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Curriculum 2.0 represents a broad restructuring of the UME program, based on the assumption that an inflexible, classroom-based curriculum cannot prepare our graduates to function expertly in a complex, changing and contingent environment. Curriculum 2.0 is not a static sequence of courses, but is instead a dynamic healthcare system of learning that adheres to competency-based principles, situates learning in the workplace, generates and incorporates evolving health care knowledge, and responds to changing needs of patients, populations and learners. Unique features of Curriculum 2.0 include the following:
1. A pre-clerkship phase called Foundations of Medical Knowledge (FMK), which is limited to one year, fully integrates biomedical, behavioral, social and systems sciences, medical humanities, and physical diagnosis. FMK uses a case-supported format that promotes self-directed learning and critical thinking skills.
2. Foundations of Health Care Delivery (FHD) is a key component of Curriculum 2.0. The goals of FHD are to integrate the patient care experience with health professions knowledge, integrate systems knowledge with patient care, nurture self-directed workplace learners, cultivate respectful professionals and prepare leaders who contribute to a collaborative practice-ready workforce. Vanderbilt University medical students can select one of two pathways to complete the program requirements for FHD. These pathways are Continuity Clinical Experience (CCX) or the Vanderbilt Program in Interprofessional Learning (VPIL).
3. Learning Communities (LCs) are longitudinal groups of faculty and students created to foster student professional development, specifically addressing personal areas of metacognition and reasoning, ethics, service, and leadership, as well as knowledge and understanding of the broader healthcare environment and payment. Academic sessions are developmentally appropriate as the students mature through the phases, as well as effectively integrated with other course and clerkship efforts.
4. Physical Diagnosis teaches students advanced clinical skills. Throughout the medical school curriculum, students receive opportunities to learn and practice advanced physical diagnosis skills in small group settings. These topics are varied, based on achieving higher levels of competency, and taught by Dr. Mike Fowler and other instructors.
5. A required research course introduces students to domains of health-related research, principles of study design, and research methodologies. This will prepare students for a 3-6 month research project in the Immersions phase.
6. A core clerkship phase, Foundations of Clinical Care (FCC), occurs in the second academic year. FCC will consist of six clerkships over a 41-week period. A Diagnostics and Therapeutics (D&T) course running throughout FCC will emphasize cost effective diagnostic approaches for a set of 25 presenting problems, known as the Vanderbilt Core Clinical Curriculum (VC3). D&T will employ a flipped classroom strategy, with online modules providing required content that students will apply to their own patients during small group discussions. FCC will also include two 2-week electives.
7. The highly individualized Immersions phase follows, offering a variety of course formats designed to advance fundamental knowledge in the context of clinical settings selected by students based on personal interests and learning needs. Integrated Interdisciplinary Science Courses (IISCs) will use a hub and spokes model in which faculty teams deliver core content to clusters of students using multiple approaches, including case-based tutorials, online modules, journal clubs, small group discussions and self-directed learning projects. Students will select their concurrent clinical experiences from a menu of related disciplines. For example, students taking an Obesity IISC would learn core content with faculty from Molecular Physiology and Biophysics, Endocrinology, General Pediatrics, Gastroenterology, Psychiatry and Surgery, and could obtain clinical experiences in adult or pediatric diabetes clinics, bariatric surgery, or the Vanderbilt Weight Management Clinic. This phase will also include Advanced Clinical Electives (ACEs) and Acting Internships (AIs) that embed students within clinical teams and promote increasing responsibility for patient care. Finally, we will continue several "longitudinal" courses that currently thread throughout the senior year, such as the Shade Tree elective, based at our student-run free clinic. In this elective, fourth year students serve as mentors for more junior students during clinic shifts, attend a seminar series on community health and the medically underserved, and perform a clinic-based quality improvement project.
8. Case-based Learning (CBL) is one form of experiential learning in which students collaborate in a small group environment to work through patient cases. By placing the knowledge in a clinical context, students begin thinking as a professional in a clinical context. All basic science courses in the VUSM curriculum are taught using CBL.
9. Team-based Learning (TBL) is a formal example of the flipped classroom in which students prepare for the in-person session by reading assigned articles or chapters, watching videos, review websites, or completing other assignments prior to class. During the in-person session students complete multiple-choice questions individually and then in teams to assess their comprehension of the assignments. After, they work in teams to apply what they have learned in a clinical context.
10. A competency-based approach to learning and assessment with explicitly defined milestones for each major competency domain, and an assessment system "fit for purpose."1
11. A system for personalized learning that includes evidence-based self-assessments, personalized learning plans, faculty coaching, and curricular flexibility, all facilitated by a comprehensive electronic learning portfolio.
12. A rich informatics and technology infrastructure that collects learner experience and assessments in the learning portfolio, aggregates and displays performance data in a way that facilitates interpretation and decision-making, directs learners to knowledge and information resources, and has the potential to measure the impact of educational interventions through associated patient outcomes.
1Van der Vleuten CPM, Schuwirth LWT, Driessen E, Dijkstra J, Tigelaar D, Baartman LKJ, van Tartwijk J. A model for programmatic assessment fit for purpose. Med Teach, 2012; 34(3): 205-214.
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