Over 120 faculty, students and staff from all four present campuses attended a curriculum retreat in February 2016, where options for curricular structures and content were discussed and further elaborated by small working groups. The College Committee on Instruction and Appraisal subsequently adopted several recommendations regarding the overall curricular structure and content, now in the process of formal approvals through the College of Medicine and University Faculty Senate. Details of these latest recommendations can be found below in the section entitled From the Retreat: Integrated Coursework, Organized into Five Thematic Content Areas.
Also in February, the College received approval from the Liaison Committee on Medical Education (LCME) to proceed with plans to offer the entire M1 through M4 curriculum in Peoria and Rockford, beginning in 2017. This expansion is an integral component of the broader curriculum renewal project, as is further explained in the text below. Such approval must be obtained from the LCME, recognized by the US Department of Education and the World Federation on Medical Education as the authority for the accreditation of medical education programs leading to the MD degree in the United States and Canada, prior to embarking on the expansion of programs at branch campuses or major curriculum change.
Why Change the Curriculum?
The curriculum is always evolving and changing to reflect new advances in medicine and new concepts in education – for example, we have adopted and even become a national leader over the past few years in the use of Team Based Learning® methods. There has, however, been no comprehensive reconsideration of the fundamental structure and content of the MD curriculum for more than three decades. Meanwhile, the broader medical education community has been very actively working toward the realization of new approaches to professional education, best exemplified by the Carnegie Foundation for the Advancement of Teaching’s volume published on the centenary of Abraham Flexner’s famous 1910 Carnegie Report. A number of our own faculty have been involved in this recent proliferation of educational research and curriculum development at the national level, and it is time to incorporate these advances into the curriculum of the College!
In late 2013 the College Committee on Instruction and Appraisal charged three Task Forces with a comprehensive review of the MD curriculum across the University of Illinois College of Medicine’s four campuses. These three task forces – on Curricular Transformation, Student Assessment, and Program Evaluation – are comprised of faculty and student educational leaders from across the College, and have been meeting regularly to assess potential means of enhancing the learning environment for our medical students and faculty. Each task force has been reviewing the relevant literature, exploring trends in curriculum at other schools, and conducting interviews with our peers around the country. A set of basic working principles was published by each task force in June 2014 and a new mission statement for the MD program was created. From that point the emphasis has been on developing plans and timelines for curriculum development and implementation. We are now poised to debut a new MD curriculum for the class that will enter in August 2017.
An additional impetus for curricular transformation arose in March 2015, when the University of Illinois Board of Trustees authorized the development of a new, separately-accredited medical school in Urbana. Given the role the Urbana campus has played in our M1 curriculum across the current three downstate campuses (students assigned to Peoria and Rockford for the M2-M4 years begin in Urbana for their M1 year), the resulting restructuring of the College will necessarily involve a major curricular modification and the expansion of campus resources in Peoria and Rockford to accommodate M1 students. Beginning in fall 2017, all first-year University of Illinois College of Medicine students will therefore matriculate at either the Chicago, Peoria, or Rockford campus and will be based there for the duration of their MD curriculum. This change in structure challenges us to find ways to ensure an appropriate learning environment for the basic sciences in Peoria and Rockford. It also provides an exciting opportunity for innovative solutions to the longstanding difficulties we have faced in coordinating curriculum development, delivery, and evaluation across our campuses. The overarching goals of this restructuring of the College and its MD curriculum can be summarized as follows:
- To further the identity of the University of Illinois College of Medicine as a single, unified educational endeavor with state-wide impact
- To provide each campus with a complete, four-year template within which to build integrated educational experiences with maximal continuity of faculty, peer, patient, and community relationships
- To enhance integration of the basic, clinical and social sciences, and experiential clinical opportunities both vertically and horizontally
- To better individualize the learning process, according to students’ aptitudes and learning needs, while simultaneously ensuring that every student achieves an appropriate level of competency in all fundamental learning outcomes
- To allow more efficient, College-wide utilization of the faculty expertise based at our individual campuses
- To better assure comparability of educational experiences for students at our three remaining campuses
- To streamline the committee structures and administrative mechanisms for curricular management and oversight
One College of Medicine, One Curriculum, Three Campuses
There will be a single curriculum for Chicago, Peoria and Rockford, with alignment of all major aspects of course and clerkship structure, scheduling, and assessment across the three campuses.
The curriculum will be organized as three sequential “phases.” Phase 1 will be based in the classroom and in various (mostly outpatient) clinical settings, with a comprehensive introduction to the knowledge, skills, interpersonal and societal perspectives, and commitments to personal growth that are necessary for the profession. Phase 2 will include the traditional “core” clinical clerkship rotations. In addition, it will allow time for scheduling elective rotations in other disciplines, research time, or time for other academic pursuits such as research blocks, global health experiences, and components of the College’s Special Curricular Programs.
Much of the Phase 1 (pre-clerkship) curriculum and some didactic components of the clerkship-predominant Phases 2 and 3 will utilize “flipped classroom” methods as a means of making the faculty expertise at each campus available to the College as a whole. We will do this by developing common curricular materials for use at all three campuses. In-class activities will vary by campus, with the most appropriate methods determined by consideration of student factors (e.g. class size, participation in special curricular tracks such as the Rural Medicine Program in Rockford) and local resources (e.g., individual faculty expertise, local interprofessional education opportunities). This approach will also further ensure the comparability of educational resources and learning experiences across the campuses.
From the Retreat: Integrated Coursework, Organized Into Five Thematic Content Areas
The following recommendations were adopted by the CCIA as a result of the February curriculum retreat:
- Curricular content across all three phases will be organized by five major themes: Foundational Knowledge, Clinical Practice of Medicine, Health & Society, Health Systems, and Professional Development
- Phase 1 content will be organized into a limited number of courses integrating the 5 themesand further organized into sequential, systems-oriented modules
- Phase 1 curricular content will be revisited and reinforced in a spiral fashion in Phases 2 and 3
Longitudinal Clinical Experience
The College has a long tradition of involving students in clinical interactions with patients from early in the first year. In the new curriculum, we will further enhance these opportunities, taking advantage of the abundant primary care resources at each of our three campuses, including the Rural Medicine (RMed) Program sites affiliated with the Rockford campus, the Mile Square Federally Qualified Health Center in Chicago, and the Unity Point family medicine practice in Peoria. Our ultimate goal is to involve every student in a team-oriented, interprofessional clinical practice setting as an ongoing feature of their medical student experience.
Longitudinal, Competency-Based Assessment
The College is one of ten US medical schools involved in an Association of American Medical Colleges pilot study of thirteen “Core Entrustable Professional Activities,” or core EPAs. The project is exploring thirteen tasks that every medical student, upon graduation from medical school and assumption of the responsibilities of residency, should be able to perform without direct supervision. The goal is to develop reliable means of assessing medical students’ progress toward these skills as they progress throughout medical school.
A number of other innovative assessment strategies are also being explored, including the use of adaptive learning technologies that tailor the presentation of study material to each individual student’s learning needs.
Student performance in the Phase 1 (pre-clerkship) curriculum will be recorded as Pass-Fail, given the documented positive impact on student well-being and the alignment of this approach with a competency-based, team-oriented learning environment.
What is the Timeline for Implementation?
While much remains to be done before the first students begin the new curriculum in August 2017, all is on schedule. The dean has committed the resources to ensure appropriate expansion of facilities and faculty resources, especially in Peoria and Rockford, as well as the necessary investments in distributed learning technology to support the shared, three-campus curriculum.
Upon approval by the College of Medicine Executive Committee and appropriate University Senate entities, a sufficiently detailed plan will be ready in the summer of 2016 for presentation to applicants who would enter the College in August 2017. Meanwhile, recruitment of new faculty, facilities renovations, and the development of curricular materials will be a continual focus throughout 2016 and 2017.