MCP-Hahnemann School of Medicine

Curriculum Management and Governance Structure

• ♦ The school has implemented institutional management to achieve a well-coordinated coherent curriculum based on principles of adult learning.
• ♦ Management of the four-year program is vested in a faculty committee known as the Educational Coordinating Committee (ECC) with strong support from the Office of Educational Affairs.
• ♦ The ECC is responsible for coordinating graduate medical education and continuing medical education.
• ♦ The ECC is chaired by a faculty member appointed by the dean and includes faculty (not from prescribed departments) who are appointed by the dean; four students, and ex officio members from various divisions of the Office of Educational Affairs.
• ♦ The ECC reports to the Executive Committee of the Faculty and receives direction from the dean.
• ♦ The ECC is supported by standing committees and adhoc subcommittees.
• ♦ Course directors are members of the Year One and Year Two, clerkship directors are members of the third- and fourth-year subcommittees of the ECC.
• ♦ Two curricular paths are offered in the first two years of the educational program. The Program for Integrated Learning (PIL), a problem-based learning curriculum introduced in 1992, uses small-group learning and clinical case-based problem solving. The Interdisciplinary Foundations of Medicine (IFM) curriculum, introduced in 1997, is integrated across disciplines, utilizing clinical symptom presentations.
• ♦ Each student selects a path based on his or her own learning style.
• ♦ Both curricula are provided support by the Office of Educational Affairs and its Division of Medical Education.

Office of Education

• ♦ The Office of Educational Affairs (OEA) has responsibilities for undergraduate, graduate, and continuing medical education and biomedical graduate programs and was established originally in the 1970s.
• ♦ The OEA is directed by the vice dean for educational and academic affairs.
• ♦ The OEA is responsible for several interdepartmental courses.

Budget to Support Educational Programs

• ♦ There is a discrete budget to support the educational programs.
• ♦ Educational programs are supported through direct allocations from the dean to academic departmental budgets for teaching activities.
• ♦ The dean's budget supports the OEA and its associated activities.

Valuing Teaching

• ♦ Each department has identified at least one faculty member whose primary responsibility is to direct the course(s) and clerkship(s) offered by the department.
• ♦ Faculty are recognized by awards such as the Lindback Award, and the Golden Apple Award for exemplary teaching.
• ♦ The quality and quantity of participation in educational programs are important in promotion and tenure as well as salary determinations.

CURRICULUM RENEWAL PROCESS

Learning Outcomes

• ♦ The Medical College of Pennsylvania had exit objectives in place in 1993 when it merged with Hahnemann University. The objectives have been adopted by the merged entity MCP Hahnemann School of Medicine.
• ♦ The exist objectives have been reviewed recently through the ECC and modified to accommodate increased need for proficiency in such areas as information technology.
• ♦ Achievement of outcomes is determined in a number of ways, including evaluation as a self-directed learner; discipline-based written and oral examinations, faculty observation of clinical skills (standardized patients), scores on USMLE Steps 1 and 2; scores on NBME subject exams in all third-year clinical courses; and a clinical skills exam in the fourth year required for graduation.
• ♦ The list of outcomes is available from the author.

Changes in Pedagogy

• ♦ Students may choose between the IFM and PIL curricular tracks for their first two years of study.
• ♦ In the third year, all students spend at least one third of their clinical experience in an ambulatory setting.
• ♦ Medicine, surgery, obstetrics-gynecology, and pediatrics have achieved an appropriate balance between inpatient and outpatient instruction. Family medicine is an allambulatory experience.
• ♦ The fourth-year curriculum is based on a Pathway System initiated in 1997. The system was developed to allow the student to concentrate in a specific discipline while providing a broad general professional education and improving the advisory/career-counseling process.
• ♦ Students interact with patients in the Barbara E. Chick Clinical Educational and Assessment Center (CEAC). Students see standardized patients in the CEAC's ten examining rooms.

Application of Computer Technology

• ♦ Effective August 2000, all incoming students are required to have personal computers.
• ♦ The exit objectives include “the ability to utilize information technology to enhance ongoing learning, professional development, and continuing clinical competence.”
• ♦ Computers, multimedia technology, and the Internet allow students to augment the information and skills learned from classes, print materials, and clinical rotations.
• ♦ Faculty have developed interactive learning tools ranging from biochemical exercises to simulated patients presenting ethical dilemmas.
• ♦ Lecture handouts and lab manuals are increasingly available on the Web.

Changes in Assessment

• ♦ A state-of-the-art, clinical skills learning laboratory using standardized patients enables assessment of students' progress through the four-year curriculum.
• ♦ Students are assessed using computers in a medical ethics program MedEthEx.
• ♦ There is a third-year psychiatry—ethics OSCE during the psychiatry clinical clerkship.

Clinical Experiences

• ♦ Every first- and second-year IFM student spends four afternoons in a community-based, primary care physician's office. Every PIL student spends nine weeks between years one and two working in a community-based physician's office.
• ♦ During the second year, a PIL student spends approximately 60 hours in a community-based physician's office learning the fundamentals of physical diagnosis. An IFM student learns the basics of physical diagnosis in the inpatient setting.
• ♦ In the third year, students are provided with a broad clinical experience in family medicine (six weeks), medicine (12 weeks), surgery (12 weeks), pediatrics (six weeks), psychiatry (six weeks), and obstetrics—gynecology (six weeks).
• ♦ In the fourth year, students select clinical electives based on their pathway choices.

Curriculum Review Process

• ♦ In 1995, the dean of MCP/Hahnemann charged a faculty committee reporting to the ECC with the development of a new curriculum that integrated basic sciences in a clinical context.
• ♦ In 1997, the IMF curriculum was implemented with these guiding precepts:
• Establishing a logical, integrated, and aligned sequencing of functional systems based on learning objectives developed by faculty
• Using clinical cases as a contextual framework to accomplish the learning objectives
• Building on previous constructs (in blocks) with sequential objectives
• Reinforcing concepts without being redundant
• Including the following topics in all blocks and illustrative cases:
• basic science
• critical thinking/decision making
• developmental stages
• doctor-patient interactions
• ethics
• impacts of illness on patient, family, community, and society
• population-based medicine/biostatistics/epidemiology/health care economics
• professionalism
• roles of gender, ethnicity, age
• societal/environmental roles in illness
• promotion of disease prevention
• linking evaluation to achievement of goals and objectives
• ♦ These concepts led to the design and implementation of the IFM curriculum.
• ♦ The responsibility for curricular and student evaluation resides with the appropriate faculty, with assistance from the Assessment and Evaluation Division of the OEA.