Shaping a health care revolution
April 18, 2014
We are moving through a period of enormous change in health care. New technologies, new knowledge about health and disease and new ways to organize and finance health care delivery – along with an expanding focus on access, prevention and population health – are catalyzing profound and positive change at every level of our health care system.
At OHSU, we are responding and leading through this period of change, with many initiatives designed to build on and expand lasting ways of achieving success across our missions of education, research and clinical care. And now, after years of hard work from many people, I am pleased to report on two specific outcomes: we’ve launched our new M.D. curriculum and we’ve opened the new – and extraordinary – Collaborative Life Sciences Building on Portland’s South Waterfront.
Why a new M.D. curriculum? It’s a question I continue to get on a fairly regular basis.
A century ago, Abraham Flexner proposed a model of medical education consisting of two years of basic science instruction followed by two years of clinical training. The model was largely adopted across U.S. medical schools. While variants have evolved during the ensuing years, the approach hasn’t changed much.
But as noted, over the past two decades in particular, the pace of medical change has accelerated, has sped up to a breathtaking rate, and there’s no reason to expect this will slow down. On top of this, educational research has upended ideas about how we learn. In recognition of this, faculty and leaders at the OHSU School of Medicine, in collaboration with partners across the state and nation, boldly moved forward in developing a new medical curriculum designed to ensure future physicians are ready to thrive in this dynamic new environment while helping to shape the course of the accelerating health care revolution.
What is at the heart of our new M.D. curriculum?
We aren’t discarding current strengths in the curriculum such as early patient interactions and rural health experiences. Rather, we are adding a new focus on teaching future physicians how to be experts at continuously assessing and improving their own skills, adapting to discoveries and technology changes and leading a culture change that ensures the health care system of the future is continuously improving. We’re reinforcing this outcome by the very way we teach.
We’ve flipped classrooms, moving away from primarily large lectures where students are passive, in favor of active students learning in group discussion and applied patient case-studies. The curriculum expands our use of simulation technology for real-world, patient care role-playing, strengthens our embedded clinical experiences and reinforces our commitment to rural and community-based education.
Our curriculum deliberately connects knowledge acquisition and its application. Students learn foundational sciences – anatomy, genetics, pharmacology, immunology – through an integrated prism of its application in clinical and social sciences. Woven throughout the foundational curriculum are threads on quality, ethics, informatics, communications, safety, professionalism, clinical reasoning and more.
Our new curriculum is competency-based, rather than time-based. To graduate, a student will demonstrate competency in defined areas – such as delivering care as part of an interprofessional team, demonstrating skills in lifelong learning, and integrating direct physical exam findings with laboratory data, imaging studies and genetic profiles to develop a diagnosis. If a student – for example, a nurse, physician assistant or someone with a background in science – enters the M.D. program already competent in some of these defined areas, they may complete medical school in less than four years.
We are fortunate that the home for this new curriculum, in part, is the inspiring Collaborative Life Sciences Building, in which we’ve built new classrooms and learning studios, research laboratories, student lounges and a 20,000-square foot interprofessional simulation facility. Inside this amazing building students from multiple disciplines and schools learn together. The design is intended to facilitate interprofessional interactions and organically reinforce and extend the goals of our new curriculum.
These two events – the launch of the M.D. curriculum and the opening of the building – are milestones for the school. I invite you to join us to mark this moment. On Tuesday, September 30, 2014, American Medical Association President Robert Wah, M.D. '83, will deliver the Mark O. Hatfield Lecture at the Collaborative Life Sciences Building, followed by a celebratory reception on the terrace overlooking the Willamette River. Details can be found here. I hope to see you there.