EPC Curriculum Documents Subcommittee

February 24, 2003

 

Present:

P. Davis, Chair

T. Cameron, Staff

G. Dunaway

E. Nelson

 

Dr. Davis began the meeting by directing the attention of the group to the LCME Accreditation Standards (http://www.lcme.org/functionslist.htm).  In particular, the following institutional and educational standards appeared to deal directly with the faculty issues discussed by the subcommittee, except the attitudinal issue delineated in the AAMC Compact Between Teachers and Learners of Medicine (http://www.aamc.org/newsroom/pressrel/compact.pdf) and the concept of faculty as researchers:

 

IS-15. All medical school faculty members should work closely together in teaching, research, and health care delivery.

Because the education of both medical students and graduate physicians requires an academic environment that provides close interaction among faculty members, those skilled in teaching and research in the basic sciences must maintain awareness of the relevance of their disciplines to clinical problems. Conversely, clinicians must maintain awareness of the contributions that basic sciences bring to the understanding of clinical problems. These reciprocal obligations emphasize the importance of collegiality among medical school faculty across disciplinary boundaries and throughout the continuum of medical education.

ED-1. The medical school faculty must define the objectives of its educational program.

Educational objectives are statements of the items of knowledge, skills, behaviors, and attitudes that students are expected to exhibit as evidence of their achievement. They are not statements of mission or broad institutional purpose, such as education, research, health care, or community service. Educational objectives state what students are expected to learn, not what is to be taught.

Student achievement of these objectives must be documented by specific and measurable outcomes (e.g., measures of basic science grounding in the clinical years, USMLE results, performance of graduates in residency training, performance on licensing examinations, etc.). National norms should be used for comparison whenever available.

ED-1-A. [adopted March 2003; effective July 2004] The objectives and their associated outcomes must address the extent to which students have progressed in developing the competencies that the profession and the public expect of a physician.

There are several widely recognized definitions of the characteristics appropriate for a competent physician, including the physician attributes described in the AAMC's Medical School Objectives Projects, the general competencies of physicians resulting from the collaborative efforts of the ACGME and ABMS, and the physician roles summarized in the CanMEDS 2000 report of the Royal College of Physicians and Surgeons of Canada. To comply with this standard, a school should be able to demonstrate how its institutional learning objectives facilitate the development of such general attributes of physicians. A school may establish other objectives appropriate to its particular missions and context.

ED-5. The medical faculty must design a curriculum that provides a general professional education, and fosters in students the ability to learn through self-directed, independent study throughout their professional lives.

ED-26. The medical school faculty must establish a system for the evaluation of student achievement throughout medical school that employs a variety of measures of knowledge, skills, behaviors, and attitudes.

Evaluation of student performance should measure not only retention of factual knowledge, but also development of the skills, behaviors, and attitudes needed in subsequent medical training and practice, and the ability to use data appropriately for solving problems commonly encountered in medical practice.

The LCME urges schools to develop a system of evaluation that fosters self-initiated learning by students and disapproves of the use of frequent tests which condition students to memorize details for short-term retention only.

ED-34. The program's faculty must be responsible for the detailed design and implementation of the components of the curriculum.

Such responsibilities include, at a minimum, the development of specific course or clerkship objectives, selection of pedagogical and evaluation methods appropriate for the achievement of those objectives, ongoing review and updating of content, and assessment of course and teacher quality.

ED-35. The objectives, content, and pedagogy of each segment of the curriculum, as well as for the curriculum as a whole, must be subject to periodic review and revision by the faculty.

ED-37. The faculty committee responsible for the curriculum must monitor the content provided in each discipline so that the school's educational objectives will be achieved.

The committee, working in conjunction with the chief academic officer, should assure that each academic period of the curriculum maintains common standards for content. Such standards should address the depth and breadth of knowledge required for a general professional education, currency and relevance of content, and the extent of redundancy needed to reinforce learning of complex topics. The final year should complement and supplement the curriculum so that each student will acquire appropriate competence in general medical care regardless of subsequent career specialty.

The attributes identified as unique to SIUSOM were reiterated, and, in the discussion that followed, members present noted that not all faculty would agree that the attributes are unique to SIUSOM or that, in fact, that they truly reflected SIUSOM.  It was suggested that the list of attributes be referred to as goals, strengths, or emphases. 

  • Student-oriented

  • Primary care emphasis

  • Rural emphasis

  • Medical Humanities emphasis

  • Computer-assisted Instruction and Assessment

  • Early clinical experiences/exposure

  • Community orientation (provides clinical training that is similar to what graduates will see in practice)

  • Student-faculty ratio

  • Continuous reassessment of curriculum by faculty

  • Integrated Clinical Science/Basic Science Experiences

  • Life-long/Self-Directed Learning Emphasis

It was also noted that, although most faculty are enthusiastic educators, not all faculty view their primary role as teaching.  It was suggested that faculty needed more information about why the curriculum is organized and delivered in its current format:  applicability, retention, enthusiasm from learners, self-directed learning, teamwork, etc.  It was also suggested that the emphases should include a statement that described the tradition of faculty involvement and commitment, curriculum built on the concept of fostering long-term commitment to life-long learning, and respect for patients.

There was discussion about current faculty perceptions that the recent curriculum change was organized, orchestrated, and administered by the SIUSOM administration, in spite of the fact that faculty were heavily involved in the curriculum development, design, and implementation of the curriculum.  Although some of the misperception might be caused by the fact that some of the faculty involved in the process had administrative titles, the disenfranchisement appears to go deeper.  One suggestion was that some faculty believe that individual faculty members should have control of their teaching efforts, although it was noted that, at most institutions, faculty have a responsibility to teach what the curriculum is designed to teach.  The issue for the subcommittee is how to move beyond the concept that faculty were coerced/forced to participate in a curriculum in which they did not believe and to develop a plan for how issues and concepts can be framed in manner that allows faculty to work toward a common goal.

Action Steps for Next Meeting:

  • Dr. Davis will develop a “Faculty Statement of Principles” based on the LCME Accreditation Standards related to faculty issues and the AAMC Compact between Teachers and Learners of Medicine

Next Meeting:  9 am, March 31 (this was later changed to 8:30 am, June 2, 2003):