In 2013-2014, the AUBFM started implementing a new curriculum which it called The Impact Curriculum, starting with Year 1, to be phased in gradually over time. This was the first major restructuring of the medical program since the 1970's. The effort was led by Dr. Ramzi Sabra, Assistant Dean for Undergraduate Medical Education, and was the result of the contribution of more than 80 faculty members and students. The Impact Curriculum is a dynamic entity and is considered as work in progress rather than a finished product; it is subject to constant examination, monitoring, revision and renewal. Below is a description of the basic philosophy, elements and structure of the curriculum.
The mission of the Impact Curriculum is to provide students with an educational program and learning environment in which they will acquire in-depth knowledge, superior skills, humanitarian values, and professional excellence. The Impact Curriculum is a student-centered, competency-based, integrated, dynamic curriculum that emphasizes active and contextual learning, teamwork, critical thinking, problem solving and self-reflection, and offers students opportunities to pursue scholarly work and to acquire leadership skills and qualities.
The vision of the Impact Curriculum is to graduate physicians who will impact and transform society as healers, scholars, educators and advocates.
- To graduate physicians highly competent in the art and science of medicine
- To instill in students the values of ethicality, humanitarianism, professionalism, advocacy, social responsibility, and accountability.
- To nurture a collegial environment that supports the personal growth and development, leadership skills, and career paths of students
- To provide students with the opportunity to engage in scholarly work
- To employ state-of-the-art educational and patient care approaches and facilities
PHILOSOPHY AND APPROACH
The mission and vision of the MD program are achieved through The Impact Curriculum, which hopes to bring about transformation and impact at two levels:
- At the individual level, it provides learning opportunities that will transform young men and women into physicians who excel in all domains of medical education, strongly grounded in moral and professional values
- At a broader level, its graduates will positively impact their patients, colleagues, society, or the scientific and medical community as a whole, consistent with their roles as healers, scholars, educators and advocates for patient and social welfare.
The Impact Curriculum is founded on four pillars:
- The science of medicine
- The art of medicine
- The professional formation of the individual physician
- The socio-cultural and moral context of medicine
Each of these pillars is the basis of an educational thread that runs throughout the 4 years of undergraduate medical education, as discussed below.
The Impact Curriculum is based on various theories of learning and on research in the field of medical education. Thus, the learning program:
- is student centered: respects students’ autonomy, builds on their experience and knowledge, and recognizes that students have different learning styles
- is goal-oriented, relevant, practical, and motivating
- is standardized yet flexible
- considers the impact of the hidden curriculum on student learning
- stresses the personal growth, development, and the self examination and self-improvement skills of students
- stresses the importance of reflection as a key to effective learning
- appreciates the value and effectiveness of learning in small groups and teams
- realizes that assessment drives and reinforces learning
The Impact Curriculum is designed with a view that the admitted medical students are highly motivated, serious, and responsible adults who have knowingly chosen a career that requires sacrifice, dedication and hard work, and who regard medicine not only as a career but as a calling. They are chosen from among a highly competitive group of peers. Within the Impact Curriculum, competitiveness gives way to collaboration, teamwork and collegiality. The design of the curriculum reflects AUBFM’s respect for the maturity, choices, attitudes and achievements of its students.
Realizing that students enter medical school with the principal goal of becoming accomplished physicians, the Impact Curriculumis designed such that science-based clinical education is the driving force throughout the medical program.
The Impact Curriculum views students as integral components of the community of practice at AUBFM and AUBMC. Over the 4 years of medical education, the students gradually progress from an initial limited involvement to become central participants in this community. Throughout this time, they learn by observation, participation, reflection and discussion.
Mentorship and role modeling are of paramount importance in cementing the formal education that students receive. Furthermore, the Impact Curriculum recognizes that the learning, growth and development of students are shaped by the relationships and interactions among members of this community, their practices and routines, and the policies, culture, and “language” of the institution. The Impact Curriculum can only flourish in a community that shares its values and in an environment that upholds them.
Years 1 and 2
During the first 2 years:
- Clinical material is presented in the context of basic scientific, social, ethical and public health principles and perspectives.
- An integrated, organ-system based approach to education is employed, heavily impregnated with clinical applications and experiences and problem solving exercises, and includes contact with real or simulated patients. This approach engenders depth of understanding in students, and allows them to better apply the knowledge gained to dealing with clinical situations and problems during years 3 and 4.
- The educational approaches accommodate different learning styles in students and include:
- Lectures, which introduce topics, discuss complex phenomena and mechanisms, or integrate information
- Laboratory sessions: where principles and information relayed in lectures or readings is explored in more depth and at a more leisurely pace, with actual experiments or demonstrations. Lab sessions are frequently integrated with case discussion sessions as well.
- Small group learning sessions (e.g. case-based discussions, team based learning, problem based learning sessions) in which students collaborate, using their existing knowledge and experience, to deal with complex issues, solve problems, negotiate meaning and establish more intimate contact with academic staff. This allows students to practice their communication skills in an environment that fosters mutual respect and tolerance.
- Independent work, which promotes autonomy, self confidence, creativity and self-learning skills.
Years 3 and 4
During Years 3 and 4, learning arises from, and is embedded within, the daily clinical experiences of the students as individuals or teams. The knowledge and skills learned during Years 1 and 2 are further developed in a deliberate and spiral manner that reflects the increasing complexity of the knowledge and tasks required of the students. Thus, learning in these years is:
Patient-based: Bedside and ambulatory teaching/learning, through one-on-one encounters , rounds and clinical conferences, are the starting point for all educational activities
Student-centered: Autonomous and group learning become the dominant approaches; lectures and formal teaching are less relied on.
Standardized: It employs structured and simulated exercises that cover essential topics (not uniformly encountered in practice), and that reinforce basic science, social, ethical and epidemiological principles, to provide uniform content and experiences to the students.
Throughout the 4-year program, emphasis is placed on:
- Active learning, critical thinking and problem solving by students, and reflection, self-direction and self assessment, thus developing the students’ life-long learning skills. In this context, teachers are considered not merely as transmitters of knowledge, but as facilitators who guide and orient students, provocateurs who challenge, stimulate and provoke the students to create meaning from their experiences, and mentors who advise and act as role models.
- Alignment of assessment modalities with the educational objectives
- Providing feedback to students through both low-stakes assessment - to ensure success and increase motivation, and through high-stakes assessment - to maintain standards and ensure competency.
- Receiving feedback from students about the educational program through course, clerkship and instructor evaluations, and other means when appropriate (e.g. end of year workshops or retreats).
Finally, future targets for the the Impact Curriculum include offering students alternative tracks where they have the opportunity to engage in original scholarly work within a field of their interest, and work towards a joint degree (M.A./M.S.-M.D, and eventually M.D.-Ph.D.). This approach recognizes the diversity of talents, interests and potential among students, enhances their independence, self-discipline and creativity, and enriches the environment of learning within the medical school.
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