'More Than Just Facts': The Future of Medical Education

Sheri Sellmeyer

Disclosures

December 02, 2016

Another aspect of Accelerating Change in Medical Education is giving students earlier exposure to patient interaction. Penn State College of Medicine launched a systems navigation curriculum in 2014, paid for in part by a $1 million grant from the AMA. The program embeds first-year medical students as patient navigators in clinical sites throughout central Pennsylvania.

"They don't yet know about the doctoring side, but they can work with patients and family to help them navigate the healthcare system," says Dr Skochelak. "The student learns about where the strengths of the healthcare system are and [where the issues are]."

Part of the challenge in teaching health systems science is educating faculty as well. The Brody School of Medicine at East Carolina University established a program to teach faculty new competencies in patient safety, quality improvement, population health, and team-based care—all part of a new core curriculum for medical students. As a result of this Teachers of Quality Academy training, one participant developed a program for early recovery after surgery that has resulted in reductions in cost for selected procedures while maintaining high-quality outcomes.

Health systems science is part of four clusters created by the AMA to work with the Medical Education Consortium. They include making medical school flexible through competency-based curricula, teaching new content areas, working with the healthcare delivery systems in novel ways, and creating innovative uses for technology. The AMA's Dr Skochelak said that future developments could include a national examination in health systems science.

Consortium member Vanderbilt University School of Medicine has developed its Curriculum 2.0 with the goal of creating "master adaptive learners"—physicians who are able to adapt to the changing needs of their patients and healthcare system and engage in self-assessment.

"What we know is despite the fact that, intellectually, everyone understands doctors have to keep up, in reality, it's hard to do—and we have pretty good evidence that many physicians can't keep up," said Dr Kim Loomis, associate dean for undergraduate medical education at Vanderbilt University School of Medicine. "If you look at how often evidence-based guidelines are used, it's not where we want it to be."

Vanderbilt involves all medical students in every year of training in patient care. In second-year clerkships, they study transitions of care in their rotations. "The students are highly observant; they're watching everything we do," said Dr Loomis. "They are also new enough to the system to say, 'Why would you do it that way?' "When Vanderbilt piloted the care transition module, each student monitored four patients from one care setting to the next, including a visit to the patient's home. In monitoring more than 300 care transitions, medical students identified areas for process improvement and connected 77 patients to community services.

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