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Academic Medicine:
doi: 10.1097/ACM.0b013e318217a4bb
Addendum: Canada: Ontario

The University of Western Ontario Schulich School of Medicine & Dentistry

Rebel, Magaretha MD, MEd; DePauw, Lesley MEd; Dundas, Kris MA

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Year school was established: 1881.

School URL: www.schulich.uwo.ca.

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Curriculum Management and Governance Structure

Figure 1 presents the names of the standing committees of undergraduate medical education.

FIGURE 1: Curriculum...
FIGURE 1: Curriculum...
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♢ The undergraduate medical education committees are responsible to the Dean of Schulich Medicine & Dentistry, Executive Committee of Schulich Council, and Schulich Faculty Council for

* the content and coordination of the undergraduate medical educational program,

* assessment and promotion of medical students, and

* evaluation of the undergraduate medical education program

♢ The Associate Dean for Undergraduate Medical Education is the individual responsible for overseeing these activities.

♢ The Curriculum Committee, chaired by the Associate Dean, governs the undergraduate medical curriculum. The other committees report to the Curriculum Committee, except for the Appeals Committee.

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Office of Education

♢ The Undergraduate Medical Education (UME) Office supports students and teaching faculty in the delivery of the undergraduate medical program.

♢ There are 14 staff members in this unit including an assessment specialist and a curriculum specialist.

♢ The unit is led by the Associate Dean and a Manager. In addition there are 12 staff in the Windsor Program and five staff in our rural regional medicine office.

♢ At the Schulich School of Medicine & Dentistry, Education is a portfolio in the Dean's Office.

♢ The overall Education portfolio is led academically by the Vice Dean, Education, and encompasses undergraduate medical education, postgraduate medical education, continuing and professional development, admissions and student affairs, our rural and regional program office, dentistry, and undergraduate and graduate programs in medical sciences.

♢ There are eight Associate and Assistant Deans involved with supporting the undergraduate medical education program.

♢ The UME Office developed a new administrative support system for an integrated institutionally managed curriculum through the 2007–08 academic year.

♢ Staff resources were enhanced to assist faculty in the review of each segment of the curriculum, as well as for the curriculum as a whole with the assistance of a curriculum specialist.

♢ An assessment specialist assists faculty in the review and design of valid, reliable, and coherent assessment tools.

♢ Administrative support for interdisciplinary teaching in years one and two is also managed centrally.

♢ Support for clinical teaching in years three and four is managed both by the UME Office and also by staff in university and hospital departments.

♢ All staff members in London, Ontario work in close collaboration with their counterparts in Windsor, Ontario.

♢ Units in the Education Portfolio that support undergraduate medical education are:

* Admissions and Student Affairs. Admits and supports medical and dental students during their four-year undergraduate doctor of medicine (MD) and doctor of dental surgery (DDS) programs.

* Windsor Program Office. A component of the UME Program, Schulich Windsor supports students receiving their full four-year undergraduate medical education degrees in Windsor, Ontario – a distributed medical education site.

* Continuing Professional Development (CPD). This program provides accredited programs to enhance the knowledge and performance of health care professionals in the provision of public health care in Southwestern Ontario. The program is also responsible for faculty and staff development.

* Southwestern Ontario Medical Education Network (SWOMEN). SWOMEN supports placement of students and postgraduate trainees in rural clinical sites and also supports associated rural regional faculty.

* Educational Evaluation Unit. assists in the enhancement of medical education program through specific, ongoing programmatic evaluation

* Clinical Skills Learning Program. provides teaching and evaluation of students in communication, interviewing, and physical exam skills. The unit trains and schedules standardized and volunteer patients for use in specific curriculum teaching situations.

* Teaching & Technology Services (TTS). Although not a member of the education portfolio, TTS is a unit of the Dean's Office that offers support for Schulich faculty and staff in using technology in classrooms /meeting rooms as well as supporting the electronic materials used for teaching.

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Financial Management of Educational Programs

♢ The Schulich School of Medicine & Dentistry is financed through a combination of sources: government operating grants, tuition, direct funding from external sources, and some funding from endowment funds.

♢ For the most part, the financial crisis affected the endowment funds, which represent a very small proportion of our educational support, and thus the impact on the school's operating funds was minimal. Nevertheless, we were somewhat affected and took a planned approach to reduce costs in administrative areas that would not affect front-line teaching.

♢ The support to educational programs has remained a priority through the economic crisis.

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Valuing Teaching

♢ The Centre for Education Research & Innovation fosters an interdisciplinary community of education research that engages the Schulich School of Medicine & Dentistry, and the faculties of health sciences and education at Western. The unit conducts high-caliber research in health professions education. For more details see www.schulich.uwo.ca/ceri.

♢ There are two streams of promotion for the full-time clinical academics: the Provost Stream and the Senate Stream.

♢ In the Provost Stream, clinical academics are promoted on teaching and/or research.

♢ In the Senate Stream, clinical academics are promoted in the same way as our basic science faculty, and they must be involved with teaching and research.

♢ Performance in teaching and associated activities for both streams may include, but is not limited to: initiatives in course design and curriculum development; initiatives designed to improve clinical teaching; development of effective and innovative teaching resources, including computer courseware and keeping up with technological developments where relevant; administration in relation to effective educational planning and policy making; and instruction-development-activities intended to assist faculty members to improve their teaching.

♢ In addition to the two promotion streams highlighted above, both the university and school have put into place annual teaching awards for individuals nominated and selected by their peers.

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Curriculum Renewal Process

♢ The last curriculum renewal was launched in September 2006.

♢ The previous iteration of the curriculum had approached the concept of integration through a matrix structure of courses and subject development groups. The subject development groups were responsible for scheduling and content while the courses based on traditional subjects, such as anatomy and physiology, were responsible for objectives and student assessment. While this concept led to highly integrated teaching, assessment was not as well integrated.

♢ In order to resolve this shortcoming the subject development groups were redesigned into courses responsible for objectives, teaching, and assessment. Courses are now systems-based.

♢ The current philosophy to curriculum renewal is that it is to be embedded as an ongoing process, being evolutionary rather than revolutionary.

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Learning Outcomes/Competencies

♢ Physicians graduating from the Schulich School of Medicine & Dentistry will possess the knowledge, skills, and attitudes basic to all physicians such that they may satisfactorily proceed to further training in any area of the profession.

♢ The graduating physician will be able to identify, analyze and manage clinical problems in a way that provides effective, efficient and humane patient care. Detailed objectives are set out in Appendix 1.

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New Topics in the Curriculum since 2000

♢ Team-based learning – during classroom teaching in Year 1 and Year 2

♢ Simulations/ training in new surgical techniques – during the Surgery clerkship rotation in Year 3

♢ Global health

♢ Interprofessional education

♢ Expanded community-based and regional experiences

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Changes in Pedagogy

♢ Since 2000 the number of large-class lectures has been reduced and active learning has been increased.

♢ Small-group teaching is integrated into each course as well as is team-based learning.

♢ Courses are no longer organized by departments; they are integrated and taught from a patient-centered perspective.

♢ There is an emphasis on the generalist perspective and a lens that frames the subject material with an interprofessional view.

♢ All course content is delivered through an online curriculum management tool.

♢ Many interactive independent online learning modules have also been introduced.

♢ The clinical skills courses in Year 1 and Year 2 are now taught in the Clinical Skills Facility with an increase in the use of standardized patients.

♢ With the implementation of the Windsor Program in 2008, lectures are now video-conferenced bidirectionally between London, Ontario and Windsor, Ontario.

♢ A pilot project for lecture capture for online and mobile devices is presently under way.

♢ An online log for patient encounters and procedures in the clinical clerkship rotations has been developed.

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Changes in Assessment

♢ Since 2000 multiple forms of summative assessment have been introduced throughout the four-year program.

♢ Formative assessment has increased and is increasingly delivered through online systems and through the use of midrotation feedback as well in the clinical setting.

♢ Blueprinting and mapping of objectives to assessment have enabled us to change the emphasis on assessment to one of measuring learning outcomes.

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Clinical Experiences

♢ In addition to London, Ontario, and Windsor, Ontario, clinical teaching takes place in more than 40 rural regional locations in Ontario.

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Challenges in Clinical Education

♢ The expansion of medical school spaces in Canada in the last five years has put increasing pressure on clinical teaching sites at the tertiary and quaternary academic health centers as well as in the rural/region.

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Regional Campus

♢ An emphasis on clinical teaching in rural and regional communities has been in place since 1996. Students are required to complete at least four weeks in a rural or regional location during clinical clerkship (Year 3).

♢ The undergraduate medical education program has also expanded to Windsor, Ontario in partnership with the University of Windsor, Windsor Regional Hospital and Hôtel-Dieu Grace Hospital. The expansion began in 2002 with Year 3 clinical clerkship training.

♢ Beginning in September 2008, a four-year undergraduate medical program was offered, starting with an entry class of 24 first-year students. The charter class of medical students in the Windsor Program at the University of Windsor were members of the 147-strong class of 2012 of the Schulich School of Medicine & Dentistry.

♢ All students graduate with an MD degree from The University of Western Ontario. The class size in Windsor is now 38. Three years of students are currently enrolled in the Windsor Program – a total of 92 students in 2010–2011.

♢ The Windsor Program is being delivered at the Medical Education Building on the campus of the University of Windsor, at Windsor Regional Hospital, Hôtel-Dieu Grace Hospital, and at other Windsor clinical sites, as well as regional education sites through the Southwestern Ontario Medical Education Network (SWOMEN).

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Highlights of the Program/School

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Clinical Experience

♢ Many students are attracted to the Schulich/Western MD program because of the breadth and depth of clinical experience.

♢ The Clinical Clerkship offered at Schulich/Western is a single course of eight course weights. The rotations that are components of the clerkship are:

* Family Medicine: 1.0 weight, 6 weeks

* Internal Medicine: 2.0 weights, 12 weeks

* Obstetrics & Gynaecology: 1.0 weight, 6 weeks

* Paediatrics: 1.0 weight, 6 weeks

* Psychiatry: 1.0 weight, 6 weeks

* Surgery: 2.0 weights, 12 weeks

* All students experience a broad range of clinical exposure, including a mandatory four weeks of clinical training in an approved center outside of London or Windsor.

* Students have the opportunity to take graded responsibility for patient care in a supportive setting where a balance will be established between time for service-work and education.

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Other

♢ More than $6 million in financial assistance is provided annually by the school (approximately half is provided to undergraduate medical students).

♢ Our curriculum includes an emphasis on Ecosystem Health, encouraging students and faculty to consider the bidirectional interactions between human actions and the environment, and their impact on health.

♢ Building on a history of student activity in Africa, China, and India, as well as a long-running Medical Electives Overseas Program, the Office of Global Health helps students learn and prepare for international learning experiences.

♢ With more than $140 million in research funding annually, Schulich Medicine & Dentistry is home to 23 Canada Research Chairs, and hundreds of other world-class research teams and investigators.

♢ Schulich Medicine & Dentistry fosters an environment where students, faculty and staff respond to community needs and get involved in social, political, and health issues.

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Cited Here...

Appendix 1
Appendix 1
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Appendix, continued...
Appendix, continued...
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© 2010 Association of American Medical Colleges

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