August 14, 2009

New curriculum shines at School of Medicine

Featured Image

Third-year School of Medicine students, from left, Stephen Kappa, Elyne Kahn and Eric Rellinger attend orientation in Light Hall. (photo by Anne Rayner)

New curriculum shines at School of Medicine

A major revision of the Vanderbilt School of Medicine curriculum, fully implemented this past school year, has received a good review from both students and faculty.

“We are pleased but are still in a constant quality improvement mode and we’ll continue with that, just as we do in our approach to clinical care,” said Bonnie Miller, M.D., senior associate dean for Health Sciences Education. “We are very proud of the progress we’ve made but we know we must always strive to improve.”

Early results of VUSM’s incoming class on Step 1 of the United States Medical Licensing Examination (USMLE) showed students’ scores have improved, indicating that the new curriculum is successful.

“On average, our students performed extremely well, even better than before the curriculum change. While improved Step 1 performance was not a goal of the revision, it’s very gratifying to see that our students are still obtaining an excellent foundation in the basic sciences,” Miller said.

The change in curriculum for the School of Medicine was made for a variety of reasons. Important topics such as safety, quality, clinical epidemiology, health economics and communication skills required more emphasis and the faculty wanted to use new teaching technologies, such as simulations.

Miller said it was also important to maintain top-level biomedical science training. Another concern was that the complexity and scale of the change might threaten the collegial atmosphere that has always made Vanderbilt special.

“Our concern from the beginning was that collegiality and caring for students should not be damaged, and we also didn’t want to lose any faculty members. Neither of those things happened, so that’s a very important measure of success,” Miller said.

Neil Osheroff, Ph.D., professor of Biochemistry and Medicine, directs the new first-year course called Molecular Foundations of Medicine and heads the first-year teaching team. He said students found that the new curriculum elevated first-year studies by making them more contiguous with subsequent years.

Osheroff credits Miller for having the vision for this new curriculum from the start, and now that the faculty has been through two rounds, he says they can see the benefits and feel confident about it as they enter the third year.

“I felt closer to the students because we work with them for many more hours per week than in the past. While this new course is intense and rigorous, it helps students connect the basic sciences to the medical conditions that they will be treating in the future. It makes the curriculum more interesting to the students, and it is more fun teaching if students enjoy their studies more and learn more,” Osheroff said.

Under the new curriculum, rather than teaching courses in separate and traditional categories like physiology and anatomy, a core of integrated coursework was designed to bring the teachers together in one class. This encouraged a more congruent set of lessons.

For example, in putting gross and micro anatomy together with physiology, teams of instructors worked together to build the lesson around the relationships of these sciences within the body. This is called an integrated, organ systems-based approach.

The new curriculum also introduced intersessions between blocks to further explore multi-disciplinary topics within the core courses, such as cancer and diabetes. Coursework was added to enhance focus on communication skills, cultural competence and professionalism. A chronic illness course brought Family Nurse Practioner (FNP) students from Vanderbilt University School of Nursing together with VUSM students to work with a patient, encouraging the type of teamwork now commonly seen in practice.

Rising fourth-year medical student Natalie Jacobowski was co-chair of the student curriculum committee last year. She said students were an active part of ongoing review.

“Students recognized the tremendous dedication of the faculty to continue to provide us with an excellent education. We also saw the responsiveness of faculty to feedback from the students. If students identified a need and asked for a change, the faculty made a great effort to do so,” Jacobowski said.

“The instructors met biweekly with the class curriculum committee and talked about ’just in time’ improvements, or tweaks to the program to help students be successful. This created a wonderful sense of involvement,” Miller said.

Now that all the feedback is in, Miller said the school already has some projects to work on to continue to improve. For instance, faculty are working together to better protect unscheduled, out-of-classroom time for students, so they have more time for self-directed study and Emphasis projects.

The implementation of the Emphasis Program was one of the first changes in the new curriculum. Emphasis projects, which encourage first- and second-year students to participate in a self-directed research project under the mentorship of a VUMC expert, began in 2004.

To view the new currriculum, click here.