Starting in July, Wichita and other KU School of Medicine campuses will phase in a new curriculum intended to give medical students more hands-on, team-based training and teach them in ways they’ll better retain the information.
Dr. Scott Moser, associate dean for curriculum, said an overarching goal of ACE (short for Active, Competency-Based and Excellence-Driven) is to close the divide that’s long existed between the first two years of medical school – traditionally lecture-intensive passive learning – and the final two years.
“There will be a greater emphasis on clinical skills during those first two years, taking histories, for example, so they’ll be better prepared for their clinical years, the last two years,” he said.
The curriculum will be rolled out over four years at the Wichita, Salina and Kansas City campuses. “It represents enough of a change that throwing students into it at different levels wouldn’t have been good,” said Dr. Moser, adding that the four-year time frame will make fine-tuning easier.
The Active component of the curriculum has two major pieces during the first two years, with each class of 28 students divided into four small groups of seven:
Problem-based learning. KUSM-W has had this piece for a while but will expand the approach. Each session involves a small group, facilitated by a faculty member, looking at a patient case. “The focus of cases is very much on diagnosis and diagnostic reasoning. They depend on some of the basic science they’re getting, but they’re applying it to clinical problem solving,” Dr. Moser said.
Case-based collaborative learning. These once or twice weekly sessions will focus on learning basic science in a small group session, and involve pre-session non-graded homework and a quiz. The case, including diagnosis, is introduced to students over two hours and “pulls out the basic science principles.” The small groups will then come together for a large group session, typically led by the faculty member who wrote the case. “There’s evidence that students do just as well in knowledge after these sessions and they retain it much better over time,” he said. “We’re very excited about this. We’re cutting back on the number of lectures.”
The Competency-Based part of the ACE curriculum focuses on ensuring that students have the skills needed to take better care of patients. Students who master particular material move ahead, while those having difficulty with something receive remediation then and there.
The Excellence-Driven piece creates an honors track within the curriculum. Students in that track must be in the top fourth of their class and do a scholarly project, which doesn’t have to be published but has to be publication ready. If they fulfill both criteria, they’ll graduate with honors.
Taken together, the curriculum should result in medical students with skills that are noticeably different to the community faculty and preceptors who help train them, Dr. Moser said.
“My anticipation is that the students will come to doctors better prepared for their clinical work than they have before. Their clinical skills should be better, and they should be more comfortable with patients,” he said. “They should see students who are more independent learners, more able to take a clinical question and follow up and learn about it, instead of just being told what to do. They should be more effective team members in practices or on rounds.”
The medical students should also come out of school better prepared for two challenges they will contend with as professionals: continuing education and burnout.
“Doctors have to be good active learners for the rest of their careers, so taking control of their learning in a more active way is important to their professional development,” he said. “We’ve also recognized that medical school is a real grind on students lives. So we’re paying attention to building in an emphasis on student wellness. We are giving them tools to take better care of themselves so they can be better doctors for their patients.”
One challenge of the curriculum is it requires more faculty time with students. “We have a much higher level of faculty involvement in the first two years than we ever had in the years before.”
The school plans to meet that need by tapping both full-time and volunteer faculty, as well as drawing more heavily on basic scientists from Wichita State and Newman universities. Dr. Moser said he’s had some “folks who have spontaneously volunteered” once they learned about the new approach but he’s still recruiting.
“If there are any clinicians interested in doing new teaching with the students, I would be glad to talk with them,” he said.
Additional details on the curriculum can be found at www.kumc.edu/school-of-medicine/education/ace-curriculum.html
Physicians interested in teaching students with the new curriculum can contact Dr. Scott Moser at firstname.lastname@example.org.