Vanderbilt School of Medicine has a history of excellence and continuous improvement in medical education. The MD curriculum is currently in transition from a traditional model (2 years of basic science followed by 2 years of clinical training) into a fully integrated approach that blends basic science and clinical experiences from the start. This new curriculum is described in detail below. Different educational elements and programs have been piloted and phased in over the past few years.
Curriculum 2.0 is an innovative approach to teaching and learning. Informed by learning theory, Curriculum 2.0 seeks to promote deeper comprehension of the many scholarly fields essential to our understanding and practice of medicine.
Acknowledging the explosion of information relative to medicine and the pervasive access to multiple information sources, an explicit goal of Curriculum 2.0 is to coach students in how to learn. Medicine is constantly evolving; we believe this is one of its greatest appeals as a career. Ours is a workplace in which every learner works and every worker learns. Curriculum 2.0 is designed to launch our students into a life-long learning process that will extend well beyond their time on our campus. Vanderbilt graduates will be positioned to assume leadership roles in shaping the future of medicine.
The first phase of the curriculum, Foundations of Medical Knowledge, will provide a solid, broad foundation of knowledge and skills. Multiple learning methodologies, including teamwork around structured cases, will be utilized to promote integration and application of new information. Subsequent years of training will deliberately build upon this foundation, with escalating level of detail as the learner advances. The intent is to focus on conceptual understanding, promoting better retention of information.
Progressing through the curriculum, the student will have graduated responsibilities. The Foundations of Clinical Care provides education in multiple medical disciplines via clerkships in medicine, surgery, pediatrics, obstetrics and gynecology, psychiatry, and neurology. There are elective opportunities as well.
VC3, a symptom-based framework of core clinical problems, is coupled with a portfolio system that automatically tracks individual student-patient encounters. These programs promote integration of learning across disciplines. A unifying longitudinal course (Diagnostics and Therapeutics) explicitly addresses the strengths and limitations of various diagnostic/therapeutic approaches and elucidates clinical reasoning; this will encourage informed, effective and efficient care.
The Immersion Phase is a highly individualized period that builds upon the foundational knowledge acquired earlier, in a context that is most relevant to each student’s individual interests. Immersion courses will solidify clinical skills; deepen foundational science knowledge through meaningful clinical engagement; allow students to dive into areas of personal learning needs and/or interest; expand knowledge and skills in leadership and scholarship; ensure readiness for residency; and enhance workplace learning skills. Students will select from a broad menu of courses including Integrated Science Courses, Advanced Clinical Experiences, Acting Internships and Advanced Electives. During a portion of the immersion phase, students will participate in a three- to six-month mentored research experience, tailored around each student’s particular research and clinical interests. The longitudinal curricular elements of Foundations of Healthcare Delivery and Learning Communities will remain integral to student development during the Immersion Phase.
The Vanderbilt Core Clinical Curriculum (VC3) consists of 25 core presenting problems of patients that are so common and so important that we feel all students should attain competence in managing them before leaving the undergraduate phase of their medical education. VC3 takes advantage of a number of unique Vanderbilt resources for clinical education. Particularly, it pulls together the components of 1) clearly defined learning goals, supportive resource materials for self-directed learning, and ongoing feedback and assessment 2) high powered technological resources through Vanderbilt’s Knowledge Map curriculum mapping and Electronic Portfolio systems and 3) clinical mentoring and individual feedback through the MCT program.
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).
The Learning Communities are intentionally developed longitudinal groups of faculty and students that aim to enhance students’ medical school experience and maximize learning. At Vanderbilt, our focus within the Colleges on wellness and career advising addresses enhancing the student experience. The Learning Communities’ academic component seeks to maximize learning, specifically learning related to student development as professionals. Helping students build an appropriate image of the medical profession and skill set related to functioning within the healthcare environment are the essential foundations for future success. Development as professionals involves knowledge, skills and attitudes related to students’ practice, as well as the environment within which the practice will occur. The longitudinal nature and trusting environment created within the Learning Communities fosters 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. The academic sessions will be developmentally appropriate as the students mature through the phases, as well as effectively integrated with other course and clerkship efforts. In sum, the Learning Communities will provide the nurturing environment to maximize student development as professionals.
The Learning Communities experience includes:
- Ethics - The Ethics sessions will provide students with a foundational understanding of the major moral philosophies and tenets of biomedical ethics, by illustrating these principles through the lenses of cases in clinical medicine, biomedical research and healthcare policy. Additionally, students will critically examine their own moral intuitions, and appreciate the importance of listening carefully to others in moral matters, especially one’s colleagues, patients and patient’s families.
- Colloquium - The Colloquium sessions will foster the development of a deeper understanding of cognition, including critical thinking, clinical reasoning, and metacognition, allowing students to cope with uncertainties encountered secondary to the complexities of medical knowledge, as well as coping with adversity, illness, and dying. Additionally, students will develop an appreciation for the importance of patient stories (narrative medicine), and be guided in the ‘deliberate practice’ of mindful reflection to elicit and nurture their capacity for empathy and personal well-being.
- Leadership - The Leadership sessions will encourage students to recognize leadership as both an identifiable set of skills and abilities, and a process utilized to enable individuals themselves and others to more effectively achieve a common goal. Sessions will focus on critical leadership topics ranging from self-awareness to conflict management with the aim of helping students develop their own leadership skill sets.
- Policy - The Policy sessions will expand student understanding of the environment of health care is delivery. Focus will be given to exploring the major components of healthcare payment, the influence physicians have on healthcare costs, and the ethics of patient/physician rights and responsibilities regarding healthcare.
- Service Learning - Sessions focusing on Service Learning will begin during the second year of the Learning Communities. These sessions will highlight service as an important component of every physician’s career, and explore the role of physician as advocate for patients, families and the healthcare system. Students will be provided with opportunities to learn through serving in the community, highlighting the importance of identifying and meeting real-life community needs.
Research training and experience throughout the curriculum fosters the development of research acumen (i.e. teamwork, communication, critical thinking, inquisitiveness, analytical skill). It provides a scaffold on which to both practice medicine and perform research.