Developing a Medical School Curriculum for the 21st Century

Rendering of UConn Health academic building

The Academic Building Addition and Renovation project will consist of a nearly 18,000-square-foot addition to the existing building.

UConn Health has begun an ambitious undertaking to revise its medical school curriculum to better reflect new knowledge and new ways of learning – in tandem with impressive plans to renovate its academic building and expand incoming medical and dental class sizes.

Leading the medical curriculum reform effort is Dr. Suzanne Rose, senior associate dean for education at the School of Medicine. “The field of medicine and the expectations of our students with regard to education are changing rapidly,” she says. “UConn is prepared and excited for these changes. Our purpose is to educate the next generation of clinicians and scientists to serve our patients and our communities.”

The current medical school curriculum at UConn – which offers the state’s only public medical and dental schools – is about 20 years old, Rose points out. In the past two decades, there has been “an explosion of scientific information” as well as new technology and new models of teaching.

At the same time, the health care environment itself is changing. Health care financing and technologies are evolving constantly. More is known about preventive medicine. Diseases can be detected and treated sooner. Care once delivered only within a hospital is moving to outpatient settings. And the population is aging as people live longer.

Rose says that the objectives of the curriculum reform effort include training medical students to be physicians for the 21st century, graduating future physicians who are life-long learners and teachers, creating an individualized educational experience, promoting scholarship in education, and distinguishing UConn as a leader in medical education.

Looking at the curriculum and beyond

These goals have special significance to Dr. Thiruchandurai V. Rajan, professor of pathology and laboratory medicine and co-chair of the Curriculum Reform Steering Panel that is helping to guide the development of the new curriculum. Rajan advocates a nationwide effort to reconsider how today’s physicians are trained and what they learn.

“Medicine is changing, and so are learning methods,” he says. “We should consider whether the content we teach is really relevant. We already have the best and the brightest students pursuing a career in medicine, but are we teaching facts they will never remember or information they don’t need? Or if there is other information, like running a business or dealing with insurance companies and federal regulations, that we should include in their training.”

academic_interior

The centerpiece of the academic building renovation is a studio-based learning center in the round, with seating for up to 400 in more traditional theater style.

Rajan is an advocate for video-based learning techniques that have proven successful at places such as the nonprofit Kahn Academy. “We have a good curriculum and our students do well in their preparatory boards,” he says. “It’s not as though our curriculum is broken, but it’s time to revisit it.”

Rajan hopes that a nationwide movement to change how medical students are taught can also help reduce the amount of debt that they incur during their education – which can exceed $150,000 – and the number of years it takes. The training process for doctors can be about a dozen years or longer – four years of college, four of medical school, three to five years of residency (a training program with supervision from more experienced doctors) and, in some specialties, another one to two years in a fellowship (advanced training in a certain field).

Changing how students learn

Medical schools in the U.S. are largely lecture based, where an instructor at the front of the room talks and students take notes. But today’s new adult learning theories are focused on problem solving and interaction. “We have to think about technology and teamwork, how we can use simulated environments, how to integrate electronic medical records,” Rose explains.

The idea of team-based learning fits perfectly with plans to expand and renovate the academic building in Farmington. These construction plans have sprung from Bioscience Connecticut, the forward-thinking initiative approved by the state to stimulate economic growth and meet the future health care needs of the region. One of the key goals of Bioscience Connecticut is to attract more graduates to practice medicine and dentistry in Connecticut.

The Academic Building Addition and Renovation project will consist of a nearly 18,000-square-foot addition to the existing building, allowing the UConn Schools of Medicine and Dental Medicine to grow their class sizes by 30 percent. Design work is happening now, and construction expected to begin later this year.

The centerpiece of this renovation is a studio-based learning center in the round, with seating for up to 400 in more traditional theater style. This impressive facility will serve multiple purposes: classroom learning, meetings, continuing medical education and more. Medical simulation exercises and the use of standardized patients are widely used at UConn, and their use is expected to increase in the future as part of the new curriculum.

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Dr. Darrell G. Kirch, president and CEO of AAMC, with Dr. Suzanne Rose, senior associate dean for education at the UConn School of Medicine. (Janine Gelineau/UConn Health Photo)

The goal is for the new curriculum to be in place for the incoming class of 2016 and the completion of the new addition. “We are working toward a team-based and inter-professional approach across the continuum of medical education programs,” Rose says. “Our medical school is taking action to evolve in order to match the educational needs of our students. And our students are all about making a difference.”

Curriculum reform receives enthusiastic kickoff

Medical school curriculum reform at UConn Health received an enthusiastic kickoff with a retreat featuring Dr. Darrell G. Kirch, president and CEO of the Association of American Medical Colleges (AAMC), which represents the nation’s medical schools, teaching hospitals, and academic societies.

Kirch described the transformation he has seen on the Farmington campus as “phenomenal” and “exciting,” and said he is eager to see what the future will bring to UConn and its impressive bioscience initiative.

He explained how forces such as the current political climate, health care spending, projected supply and demand of physicians, and an aging population of both patients and physicians are adding up to a pressing need to change the country’s medical model. “The consensus is that we can’t continue with business as usual,” he said. “And we can’t make positive change unless we face the facts.”

Kirch praised UConn efforts to innovate and bring about change in its medical school curriculum, and offered some suggestions on how to accomplish it:

  • Recognize the need to build a culture for the future, moving away from hierarchical, autonomous and competitive learning to a more collaborative, team-based, service-based and patient-centered model.
  • Meet the needs of learners of the future by rethinking how students are tested, and be adaptive to the use of technology in learning.
  • Adopt a competency-based approach to education.
  • Focus on the patient at the center, emphasizing patient-centered clinical models.
  • Foster the growth of future leaders in all areas.
  • Understand that the imperative for change is part of the core ethics of medicine.

“You can go down in the bunker… or you can actively participate” in the need for change,” Kirch said. “You can try to turn all these forces to the advantage of UConn – and most importantly, to the advantage of patients.”


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