Western Reserve 2 – WR 2
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Western Reserve2 – WR2
Integrating Basic and Clinical Sciences
Presentation by: Amy L. Wilson-Delfosse, Ph.D.James Bruzik, Ph.D.Case Western Reserve UniversitySchool of Medicine
Why Did Case Change?The Western Reserve curriculum designed in the 1950s continued with only minor revisions despite enhancements in computer technology and unprecedented changes in the health care system
Classrooms with ~30% of students attending
Watching lectures online double time
Paper syllabus boundaries
Students not preparing for class
Teacher-centered
Why Did Case Change?
Course silos “I don’t know if you’ve had this yet but”
Multiple choice tests –nothing else counted, binge and purge approach to learning
Difficult to get faculty to teach – clinical and research productivity
Dean’s Vision – research and scholarship block and MD thesis
Principles of Western Reserve2: Building on Western Reserve1
Integration of health and disease (normal and abnormal) – systems biology
Experiential learning, scholarship, critical thinking, lifelong learning
Active interchange of ideas between students and faculty
Graduate school environment – independent study and self-directed learning
Weave scientific foundations and clinical medicine throughout the 4 year curriculum
Principles of Western Reserve2: Building on Western Reserve1
Integration of health and disease (normal and abnormal) – systems biology
Experiential learning, scholarship, critical thinking, lifelong learning
Active interchange of ideas between students and faculty
Graduate school environment – independent study and self-directed learning
Weave scientific foundations and clinical medicine throughout the 4 year curriculum
Year I Year II Year III Year IV
Foundations of Medicine and Health
(20 months, including vacation)
Core Clinical Rotations
IQ+ Program
(48 weeks, flexible scheduling)
Research &
Scholarship
(16 week block +
electives, flexible
scheduling)
Advanced Clinical and Scientific
Studies
Areas of Concentration
Electives
(10 months, flexible scheduling)
Western Reserve2 Curriculum
Refl
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Ass
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Refl
ectio
n, In
tegr
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July Year 1
March Year 2
Homeostasis
Host Defense and Host Response
Cognition, Sensation,
and Movement
Food to Fuel
(Host Defense,
Microbiology, Blood, Skin,
Auto-immune)
(Endo, Repro,
Development,
Genetics, Mol Biol, Cancer
Biology)
(GI, Nutrition,
Energy, Metabolism, Biochemistry
)
(Neuro, MindMusculoskelet
al, Cellular Neurophysiolo
gy
(CV, Pulm, Renal, Cell Regulation,
Pharmacology, Cell
physiology)
The Human Bluepri
nt
Refl
ectio
n, In
tegr
atio
n &
As
sess
men
t
1 Week Clinical Immersi
on
1 Week Clinical Immersi
on
1 Week Clinical Immersi
on
1 Week Clinical Immersi
on
1 Week Clinical Immersi
on
BOARD REVIEW BLOCK
(Medical Error, Public Health,
Inequities, Bioethics, Profession
alism Epi/Biostat
s)
Becoming a
Doctor(5 wk)
Refl
ectio
n, In
tegr
atio
n &
As
sess
men
t
Structure (Anat., Histo-Path, Radiology)
Foundations of Clinical Medicine
WR2 Foundations of Medicine and Health
Case Inquiry Group (IQ)
Student-centered small groups with a faculty facilitator
Case-based
Self-directed learning
Team work
Quality improvement – “check out”
August to December
Year 1
January (Year 1) to December (Year 2)
January
Year 2
Introduction to clinical skills
Advanced Clinical Skills
RAMP (Rotating
Apprenticeships in Medical
Practice)
Clinical Preceptorships
FCM Seminars Health Policy, Leadership and
Advocacy, Professionalism, Ethics
Web Resources
Integration andAssessment
WR2: Eary Patient Experiences
Core and Advanced Clinical Experiences: Core Clinical Rotations
Core 1 (16 weeks): Internal Medicine and Surgery + Peri-Op and Acute Pain
Core 2 (16 weeks): Pediatrics, OB-Gyn, Family Medicine (Prevention/Wellness)
Core 3 (8 weeks): Neuroscience and Psychiatry + Chronic pain
Advanced Cores (4 weeks each): Undifferentiated and Emergent Care Aging and Society: Geriatrics, Chronic Disease, Palliative
Care, Health Systems
4 hours Friday afternoon in group of 10-12 students
Reinforce importance of basic science and emerging basic science knowledge in the practice of
clinical medicine
Continue to use a team-based, learner-centered small group to enhance professional growth and
development
Practice advanced skills in communication, physical exam, clinical reasoning, evidence based
medicine
Basic Science During Clerkships: IQ+
Reflection
Case discussion – DDX and learning objectives
Research and discussion with experts (basic science and clinical faculty)
Skills practice
Checkout
IQ+: Typical Session
Example Case: HLHS
Check-in: Debrief, possible directed reflections on dealing with a sick child or the parent of a sick child.
Go through the case in step by step – starting with a “blue baby”– generate a differential diagnosis, discuss the perinatal changes in the circulation
Come up with a list of learning objectives and questions for the experts.
Expert session - paired basic scientist & neonatologist meet with larger group. Mini-didactics + Q+A – focusing on emerging science on the heritable nature of this problem + clinical insights.
HLHS continued …
Skills practice – Students interview the standardized parent of this baby – script calls for integration of recently learned information + focus on delivering bad news and communicating with families.
Check out
HLHS continued …
Assessment
Attendance
Facilitator assessment
Case development/presentation (teams)Students write cases and run the IQ+ afternoonOpportunities for scholarship Opportunities for peer teaching
Acknowledgements
The faculty, staff and students of CWRU School of Medicine
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