Tackling a master’s degree during medical school—usually in public health or business—has become increasingly popular among students as they prepare for the rigors of the profession. Many schools now are focused on developing a mastery of learning that is essential for physicians’ entire careers—but it doesn’t involve an additional degree.
The AMA’s Accelerating Change in Medical Education Consortium—working to modernize and reshape the way physicians are trained—brings schools together to share ideas and experiences with new programs designed to improve competency, leadership and patient care through innovations that prepare students to thrive in an evolving care delivery system. A priority area for many of the schools is training students to become lifelong learners, also known as “master adaptive learners.”
Pathways at Harvard
Harvard Medical School, which joined the consortium this year, created the Pathways Curriculum and implemented it in August 2015. The program aims to create master adaptive leaners who are self-directed, reflective, curious, cognitively flexible, and capable of embracing uncertainty and dealing with complexity.
To foster that, the school has moved to a 14-month pre-clerkship curriculum and then returns students to integrated classroom/clinical experiences after their core clerkships. Among other changes, three Professional Development Weeks provide students with feedback about their evolving skills, and students meet regularly with their advisers to work on individualized plans to guide their development.
“There is a great emphasis on self-directed learning … we want people to be motived by learning and growing, not just studying for what they are being tested on,” said Edward Krupat, PhD, director of Harvard Medical School’s Center for Evaluation and an associate professor of psychology in the Department of Psychiatry at the Beth Israel Deaconess Medical Center.
Harvard Medical School leaders also are trying to change the culture so students understand that there are shades of gray in medicine and will be willing to say that they don’t know something, Krupat said.
Translational learning in North Carolina
The University of North Carolina School of Medicine, which also joined the consortium this year, is in its second year of Translational Education at Carolina (TEC), a change that has the school expanding the ways in which it develops students’ physician leadership skills. As part of the changes, UNC will now tap into the university’s public health and population science and business school talents.
The TEC program is built on three threads: the translation of medical science to the care of people, patients and populations. It also now will include a professional development thread that will be woven throughout the four years of medical school. Students will become more familiar with the health care system and how it is financed and become familiar with business terms, such as value-based purchasing.
Physicians will need to focus on populations instead of just the patients, said Julie Byerley, MD, vice dean for education at the University of North Carolina School of Medicine. It also demands that physicians work in teams and recognize their unique role on the team.
“Medicine is always changing, but the pace of change in health care right now is incredibly rapid,” Dr. Byerley said. “We want our graduates to take care of the patients in front of them with the goal in mind of taking care of the entire population.”
Technology in Texas
The University of Texas Rio Grande Valley School of Medicine (UTRGV SOM) in Edinburg, Texas, another school that joined the consortium in 2016, will use technology to support communication and empathetic interactions with patients in diverse groups and in multiple settings for numerous preventive health, health maintenance and health care delivery purposes.
“The aspects of the UTRGV SOM curriculum that we are most excited about in terms of facilitating the students to becoming master adaptive learners are the structured and guided opportunities threaded throughout the curriculum for reflection and self-directed, independent learning so that the students become competent, self-aware lifelong learners with an interest in and skills to work with underserved populations,” said Arden D. Dingle, MD, psychiatry professor and UTRGV SOM’s chief of child and adolescent psychiatry, and Valerie Terry, PhD, instructional development designer and communication discipline coordinator at UTRGV SOM.
The school, which matriculated its inaugural class of 55 students in June 2016, is in the Lower Rio Grande Valley. The region shares its southern border with Mexico, and much of the population lacks access to quality, affordable health care. The medical school’s curriculum features problem/case-based learning and hands-on experiences that incorporate information and approaches that are relevant to working with underserved populations.
“Due to the different cultural background of this large population, we are engaging students with family ties and similar socioeconomic backgrounds as well as cultural traditions who would want to stay long term in the Rio Grande Valley,” Francisco Fernandez, MD, the school of medicine’s dean wrote in a letter to the consortium.
Curriculum 2.0 at Vanderbilt
Leaders at Vanderbilt University School of Medicine, one of the 11 founding members of the consortium in 2013, said they have benefited from participating in the consortium. Among the changes they have accomplished:
- Attention to all domains from the first day
- Standardized milestones across settings
- A portfolio coach for each student
- Systems-oriented activities in clerkships
- Population health and advocacy
Improving student perceptions of competency-based assessment, practical applications of the master adaptive learner construct and connecting personalized learning goals to daily work are among the areas Vanderbilt medical school leaders are now working to change.
Other consortium projects
The 32 consortium schools are also changing other ways medical students study, including paving a new path to residency, relaying student competency to residency programs and training students for rural medicine. You also can read about what students at the forefront of transforming med ed have to say about their experiences.
