report of the strategic planning committee for medical ... · report of the strategic planning...

Report of the Strategic Planning Committee for Medical Education

June 2010

Report of the Strategic Planning Committee for Medical Education June 2010

Yale School of Medicine Report of the Strategic Planning Committee for Medical Education

Contents

Introduction ........................................................................................................................................... 1 Background and Context ..................................................................................................................... 1 Feedback ............................................................................................................................................. 2 Final Recommendations ...................................................................................................................... 3 Implementation Process ...................................................................................................................... 3

Findings and Recommendations ............................................................................................................ 4 Educational Program Objectives: Creating a Blueprint for Curriculum Reform .................................... 4

Overview ......................................................................................................................................... 4 Findings .......................................................................................................................................... 5 Recommendations ........................................................................................................................... 5

Overarching Goals of the Curriculum .......................................................................................... 6 Guiding Principles for Renewing the Curriculum ......................................................................... 7

Elevating the Status of Teaching at Yale: Developing Programs and Initiatives to Support and

Reward Teaching ................................................................................................................................ 9 Overview ......................................................................................................................................... 9 Findings .......................................................................................................................................... 9 Recommendations ........................................................................................................................... 9

Appendices ........................................................................................................................................... 13 A. The Strategic Planning Committee for Medical Education .......................................................... 13 B. Full Listing of Materials Reviewed by the Committee ................................................................. 14 C. Methods to Obtain Feedback ...................................................................................................... 18 D. Student Liaison Committee Report ............................................................................................ 19 E. Implications for the Overarching Goals ...................................................................................... 22

This report is available online at http://medicine.yale.edu/education/strategicplan.

Yale School of Medicine

Report of the Strategic Planning Committee for Medical Education Page 1 of 29

Introduction

This report presents the findings and recommendations of The Strategic Planning Committee for

Medical Education (“the Committee”). While it is generally acknowledged that the educational

program at Yale School of Medicine is exceptional, with many strengths and successes, the purpose of

this strategic planning effort was to take a broad and comprehensive look at the state of medical

education at Yale, consider ways that it could be improved and set a course for guiding its future

direction. Convened in October 2008, the Committee was charged by the Dean to make

recommendations that would:

• Renew and refocus Yale’s vision for medical education

• Strengthen the quality of our educational program

• Set clear priorities for moving forward that demonstrate our commitment to excellence and

advance our reputation as a leader in medical education

The Committee was comprised of 18 members representing over 10 departments and offices.

(Appendix A)

Background and Context

To prepare for this important task, the Committee reviewed extensive materials that provided the

context and background for assessing the school’s strengths and weaknesses as well as determining

how much and what kind of change is needed. This included information from many sources (journal

articles, reports, surveys, websites, etc.) related to:

• The many challenges facing medical education, and the strong national call for reform

• The current state of medical education here at Yale, including curriculum design and content,

learning objectives, teaching and assessment methods, faculty teaching effort, accreditation

issues, and educational resources

• The mission and core values of the medical school, including the Educational Mission

Statement, the School-wide Learning Objectives and the Yale System of Medical Education

(“the Yale System”)

• What other schools are doing to reform and improve their educational programs

• The history and recommendations of Yale’s prior strategic planning efforts in medical

education

A full listing of the materials reviewed by the Committee, along with sample documents are provided

in Appendix B.



In making its recommendations, the Committee took into account that:

• There is concern at a national level that medical school curricula have not evolved

sufficiently since the time of Flexner, and as a result students are graduating unprepared to

meet the demands and challenges of future medical practice.

• There is evidence that serious curriculum reform has been achieved or is under way at

medical schools across the country. These changes are designed to improve integration,

better address societal concerns (e.g. communications, professionalism, safety, health

disparities), and give new thought to teaching and evaluation methods, the use of

technology, and support for faculty.

• Our curriculum, in its current structure, lacks the flexibility needed for innovative curricular

reform. In addition, time for students to complete their thesis, participate in research,

explore clinical interests, and identify career paths has been greatly diminished.

• At Yale there have been four prior strategic planning efforts in medical education over the

past two decades. Strikingly similar conclusions have been reached about the areas in need

of improvement, especially integration of our curriculum and enhancing the status of and

support for teaching. However, while some improvements came as a result of these prior

efforts, much of what has been recommended has not been successfully implemented.

• It is widely recognized, both nationally and here at Yale, that faculty have limited resources

to help them develop as educators and are finding it increasingly difficult to find time or

support for teaching.

• Accreditation standards are increasingly focused on the need for centralized oversight of the

educational program, clear School-wide Objectives that guide the curriculum, integration of

topics, and effective assessment of student performance.

Feedback

In order to include the broader medical school community in the strategic planning process, a

preliminary report of the Committee’s findings and recommendations (The Report of the Strategic

Planning Committee for Medical Education: Initial Recommendations, May 2009) was widely distributed

to faculty, students, alumni, and staff along with a request for feedback. The initial findings and

recommendations were also presented and discussed in a number of settings, including student,

alumni, and faculty groups as well as meetings with departmental and educational leadership

(Appendix C). Extensive written and verbal feedback, including a response from the Student Liaison

Committee on Strategic Planning (Appendix D), was carefully compiled, reviewed and deliberated on

by the Committee. This feedback was incorporated into the final report, and we believe that these

final recommendations reflect the consensus view and collective wisdom of the broad medical school

community and its leadership.



Final Recommendations

The Committee’s final recommendations are based on the following two priorities:

1. Creating a blueprint for curriculum reform using new educational program objectives.

2. Elevating the status of teaching at Yale through the development of programs and initiatives

to support and reward teaching.

This report presents an overview of each of these issues followed by the Committee’s findings and

recommendations.

Implementation Process

Implementing the recommendations of this Strategic Planning Report will require an inclusive and

collaborative process with active participation by departments, clinical and basic science faculty,

students, and others. Open discussion, broad-based input and shared responsibility are all essential

for curriculum reform to be successful. This approach is especially critical as the school makes

important decisions about the content, pedagogy, curriculum structure, specific learning objectives,

and evaluation methods needed to ensure that the overarching goals and guiding principles of the

new curriculum are met.

All decisions moving forward, including those related to curriculum reform and assessment, must be

guided by the fundamental principles and values of the Yale System that give our school its distinct

identity and character and make Yale unique among medical schools. It has been described as the

school’s “most powerful educational strength,” and is undeniably a major factor in our ability to

consistently attract such extraordinarily talented students. The Yale System enjoys widespread and

passionate support from our students, faculty, and alumni. The Committee appreciates the depth of

this support and shares a strong commitment to the Yale System’s principles and values.

Finally, it should be noted that in order to promote open and creative thinking, the Committee’s

charge was to consider what would be best for the school without concern for whether or how specific

initiatives would be funded. The Committee recognizes, however, that the allocation of necessary

resources is a critical component of any effort to improve medical education at YSM, and it is implicit

that developing budgets for our recommendations and obtaining the financial resources needed to

implement and maintain them will be an essential next step in moving this strategic plan forward.



Findings and Recommendations

Educational Program Objectives: Creating a Blueprint for Curriculum Reform

Overview

The continuous and at times dramatic changes in science, medical practice, education pedagogy, and

accreditation requirements present many challenges to medical education and underscore the need for

curriculum reform. To successfully prepare students for careers in medicine, medical schools must

consider and take into account:

• The rapid explosion of knowledge in the basic sciences, including remarkable advances in

molecular biology (i.e. proteomics, genomics) that increasingly inform our understanding of

disease, lead to the development of new treatments, and offer hope for cures

• The evolution in medical practice, including the shift in locus of care from the hospital to the

outpatient setting, the increasingly diverse patient population, the growing rates of chronic

illness, the need to work in multidisciplinary teams, and the expectations for

fiscal accountability

• The advancements in education based on current learning theory, opportunities afforded by

rapidly evolving technologies and changing expectations of our students, including greater

use of small group interactive teaching, opportunities for Web-based learning, and rapid

growth of simulation centers that utilize high-fidelity mannequins, standardized patient

programs, etc.

• The impact and importance of evolving accreditation standards

In response, there has been significant curriculum reform at medical schools across the country. To

better understand this, the Committee reviewed the mission statements, educational program

objectives, and curriculum design and content of 12 other medical schools similar to Yale in mission

and academic standing. The data revealed that 10 of 12 have engaged in relatively recent and quite

substantial curriculum reform. More specifically, we learned that:

• The number of School-wide Objectives varies greatly in detail, number (9 to 44, average 22),

and organization (some based on the Medical School Objectives Project of the AAMC, others

moving towards ACGME competencies)

• The integration of topics almost always involves use of blocks, modules, or themes that

connect a varying number of courses within a unifying concept

• More than half of the schools have moved up the start date of year one and the start of clinical

rotations

• Many schools use “inter-sessions” in both the preclinical and clinical years to incorporate or

re-visit special topics, including the basic sciences during clerkships



Of course, the extent to which true integration and reform has been achieved (rather than just a

“repackaging” of topics without real change in the teaching or pedagogical approach) is unknown. In

addition, the actual success of curriculum reform at other schools is hard to determine, and no clear

outcome measures in terms of student learning are available.

With all of this in mind, the Committee conducted a detailed review of the Yale educational program,

studied the recommendations of prior strategic planning reports, and considered the areas that have

been longstanding concerns of the LCME.

Findings

1. The Committee recognizes the central importance of the School-wide Objectives as the

foundation for our educational program. However, Yale’s current School-wide Objectives,

while well written and thoughtful, are numerous (38) and contain considerable detail. This

makes them difficult to use as overarching guides for the curriculum, and it is challenging to

provide meaningful outcome measures for each one, as required for accreditation.

2. The Committee identified a clear need for further integration of our curriculum, increased

attention to improving our methods of assessment and much greater flexibility in our

curriculum structure.

Recommendations

1. The most effective way to address these findings is to rebuild the curriculum from the ground

up. This must begin with the creation of a new set of educational program objectives

(“overarching goals”), which will serve as the foundation for our curriculum, define its

content, and drive future planning. In addition, there should be a clear set of principles

(“guiding principles for renewing the curriculum”) that guide the process, set expectations

for educators and students, and inform decisions about curriculum design and structure.

These overarching goals and guiding principles should be based on the qualities we expect to

see in our graduating students. They will define the educational vision and impart the values

of our school that together will serve as the blueprint for our curriculum reform.

2. Given the profound importance of the Yale System to our medical school and recognizing the

many challenges we face as we embark on curriculum reform, renewed attention to the Yale

System is essential. Despite its many strengths and unique features, throughout its history the

Yale System has come to mean different things to different people, and its interpretation has

varied over time. At present there is debate in our school about how the Yale System applies

in such important areas as attendance, assessment, and the requirement that our students take

“more than usual responsibility for their education.” The fundamental principles of the Yale

System, including clarification of how they apply in a new, forward-looking curriculum,

should be included in the Guiding Principles for Renewing the Curriculum.

Eight newly crafted overarching goals and five guiding principles for rebuilding and renewing the

curriculum follow.

Yal

e S

choo

l of

Med

icin

e

Rep

ort

of t

he

Str

ateg

ic P

lan

nin

g C

omm

itte

e fo

r M

edic

al E

du

cati

on

Pag

e 6

of

29

Ove

rarc

hing

Goa

ls o

f the

Cur

ricu

lum

Th

e p

urp

ose

of t

he

Yal

e S

choo

l of

Med

icin

e cu

rric

ulu

m is

to

edu

cate

an

d in

spir

e st

ud

ents

to

bec

om

e p

hys

icia

ns

wh

o ac

hie

ve e

xcel

len

ce in

pat

ien

t ca

re,

un

der

stan

d a

nd

ad

van

ce t

he

scie

nce

of

med

icin

e, a

nd

bec

ome

lead

ers

in t

hei

r ch

osen

fie

ld. E

mp

has

is is

pla

ced

on

goa

ls t

hat

mee

t th

e g

row

ing

nee

ds

of a

chan

gin

g s

ocie

ty a

nd

med

ical

pra

ctic

e. A

str

ong

fou

nd

atio

n in

sci

ence

pro

vid

es s

pec

ial o

pp

ortu

nit

ies

for

stu

den

ts t

o p

arti

cip

ate

in c

reat

ive

end

eavo

rs

that

fos

ter

the

life

-lon

g p

urs

uit

of

sch

olar

ship

. In

ord

er t

o g

ive

an id

ea o

f w

hat

th

is in

volv

es, s

ome

sam

ple

imp

lica

tion

s fo

r im

ple

men

tin

g e

ach

of

the

over

arch

ing

goa

ls a

re in

clu

ded

in A

pp

end

ix E

.

1.

Hea

lth

Prom

otio

n an

d D

isea

se

Prev

enti

on

Stu

den

ts a

pp

ly s

cien

tifi

c kn

owle

dg

e an

d u

se c

lin

ical

ski

lls

to p

rom

ote

hea

lth

an

d p

reve

nt

dis

ease

in

ind

ivid

ual

s an

d c

om

mu

nit

ies.

2.

Mec

hani

sms

and

Tre

atm

ent

of D

isea

se

Stu

den

ts a

cqu

ire

know

led

ge

at t

he

mol

ecu

lar,

cel

lula

r, o

rgan

-sys

tem

, wh

ole

bod

y, a

nd

so

ciet

al le

vels

, an

d

inte

gra

te t

his

kn

owle

dg

e w

ith

cli

nic

al s

cien

ce a

nd

ski

lls

to d

iag

nos

e an

d t

reat

dis

ease

.

3.

Clin

ical

Rea

soni

ng

S

tud

ents

exe

rcis

e cl

inic

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dg

men

t b

ased

on

a t

hor

ou

gh

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der

stan

din

g o

f th

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atie

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ap

pli

cati

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scie

nti

fic

pri

nci

ple

s, a

nd

kn

owle

dg

e of

th

e h

ealt

h c

are

syst

ems.

Cli

nic

al r

easo

nin

g is

lear

ned

th

rou

gh

p

ract

ice,

sel

f-re

flec

tion

, an

d f

eed

bac

k.

4.

Pati

ent C

are

Stu

den

ts a

chie

ve c

om

pet

ency

in t

he

care

of

pat

ien

ts a

t a

leve

l req

uir

ed t

o ex

cel i

n r

esid

ency

.

5.

Prof

essi

onal

ism

and

Com

mun

icat

ion

Stu

den

ts d

emon

stra

te r

esp

ectf

ul a

nd

eth

ical

beh

avio

r in

all

of

thei

r p

rofe

ssio

nal

inte

ract

ion

s an

d p

rovi

de

com

pas

sion

ate,

em

pat

hic

car

e to

pat

ien

ts a

nd

fam

ilie

s. P

rofe

ssio

nal

ism

an

d c

om

mu

nic

atio

n s

kill

s ar

e ac

qu

ired

th

rou

gh

pra

ctic

e, s

elf-

refl

ecti

on, a

nd

fee

db

ack.

6.

Res

pons

ibili

ty to

Soc

iety

S

tud

ents

lear

n t

o p

ract

ice

med

icin

e w

ith

cu

ltu

ral c

om

pet

ence

an

d f

isca

l res

pon

sib

ilit

y in

pre

par

atio

n f

or

wor

k in

a s

ocie

ty c

har

acte

rize

d b

y d

iver

se p

opu

lati

ons

and

eco

nom

ic c

onst

rain

ts.

7.

Cre

atio

n an

d D

isse

min

atio

n

of K

now

ledg

e

Stu

den

ts m

anif

est

ind

epen

den

t an

d c

reat

ive

thin

kin

g f

oste

red

by

a co

llab

orat

ive

gra

du

ate

sch

ool

en

viro

nm

ent.

Th

ey p

erfo

rm m

ento

red

sch

olar

ly r

esea

rch

cu

lmin

atin

g in

a f

orm

al w

ritt

en t

hes

is t

o p

rom

ote

crit

ical

th

inki

ng

, un

der

stan

d t

he

scie

nti

fic

met

hod

, an

d c

ontr

ibu

te t

o m

edic

al k

now

led

ge.

8.

Phy

sici

an a

s Sc

ient

ist

Studen

ts learn to app

roach medicine

from a scienti

ficallyminded p

erspective an

d are educate

d and mentor

ed by leading

scientists. Thi

s prepares the

m for careers

in biomedical s

cience and as

medical

practitioners,

and to becom

e the next gen

eration of med

ical scientists

and leaders i

n academic

medicine.

Yal

e S

choo

l of

Med

icin

e

Rep

ort

of t

he

Str

ateg

ic P

lan

nin

g C

omm

itte

e fo

r M

edic

al E

du

cati

on

Pag

e 7

of

29

Gui

ding

Pri

ncip

les

for

Ren

ewin

g th

e C

urri

culu

m

1.

Inte

grat

ion

B

asic

, cli

nic

al, a

nd

soc

ial s

cien

ces

are

inte

gra

ted

th

rou

gh

out

all y

ears

of

the

curr

icu

lum

. Th

is

req

uir

es t

hat

:

• T

he

des

ign

an

d im

ple

men

tati

on o

f th

e cu

rric

ulu

m a

re in

terd

isci

pli

nar

y an

d

inte

rdep

artm

enta

l.

• B

asic

sci

enti

sts

and

cli

nic

ian

s p

lan

an

d t

each

tog

eth

er t

o as

sure

th

at t

he

curr

icu

lum

re

pea

ted

ly e

mp

has

izes

an

d d

emon

stra

tes

the

imp

orta

nce

of

the

bas

ic s

cien

ces

in

un

der

stan

din

g a

nd

pra

ctic

ing

cli

nic

al m

edic

ine.

• E

du

cato

rs*

un

der

stan

d h

ow t

hei

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ach

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fit

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to t

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goa

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over

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skil

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nd

pro

fess

ion

al a

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e w

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stu

den

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ula

te.

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der

stan

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stru

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f th

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th

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wit

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hav

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rly

clin

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exp

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nce

s to

pro

vid

e in

spir

atio

n a

nd

con

text

for

le

arn

ing

th

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ien

tifi

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un

dat

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s of

med

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2.

Lear

ning

Env

iron

men

t Y

ale’

s d

isti

nct

iden

tity

am

on

g m

edic

al s

choo

ls is

b

uil

t on

th

e p

rin

cip

les

and

val

ues

of

the

Yal

e S

yste

m o

f M

edic

al E

du

cati

on. R

esp

ect

for

stu

den

t in

itia

tive

an

d m

atu

rity

, clo

se f

acu

lty

men

tori

ng

, an

d a

req

uir

ed t

hes

is t

o p

rom

ote

scie

nti

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inq

uir

y ar

e al

l hal

lmar

ks o

f ou

r u

niq

ue

lear

nin

g

envi

ron

men

t. S

tud

ents

are

ass

esse

d b

ased

on

th

eir

per

form

ance

, bu

t th

ere

is n

o cl

ass

ran

k an

d

effo

rts

are

mad

e to

min

imiz

e co

mp

etit

ion

. E

mp

has

is is

pla

ced

on

col

lab

orat

ion

, sel

f-d

irec

ted

le

arn

ing

, an

d t

he

exp

ecta

tion

th

at s

tud

ents

tak

e m

ore

than

th

e u

sual

res

pon

sib

ilit

y fo

r th

eir

edu

cati

on. C

reat

ing

th

is le

arn

ing

en

viro

nm

ent,

an

d p

rese

rvin

g t

he

valu

es o

f th

e Y

ale

Sys

tem

in a

re

new

ed f

orw

ard

-loo

kin

g c

urr

icu

lum

, is

a re

spon

sib

ilit

y sh

ared

by

stu

den

ts a

nd

fac

ult

y, a

nd

w

ill r

equ

ire

that

:

• T

he

curr

icu

lum

des

ign

be

flex

ible

an

d p

rovi

de

opp

ortu

nit

ies

as w

ell a

s ti

me

for

stu

den

ts t

o ex

plo

re t

hei

r in

tere

sts

and

pu

rsu

e in

div

idu

al g

oals

.

• S

tud

ents

acc

ept

thei

r re

spon

sib

ilit

y to

act

ivel

y p

arti

cip

ate

in t

he

curr

icu

lum

an

d

reco

gn

ize

that

cer

tain

act

ivit

ies

req

uir

e th

eir

pre

sen

ce a

nd

en

gag

emen

t in

ord

er f

or

effe

ctiv

e le

arn

ing

an

d m

ean

ing

ful a

sses

smen

t to

tak

e p

lace

. Th

is b

ecom

es in

crea

sin

gly

im

por

tan

t as

th

e cu

rric

ulu

m c

onti

nu

es t

o sh

ift

tow

ard

sm

all g

rou

ps

that

rel

y on

in

tera

ctiv

e d

iscu

ssio

n a

nd

col

lab

orat

ive

case

-bas

ed le

arn

ing

.

• A

sses

smen

t m

eth

ods

emp

has

ize

an a

bil

ity

to c

orre

late

an

d a

pp

ly k

now

led

ge

rath

er

than

rec

ite

info

rmat

ion

, an

d in

clu

de

mu

ltip

le o

pp

ortu

nit

ies

for

dir

ect

obse

rvat

ion

by

and

fee

db

ack

from

fac

ult

y an

d o

ther

ed

uca

tors

*. S

tud

ents

em

bra

ce t

he

imp

orta

nce

of

feed

bac

k as

a m

ean

s of

ass

uri

ng

th

ey h

ave

acq

uir

ed t

he

know

led

ge,

ski

lls,

an

d

pro

fess

ion

al a

ttri

bu

tes

to p

rep

are

them

fo

r re

sid

ency

an

d e

xcep

tion

al m

edic

al p

ract

ice.

• F

acu

lty

con

tin

ue

the

clos

e m

ento

rsh

ip a

nd

gu

idan

ce o

f st

ud

ents

th

at o

ccu

rs w

ith

in a

s w

ell a

s ou

tsid

e th

e sc

hed

ule

d h

ou

rs o

f th

e cu

rric

ulu

m a

nd

co

mm

it t

o th

e in

crea

sin

g

use

of

smal

l gro

up

inte

ract

ive

lear

nin

g.

• In

stit

uti

onal

an

d d

epar

tmen

tal l

ead

ersh

ip r

ecog

niz

e, e

nco

ura

ge,

an

d s

up

por

t th

e su

bst

anti

al c

om

mit

men

t of

fac

ult

y.

Yal

e S

choo

l of

Med

icin

e

Rep

ort

of t

he

Str

ateg

ic P

lan

nin

g C

omm

itte

e fo

r M

edic

al E

du

cati

on

Pag

e 8

of

29

3.

Scho

lars

hip

and

Cre

ativ

e T

hink

ing

T

he

curr

icu

lum

is b

uil

t on

th

e sc

ien

tifi

c fo

un

dat

ion

of

med

ical

kn

ow

led

ge

in w

hic

h

ind

epen

den

t, s

chol

arly

res

earc

h is

req

uir

ed. T

he

myr

iad

of

opp

ortu

nit

ies

for

rese

arch

un

der

th

e m

ento

rsh

ip o

f sk

ille

d f

acu

lty

mak

es o

ur

sch

ool

un

iqu

e an

d s

pec

ial,

an

d r

equ

ires

th

at:

• S

uff

icie

nt

tim

e b

e p

rovi

ded

in t

he

curr

icu

lum

to

allo

w t

he

pu

rsu

it o

f sc

hol

arsh

ip.

• F

acu

lty

rem

ain

com

mit

ted

to

men

tori

ng

stu

den

ts t

o b

ecom

e cr

eati

ve t

hin

kers

an

d

con

trib

uto

rs t

o th

e m

any

fiel

ds

of m

edic

ine.

4.

Ass

essm

ent a

nd R

efle

ctio

n

Th

e sc

hoo

l has

a r

esp

onsi

bil

ity

to s

ocie

ty t

o en

sure

th

at it

s st

ud

ents

dem

onst

rate

pro

fici

ency

in

co

mp

eten

cies

rel

ated

to

hea

lth

car

e d

eliv

ery.

T

he

sch

ool a

lso

reaf

firm

s th

e im

por

tan

ce o

f p

rep

arin

g t

he

stu

den

t fo

r li

fe a

s a

ph

ysic

ian

in

wh

ich

con

tin

ued

ass

essm

ent,

fee

db

ack,

an

d

refl

ecti

on a

re w

oven

into

th

e fa

bri

c of

on

e’s

pro

fess

ion

al li

fe. M

eeti

ng

th

ese

du

al

resp

onsi

bil

itie

s re

qu

ires

th

at:

• M

ult

iple

op

por

tun

itie

s fo

r as

sess

men

t ar

e im

bed

ded

in t

he

curr

icu

lum

, all

owin

g

stu

den

ts a

nd

ed

uca

tors

* to

det

erm

ine

that

th

e ov

erar

chin

g g

oals

an

d s

pec

ific

lear

nin

g

obje

ctiv

es o

f th

e co

mp

onen

ts o

f th

e cu

rric

ulu

m a

re b

ein

g m

et.

• S

tud

ents

, th

rou

gh

on

goi

ng

fee

db

ack

and

ref

lect

ion

, use

th

e re

sult

s of

ass

essm

ent

to

eval

uat

e th

eir

pro

gre

ss a

nd

iden

tify

are

as in

nee

d o

f im

pro

vem

ent.

• E

du

cato

rs*

use

fee

db

ack

from

mu

ltip

le s

ourc

es in

ord

er t

o im

pro

ve t

he

curr

icu

lum

.

• E

du

cato

rs*

and

stu

den

ts, t

hro

ug

h m

ento

rin

g a

nd

dia

log

ue,

con

tin

ual

ly r

efle

ct o

n

thei

r ex

per

ien

ces

to im

pro

ve t

hei

r p

erfo

rman

ce a

s p

rofe

ssio

nal

s.

5.

Edu

cato

r D

evel

opm

ent

Th

e in

stit

uti

on m

ust

pro

vid

e fo

rmal

pre

par

atio

n

and

tra

inin

g o

f fa

cult

y, r

esid

ents

, an

d o

ther

ed

uca

tors

* so

th

at:

• E

du

cato

rs*

pos

sess

exp

erti

se in

eff

ecti

ve t

each

ing

an

d a

sses

smen

t m

eth

ods.

• E

du

cato

rs*

invo

lved

in c

urr

icu

lum

des

ign

are

ab

le t

o cr

eate

lear

nin

g o

bje

ctiv

es,

asso

ciat

ed le

arn

ing

act

ivit

ies,

an

d c

orre

spon

din

g m

eth

ods

of a

sses

smen

t to

ach

ieve

th

e ov

erar

chin

g g

oals

of

the

med

ical

sch

ool c

urr

icu

lum

.

• R

esid

ents

un

der

stan

d t

hei

r u

niq

ue

infl

uen

ce a

nd

imp

act

on t

he

edu

cati

on a

nd

p

rofe

ssio

nal

dev

elop

men

t of

med

ical

stu

den

ts.

* T

he t

erm

“ed

uca

tor”

ref

ers

to fa

cult

y, r

esid

ents

, fel

low

s, n

urs

es, p

hysi

cian

ass

ocia

tes,

an

d al

l oth

ers

who

pro

vide

edu

cati

onal

exp

erie

nce

s fo

r ou

r st

ude

nts

.



Elevating the Status of Teaching at Yale: Developing Programs and Initiatives to Support and Reward Teaching

Overview

Through their teaching and other important roles in planning and organizing the curriculum, faculty

provide the foundation of our educational program. However, it is increasingly difficult for them to

find time or secure support for teaching and other educational activities. Many factors contribute to

this, including:

• Uncertainty about the value of teaching and educational activities in the reappointment and

promotions process

• Strict reporting requirements on grants

• Increasing clinical demands

This increasing pressure on and reduced availability of faculty is of great concern because it

jeopardizes the quality and consistency of our educational program.

Findings

1. The need to better recognize, support, and reward teachers and educators has emerged as a

central theme and clear recommendation of this strategic planning process, just as it had in

each of the four prior strategic planning efforts. These issues must be addressed if successful

curriculum reform and meaningful improvement in education is to be achieved.

Recommendations

1. The importance of educational leadership roles in each department must be acknowledged

and the time and effort it takes to do them well and successfully must be recognized and

protected.

2. The value of teaching and other contributions to medical education must be recognized and

consistently rewarded in the reappointment and promotions process.

3. The medical school must provide educator development opportunities, access to expertise in

education, and reliable assessment data about faculty teaching that can be used in the

reappointment and promotions process.

The following initiatives are designed to fulfill each of these recommendations.



“The importance of educational leadership roles in each department must be acknowledged and the time

and effort it takes to do them well and successfully must be recognized and protected.”

1) For each educational leadership role (Director of Medical Studies [DMS], Course Director,

Module Director, Clerkship Director, Electives Director), there must be a clear job

description outlining the responsibilities of the position and the time it takes to perform

these critical functions must be protected. The amount of time needed must take into

account participation in central School of Medicine educational activities and be adjusted

based on the department’s overall teaching contribution. This will require a collaborative

mechanism involving both departmental and central educational leadership to ensure that

these job descriptions and expectations realistically meet the educational needs of the school

and its curriculum.

2) To ensure central oversight and promote integration, the DMSs as well as the Course,

Module, Clerkship, and Electives Directors, should be directly accountable to the Deputy

Dean for Education for the portion of their time allocated to these important educational

roles. The Deputy Dean for Education will collaborate with the Department Chairs in

choosing the appropriate individuals.

3) The establishment of a more consistent structure for facilitating educational activities across

departments will be important in creating and implementing a new and more fully

integrated curriculum. To accomplish this, there must be renewed attention to the central

role of the Director of Medical Studies in medical student education.

• There must be a single individual in each department who is responsible for: 1)

overseeing medical student education; 2) participating in medical school activities

designed to enhance the coordination and integration of the curriculum across all

four years; and 3) organizing, supporting, and guiding the activities of the faculty

and residents who are teaching.

• The Department Chair and Deputy Dean for Education must ensure that the DMS

has the appropriate authority to carry out these responsibilities.

• A council, convened by the Deputy Dean for Education and comprised of the DMSs

from each department, should be created and meet regularly. This will serve as a

forum for communication, and promote sharing of information about our

curriculum and other important issues in medical education.

4) The issue of protected time for teaching is equally important and complex, and will require

further discussion involving the Dean, the Deputy Dean for Education, and the Department

Chairs. There must be a mechanism to ensure sufficient participation of faculty so that the

teaching needs of the school and its curriculum are met.



“The value of teaching and other contributions to medical education must be recognized and consistently

rewarded in the reappointment and promotions process.”

1) In order to provide information that is useful to the reappointment and promotions

committees, better metrics for defining and measuring faculty effort and accomplishment in

medical education must be developed.

2) The Deputy Dean for Education should continue to be a member of the reappointments

and promotions committees. For those faculty seeking reappointment or promotion based

on achievement in education, the Deputy Dean for Education should be prepared to

evaluate their contribution based on the metrics identified above.

3) The availability of basic science teachers is critically important to our curriculum.

Opportunities for reappointment or promotion based on their contribution to the education

of our students needs to be examined. This will require further discussion involving the

Dean and the Department Chairs.

“The medical school must provide educator development opportunities, access to expertise in education,

and reliable assessment data about faculty teaching that can be used in the reappointment and

promotions process.”

1) Create a “Teaching and Learning Center” at Yale School of Medicine that has dedicated

resources, education experts, and a clear mission to promote excellence in medical

education. The Center will have three critical components:

• Educator Development – Programs (seminars, workshops, and individual

consultations) that focus on important topics in medical education such as teaching

skills, curriculum development, assessment methodology, and scholarship in

education.

• Assessment – Centralized resources and expertise focusing on activities such as:

o evaluating the effectiveness of the curriculum, the knowledge and skills of

our students, and the quality of faculty teaching.

o developing effective methodologies for providing students with interactive

and constructive feedback needed for self-assessment and to enhance their

development as future physicians.

o developing mechanisms for collecting evaluation data, organizing results,

and providing feedback to faculty and committees.

o providing faculty and education committees with help developing new and

reliable methods of assessment, as well as guidance in understanding,

interpreting, and effectively utilizing the results.

All efforts at effective, accurate assessment, including the development and use of

new methods, must be consistent with the Yale System of education, highlight the

importance of feedback and preserve the collaborative, collegial learning

environment we cherish.



• Technology – Expertise focusing on the role of technology in medical education.

The purpose is to ensure that the school is informed and up to date about

opportunities to use new and evolving technologies in curriculum development,

Web-based learning, simulation, and assessment. Consultation to faculty and

education committees will be provided, along with direct assistance in the

development and implementation of new pedagogies and other “technology-based”

initiatives.

2) The Society for Distinguished Teachers should be incorporated into the “Teaching and

Learning Center,” and its purpose and mission clarified. The funds of the Society can be

used to support and reward teaching in a number of ways, including grants for innovative

curriculum projects or research in medical education.



Appendices

A. The Strategic Planning Committee for Medical Education Richard Belitsky, M.D., Committee Chair

Deputy Dean for Education Harold W. Jockers Associate Professor of Medical

Education Associate Professor of Psychiatry

Nancy R. Angoff, M.D., M.P.H., M.Ed.

Associate Dean for Student Affairs Associate Professor of Medicine

Margaret J. Bia, M.D.

Professor of Medicine

Eve R. Colson, M.D.

Associate Professor of Pediatrics

Michael P. DiGiovanna, M.D., Ph.D.

Associate Professor of Medicine and Pharmacology

Gail D’Onofrio, M.D.

Professor of Emergency Medicine Chair, Department of Emergency Medicine

Fred Gorelick, M.D.

Professor of Medicine and Cell Biology

Frederick D. Haeseler, M.D.

Associate Clinical Professor of Medicine

Margaret K. Hostetter, M.D.

Jean McLean Wallace Professor of Pediatrics Professor of Microbial Pathogenesis Chair, Department of Pediatrics

Peter W. Marks, M.D., Ph.D.

Associate Professor of Medicine

Aldo J. Peixoto, M.D.

Associate Professor of Medicine

William C. Rando, Ph.D.

Director, McDougal Graduate Teaching Center

Robert M. Rohrbaugh, M.D.

Associate Professor of Psychiatry

Michael L. Schwartz, Ph.D.

Associate Professor of Neurobiology

John H. Sinard, M.D., Ph.D.

Professor of Pathology and of Ophthalmology and Visual Science

Dennis D. Spencer, M.D.

Harvey and Kate Cushing Professor of Neurosurgery

Chair, Department of Neurosurgery

Ex-officio:

Mary J. Hu, M.B.A.

Director, Office of Institutional Planning and Communications

Gisella Weissbach-Licht

Director of Curriculum Management

Administrative Coordinators:

Jennifer Frahm

Dorothy Meyer



B. Full Listing of Materials Reviewed by the Committee


Educational Program Documents and Data

1. Student Handbook 2008: The Yale System of Education, Education Mission Statement and School-wide Objectives

2. Viseltear, A: The Yale plan of medical education: the early years. The Yale Journal of Biology and Medicine 1986; 59: 627-648

3. Curriculum: Overview and Structure

4. School-wide Objectives and Related Outcome Measures

5. Course Hours and Teaching Methods (2008-2009)

6. Methods of Assessment

7. Fifth Year Statistics: Percent of Class and Student Activities (2004-2009)

8. Education Committee Structure for Oversight, Management & Review of the Educational Program (2008)

9. Liaison Committee on Medical Education (LCME): Findings from the YSM Accreditation Site Visit, November 2007

10. Description of Central Administration & Staffing for Education (2008)

11. Composition of Faculty (2008)

12. Admissions Statistics (2008)

13. Medical Student Board Scores: Step 1 (1994-2007), Step 2CK (1995-2008) and Step 2CS (2005-2008)

14. Match Results for Classes of 2006-2008

15. Admissions Surveys : Reasons for Choosing and Declining Yale (2004-2008)

16. Allocation of Physical Space for Education: Teaching Space and Administrative Offices (2008)

17. Data About Medical Student Research Activities & Academic Careers after Graduation (2008)

18. Facts and Figures (2008)

19. Budget: Operating Income & Expenses (FY 2007)

Educational Strategic Planning Reports

1. 1988 Task Force for Curriculum Evaluation (“The Benz Report”)

2. 1990 Academic Plan for the Yale University School of Medicine (“The Rosenberg Report”)

3. 1992-1996 Preparing Physicians for the Future: A Program in Medical Education (“The Robert Wood Johnson Report”)

4. 1998-2000 Renewing the Yale System of Medical Education: Report of the Dean’s Committee on Medical Education (“The Horowitz-Janeway Report”)



Review of Peer Institutions

Educational Mission Statements, Program Objectives and Curriculum Design

1. Case Western Reserve University School of Medicine

2. University of Chicago Pritzker School of Medicine

3. Columbia University College of Physicians and Surgeons

4. Weill Cornell Medical College

5. Duke University School of Medicine

6. Harvard Medical School

7. Johns Hopkins University School of Medicine

8. University of Pennsylvania School of Medicine

9. University of Pittsburgh School of Medicine

10. University of Rochester School of Medicine and Dentistry

11. Stanford University School of Medicine

12. Washington University School of Medicine

Literature Review, Publications and Reports

National Issues in Medical Education and the Call for Reform

1. Cooke, M, Irby, DM, Sullivan, W, Ludmerer, K: American medical education 100 years after the Flexner report. N Engl J Med 2006; 355: 1339-44

2. Initiative to Transform Medical Education: Recommendations for change in the system of medical education. The American Medical Association, 2007

3. Training Tomorrow’s Doctors: The Medical Education Mission of Academic Health Centers. A Report of the Commonwealth Fund, Task Force on Academic Health Centers, 2002

4. Educating Doctors to Provide High Quality Medical Care: A Vision for Medical Education in the United States. Report of the Ad Hoc Committee of Deans. Institute for Improving Medical Education. Association of American Medical Colleges, 2004

5. Cox, M, Irby, DM: A new series on medical education. N Engl J Med 2006; 355: 1375-6

6. Academic Health Centers – Leading Change in the 21st Century. Institute of Medicine, 2003

7. Learn, Serve, Lead: The Mission, Vision, and Strategic Priorities of the AAMC. Association of American Medical Colleges, 2007

8. Joint Educational Program of the AMA Council on Medical Education and Section on Medical Schools, American Medical Association, 2005

9. Is It Time to Transform Medical Education? The American Medical Association, 2008 (Web Archive)

10. Recommendations for Clinical Skills Curricula for Undergraduate Medical Education, Association of American Medical Colleges, 2005

11. Reece, EA. Averting a gathering storm: research education back stage in medical schools. AAMC Reporter: September, 2008



12. Epstein, RM. Assessment in medical education. N Engl J Med 2007; 356: 387-96

13. Report to the American Association of Medical Colleges, Update on New LCME Standards and Policies. Dan Hunt, MD, MBA, LCME Secretary, 2008-2009

14. Advancing Educators and Education: Defining the Components and Evidence of Educational Scholarship. Summary Report and Findings from the AAMC Group on Educational Affairs Consensus Conference on Educational Scholarship. Association of American Medical Colleges, 2007

Education Pedagogy and Technology

1. Learner 2.0? IT and 21st-Century Learners in Higher Education. Moore, AH, Fowler, SB, Jesiek, BK, Moore, JF, Watson, CE. EDUCAUSE Center for Applied Research. Research Bulletin, Issue 7, Volume 2008

2. Millennial Behaviors and Higher Education Focus Group Results: How are Millennials different from previous generations at the same age? Richard Sweeney, New Jersey Institute of Technology, 2007 (Web Archive)

3. Viseltear, AJ. The Yale plan of medical education: the early years. The Yale Journal of Biology and Medicine 1986; 59: 627-648

4. The ECAR Study of Undergraduate Students and Information Technology, 2008. Judith Borreson Caruso and Gail Salaway. EDUCAUSE Center for Applied Research, October 2008

5. Holmberg, D. Student evaluations. The New York Times, July 2007

Funding of Medical Education

1. Howell, LP, Hogarth, M, Anders, TF. Creating a mission-based reporting system at an academic health center. Acad Med. 2002; 77:130-38

2. Stites, S, Vansaghi, L, Pingleton, S, Cox, G, Paolo, A. Aligning compensation with education: design and implementation of the educational value unit (EVU) system in an academic internal medicine department. Acad. Med. 2005; 80: 1100-06

3. Kennedy, DW, Johnston, E, Arnold, E. Aligning academic and clinical missions through an integrated funds-flow allocation process. Acad Med. 2007; 82:1172-77

4. Mallon, WT, Jones, RF. How do medical schools use measurement systems to track faculty activity and productivity in teaching? Acad. Med. 2002; 77: 115-23

5. Mallon, WT. Introduction: The history and legacy of mission-based management. Academic Medicine, Management Series: Mission-Based Management, 2006

6. Howell, LP, Hogarth, MA, Anders, TF. Implementing a mission-based reporting system at an academic health center: a method for mission enhancement. Acad. Med. 2003; 78: 645-51

7. Sloan, TB, Kaye, CI, Allen, WR, et al. Implementing a simpler approach to mission based planning in a medical school. Acad. Med. 2005; 80: 994-1004



Presentations to the YSM Strategic Planning Committee for Medical Education

1. The Case for Change: A Review of the National Call for Reform, LCME Accreditation Standards and Policies, YSM Curriculum, Assessment Methods and Faculty Teaching Efforts

2. Matters of the Heart: A Review of Our Core Values and Principles: The Yale System of Education, Educational Mission Statement and School-wide Objectives

3. A Look Outside the Hallowed Halls: A Review of What Other Schools are Doing to Change, Reform and/or Improve Their Educational Programs

4. Education Finances at YSM: A Review of Income, Expenses, Operating Budget and Line of Business for MD Degree Program



C. Methods to Obtain Feedback

1. Written Responses to Request for Feedback: E-mails and letters

2. Presentations and Discussions at Meetings:

A. Student Groups:

• Medical Student Council Meeting

• Medical Student Leadership Meeting

• Town Hall Meeting

• Student Liaison Committee

B. Alumni Focus Groups:

• Boston

• New York City

• New Haven

C. Department Chairs:

• Individual meetings with all Department Chairs (27)

• Chairs and Deans Meeting

D. Faculty Groups:

• YSM Library

• Child Study Center

• Emeritus

• Department of Immunobiology

• Department of Pathology

E. Education Leadership and Administration:

• Clerkship Directors Meeting

• Course Directors Meeting

• Module Directors Meeting

• Joint Educational Policy and Curriculum Committees Meeting

• Graduate Medical Education Meeting

• Clerkship Administrators Meeting

• Office of Education Full Staff Meeting



D. Student Liaison Committee Report

Yal

e S

choo

l of

Med

icin

e

Rep

ort

of t

he

Str

ateg

ic P

lan

nin

g C

omm

itte

e fo

r M

edic

al E

du

cati

on

P

age

22 o

f 29

E. I

mpl

icat

ions

for

the

Ove

rarc

hing

Goa

ls

Th

rou

gh

out

thes

e im

pli

cati

ons,

ed

uca

tor

refe

rs t

o fa

cult

y, r

esid

ents

, fel

low

s, n

urs

es, p

hys

icia

n a

ssoc

iate

s, a

nd

all

oth

ers

wh

o p

rovi

de

edu

cati

onal

exp

erie

nce

s fo

r ou

r st

ud

ents

.

1.

Hea

lth

Prom

otio

n an

d D

isea

se P

reve

ntio

n

Stu

den

ts a

pp

ly s

cien

tifi

c kn

owle

dg

e an

d u

se c

lin

ical

ski

lls

to p

rom

ote

hea

lth

an

d p

reve

nt

dis

ease

in in

div

idu

als

and

co

mm

un

itie

s.

Exa

mpl

es o

f im

plic

atio

ns

for

the

curr

icu

lum

, ed

uca

tors

, an

d st

ude

nts

in

clu

de t

he

foll

owin

g:

CU

RR

ICU

LUM

E

DU

CA

TO

RS

STU

DE

NT

S

• O

pp

ortu

nit

ies

for

invo

lvem

ent

in

mu

ltid

imen

sion

al p

atie

nt

asse

ssm

ents

th

at

incl

ud

e an

d a

dd

ress

: o

G

enet

ic d

eter

min

ants

o

N

utr

itio

n

o

Lif

e st

yle

beh

avio

rs

o

En

viro

nm

enta

l fac

tors

• C

over

age

of:

o

Use

of

scre

enin

g t

ests

o

M

ech

anis

ms

of p

reve

nti

on

o

Gen

eral

pu

bli

c h

ealt

h e

du

cati

on

• O

pp

ortu

nit

ies

to le

arn

th

e co

un

seli

ng

ski

lls

nee

ded

to

pro

mot

e h

ealt

h,

pre

ven

t d

isea

se,

and

pro

vid

e p

atie

nt

edu

cati

on

• A

tten

tion

to

ph

ysic

ian

hea

lth

an

d w

ell-

bei

ng

• E

du

cato

rs a

cqu

ire

or e

nli

st t

he

nec

essa

ry

exp

erti

se t

o in

clu

de

hea

lth

pro

mot

ion

an

d

dis

ease

pre

ven

tion

in t

hei

r cu

rric

ula

r d

esig

n

• E

du

cato

rs in

clu

de

facu

lty

from

an

d w

ork

in

coll

abor

atio

n w

ith

th

e S

choo

l of

Pu

bli

c H

ealt

h

• E

du

cato

rs o

bse

rve

and

giv

e fe

edb

ack

to

stu

den

ts c

oun

seli

ng

pat

ien

ts f

or h

ealt

h

pro

mot

ion

an

d d

isea

se p

reve

nti

on

• S

tud

ents

con

sist

entl

y ad

dre

ss is

sues

of

hea

lth

pro

mot

ion

an

d d

isea

se p

reve

nti

on a

s an

inte

gra

l par

t of

th

eir

enco

un

ters

wit

h

pat

ien

ts

• S

tud

ents

lear

n t

he

skil

ls n

eces

sary

to

cou

nse

l pat

ien

ts f

or h

ealt

h p

rom

otio

n a

nd

d

isea

se p

reve

nti

on

• S

tud

ents

pra

ctic

e th

ese

skil

ls w

ith

dir

ect

edu

cato

r ob

serv

atio

n a

nd

fee

db

ack

Yal

e S

choo

l of

Med

icin

e

Rep

ort

of t

he

Str

ateg

ic P

lan

nin

g C

omm

itte

e fo

r M

edic

al E

du

cati

on

P

age

23 o

f 29

2.

Mec

hani

sms

of D

isea

se a

nd T

reat

men

t

Stu

den

ts a

cqu

ire

know

led

ge

at t

he

mol

ecu

lar,

cel

lula

r, o

rgan

-sys

tem

, wh

ole

bod

y, a

nd

so

ciet

al le

vels

an

d in

teg

rate

th

is k

now

led

ge

wit

h c

lin

ical

sci

ence

and

ski

lls

to d

iag

nos

e an

d t

reat

dis

ease

.

Exa

mpl

es o

f im

plic

atio

ns

for

the

curr

icu

lum

, ed

uca

tors

, an

d st

ude

nts

in

clu

de t

he

foll

owin

g:

CU

RR

ICU

LUM

E

DU

CA

TO

RS

STU

DE

NT

S

• N

ew f

ram

ewor

ks t

o en

sure

th

at t

he

rela

tion

ship

s b

etw

een

th

e sc

ien

tifi

c fo

un

dat

ion

s o

f m

edic

ine

and

cli

nic

al

pra

ctic

e ar

e em

ph

asiz

ed t

hro

ug

hou

t al

l fou

r ye

ars

• C

over

age

of

the

mu

ltip

le m

ech

anis

ms,

in

clu

din

g s

ocie

tal i

nfl

uen

ces,

th

at le

ad t

o ch

ron

ic a

nd

com

ple

x d

isea

ses

• A

tten

tion

to

the

mec

han

ism

s th

at li

nk

stre

ss a

nd

oth

er p

sych

olog

ical

fac

tors

to

dis

ease

• O

pp

ortu

nit

ies

for

stu

den

ts t

o ob

serv

e h

ow

an u

nd

erst

and

ing

of

ph

ysio

log

ic

mec

han

ism

s in

form

s cl

inic

al d

ecis

ion

m

akin

g a

nd

tre

atm

ent

• C

lin

icia

ns

and

bas

ic s

cien

tist

s co

llab

orat

e to

iden

tify

th

e b

asic

sci

ence

con

cep

ts a

nd

know

led

ge

esse

nti

al f

or f

utu

re p

hys

icia

ns

• E

du

cato

rs c

om

mit

to

inte

gra

tin

g b

asic

scie

nce

con

cep

ts w

ith

cli

nic

al t

each

ing

• S

tud

ents

con

tin

uou

sly

app

ly t

hei

r

know

led

ge

of

bas

ic s

cien

ce a

s th

ey le

arn

abou

t th

e cl

inic

al m

anif

esta

tion

s of

dis

ease

and

par

tici

pat

e in

pat

ien

t ca

re

Yal

e S

choo

l of

Med

icin

e

Rep

ort

of t

he

Str

ateg

ic P

lan

nin

g C

omm

itte

e fo

r M

edic

al E

du

cati

on

P

age

24 o

f 29

3.

Clin

ical

Rea

soni

ng

Stu

den

ts e

xerc

ise

clin

ical

jud

gm

ent

bas

ed o

n a

th

oro

ug

h u

nd

erst

and

ing

of

the

pat

ien

t, a

pp

lica

tion

of

sou

nd

sci

enti

fic

pri

nci

ple

s, a

nd

kn

owle

dg

e of

hea

lth

car

e sy

stem

s. C

lin

ical

rea

son

ing

is le

arn

ed t

hro

ug

h p

ract

ice,

sel

f-re

flec

tion

an

d f

eed

bac

k.

Exa

mpl

es o

f im

plic

atio

ns

for

the

curr

icu

lum

, ed

uca

tors

, an

d st

ude

nts

in

clu

de t

he

foll

owin

g:

CU

RR

ICU

LUM

E

DU

CA

TO

RS

STU

DE

NT

S

• N

ew f

ram

ewor

ks t

o en

sure

th

at t

he

scie

nti

fic

fou

nd

atio

ns

of m

edic

ine

are

inte

gra

ted

wit

h a

nd

em

ph

asiz

ed d

uri

ng

clin

ical

tra

inin

g

• O

pp

ortu

nit

ies

for

edu

cato

rs a

nd

stu

den

ts t

o

reco

gn

ize

and

ad

dre

ss g

aps

in t

hei

r

know

led

ge

• E

mp

has

is o

n in

tera

ctiv

e le

arn

ing

in s

mal

l

gro

up

s

• E

xper

ien

ces

in o

utp

atie

nt

sett

ing

s w

her

e

ther

e ar

e re

pea

ted

op

por

tun

itie

s to

ob

serv

e

and

pra

ctic

e th

e sk

ill o

f cl

inic

al r

easo

nin

g

• O

pp

ortu

nit

ies

in e

ach

cle

rksh

ip f

or s

tud

ents

to le

arn

, dem

onst

rate

, an

d r

ecei

ve f

eed

bac

k

abou

t th

eir

abil

ity

to g

ath

er k

ey d

ata

to

crea

te a

dif

fere

nti

al d

iag

no

sis

and

tre

atm

ent

pla

n

• E

du

cato

rs a

re s

kill

ed a

t ob

serv

ing

stu

den

t p

erfo

rman

ce a

nd

pro

vid

ing

fee

db

ack

• E

du

cato

rs a

re s

kill

ed a

t fa

cili

tati

ng

sm

all-

gro

up

inte

ract

ive

lear

nin

g

• S

tud

ents

dev

elop

an

d a

pp

ly t

he

skil

ls o

f sc

ien

tifi

c an

d c

lin

ical

rea

son

ing

to:

o

C

are

for

pat

ien

ts

o

Cri

tica

lly

eval

uat

e th

e m

edic

al

lite

ratu

re u

sin

g t

hei

r kn

ow

led

ge

of

bas

ic s

cien

ce, b

iost

atis

tics

an

d s

tud

y d

esig

n

• A

ssim

ilat

e n

ew d

evel

opm

ents

into

th

eir

un

der

stan

din

g o

f m

edic

al p

ract

ice

Yal

e S

choo

l of

Med

icin

e

Rep

ort

of t

he

Str

ateg

ic P

lan

nin

g C

omm

itte

e fo

r M

edic

al E

du

cati

on

P

age

25 o

f 29

4.

Pati

ent C

are

Stu

den

ts a

chie

ve c

om

pet

ency

in t

he

care

of

pat

ien

ts a

t a

leve

l req

uir

ed t

o ex

cel i

n r

esid

ency

.

Exa

mpl

es o

f im

plic

atio

ns

for

the

curr

icu

lum

, ed

uca

tors

, an

d st

ude

nts

in

clu

de t

he

foll

owin

g:

CU

RR

ICU

LUM

E

DU

CA

TO

RS

STU

DE

NT

S

• M

ult

iple

op

por

tun

itie

s to

pra

ctic

e an

d

dev

elop

cli

nic

al s

kill

s th

rou

gh

su

per

vise

d

inte

ract

ion

s w

ith

rea

l an

d s

imu

late

d

pat

ien

ts.

• F

req

uen

t op

por

tun

itie

s fo

r st

ruct

ure

d

asse

ssm

ent

and

fee

db

ack

by

edu

cato

rs

• E

xper

ien

ces

wit

h p

atie

nt

asse

ssm

ent

in a

va

riet

y of

set

tin

gs

from

ho

me

to h

osp

ital

em

ph

asiz

ing

:

o

Fu

nct

ion

o

R

ehab

ilit

atio

n

o

Pai

n a

nd

sym

pto

m m

anag

emen

t o

D

eath

an

d d

yin

g

o

Pri

orit

izat

ion

of

trea

tmen

t g

oals

o

U

se o

f co

mp

lem

enta

ry a

nd

al

tern

ativ

e m

edic

ine

(CA

M)

by

pat

ien

ts

• A

ctiv

itie

s th

at p

rom

ote

refl

ecti

on a

nd

d

iscu

ssio

n a

mon

g s

tud

ents

an

d e

du

cato

rs

on t

he

mea

nin

g o

f se

rvic

e

• O

pp

ortu

nit

ies

to e

ffec

tive

ly u

se

bib

liog

rap

hic

res

ourc

es a

t th

e p

oin

t of

car

e

• E

du

cato

rs a

cqu

ire

pre

cep

tin

g s

kill

s in

clu

din

g:

o

R

ole-

mo

del

ing

o

D

irec

t ob

serv

atio

n

o

For

mat

ive

feed

bac

k o

S

um

mat

ive

asse

ssm

ent

• E

du

cato

rs c

on

sist

entl

y ob

serv

e st

ud

ents

an

d p

rovi

de

feed

bac

k as

th

ey in

tera

ct w

ith

re

al a

nd

sim

ula

ted

pat

ien

ts

• E

du

cato

rs c

olla

bor

ate

wit

h r

esid

ency

p

rog

ram

dir

ecto

rs t

o en

sure

th

at o

ur

curr

icu

lum

pre

par

es s

tud

ents

wit

h t

he

know

led

ge,

ski

lls,

an

d p

rofe

ssio

nal

at

titu

des

exp

ecte

d o

f b

egin

nin

g r

esid

ents

• S

tud

ents

dev

elop

an

d p

ract

ice

the

skil

ls t

o:

o

Est

abli

sh r

app

ort

and

gat

her

in

form

atio

n u

sin

g p

atie

nt-

cen

tere

d

inte

rvie

win

g a

nd

ph

ysic

al e

xam

sk

ills

o

O

rgan

ize

and

sh

are

pat

ien

t in

form

atio

n u

sin

g p

rese

nta

tion

an

d

doc

um

enta

tion

ski

lls

• S

tud

ents

acc

ess

bib

liog

rap

hic

res

ourc

es t

o d

eep

en t

hei

r u

nd

erst

and

ing

of

clin

ical

is

sues

• S

tud

ents

beh

ave

in w

ays

that

ref

lect

altr

uis

m, c

om

pas

sion

, sci

enti

fic

inte

gri

ty,

and

res

pec

t fo

r p

atie

nts

an

d t

hei

r au

ton

omy

Yal

e S

choo

l of

Med

icin

e

Rep

ort

of t

he

Str

ateg

ic P

lan

nin

g C

omm

itte

e fo

r M

edic

al E

du

cati

on

P

age

26 o

f 29

5.

Prof

essi

onal

ism

and

Com

mun

icat

ion

Stu

den

ts d

emon

stra

te r

esp

ectf

ul a

nd

eth

ical

beh

avio

r in

all

of

thei

r p

rofe

ssio

nal

inte

ract

ion

s an

d p

rovi

de

com

pas

sion

ate,

em

pat

hic

car

e to

pat

ien

ts a

nd

fam

ilie

s. P

rofe

ssio

nal

ism

an

d c

om

mu

nic

atio

n s

kill

s ar

e ac

qu

ired

th

rou

gh

pra

ctic

e, s

elf-

refl

ecti

on

, an

d f

eed

bac

k.

Exa

mpl

es o

f im

plic

atio

ns

for

the

curr

icu

lum

, ed

uca

tors

, an

d st

ude

nts

in

clu

de t

he

foll

owin

g:

CU

RR

ICU

LUM

E

DU

CA

TO

RS

STU

DE

NT

S

• E

mp

has

is o

n p

atie

nt-

cen

tere

d m

edic

ine*

at

all l

evel

s of

th

e cu

rric

ulu

m

• O

pp

ortu

nit

ies

for

stu

den

ts t

o ob

serv

e th

e m

odel

ing

of

pro

fess

ion

alis

m a

nd

par

tici

pat

e in

dis

cuss

ion

s ab

ou

t p

rofe

ssio

nal

beh

avio

r ar

e p

rovi

ded

th

rou

gh

out

all f

our

year

s

• P

rog

ram

s an

d e

xper

ien

ces

that

dem

onst

rate

th

e in

terd

isci

pli

nar

y te

am a

pp

roac

h t

o p

atie

nt

care

an

d r

esea

rch

as

wel

l as

teac

h

the

com

mu

nic

atio

n s

kill

s re

qu

ired

to

wo

rk

coll

abor

ativ

ely

• M

ech

anis

ms

to a

dd

ress

un

pro

fess

ion

al

pra

ctic

es a

nd

beh

avio

r

* P

atie

nt-

cen

tere

d m

edic

ine

is m

edic

ine

focu

sed

on th

e pa

tien

t an

d fa

mil

y in

whi

ch t

he o

vera

ll w

ell-

bein

g of

the

pat

ien

t is

the

fi

rst

prio

rity

• E

du

cato

rs e

mp

has

ize

and

con

sist

entl

y m

odel

pro

fess

ion

alis

m, r

ecog

niz

ing

th

e p

rofo

un

d e

ffec

t th

is h

as o

n t

he

pro

fess

ion

al

dev

elop

men

t of

stu

den

ts

• E

du

cato

rs c

reat

e an

d p

arti

cip

ate

in

opp

ortu

nit

ies

for

self

-ref

lect

ion

• A

cad

emic

Ad

viso

rs f

ollo

w a

nd

mon

itor

th

e ac

adem

ic p

rog

ress

an

d p

rofe

ssio

nal

b

ehav

ior

of s

tud

ents

• E

du

cato

rs in

corp

orat

e co

nte

nt

and

en

cou

rag

e d

iscu

ssio

ns

abou

t p

rofe

ssio

nal

ism

in t

hei

r co

urs

es, m

odu

les,

cl

erks

hip

s an

d e

lect

ives

• E

du

cato

rs a

cqu

ire

or e

nli

st t

he

nec

essa

ry

exp

erti

se t

o ad

dre

ss u

np

rofe

ssio

nal

b

ehav

ior

• S

tud

ents

kn

ow

an

d m

eet

thei

r ed

uca

tio

nal

re

qu

irem

ents

, cog

niz

ant

of t

hei

r re

spon

sib

ilit

y in

a f

lexi

ble

en

viro

nm

ent

• S

tud

ents

par

tici

pat

e in

gu

ided

, on

goi

ng

as

sess

men

t, f

eed

bac

k, a

nd

sel

f-re

flec

tion

to

atta

in t

he

hig

hes

t st

and

ard

s of

p

rofe

ssio

nal

ism

in m

edic

ine

• S

tud

ents

dev

elop

an

aw

aren

ess

of t

he

eth

ical

an

d m

oral

ch

alle

ng

es in

med

icin

e

• S

tud

ents

un

der

stan

d t

he

un

iqu

e ro

le o

f an

d

dem

onst

rate

res

pec

t fo

r ea

ch m

emb

er o

f th

e in

terd

isci

pli

nar

y te

am

• S

tud

ents

un

der

stan

d t

hat

th

e d

octo

r-p

atie

nt

rela

tion

ship

is a

par

tner

ship

, ad

voca

te f

or t

hei

r p

atie

nts

, an

d p

lace

p

atie

nt

nee

ds

abov

e th

eir

ow

n

Yal

e S

choo

l of

Med

icin

e

Rep

ort

of t

he

Str

ateg

ic P

lan

nin

g C

omm

itte

e fo

r M

edic

al E

du

cati

on

P

age

27 o

f 29

6.

Resp

onsi

bilit

y to

Soc

iety

Stu

den

ts le

arn

to

pra

ctic

e m

edic

ine

wit

h c

ult

ura

l com

pet

ency

an

d f

isca

l res

pon

sib

ilit

y in

pre

par

atio

n f

or t

hei

r w

ork

in a

soc

iety

ch

arac

teri

zed

by

div

erse

pop

ula

tion

s an

d e

con

om

ic c

onst

rain

ts.

Exa

mpl

es o

f im

plic

atio

ns

for

the

curr

icu

lum

, ed

uca

tors

, an

d st

ude

nts

in

clu

de t

he

foll

owin

g:

CU

RR

ICU

LUM

E

DU

CA

TO

RS

STU

DE

NT

S

• M

ult

iple

op

por

tun

itie

s to

lear

n a

bou

t:

o

Cu

ltu

ral c

omp

eten

ce a

nd

res

pec

t

o

Eco

nom

ic a

nd

reg

ula

tory

co

nst

rain

ts o

n t

he

pra

ctic

e of

m

edic

ine

o

A

dvo

cacy

an

d h

ealt

h c

are

pol

icy

o

Glo

bal

hea

lth

o

H

ealt

h c

are

dis

par

itie

s o

P

atie

nt

safe

ty a

nd

pre

ven

tion

of

med

ical

err

ors

• E

du

cato

rs a

cqu

ire

or e

nli

st t

he

nec

essa

ry

exp

erti

se t

o cr

eate

an

d im

ple

men

t a

curr

icu

lum

in h

ealt

h c

are

dis

par

itie

s,

cult

ura

l co

mp

eten

ce a

nd

co

st e

ffec

tive

m

edic

ine

• E

du

cato

rs e

mp

has

ize

the

imp

act

of d

iver

se

cult

ura

l per

spec

tive

s on

pat

ien

t ca

re

• S

tud

ents

inte

gra

te k

now

led

ge

of

the

soci

al,

cult

ura

l, p

oli

tica

l, a

nd

eco

nom

ic

det

erm

inan

ts o

f h

ealt

h a

nd

dis

ease

into

th

eir

wor

k w

ith

pat

ien

ts

• S

tud

ents

ref

lect

on

hea

lth

an

d il

lnes

s fr

om

th

e p

ersp

ecti

ve o

f th

eir

own

an

d o

ther

cu

ltu

res

• S

tud

ents

rec

og

niz

e th

e re

spon

sib

ilit

y of

p

hys

icia

ns

to t

ake

a le

ader

ship

rol

e in

sh

apin

g h

ealt

h c

are

pol

icy

and

pra

ctic

e

Yal

e S

choo

l of

Med

icin

e

Rep

ort

of t

he

Str

ateg

ic P

lan

nin

g C

omm

itte

e fo

r M

edic

al E

du

cati

on

P

age

28 o

f 29

7.

Crea

tion

and

Dis

sem

inat

ion

of K

now

ledg

e

Stu

den

ts m

anif

est

ind

epen

den

t an

d c

reat

ive

thin

kin

g f

oste

red

by

a co

llab

orat

ive

gra

du

ate

sch

ool e

nvi

ron

men

t. T

hey

per

form

men

tore

d s

chol

arly

rese

arch

cu

lmin

atin

g in

a f

orm

al w

ritt

en t

hes

is t

o p

rom

ote

crit

ical

th

inki

ng

, un

der

stan

d t

he

scie

nti

fic

met

hod

, an

d c

ontr

ibu

te t

o m

edic

al k

now

led

ge.

Exa

mpl

es o

f im

plic

atio

ns

for

the

curr

icu

lum

, ed

uca

tors

, an

d st

ude

nts

in

clu

de t

he

foll

owin

g:

CU

RR

ICU

LUM

E

DU

CA

TO

RS

STU

DE

NT

S

• E

xpli

cit

sup

por

t an

d t

ime

allo

cate

d f

or

med

ical

stu

den

t re

sear

ch a

nd

th

e M

.D.

thes

is p

rog

ram

• S

uff

icie

nt

flex

ibil

ity

in t

he

sch

edu

le s

o th

at

stu

den

ts c

an id

enti

fy r

esea

rch

inte

rest

s an

d

fin

d a

pp

rop

riat

e m

ento

rs

• E

du

cato

rs a

re c

omm

itte

d t

o cl

ose

men

tors

hip

an

d g

uid

ance

of

stu

den

ts

• S

tud

ents

use

th

e ti

me

allo

cate

d f

or r

esea

rch

re

spon

sib

ly, c

ogn

izan

t of

oth

er e

du

cati

onal

re

qu

irem

ents

an

d in

tere

sts

• S

tud

ents

cre

ate

and

dis

sem

inat

e kn

owle

dg

e b

y p

ub

lish

ing

, pre

sen

tin

g a

t m

eeti

ng

s,

teac

hin

g a

nd

com

mu

nic

atin

g t

hei

r sc

ien

tifi

c th

oug

hts

an

d f

ind

ing

s w

ith

th

e b

road

er

com

mu

nit

y

Yal

e S

choo

l of

Med

icin

e

Rep

ort

of t

he

Str

ateg

ic P

lan

nin

g C

omm

itte

e fo

r M

edic

al E

du

cati

on

P

age

29 o

f 29

8.

Phys

icia

n as

Sci

enti

st

Students learn

, in preparatio

n for careers in

biomedical sc

ience and as m

edical practitio

ners, to approa

ch medicine fr

om a scientific

ally minded p

erspective

and are educat

ed and mento

red by leading

scientists. Thi

s prepares the

m to become t

he next genera

tion of medica

l scientists and

leaders in aca

demic medici

ne. E

xam

ples

of

impl

icat

ion

s fo

r th

e cu

rric

ulu

m,

edu

cato

rs a

nd

stu

den

ts i

ncl

ude

th

e fo

llow

ing:

CU

RR

ICU

LUM

E

DU

CA

TO

RS

STU

DE

NT

S

• N

ew f

ram

ewor

ks t

o en

sure

th

at t

he

scie

nti

fic

bas

is o

f m

edic

ine

is t

aug

ht

as a

n

inte

gra

l par

t of

cli

nic

al t

rain

ing

• O

pp

ortu

nit

ies

and

tim

e fo

r st

ud

ents

to

exp

lore

th

eir

care

er in

tere

sts

and

pu

rsu

e in

div

idu

al g

oal

s

• O

pp

ortu

nit

ies

to le

arn

th

e co

nce

pts

an

d

pra

ctic

e th

e sk

ills

nee

ded

to

bec

om

e ef

fect

ive

lead

ers

• E

du

cato

rs m

ento

r st

ud

ents

in t

he

scie

nti

fic

bas

is o

f m

edic

al p

ract

ice

• E

du

cato

rs s

erve

as

role

mo

del

s fo

r st

ud

ents

as

th

ey p

urs

ue

care

ers

in m

edic

al s

cien

ce

• E

du

cato

rs c

omm

un

icat

e th

e li

mit

s of

sc

ien

tifi

c kn

ow

led

ge

in t

he

pra

ctic

e of

m

edic

ine

• E

du

cato

rs d

evel

op a

nd

mod

el le

ader

ship

sk

ills

• S

tud

ents

are

com

mit

ted

to

usi

ng

an

d

con

tin

uo

usl

y u

pd

atin

g t

hei

r kn

owle

dg

e of

b

iom

edic

al s

cien

ce a

s th

ey le

arn

cli

nic

al

med

icin

e an

d c

are

for

pat

ien

ts

• S

tud

ents

lear

n t

o ev

alu

ate

evid

ence

to

as

cert

ain

th

at it

is s

cien

tifi

call

y va

lid

• S

tud

ents

see

k op

por

tun

itie

s to

lear

n,

pra

ctic

e an

d d

evel

op le

ader

ship

ski

lls