The College of Medicine at the University of South Alabama has embarked on a comprehensive project of curriculum renewal for its undergraduate medical education program leading to the M.D. degree.
Since the establishment of the College in 1969, undergraduate medical education at USA has followed a traditional curriculum focused on a lecture-intensive process driven by cognitive objectives in the first two years and by a combination of cognitive, attitudinal, and psychomotor objectives in years 3 and 4 This tiered 2+2 approach placed a heavy emphasis during the first two years of medical school on the assimilation of facts about the structure, function, and diseases of the human body through basic science courses organized by disciplines, such as physiology, gross anatomy, pharmacology and pathology. During the third and fourth years of training, the emphasis transitioned abruptly from the acquisition of basic science knowledge to immersion training in clinical education and patient-oriented care.
The new curriculum under development at USA focuses on the concept of education across the continuum. It is fueled by the challenge in medical education of how best to move the matriculating medical student along the pathway to becoming a competent physician and life-long learner. The job is complex as young physicians must be able to satisfy an ever increasing level of competency in all aspects of their profession. The goal of curriculum renewal at USA is to provide a dynamic plan of learning expectations and awareness in training of what needs to be accomplished toward expertise of becoming a competent physician.
Curriculum renewal at USA is paced by a timeline that has already begun with a reframing of the Educational Objectives of the College of Medicine around six core competencies for medical training delineated by the Accreditation Council for Graduate Medical Education and American Board of Medical Specialties in 1999.
Beginning in 2012, freshmen entering USA College of Medicine will undertake a curriculum devoted to the integrated instruction of all competencies beginning in the first week of medical school. Replacing traditional discipline- based basic science courses, instruction will commence with a two- year sequence of modules devoted to different organ systems.
Using the cardiovascular system as an example, students will learn basic medical knowledge covering the structure, function, and pathology of the heart and medical treatment of heart conditions. At the same time students will learn to monitor and evaluate heart sounds and other diagnostic tests while acquiring professional and interpersonal communication skills needed for accurate diagnosis, documentation of care and relating effectively with heart patients. Students will be taught on enhancing patient care and their obligation to be life-long learners capable of analyzing and applying the latest developments in cardiac care.
Years three and four of training also change significantly in the competency-based, integrated curriculum. The objectives, pedagogy, and assessment of all clinical rotations will be integrated to satisfy the continuum and to optimally prepare students to enter residency programs with previously established competency-driven curriculums. In addition, the focus on vertical training that intensifies the clinical experience introduced into the first two years will likewise expand the delivery of basic medical knowledge and its application into clinical settings.
The goal of engaging students in a holistic curriculum across the full four years of medical school at USA is improved training and competency in all areas that define the science and art of doctoring. Progress toward the synthesis of skills into observable behaviors related to each competency will be carefully assessed in a series of milestones designed to achieve national standards of excellence at every level of training during the entire undergraduate medical education program.
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