Curriculum Revision – An Update and Some Reflections from the Doodle Queen
Robin English, M.D.
Professor and Assistant Dean for Undergraduate Medical Education
An LCME accreditation standard states that a medical school must periodically review its curriculum, both as a whole and as individual phases. LSU School of Medicine reviewed and revised our third and fourth year curriculum in 2009, and in 2012, we began the process of revising our pre-clerkship curriculum. After a broad needs assessment and a restructuring of the curriculum committees, we reviewed and updated our educational program objectives (EPOs) and overall curriculum goals. Among our goals for the revision were improved content integration, increased coverage of topics such as evidence based medicine and cultural competency, enhanced elective opportunities for personal career development, and a decrease in lecture hours to allow for more active learning sessions. These goals and the EPOs have served as the guide for all of the work that we have done to date.
The newly formed Curriculum Renewal Committee reviewed numerous curriculum models and recommended a hybrid structure that included discipline-based courses in the first year and systems-based integrated courses in the second year. We identified content directors and new basic science and clinician course co-directors who immediately got to work ensuring that we covered the necessary material without unnecessary redundancy. We also convened work groups of faculty with expertise to examine our teaching of subjects such as cancer and infectious disease. We added new courses and modified existing ones to meet our goals and better address our EPOs. In addition to amending existing lectures and developing new ones, we wrote 28 new Team-Based Learning sessions, 10 customized National Board of Medical Examiners examinations, and countless internal examinations and clicker sessions to help our students receive timely feedback and fair assessments. After receiving faculty approval, we started our new curriculum for the incoming class of 2019 in the summer of 2015.
That group of students is now immersed in their clerkships, and we are in the third year of our new curriculum. We have made modifications based on frequent, real-time feedback from faculty and students – some have been small, others more substantial – but we continue to keep our original goals and EPOs in focus. We are following numerous subjective and objective outcomes. While USMLE Step 1 scores have not significantly changed since previous years, our students’ perceptions of basic science and clinical integration across the first two years has greatly increased. We have also met our goals of increasing contact hours in certain curricular content, increasing elective opportunities, and replacing some lecture hours with active learning sessions. The Curriculum Steering and Renewal Committees plan to remain focused on continuous monitoring of our goals and objectives. The student-run Aesculapian Society has been outstanding with respect to providing feedback to our faculty, and we thank them for all the hard work and help that they provide us.
So far, I have deliberately used the word “we” to describe some of what has taken place over the past few years. This curriculum revision would not have been successful without the hard work and countless hours that many of our faculty and students contributed. We made it happen. However, I have engaged in a significant amount of personal reflection throughout this process, and I have learned more than I ever thought possible. I attended lectures, studied alongside my students, and have a newfound love for the basic sciences, which I continue to foster through ongoing study. I got to know a lot of my fellow faculty very well, learning a great deal from them and developing hopefully lifelong friendships and fruitful relationships. I asked a lot of them on a daily basis, including attending numerous meetings (thus the self-appointed moniker Doodle Queen) and changing their pedagogical approaches. I am so appreciative of all of the work.
I think I can speak for the faculty who have been most heavily involved when I say that one of the best benefits of this process has been the connection of basic scientists with clinicians and of faculty across disciplines. We have an amazing faculty – our students are fortunate to have their expertise and guidance, and I personally feel privileged to call them colleagues. I look forward to continuing our work together as we persist in the implementation of our new curriculum.