Ensuring Curriculum Congruence in Medical Education

1. Congruence in the medical curriculum

2. How to make sure the plan comes together David Taylor Liverpool

3. The first thing • Is to decide what you want to do • And keep checking that it is still what you want to do!

4. In the UK there is little flexibility • The GMC have produced two documents • Tomorrow’s Doctors • The New Doctor • Between them they define what we have to make sure the students know

5. Our handbook gives a generic syllabus • Subject knowledge & understanding • As ‘core’, students will be able to synthesize, appraise, explain, and apply the relevant information/evidence about: • the structure and mechanisms of the body in health and disease, from molecules up to the whole organism related to: • normal and abnormal structure and function of the body and its defence mechanisms; the natural history, symptoms, and signs of disease; and the biological rationale for therapy and the processes underlying its complications • variability in the role of the determinants of health and disease, the presentation of disease, and the response to therapy • clinical diagnosis and management of common conditions • The interrelationships of social, psychological, economic, political, environmental, cultural factors on health and disease

6. Our first step • Was to decide which 200 cases a student would need to be familiar with when they graduated • We finally agreed on about 208

7. Core Cases

8. Then • We decided which cases the students would study through PBL

9. PBL modules

10. Scenario

11. Then • The students determine the learning objectives in their PBL groups – they can see every groups’ learning objectives

12. Learning objectives

13. Which we examine

14. Not just knowledge but skills • Communicating effectively • Working in a team • Being aware of limitations • Understanding disease processes • Managing time effectively • Developing appropriate attitudes towards personal health and wellbeing • Recognition of social and emotional factors in illness and treatment

15. Providing care for people of different cultures • Coping with uncertainty • Making the best use of laboratory and other diagnostic services • Using informatics as a tool in medical practice • Understanding the purpose and practice of audit, peer review and appraisal • Understanding the relationship between primary and social care and hospital care • Using opportunities for disease prevention and health promotion • Being aware of legal and ethical issues

16. Understanding the principles of evidence-based medicine • Diagnosis, decision making and the provision of treatment including prescribing • Keeping accurate records • Obtaining valid consent • Calculating accurate drug dosages • Writing a prescription

17. Venepuncture • Arterial blood sampling • Suturing • Performing an electrocardiogram • Basic cardiopulmonary resuscitation • Administering oxygen therapy safely • Correctly using a nebulizer • Inserting a nasogastric tube • Urinary catheterization • Control of haemorrhage

18. Each year • We review the cases in the light of the learning objectives the students are obtaining • And the examination results • And change the cases accordingly

19. Each year • And we review the content of one of the four subject themes • S&F, IGS, PP, PPD • A senior committee of subject specialists does the initial work • Then the programme team makes the agreed changes

20. Periodic review • 2006 years 1 & 2 • 2007 years 3 & 4 • 2008 year 5 • 2009 whole programme • university plus external advisors • General Medical Council • 2010 year without review! • 2011 I will be 55 …