Three years ago, Yale School of Medicine introduced a new curriculum with the promise that it would bring the school into the 21st century without sacrificing what makes it special and unique. So how’s it going?
Deputy Dean for Education Richard Belitsky, MD, and Associate Dean for Curriculum Michael L. Schwartz sought to answer that question at a presentation during the annual alumni reunion weekend. In response to concerns expressed by alumni in the past, the pair emphasized safeguards built into the new curriculum to assure it is making the school better and remaining true to the Yale spirit.
“The covenant between us and all of you was, let us build it with the promise that we will continuously study our new curriculum, get feedback, and learn from that process to constantly improve what we are doing,” Belitsky told his audience of about 75.
The curriculum includes a wide variety of assessments and practices that result in continuous review and refinement, Schwartz said. At the heart of the process is input from the students and faculty, who are surveyed after every course and clerkship, he said. The resulting data is fed to curriculum directors who determine what, if any, changes are needed. In addition, there is a comprehensive review of all aspects of the curriculum every 18 months, he said.
“Through these reviews, we identify those things that are working, those things that are not working, and things that students think we should do differently to help them learn better,” Schwartz said.
The thorough going and comprehensive assessment effort has already resulted in significant changes, Schwartz said. They include an increase in simulations, switching some courses from the first to the second year and vise versa and expanded use of interactive technology, including demonstration videos and other digital materials.
The school also holds an annual retreat at which faculty probe larger societal, policy, and pedagogical topics for possible inclusion in the curriculum, Schwartz said. For example, at this year’s retreat addiction medicine, sex and gender medicine and diversity and social justice in medicine, were areas discussed for greater inclusion in the curriculum he said.
The decision to revamp the curriculum came about almost a decade ago, Belitsky said. The concern was not that something was terribly wrong, but rather that Yale needed to keep up with the rapid changes transforming medicine and society. They included explosions in scientific knowledge and technology, a major evolution in way medicine is practiced, changes in patients’ expectations of how doctors do their jobs, as well in changes in student learning styles, he said.
“We took a big step back, took a deep breath and said, ‘You know what? Let’s take a fresh look at our school,’” Belitsky said. “Let’s look in detail at who we are and what we stand for, what we do well and what we do best, but also let’s look at things about our school that need to be addressed, improved, modified or changed.”
The resulting curriculum is based on a new set of overarching goals, which include for example an emphasis on preventive medicine and responsibility to society while maintaining a focus on training doctors as scientists. The new curriculum also gives students earlier clinical experience as well as increased flexible time to complete their thesis and pursue their professional interests, Belitsky and Schwartz said.
Associate Dean for Student Affairs Nancy R. Angoff, MD, MPH, Med, outlined the extensive support services available to students in the new curriculum, including a greatly expanded academic advisory program and everything from social and stress-reduction activities to peer counseling and tutoring. Angoff credited the peer advocate program with greatly improving the overall wellness of the student body, and emphasized her 24-hour availability.
“Peer advocates are student-chosen confidantes who are mature listeners that can direct students to the appropriate resources,” Angoff said. “We have many, many support systems in place to make sure students stay connected and cared for so they can flourish in medical school and beyond.”