The Reports: United States: Pennsylvania
Drexel University College of Medicine
Curriculum Management and Governance Structure
- ♦ There is a medical school standing curriculum committee established by the Faculty Bylaws; the Educational Coordinating Committee (ECC) reports to the Dean of the College of Medicine through the Executive Committee of the Faculty, which includes department chairs and elected faculty representatives (Figure 1).
- ♦ The ECC has nine faculty members, including four department chairs and four medical students.
- ♦ There are two formal subcommittees of the ECC: the Year 1 + 2 Committee and the Year 3 + 4 Committee.
- ♦ The ECC also appoints ad hoc subcommittees to address specific curriculum development or assessment needs of the school.
- ♦ Additional faculty committees support components of the curriculum including the two preclinical parallel curricular tracks, Program for Integrated Learning (PIL), and Interdisciplinary Foundations of Medicine (IFM) and the Clerkship Directors monthly meetings.
- ♦ All faculty educational committees are supported by the Office of Educational Affairs (OEA) through the Vice Dean for Medical Education and Academic Affairs office.
Office of Education
- ♦ The OEA with responsibilities for Undergraduate Education, Continuing Medical Education, and the Office of Student Affairs and Admissions is directed by the Vice Dean for Educational and Academic Affairs.
- ♦ The OEA supports the curriculum through its Division of Assessment and Evaluation (DAE), which is responsible for scoring first- and second-year multiple-choice examinations, administering NBME examinations for third-year students, maintaining a longitudinal database that tracks student progress throughout the fourth-year curriculum, and collecting student feedback electronically and by open forums following completion of each educational unit.
- ♦ The DAE provides regular data reports that aid educational committees and administrative officers in their various decision-making processes.
- ♦ The OEA is responsible for identifying and maintaining effective relationships with its academic clinical campuses and overall supervision of the Division of Clinical Education that assigns students to clinical sites for their clerkships and fourth-year electives.
- ♦ The OEA serves as the office of medical education with 19 full- or part-time Assistant/Associate Deans and faculty, 11 program directors, and 36 support staff.
- ♦ All basic science and clinical departments have designated full-time or part-time faculty educators who are supported by the OEA (9 Clerkship Directors, 24 Pathway Directors, and 18 Course Directors).
- ♦ The OEA provides significant resources and centralized administrative and organizational support to the education programs and directs interdepartmental courses (e.g., clinical skills education, Introduction to Clinical Medicine, Community Service).
Financial Management of Educational Programs
- ♦ There are well-defined faculty-developed formulas for allocating financial resources to all departments based on their educational contributions, which are periodically reviewed by the medical school finance committee.
- ♦ These educational allocations to the departments are supplemented by the OEA budget to support the educational programs across the four years of the curriculum.
- ♦ There is no formal academy for educators.
- ♦ All primary educators work closely together on curriculum committees and promotion committees and have strong collaborative relationships in planning and implementing the integrated curriculum, especially in Years 1 and 2.
- ♦ Scholarly activity in education is highly valued by the Appointments and Promotions committee with promotion to unqualified titles of Associate Professor and Professor for full-time educators.
- ♦ Tenure is available for primary educators in the basic science departments.
- ♦ Educational faculty are honored with annual student and peer faculty education awards celebrated at the Golden Apple Awards, on Faculty Day, and at Commencement.
Curriculum Renewal Process
- ♦ The most recent major curriculum change occurred in 1998 with the creation and implementation of the Interdisciplinary Foundations of Medicine (IFM) curriculum, an integrated basic science curriculum presented in a clinical context designed to complement the parallel problem-based learning track, the Program for Integrated Learning (PIL).
- ♦ Annual reviews of all curricular components occur across the four years by the appropriate curriculum committees.
- ♦ The objectives of the curriculum renewal process include a regular reevaluation of the medical school educational exit objectives, review of medical school and nationally established course and clerkship objectives, and linkage to the medical school assessment plan to determine whether the objectives have been accomplished.
- ♦ The renewal process includes careful review of all components of the curriculum (PIL Blocks, IFM Modules, Clerkship Blocks, Pathway System) with focus on student performance and achievement of educational objectives, student feedback of each component of the curriculum and overall comparability of curricular tracks in the first and second years, and all required third- and fourth-year clinical clerkships.
- ♦ The medical school established Exit Objectives that are periodically reviewed and revised (see List 1).
- ♦ These Exit Objectives are currently under review by an ad hoc ECC committee of faculty with the intent of linking those objectives to the ACGME Competencies.
- ♦ All recommendations of learning outcomes must be considered and accepted by the ECC and the Executive Committee of the Faculty before implementation.
New Topics in the Curriculum Since 2000
- ♦ A longitudinal Professionalism curriculum throughout the four years includes lectures, small-group discussion, and faculty and student peer review with feedback from both to students.
- ♦ Drexel was designated a Center of Excellence for Physician Information by the National Institute on Drug Abuse (NIDA) based on its medical education programs in substance use education.
- ♦ Several courses use team-based learning as one of multiple learning modalities.
- ♦ Standardized patients have been integrated in lieu of paper cases into the small-group learning process for the problem-based learning curriculum (PIL).
- ♦ Simulation has been integrated into the first- and second-year curriculum including physiology, pharmacology, and clinical skills courses. All clerkships have developed discipline-specific simulations, and simulations are integral to Intersession I—Transition to the Clinical Years and Intersession II—Transition to Residency during the fourth year.
- ♦ An intensive two-week fourth-year Translational Research course provides students the opportunity to design a clinical research project with a critical review of the pertinent literature and develop a Human Subjects application and informed consent form for the study.
Changes in Pedagogy
- ♦ The OEA offers five fourth-year educational electives, which enhance the clinical and teaching skills of medical students as they transition into residencies programs and enhance the educational environment for first- and second-year medical students.
- ♦ Fifty percent of the fourth-year class participates in one of these electives.
- ♦ The four-year curriculum is heavily supported by the use of technology:
- A detailed calendar, which includes all lectures and handouts given in every course, is available electronically.
- All courses and clerkships have active websites and postsupplementary material including electronic self-study exercises.
- Courses use electronic bulletin boards to engage the students in discussion.
- Doc.com, a web-based interactive resource on physician-patient communication, was developed jointly by Drexel and the American Academy of Communication in Healthcare and is utilized at Drexel and at more than 30 other medical schools around the world.
- WebOSCE, a web-based program developed at Drexel and linked to doc.com, allows for live interactions and feedback from standardized patients remotely. This program has been used to teach smoking cessation counseling and giving bad news and will be used in 2010 to teach screening and initial counseling in substance use disorders.
- A well-developed web-based clinical skill portal, including downloadable video demonstrations of the evidence-based physical examination, is used to support and evaluate our clinical skills curriculum.
Changes in Assessment
- ♦ Electronic feedback is expected from all students in Years 1-4 following the completion of each educational unit (e.g., Block, Module, Clerkship, and Electives).
- ♦ Student Forums are held at the end of each educational unit in the first and second years. Small groups of students are invited to meet regularly with faculty and administrators to provide verbal feedback that is utilized to modify curriculum as deemed appropriate.
- ♦ Professionalism Peer Review Assessment has been implemented as part of the longitudinal Professionalism Curriculum. First-year students are expected to evaluate peers in small groups in several courses. The assessment tool provides numerical and open-ended anonymous feedback, which faculty tabulate. Students are “commended” for outstanding professional behavior, whereas other students are identified for “remediation.”
- ♦ The Clinical Skills Passport was established for all clerkships.
- ♦ The medical simulation center, physically and electronically linked to the established clinical skills laboratory, was opened in late 2009 and is heavily utilized for preclinical and clinical education and evaluation of medical students.
- ♦ The web-based Clinical Skills Portal was developed to both teach and evaluate clinical skills.
- ♦ Comprehensive comparability studies are performed by each discipline annually on all clinical sites that teach our students in that discipline and are reported to the ECC.
- ♦ The Admissions Committee has implemented the use of an onsite essay to assess noncognate traits in applicants who come for an interview.
- ♦ The medical school utilizes multiple urban, suburban, and rural clinical educational sites in Pennsylvania, New Jersey, and Delaware to support the clinical education of our students.
- ♦ In addition to the Philadelphia-based hospitals including Hahnemann University Hospital, St. Christopher's Hospital for Children, Friends Hospital, Abington Memorial Hospital, and Mercy Catholic Medical Center, we have regional medical campuses at Allegheny General Hospital, Saint Peter's University Hospital, and Monmouth Medical Center. Students also have clinical rotations available at Coatesville VA Medical Center, Crozer-Chester Medical Center, Easton Hospital, Lancaster General Hospital, Lehigh Valley Health Network, PinnacleHealth, The Reading Hospital and Medical Center and York Hospital.
- ♦ Challenges include
- competition with other medical schools for clinical sites
- the acquisition and development of new clinical sites
- maintenance of comparability and excellence in the clinical education provided our students across all sites
- ♦ There are three Regional Campuses: Allegheny General Hospital, Saint Peters University Hospital, and Monmouth Medical Center.
Highlights of the Program/School
© 2010 Association of American Medical Colleges
- ♦ Students have the choice between two preclinical curricular tracks (IFM or PIL) to best meet individual student's learning style and the choice from multiple clinical sites with exposure to urban, rural, and community health care delivery systems
- ♦ The educational environment, enhanced by the use of technology, is student focused with a cadre of dedicated educators who are directly supported and rewarded for their educational contributions.
- ♦ The uniquely structured fourth-year Pathway System with discipline-specific faculty advising linked to the Career Development Center ensures that all students have a balanced general foundation in medicine and more specialized training designed to ease the transition between the fourth year and the residency of their choice.
- ♦ The Office of Community Experience in OEA successfully integrates meaningful community service programs across four years that prepare medical students to address socioeconomic determinants of illness and to become community-responsive physicians.