia • Textbooks • Podcasts • Text: Concise Histology • Podcasts • Kluzak A/V resource • SAMPLE OBJECTIVE TOPICS: • Calorie content of food • Genetics of weight control • Digestion and absorption of food • Biochemical metabolism • Basal metabolism/energy expenditure • Histology/histopathology of fat tissue • Pancreas/insulin physiology and pathophysiology • Clinical skills – interacting with a patient; motivational interviewing • Public health – obesity epidemic • Interprofessional education • Working in a team wichita.kumc.edu

2. 7. Objective Tracking Database Tracks mastery of LO’s for each student by case. Can be rearranged to show mastery of concepts by: organ system discipline Bloom’s Taxonomy other 1. Weekly Clinical Cases 3. Directed Self-Learning Variety of knowledge acquisition offerings: Podcasts Web pages Textbooks A/V clips 5. Assessment of Learning Obj’s Assess individual or small groups of LO’s. Web-based to feed into Obj Tracking Database. 2. Learning Objectives Progression from directed to self-generated through 4 years Broad differential diagnosis aim 4. Mid-week small group 6. End of week wrap-up May include live patient 8. Knowledge Consolidation Step 1 / Step 2 prep guided by Obj Tracking Database