Rush Medical Colleges M1M2 (and M3M4) Curriculum Renewal: An - PowerPoint PPT Presentation

Rush Medical College’s M1M2 (and M3M4) Curriculum Renewal: An Informal Conversation Elizabeth Baker MD, MHPE Acting Senior Associate Dean

Rush Medical College today • 88.4% of 2016 graduates agreed to strongly agreed that they were satisfied with their education • Program directors rated 90% of our graduates’ preparedness as good to outstanding

Rush Medical College Step 1 Scores RMC 1 ST RMC 1 ST Nat’l 1 ST Nat’l 1 ST RMC Calendar Yr. Attempt Attempt Cohort Attempt Pass Attempt Avg. Avg. Top 5 of 1 ST Attempt On-Track Pass On-Track Avg. Rate Score Scores Rate Score Class of 2014 96.0% 96.0% 231.5 229 261.2 2016 Class of 2015 100.0% 95.0% 230.6 229 256.4 2017 Class of 2016 100.0% Not Available 234.1 Not Available 262.4 2018

Rush Medical College: The Match 2017 115 students: Where our students matched: • 100% matriculated into a • Rush! 15 students • residency UC- Davis/San Diego, USC, UCLA • Baylor • 21 specialties • Yale 70 – 25 IM • Northwestern institutions – 12 FM • U of Chicago – 9 pediatrics • Icahn Beth Israel/Mount Sinai – 12 EM • Stanford – Neurosurg, ENT, ortho, radiology, • Mayo psychiatry… • Vanderbilt

Key Contributors Committee members and Office of Medical Student working groups Programs • • Basic scientists Bob Leven- Assistant Dean, Basic Science Education • Clinicians • Angela Blood- Director, Curriculum • Students • Mark Grichanik- Director, Assessment • Rahul Patwari- Assistant Dean Clinical Education 40+ faculty • Keith Boyd- former Senior Associate Dean, current Senior Advisor 40+ students • Beth Baker- acting Senior Associate Dean

RMC Mission and Vision Mission Through a supportive and dynamic learning community, Rush Medical College nurtures the development of empathic, proficient physicians dedicated to continuous learning, innovation, and excellence in clinical practice, education, research and service. Vision Rush Medical College will be the global leader in student-centered, future-oriented medical education.

Rush Medical College Roles Practitioner Leader Advocate Educator Professional Communicator Scholar Collaborator

Major Basic Tenets: • Single pass curriculum (combine normal and abnormal) • Anchor around clinical cases, small group sessions • Case content from all core clinical disciplines: pediatrics, gynecology • Integrate all basic science and clinical components • Flipped Classroom- no lectures • Frequent formative assessment with real time feedback and coaching

Rush Medical College M1M2 Curriculum Additional planned features: • Early meaningful clinical experiences • Capstone- Scholar role • Step prep

The flipped classroom • Described for K-12 students (Prober and Khan, Academic Medicine 2013) • Learner-centered, competency-based, mastery of academic content (Hurtubise et al, 2013) • Self-regulated learning (White, Adv Health Sci 2007) Students are already doing this on their own

Case-based collaborative learning • Hybrid of TBL/PBL • Used at Harvard • RCT: lower performing students performed better that PBL students on final exam • Students described it as engaging, thought provoking and fun Krupat et al, Academic Medicine, 2016

Assessment • Repeated testing improves retention more than extra studying (Roediger and Karpicke, 2006) • Spacing is more effective than cramming (Kornell, 2009)

New Courses In New Calendar 2017- 2018 ACADEMIC YEAR June September October November December January February March April May M1 CURRICULUM Food to Fuel - Food to Fuel - Introduction to Host Defense and Host Cardiac, Pulmonary Nutrition and BREAK BREAK BREAK Cardiac, Nutrition and Movement and Mechanics Brain Behavior and Cognition Medicine Response and Renal Systems Energy Pulmonary Energy Metabolism and Renal Metabolism Selective Selective Selective Selective Capstone 2018- 2019 ACADEMIC YEAR September October November December January February March April BREAK M2 CURRICULUM FIRST M3 CLERKSHIP Growth, Development and the Life Preparation for Step 1 and Transition to BREAK BREAK Reproduction and Human Sexuality Hematology and Oncology Cycle Clerkships Selective Selective Selective

Scientific Foundations of Clinical Medicine Collaborative Case Learning at Rush The Rush Medical College (RMC) Collaborative Case Learning model is derived from the Case-based Collaborative Learning model (Krupat 2016). It incorporates elements of team-based learning, problem-based learning, and case-based learning into one format, maximizing the benefits of each. This model has shown advantages in student performance, engagement, and satisfaction. The RMC Curriculum Committee, composed of students and faculty, selected this model after reviewing the literature of instructional methods. Collaborative Case Learning met the Committee goals of being an active learning approach, integrating clinical and basic science, and focusing on the achievement of learning objectives. This summary intends to briefly explain the process. For further details, we refer you to the references. Faculty evaluate student Home Preparation Readiness Assurance performance on quiz before Student prepares by watching videos and/ or reading on foundational Student individually completes 5 challenging (application & inference) class MCQ based on key concepts from material before class, sourced from the knowledge, and complete a short Mastery assessment to guide the focus of their self-study material. assessment questions completed during self-study. Students are grouped into small Case Based Learning groups (~5 per group) Instructor presents a case and open-ended case-based questions to be completed. Questions Individual Completion are integrated across disciplines. The goal of the questions is to apply the knowledge garnered Students at each table complete the questions from the self- study to a “real - life” patient situation. individually in class. (15-20 min) References Krupat, E., Richards, J.B., Sullivan, Share Answers Within Table Students at each table pass their answers around the A.M., Fleenor, T.J., Schwartzstein, table, reading each other's’ responses. R.M. (2016). Assessing the Effectiveness of Case-Based Table Consensus Collaborative Learning via Randomized Students discuss and determine their group’s consensus answer. Controlled Trial. Academic Medicine. (15-20 min) . Each group submits their consensus answer to the 91 (5):723-729. facilitator, which are shared with the class after faculty review. Share Answers Between Tables Each table shares their answer on a large screen with the larger group (~25 students) Session Debrief and Presentation of Next Session Group Consensus Facilitator reviews the pertinent objectives students achieved in the exercise, and the The entire group (~25 students) discusses and determines the large group approach a practicing clinician would have chosen to the given problem. A brief introduction consensus answer with help of facilitator. (15-20 min) Often the best answer to the following session follows. may be a mixture of more than one group’s suggested best answer. The group consensus process includes a discussion of the underlying physiological principles supporting the best answer. Rush is a not-for-profit health care, education and research enterprise comprising Rush University, Rush Oak Park Hospital and Rush Health.