Why can’t we stay with the curriculum we have now? It has trained our students well for a number of years.
Much has changed in medical school curricula nationally and globally since our current curriculum was last revised. About 75 percent of medical schools in the nation are undergoing or have undergone major curriculum reform. The dominant trend is movement toward integrated curricula with active learning modalities. Technology advances have made significant shifts not only possible but preferable. We want to keep our curriculum contemporary. To that end, we are improving our curriculum to fit with dominant national trends.
What is our accrediting organization going to think of all this change?
The Liaison Committee on Medical Education (LCME), our accrediting agency, is fully behind and prepared for the current trend of curriculum reform. In fact, one of the things that was commented upon in our last review by LCME was that our students spend considerable hours in lectures. If we do not change our curriculum to optimally fit national standards, we will risk citation by the LCME. Fortunately, some UW teachers have already started incorporating more contemporary teaching techniques, such as the “flipped classroom” and more case-based learning.
What do you mean by an integrated curriculum?
As stated in the article “Lessons learned about integrating a medical school curriculum: perceptions of students, faculty and curriculum leaders” from Medical Education 2008;42:778-785, integration typically refers to “interdisciplinary block courses in pre-clerkship years that bring together basic, clinical and social sciences into one course, or weave longitudinal curricular themes across the curriculum (e.g., ethics).” Integration should also occur vertically—across the four years of medical school with, for example, more revisiting of the basic sciences during the clinical years and vice versa.
Why move toward an integrated model in particular?
The article cited above goes on to say that “Integrated curricula have been widely adopted, fuelled by dissatisfaction with the way basic sciences have been taught as individual disciplines with no clinical application and by growing recognition that traditional instructional modes no longer meet current demands for interdisciplinary inquiry and practice in medicine. At the same time, cognitive theories of learning suggest that an integrated approach to education may have important benefits for learning and retention because it facilitates contextual and applied learning, and can promote development of the well-organized knowledge structures that underlie effective clinical reasoning.” Multiple citations are given.
What is the evidence for improved student performance in an integrated model?
- Students trained within an integrated curriculum made more accurate diagnoses than did students trained in a conventional curriculum (Schmidt HG et al: The development of diagnostic competence: comparison of a problem-based, an integrated, and a conventional medical curriculum. Acad Med 1996;71:658-64)
- 2) Vertical integration between basic sciences and clinical medicine in problem-based learning curricula stimulated better understanding of biomedical principles than did conventional curricula (Dahle LO et al. Pros and cons of vertical integration between clinical medicine and basic science within a problem-based undergraduate medical curriculum: examples and experiences from Linkoping, Sweden. Med Teach 2002;24(3): 280-285)
- 3) A high degree of horizontal integration occurred in the early years but more input from clinicians was needed throughout the curriculum to achieve vertical integration (Davis MH, Harden RM. Planning and implementing an undergraduate medical education curriculum: the lessons learned. Med Teach 2003;25(6): 596-608)
Will all classes be expected to use a “flipped classroom” approach?
No. A principle of the curriculum renewal is that learning approaches will be predominantly active learning. Some teachers may choose to use the flipped classroom approach, others may choose small group-case bases, and some will use a combination of approaches, including lectures. The important consideration for our teachers is that they are thinking critically about how students learn and what will maximize that learning. Active learning that places knowledge and skills in a relevant context results in the best retention.
What about WWAMI? Will the same changes go into effect across the WWAMI region? How is that possible?
One thing that has been decided is that all students will spend approximately the first 18 months of their education at their regional site for foundations training. It is possible that students will come to Seattle for one or more brief periods, but the bulk of education prior to clerkships will be at the first-year university campuses.
How will a transition from old to new curriculum go? Won’t there be some overlap and how will that be managed?
There will be an overlap period in which some students will be in the new curriculum and some will be finishing up the old curriculum. While this is a challenge for teachers, it has gone well at other medical schools. We fully expect it will go well in our settings as well.