Department of Internal Medicine
OSAC efforts focus on teaching
Dr. Joel Gordon sees a significant challenge in his new role as director of curriculum for the M3 and M4 years: to help adapt the clinical education UI medical students receive to meet 21st century needs.
“The challenge is to look at what we do to best prepare students for the practice of medicine in 2010 and beyond,” Gordon said.
Gordon, professor of internal medicine, Sahai Family Professor of Medical Education and faculty director of the Boulware learning community, began his new duties July 1. He succeeds Dr. Jerold Woodhead, associate professor of pediatrics, who had served in the position since 1995.
New emphasis on clinical education has its roots in the curriculum revision implemented in 1995, which focused primarily on the preclinical M1 and M2 years. Now the College looks to address issues in clinical education that have come to the fore as the revised curriculum has matured and evolved.
One of the new curriculum’s major innovations was the Foundations of Clinical Practice series of courses. These introduce first- and second-year medical students to content previously reserved for M3 and M4 students. One of Gordon’s goals is to complete the process by reintroducing M1 and M2 content into the clinical years.
As students encounter actual patients with real clinical problems, he explained, renewed acquaintance with the principles of physiology and pathophysiology could help them integrate the information they learned previously and put it to practical use. Likewise, he said, with principles of pharmacology that pertain directly to treatment of patients. Finally, Gordon noted that clinical rotations are an opportunity for students to apply critical reasoning skills taught earlier to determine whether articles they’ve found in their searches of the medical literature are relevant to the diagnosis or treatment of a specific patient.
Another hallmark of the new curriculum is integration of course content across basic science subject areas. Gordon said the College wants to achieve similar integration across clerkships. He suggested that closer coordination between certain clerkships could enhance students’ clinical learning. For example, internal medicine and surgery could collaborate to give students experience in the emerging discipline of hospital medicine; pediatrics and obstetrics-gynecology could work to create an experience in maternal-fetal medicine; and neurology and psychiatry could work to create a neuroscience experience.
“Thematically, we’re looking for an experience that better reflects patient-centered care and represents a systems-based approach,” Gordon said.
Other priorities on Gordon’s list include working closely with leaders of the Des Moines Area Medical Education Consortium, which conducts a broad array of undergraduate clerkships at its five member hospitals, hosting as many as 25 M3s and 10-15 M4s at any given time. “We want to make sure there’s a seamless integration of the Des Moines experiences and on-campus rotations,” Gordon said.
He’ll also oversee preparation for the clinical portion of the Liaison Committee on Medical Education’s upcoming review of the UI Carver College of Medicine; the LCME site team is expected to visit the UI in 2009. New accreditation requirements call for each clerkship to have written goals and objectives and for documentation of each student’s experience in each clerkship.
Given his interest in simulation—he is a co-developer of the ClinicSoft computer program UI medical students use to practice their case management skills—Gordon will look for opportunities to identify gaps in students learning that simulated patients could address. Students could work in simulated environments to fulfill some clinical requirements, he suggested.
Even further ahead, Gordon thinks the College might explore providing medical students the opportunity to tailor their clinical curriculum to their own interests and career goals. “Maybe one size doesn’t fit all in medical education,” Gordon said. “We could allow students to have more flexibility in what they take so they’re better prepared for the residency they want.”
Gordon admitted his agenda was “kind of daunting.” But, he said, “one day at a time, we’ll get it done."