Medical student curricular transformation takes shape

February 2, 2017  //  FOUND IN: Strategy & Leadership,

On June 25, 2015, Medical School faculty approved eight key elements of a transformed medical student curriculum — a sturdy framework that is driving changes that have already been made, as well as others on the way.

While that date serves as a milestone on a journey that began more than four years ago, much remains to be done as Michigan transforms how it trains graduates to meet the demands of today’s health care system, while also learning how to play an impactful role in the future of medicine.

“This is a journey that will continue to evolve. There will be constant change going forward,” said Rajesh S. Mangrulkar, M.D., associate dean for medical student education and a lead figure in the transformation since U-M received a $1.1 million grant from the American Medical Association to serve as one of 11 schools called to lead change in medical education.

Beginning today, a series of Headlines stories will examine aspects of the ongoing curriculum transformation and what the changes mean for students, Michigan Medicine and health care, in general.

Mangrulkar, the Marguerite S. Roll Professor of Medical Education, and other faculty leaders agree that the transformation is meeting early goals of preparing U-M graduates to be leaders and change agents in health care.

Assistant Dean for Educational Research and Quality Improvement Sally Santen, M.D., Ph.D., professor of emergency medicine and learning health sciences, said the Medical School is now “in a continuous learning cycle. We are constantly looking for ways to improve the student experience.”

So how is the student experience improving?

A student’s first year of study now includes Doctoring, a highly successful clinical skills course, and Chief Concern, a course that trains future physicians how to best solve problems in a clinical setting.

Additionally, the Interprofessional Clinical Experience course puts new students into the clinical environment beginning their first week of medical school to engage with health care teams.

The Paths of Excellence program, which is popular in helping students pursue an area of great passion, has also grown to include eight potential paths — ethics, global health and disparities, health policy, innovation and entrepreneurship, medical humanities, scientific discovery, scholarship of learning and teaching, and patient safety and quality improvement. Throughout the medical school, students are also immersed in M-Home learning communities, providing them an enriching environment in which they can thrive.

Think of the transformed curriculum as a tree. Study of each of the tree’s “branches” — patient and populations, systems focused and hospital-based practice, procedures-based care, and diagnostic and therapeutic technologies — will be implemented by Fall 2018.

“The challenge of curricular transformation is that what we have now (in teaching students) is still pretty awesome,” said Michael J. Englesbe, M.D., the Cyrenus G. Darling Sr., M.D., and Cyrenus G. Darling Jr., M.D., professor of surgery, and faculty lead on the branches. “The branches will give our students the autonomy to craft their own journey and make it more meaningful for them.”

The new curriculum also calls for a first year focused on scientific education. Throughout that year, and into year two, students begin to gain more clinical knowledge and experience.

Michelle M. Daniel, M.D., assistant dean for the curriculum, noted that science is now an emphasis at several points in a student’s tenure. “One of the biggest challenges is determining what constitutes foundational science that has to be delivered in the first year versus what should be delivered later,” said Daniel, an assistant professor of emergency medicine and learning health sciences.

Finally, the curriculum emphasizes leadership training. Mangrulkar said teams are exploring the right developmental arc in the student experience to introduce and build leadership values and skills that will allow students to have an impact on campus and after graduation.

“Leadership means working as a team, being able to communicate, to work in systems and problem solve so that you can impact change,” Mangrulkar said.

Overall, he said, the transformation is galvanizing U-M’s reputation as a leader in medical education.

As Mangrulkar said: “We have put leadership front and center and the breadth of the changes we envisioned — and the way in which we have engaged students — have distinguished us as a leader among the leaders.”

Stay tuned as Headlines takes a more in-depth look at each of the areas of curricular transformation in the coming months!

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