Over the past several years, medical educators throughout the world have increasingly embraced the concept that the development of clinical competence is the primary goal of medical education. Much thought has gone into how to define it, how to analyze its components, and how to measure it. At Vanderbilt, we embraced this challenge early on with the creation of the Clinical Transaction Project (CTP), initially funded by the Josiah Macy Foundation, the AAMC and the New York Academy of Medicine.
The Clinical Transaction Project focused on development of the skills that comprise the clinical transaction — engaging the patient in a thorough, informative, and insightful interview; performing an accurate and nuanced physical examination; and synthesizing all relevant data using a sound clinical reasoning process.
The foundational principle behind the CTP was that there are generic clinical skills that can be learned in the context of specific clinical problems.
Over the past five years, the faculty involved in this project selected core clinical problems 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. These problems were distributed amongst the required clinical rotations, which have developed learning activities to assure that all students achieve basic competence in managing the assigned problems during the course of the rotation. The Master Clinical Teachers are responsible for teaching the skills associated with many of the presenting problems.
Transition to Vanderbilt Core Clinical Curriculum (VC3) in 2009
In July 2009, CTP transformed into the Vanderbilt Core Clinical Curriculum (VC3). VC3 is not a substitute curriculum. It is a learning plan that overlays students' clinical work. It focuses attention on a finite range of conditions that the Vanderbilt faculty have determined as "core" for graduates of VUMS. The aim is for students to have meaningful experiences with each presenting problem. VC3 will provide a structure to find learning materials from the Vanderbilt curriculum and from resources identified by Vanderbilt faculty that address VC3 goals. To support active learning, VC3 will provide a way for students to post learning materials on the web that they find useful.
Participating students should:
- Work up and manage any patient with a chief complaint from the presenting problems
- Regularly read information resources that relate to the presenting problems
- Request opportunities to see patients with the presenting problems
- Incorporate reading about the presenting problems into the clinical documentation of relevant patients
- Review personal progress toward achieving the learning objectives (for example: regularly review one's portfolio to assess the location and extent of coverage of presenting problems in his/her patient encounters
- Contribute learning materials to the repository of information that describes the presenting problems
- Meet with master teachers to receive support for their learning
- Provide feedback to the VC3 leadership team about ways to improve the VC3 learning process