Supplemental digital content for Wood SK, Di Corcia M. Charles E. Schmidt College of Medicine at Florida Atlantic University. Acad Med. 2020;95(9 suppl).
Supplemental Digital Content
Supplemental Digital Appendix 1 Curriculum Map……...……….2 Supplemental Digital Appendix 2 Course and Curricular
Thread Descriptions..……….3 Supplemental Digital Appendix 3 Program Goals and
Assessment Methods………...10 Supplemental Digital Appendix 4 Clinical Curriculum
Descriptions……….12
1
4th Year Rotations
AUG SEP OCT NOV DEC JAN FEB MAR APR MAY JUN JUL
FBS NSB
FOM 2 FOM 1
ICA
Transition to Residency
INTEGRATED PATIENT FOCUSED
CURRICULUM
Orientation
USMLE Step 1 Review
&
Break FOM 3
ICA ICACommencement Synthesis & Transition
PT 2 PT 3 PT 4
1st LIC
2nd LIC
PT 1
FOM - Foundations of Medicine
FBS - Fundamentals of Biomedical Science LIC - Longitudinal Integrated Clerkship
NSB - Neuroscience and Behavior PT - Pathophysiology and Therapeutics ICA - Institutional Competency Assessment
Year
ONE
Year
TWO
Year
THREE
Year 3 ST AR TS
Year
FOUR
FOM 4
Supplemental Digital Appendix 1
2
FUNDAMENTALS OF BIOMEDICAL SCIENCE
DESCRIPTION: The Fundamentals of Biomedical Science course is designed to provide students with a broad foundation in critical biomedical science subject areas including biochemistry, molecular biology, cell biology, genetics, microbiology, immunology, pharmacology, pathology, physiology, histology, anatomy, and embryology. The course focuses first on biochemistry, molecular biology, cell biology, genetics, pharmacology and an introduction to the anatomical sciences. The course then builds on and extends this foundation into the areas of microbiology, immunology and pathology. Fundamentals of Biomedical Science is taught in 19 weeks and consists of lectures, problem based learning (PBL) sessions, team-based learning (TBL) sessions, small group discussions, and laboratory activities.
NEUROSCIENCE AND BEHAVIOR
DESCRIPTION: The Neuroscience and Behavior Course provides the basic concepts and vocabulary in the areas of neuroanatomy, neurophysiology, sensory systems, neurochemistry, neuropharmacology, neuropathology, neurology and psychiatry. The course uses an integrated approach by combining lectures, problem-based learning (PBL) and anatomy laboratory instruction. The PBL sessions in small groups provide the fundamental knowledge of common neurological and psychiatric disorders that are complemented by lectures for specific diseases. The presentation of the neuroanatomy component emphasizes correlations with clinical cases and lead to the localization of brain lesions. The instruction in gross of anatomy of the head and neck is integrated with clinical correlates.
PATHOPHYSIOLOGY AND THERAPEUTICS 1
DESCRIPTION: Pathophysiology and Therapeutics 1 provides basic concepts and vocabulary pertaining to the anatomy, chemistry, histology, microbiology, pathology, pharmacology and physiology of human nutrition, hematology and the gastrointestinal and hepatic systems, including normal nutrition and diagnosis and management of common nutritional disorders. The course uses a variety of teaching formats, including didactic lectures, large group team-based learning (TBL), small group Inquiry (IQ) cases and pathology labs, and Simulation Center instruction. IQ cases cover learning objectives not included in the lectures, so that the two formats complement but do not substitute for one another. For most sessions, there are recommended readings in the core texts. The Simulation Center component emphasizes correlations with clinical cases and differential diagnosis and treatment of digestive system lesions.
MD PROGRAM
COURSE DESCRIPTIONS
Supplemental Digital Appendix 2
3
PATHOPHYSIOLOGY AND THERAPEUTICS 2
DESCRIPTION: The Pathophysiology and Therapeutics 2 course provides the basic concepts and vocabulary in the areas of the anatomy, chemistry, histology, microbiology, pathology, pharmacology, and physiology of the cardiovascular, respiratory and related hematologic systems. The course uses an integrated approach by combining lectures, problem-based learning (IQ cases), team-based learning lessons, and simulated laboratory instruction. The IQ case sessions, in small groups, provide the fundamental knowledge of common cardiovascular and respiratory disorders that are complemented by lectures for specific diseases. The take-home IQ cases and pharmacology mini cases reinforce major themes and concepts delivered in lecture. The Simulation Center component emphasizes the clinical process of history, physical exam and medical testing to develop differential diagnoses and treat.
PATHOPHYSIOLOGY AND THERAPEUTICS 3
DESCRIPTION: The Pathophysiology and Therapeutics 3 course provides the basic concepts and vocabulary in the areas of the anatomy, chemistry, histology, microbiology, pathology, pharmacology, and physiology in three separate systems - renal, reproduction and endocrine. The renal section teaches students the structure, physiology, pathophysiology and pathology of the kidneys and genitourinary tract. The physiology section consists of fluid balance, electrolyte balance and acid base balance as well as an approach to disorders in these areas of kidney function. Diseases of the kidneys and collecting system is reviewed. The reproductive section covers basic concepts and vocabulary of male and female biology as it relates to pathology, gynecological diseases and infertility. The endocrine section covers the anatomy, histology, physiology, pathophysiology and pathology of endocrine organs. The course is taught with an integrated approach which combines lectures, pathology laboratories, inquiry (IQ) cases (a form of problem-based learning), take-home problems sets (mini cases), team-based learning (TBL), a visit to a dialysis center and Simulation Center instruction. The IQ cases consists of small groups which provide the fundamental knowledge of common renal, endocrine and reproductive diseases that are complemented by lectures about specific diseases and pathophysiology.
The take-home problem sets (mini cases) reinforce the major themes and concepts delivered in lecture. The Simulation Center and dialysis experience provide real and simulated clinical experience.
PATHOPHYSIOLOGY AND THERAPEUTICS 4
DESCRIPTION: The Pathophysiology and Therapeutic 4 course is a 6-week course in the spring semester of Year 2 that builds on the foundation in gross anatomy, histology, chemistry, pharmacology, microbiology, and immunology taught during the Fundamentals of Biomedical Science courses in fall semester of Year 1. The course is designed to provide students with the principles of pathology, pathophysiology, diagnosis, and basic treatment rationale pertaining to infectious, immunologic and hematologic diseases. Integrated to this course are core principles of dermatological and ophthalmologic disorders. The course objectives focus on the primary disorders caused by infection, immunodeficiency, autoimmunity and hematological malignancies. The course uses an integrated approach by combining lectures, problem-based learning (IQ Cases), problem sets (i.e., mini cases), and simulated laboratory instruction. IQ cases in the small-group setting use a set of core cases to focus students on pathophysiology, diagnosis, public health aspects, and a first approach to management and is complemented by lectures for specific diseases.
Mini cases reinforce major themes and concepts delivered in lecture. The laboratory component emphasizes the use of flow cytometry in the diagnosis and monitoring of immunological disorders.
MD PROGRAM
COURSE DESCRIPTIONS
4
FOUNDATIONS OF MEDICINE 1
DESCRIPTION: The Foundations of Medicine (FOM) course provides students with an understanding of the fundamental principles necessary to become a competent, compassionate and professional physician with opportunities for direct patient care. FOM is divided into four courses: FOM 1, 2, 3 and 4 which run throughout the first two years of medical school. This separation is designed to provide a summative assessment to students at the end of each FOM course.
The goal of the FOM 1 course is to assist students in developing the knowledge, skills, attitudes and behaviors that are needed to interview and examine patients;
to answer clinical questions; to understand the importance of patient advocacy and disease prevention; to instill the foundation for the ethical and legal framework of patient care; and to integrate the knowledge of basic science, clinical skills and the science of clinical practice components. The course also introduces the skills needed to provide care to specific groups of patients such as elderly patients.
FOUNDATIONS OF MEDICINE 2
DESCRIPTION: The Foundations of Medicine (FOM) course provides students with an understanding of the fundamental principles necessary to become a competent, compassionate and professional physician with opportunities for direct patient care. FOM is divided into four courses: FOM 1, 2, 3 and 4 which run throughout the first two years of medical school. This separation is designed to provide a summative assessment to students at the end of each FOM course.
The overall objectives and content areas for the FOM 2 course in Year 1 are to continue the progression of the objectives of the FOM 1 course, adding new components and clinical skills at an advanced level.
The FOM 2 course is intended to assist students to deepen their knowledge and improve their skills, attitudes and behaviors needed to interview and examine the patient, to answer clinical questions, to understand the importance of patient advocacy and disease prevention, to explore barriers to health care, and to instill the foundation for the ethical and legal framework of patient care. Students continue to develop skills to strengthen the patient physician relationship.
Additional Interprofessional Education sessions with the students and faculty from the FAU College of Nursing and School of Social Work will cover Financing of the health care system and continue the SAGE mentor visits.
MD PROGRAM
COURSE DESCRIPTIONS
1
2
5
FOUNDATIONS OF MEDICINE 3
DESCRIPTION: The Foundations of Medicine (FOM) course provides students with an understanding of the fundamental principles necessary to become a competent, compassionate and professional physician with opportunities for direct patient care. FOM is divided into four courses: FOM 1, 2, 3 and 4 which run throughout the first two years of medical school. This separation is designed to provide a summative assessment to students at the end of each FOM course.
The overall objectives and content areas for the FOM 3 course in Year 2 are to continue the progression of the objectives of the FOM 1 and 2 courses, adding new components and clinical skills at an advanced level.
The goal of the FOM 3 course is to assist the students in expanding their medical knowledge and to refine their clinical skills, attitudes and behaviors needed to interview and examine the patient; to generate and answer clinical questions;
to develop their clinical reasoning; to understand the importance of patient advocacy and disease prevention; to explore the barriers to health care and to instill the foundation for the ethical and legal framework of patient care.
The course also introduces the skills needed to care for specific groups of patients such as children, the elderly, LGBT individuals, as well as patients at the end of life.
FOUNDATIONS OF MEDICINE 4
DESCRIPTION: The Foundations of Medicine (FOM) courses provide students with an understanding of the fundamental principles necessary to become a competent, compassionate and professional physician. FOM is divided into four courses: FOM 1, 2 3 and 4 which run throughout the first two years of medical school. This separation is designed to provide summative and formative assessments to students at the end of each FOM course.
The goal of the FOM 4 course is to assist the students in expanding their medical knowledge and refining their clinical skills, attitudes and behaviors needed to interview and examine the patient; to generate and answer clinical questions using evidence; to develop their clinical reasoning; to introduce students to the hospital setting and system of inpatient medicine in preparation for the student’s Year 3 clerkships.
MD PROGRAM
COURSE DESCRIPTIONS
3
4
6
USMLE STEP 1 REVIEW
DESCRIPTION: USMLE Step 1 Review is a six-week course at the end of Year 2 in which medical students pursue directed independent study with faculty support and resources in preparation for the USMLE Step 1 Examination.
SYNTHESIS AND TRANSITION
DESCRIPTION: Synthesis and Transition is two-week course at the beginning of Year 3 designed to help students synthesize knowledge acquired in the first two years of medical school to prepare them for a smooth transition to the Year 3 clerkships. The course includes 1) Case Seminar, a complex PBL/IQ case that integrates across multiple organ systems and focuses on differential diagnosis and treatment decisions; and 2) Simulation Center and interactive work on clinical reasoning and clinical skills building across multiple core disciplines.
TRANSITION TO RESIDENCY
DESCRIPTION: This two-week capstone course is offered in March at the end of the Year 4. The goal of this course is to prepare students to work effectively as interns, residents and practicing physicians. Additionally, it helps students to develop the knowledge, attitudes and skills necessary to be successful in their professional lives. Activities that will be covered include rapid response scenarios, central venous catheter and/or interosseous line insertion, airway management, multitasking, organization and prioritization, advanced communication skills, reflective exercises, and teaching skills. These are taught by using simulated scenarios, team-based learning exercises and larger group lectures.
MD PROGRAM
COURSE DESCRIPTIONS
7
DIVERSITY, INCLUSION AND SOCIAL JUSTICE THREAD (DIS)
DESCRIPTION: The Diversity, Inclusion and Social Justice Thread exists to advance diversity, inclusion and social justice as core College of Medicine values that enhance our individual and collective capacity to achieve excellence, drive innovation and ensure health equity in our communities. In the education of our medical students, focus is placed on striving towards cultural competence in the care of patients and recognizing social justice as an integral component of achieving equity in health. In alignment with the Association of American Medical Colleges, we define cultural competence in health care as “combining the tenets of patient/family-centered care with an understanding of the social and cultural influences that affect the quality of medical services and treatment.”The goals of our Diversity, Inclusion, and Social Justice curriculum are for students to: 1) demonstrate an understanding of how patients’ cultures and belief systems impact their experience of health and illness as well as their interaction with the health care system; 2) demonstrate the capacity to provide patient/family-centered care to individuals from backgrounds different than his/her own in a respectful, compassionate and professional manner; and 3) demonstrate the capacity to address the social determinants of health that result in health inequities in our communities; and 4) recognize social justice as one component of achieving health equity.
ETHICS, PROFESSIONALISM, AND PROFESSIONAL IDENTITY THREAD (EPP)
DESCRIPTION: It is of utmost importance that our students be professional, humanistic, and ethically competent as well as medically competent. The goal of the Ethics, Professionalism, and Professional Identity Thread is to teach students to recognize, analyze, manage, and prevent ethical issues in clinical settings; support students’ emotional wellbeing when faced with ethical dilemmas; and promote the exploration of personal values and the formation of students’ professional identities. Professional identity formation (PIF) is critically important because it pertains to a student’s very being: attitudes and biases, affective self-awareness, empathy, emotional intelligence, communication skills, and virtues ranging from humility and diligence to altruism and self-care.
As stated by Cruess and Cruess, professionalism is the set of values, behaviors, and relationships that underpins the trust the public has in doctors, while professional identity formation is not just how others perceive you, but how you come to perceive yourself1. The development of all these areas – ethics, professionalism, and professional identity formation – are crucial to being a “good” physician.
MD CURRICULUM
THREADS
8
LIFELONG LEARNING AND DISCOVERY THREAD (LLD)
DESCRIPTION: To develop the next generation of physicians who will think critically, practice evidence-based medicine, participate in meaningful and ethical research, and pose thoughtful questions as life-long learners to enhance the care of their patients we have prioritized a life-long learning and discovery thread in our curriculum.
Students will be systematically introduced to the basic scientific and ethical principles of clinical and translational research, including the ways in which such research is conducted, evaluated, explained to patients, and applied to patient care.
This thread includes the overall goals of understanding: 1) The bidirectional relationship between scientific findings and patient care; 2) Ethical issues related to research, and 3) Variations in study designs and statistical analyses, and how to critically appraise methods in scientific articles, including interpretation of outcomes to guide patient-centered clinical decision making. The importance of self-directed learning will be highlighted in the thread and the skills necessary to practice evidence-based medicine will be taught such that students learn to independently identify, analyze, and synthesize relevant information, generate testable hypotheses, always appraise the credibility of their information sources, and assess applicability to patient care. This thread will focus on training students to develop the essential skills required to be motivated, self-directed, lifelong learners and evidence-based practitioners as the foundation necessary to provide the highest quality care to patients.
GERIATRICS AND HEALTHY AGING THREAD (GHA)
DESCRIPTION: Older adults are living longer, often with chronic, complex illness that affects all aspects of their lives. It is critical that physicians understand how to provide patient-centered, high quality care to this population. The goal of the Geriatrics and Healthy Aging Thread is to provide students with the knowledge and skills to care for the unique needs of an older adult population. The thread objectives align with the AAMC Minimum Geriatrics Competencies for Graduating Medical Students.
COMMUNICATION, COMPASSION, AND COLLABORATIVE CARE THREAD (CCC)
DESCRIPTION: The Communication, Compassion, and Collaborative Care Thread was developed to give medical students a strong foundation in the skills they will need as physicians to provide compassionate, humanistic, collaborative, and patient-centered care. Physicians must be empowered with an ability to communicate and empathize with the patient and their families. While excellent diagnostic skills are necessary in treating patients, it is insufficient to expect that merely making the diagnosis and crafting a treatment plan will result in desired patient outcomes.
Being able to partner with our patients and other providers on the health care team has become essential to providing patients with the care that they need. Strong physician communication skills have been correlated with improved patient
satisfaction and better patient outcomes in wide variety of diseases. The physicians of today must be able to function collaboratively on health care teams that include health professionals from other disciplines as they provide coordinated services to patients. Ensuring that our students learn effective communication skills with patients, families, colleagues, and other health professionals is critical to develop the physicians that patients and our society deserve.
MD CURRICULUM
THREADS
9
PCRS
PATIENT CARE KNOWLEDGE FOR PRACTICE PRACTICE-BASED LEARNING & IMPROVEMENT INTERPERSONAL & COMM SKILLS PROFESSIONALISM SYSTEMS-BASED PRACTICE INTERPROFESSIONAL COLLABORATION PERSONAL & PROFESSIONAL DEVELOPMENT
MD Educational Program Goals Assessment
Methods Threads EPAs
1. Demonstrate knowledge of the normal structure and function of the human.
MCQ, IE, NBME,
FNE LLD x
2. Demonstrate knowledge of the various causes of disease states, and describe the molecular, structural, and physiological alterations that underlie these states.
MCQ, NBME, FNE,
OE, SP LLD x
3. Describe the changes that occur to organs and organ
systems throughout development and aging. MCQ, NBME, FNE LLD, GHA x
4. Demonstrate knowledge of the principles underlying
normal behavior and psychopathologic disorders. MCQ,NBME,FNE,
SP LLD x
5. Describe the mechanisms of action, side effects, and
interactions of major therapeutic agents. MCQ, NBME, FNE,
OE, SP LLD x
6. Describe the principles of prevention and the non- pharmacological approaches to disease and symptom management.
MCQ, NBME,
FNE,OE, SP LLD, GHA,
CCC x
7. Demonstrate knowledge about the impact of cultural practices, socioeconomic factors, gender, sexuality, religion, ethnicity, and race on individual patients, disease, treatment and public health.
OSCE, PE,
CPE, FNE, IE, MCQ DIS, EPP
x x
8. Describe population specific factors that affect disease prevention, incidence, treatment, and outcomes, and apply this information to patient care.
OSCE, CPE, PE,
FNE, OE, SP LLD, DIS,
CCC, GHA x x
9. Demonstrate knowledge of the basic principles of organization and finance for a variety of healthcare delivery systems.
PE, CPE EPP, GHA,
CCC x x
10. Complete a thorough, accurate, and sensitive medical history and physical exam.
OSCE, PE, CPE DIS, CCC,
GHA x x x 1
11. Demonstrate effective adaptation of communication skills to the needs of the patient, the sensitivity of the information discussed, and the nature of the situation.
OSCE, PE, CPE
DIS, CCC,
GHA x
x
12. Establish appropriate relationships with patients,
respecting their values, privacy and dignity. OSCE, PE, CPE
DIS, EPP,
CCC, GHA x x
13. Develop a prioritized differential diagnosis and select
a working diagnosis following a clinical encounter. OSCE, PE, CPE,
FNE x x 2
14. Integrate and apply basic science concepts and current medical knowledge to patient care through critical thinking and clinical problem solving.
OSCE, PE, CPE,
FNE LLD
x x x
15. Locate, appraise, and assimilate evidence from the
scientific literature related to patient care. OSCE, PE,
CPE, SP, FNE LLD x x x 7
16. Gather, interpret, synthesize, and prioritize patient data in order to develop a patient management plan for acute and chronic conditions.
OSCE, PE, CPE,
OE, SP x x
3
17. Educate and counsel patients using shared decision- making about plans of care, health promotion, and disease prevention.
OSCE, PE, CPE,
FNE CC, EPP x x x 11
18. Identify the rationale for and effectively perform selected clinical procedures that are appropriate for the chief complaint.
PE, CPE LLD x x x 12
19. Recognize urgent or emergent medical problems
and initiate evaluation and management. PE, CPE x x 10
Supplemental Digital Appendix 3
10
20. Communicate medical information clearly and effectively in both written and oral form to other members of the healthcare team and generate appropriate medical records
OSCE, PE,
CPE, OE, SP DIS,CCC x x x 4, 5, 6
21. Demonstrate the ability to organize and prioritize tasks
and effectively manage time in a clinical setting. OSCE, PE,
CPE LLD
x x x
22. Give or receive a patient handover to safely transition
care responsibility. OSCE, CPE
x x 8
23. Demonstrate knowledge of the roles of other members of a healthcare team and work effectively with them in the healthcare arena.
OSCE, PE, CCC x x x x 9
24. Identify and address ethical and legal concerns in the practice of medicine and in research, recognizing different value systems while adhering to ethical
i i l
CPE EPP, LLD
x x x
25. Contribute to teaching, research, and scholarly activity in
a variety of educational settings and in patient care. IE, CPE, FNE LLD x x x
26. Utilize information technology to optimize teaching,
learning, research and patient care. FNE, SP, CPE LLD x x x x
27. Identify, correct, and report common sources of medical
errors and apply models for quality improvement. SP, CPE EPP, LLD x x x 13
28. Demonstrate professional behaviors toward patients,
families, and members of healthcare teams. CPE, FNE EPP x x x
29. Demonstrate a commitment to life-long learning including developing reflective practices, recognizing personal limitations, and demonstrating competency in giving and responding to feedback to improve performance of self
OSCE, PE,
CPE LLD
x x
30. Prioritize personal health and wellness practices and develop effective coping strategies to maintain physical and mental health, seeking assistance as needed.
FNE, PE, CPE LLD, EPP
x x
31. Demonstrate an awareness of how personal beliefs, values, emotions and tolerance of ambiguity influence behaviors with others and responses to difficult
FNE, PE, CPE CCC,EPP,
DIS x
32. Model service to patients and communities to enhance the well-being of others and to advocate for vulnerable groups and those with limited access to healthcare.
FNE, PE DIS x x
33. Demonstrate leadership skills that enhance team functioning, the learning environment, education, research and patient care.
FNE, PE CCC,
LLD x x x x x x
Threads Assessment Methods Core Entrustable Professional Activities
EPP - Ethics, Professionalism &
Professional Identity CCC - Communication, Compassion, &
Collaborative Care
DIS - Diversity, Inclusion, &
Social Justice
GHA - Geriatrics & Healthy Aging
LLD - Life-Long Learning
& Discovery
CPE - Clinical Performance Evaluation
FNE - Facilitator Narrative Evaluation
IE - In-house Examination MCQ - Multiple Choice Quiz NBME - National Board of Medical Examiners Exam OSCE - Objective Structured Clinical Examination OE - Oral Exam
PE - Preceptor Evaluation SP - Student Presentation
EPA 1: Gather a history and perform a physical examination
EPA 2: Prioritize a differential diagnosis following a clinical encounter EPA 3: Recommend and interpret common diagnostic and screening tests EPA 4: Enter and discuss orders and prescriptions
EPA 5: Document a clinical encounter in the patient record EPA 6: Provide an oral presentation of a clinical encounter
EPA 7: Form clinical questions and retrieve evidence to advance patient care
EPA 8: Give or receive a patient handover to transition care responsibility EPA 9: Collaborate as a member of an interprofessional team
EPA 10: Recognize a patient requiring urgent or emergent care and initiate evaluation and management
EPA 11: Obtain informed consent for tests and/or procedures EPA 12: Perform general procedures of a physician
EPA 13: Identify system failures and contribute to a culture of safety and improvement
11
Supplemental Digital Appendix 4
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