On July 18, 2020, the Gateway Curriculum renewal process took another important step forward by holding the first Phase 2 retreat. Phase 2, Gateway to Clinical Medicine, will be 12 months in duration and will contain the six, core clinical clerkships (Internal Medicine, Neurology, Obstetrics & Gynecology, Pediatrics, Psychiatry, and Surgery), each 8 weeks in length. As previously approved, each clerkship will begin with 1 – 3 weeks of specialty-specific foundational science, consisting of purposeful reiteration and expansion of prior material (helical learning) and new material. This material will be taught in a signs and symptoms framework (i.e., “patient presents with…”) in order to facilitate core knowledge transfer to clinical reasoning. Each clerkship will end with 1 week dedicated to assessment, reflection, coaching, and communities (ARCC). The general layout is depicted here. The order of the clerkships depicted is only for illustration purposes. Due to the unified length, students may take them in any order. The full schematic can be viewed here.
The all-day retreat was held via Zoom and attended by a broad array of Office of Medical Student Education (OMSE) staff and faculty from multiple departments, both basic science and clinical. Attendees included multiple individuals form the Phase 1 (Gateway to the Foundations) design/build teams, leadership from each of the core clerkships, and others involved in the clinical education of medical students. Expert facilitator Dr. Rita Lee from the University of Colorado School of Medicine led the retreat. The morning session was dedicated to curricular integration and the afternoon to assessment.
During the morning integration session the following questions were addressed: 1) What are the potential benefits of optimal integration? 2) What are the challenges to optimal integration? 3) What does optimal integration of foundational, clinical, and social sciences look like? The process of achieving optimal integration was discussed in the context of information flow, decision-making, program evaluation, and support structures. Based on the success of the Phase 1 design/build teams, the group decided to retain this structure for Phase 2 with a team nucleated around each core clerkship and consisting of the Clerkship Directors, Associate/Assistant Clerkship Directors, foundational science faculty, and faculty representing the social, behavioral, and health systems sciences. Once constituted the teams will meet regularly on an individual basis and also as a large group in order share ideas and maintain alignment. Members of the teams will be announced in a future edition of EdUpdate.
The afternoon assessment session began with a group dialogue about which aspects of the current assessment strategy are working well and which could be modified to achieve a more valid, reliable, unbiased outcome. Optimization of the assessment system was then discussed in a congruence framework including consideration of the work to be done, the people, and the informal and formal organizational structures. Some of the major themes included the current culture of assessment, necessary faculty development, centralized assessment mapping and alignment, minimizing bias, the importance of narrative assessment, multisource assessment, workplace-based assessments, assessment committees, standard setting, promoting a growth mindset, and support/remediation. The Director of Medical Student Assessment, Dr. Amanda Emke will continue to work with the Phase 2 teams to develop a full program of assessment for the Gateway Curriculum.