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Table 2 Examples of Recently Implemented, Self-Reported Curricular Innovations

From: Post-Carnegie II curricular reform: a north American survey of emerging trends & challenges

Types of curricular change/innovation (Representative examples with participant quotes in italics; themes in bold type) Number (N = 122) and percent respondents citing similar change(s)
Fostering/Enhancing Curricular Integration 19 (15.6%)
 --Incorporating and developing distinct curricular threads (e.g. Lifestyle Medicine, Medical Decision-Making & Laboratory Medicine, Health Equity & Advocacy, Teamwork & Leadership, Healthcare Quality & Patient Safety) (Northwestern Univ)
 -- “Alignment of histology, pathology, cell biology/biochemistry with the sequence of dissections in the anatomy course. Significant to help students integrate understanding of the inter-relatedness of these disciplines….”
 --“Integrated curriculum based on 90 ‘Chief Complaints and Concerns.”
--“We are a new school…deliberately adopted an innovative curriculum that is highly integrated and clinical presentation-based (in systems-based units with each week’s content is derived from what a clinician would need to know, understand and apply in order to diagnose a patient with a highly relevant and motivating common clinical presentation.)” ….The instructional week is based on the Kolb learning cycle, starting with motivating context (a common clinical presentation and introductory diagnostic scheme), followed by integrated instruction in relevant new material, followed by opportunities for deliberate practice (related medical skills instruction and formative assessment), followed by application in case-based small group sessions in which students apply their new knowledge in the context of the week’s clinical presentation and diagnostic scheme."
Organizational Changes (to include shortened pre-clerkship period) 16 (13.1%)
 -- Created a 4-Pillar Framework: Medical Science, Clinical Science, Health Systems Science, Health Humanities
 -- Obliterating discipline, organ system and departmentally focused course work (and normal/abnormal organization) to form large, integrated thematic blocks that require faculty from multiple disciplines from across the basic science and clinical science spectrum to work together…."
 --Adopting an organ-system model (vs discipline-based) approach;
 --“C21 provides a myriad of pathways for students to choose from (3, 4, 5 years and MSTP).”
 -- Courses based on “themes rather than departments”
 -- “Creation of semester-long, very large (20 credit) interdisciplinary courses….no courses are departmentally owned…all run by the office of med ed, however the funding structure of the school has not changed, and that can be problematic.”
Emphasis on Active Learning/Decreased Reliance Traditional Lectures 14 (11.5%)
 -- Asynchronous lecture delivery (UC Davis)
 -- Marked increase active learning; minimum 50% active learning throughout pre-clerkship curriculum;
 -- Use of “flipped” classroom activities
 -- Expanded use of Problem Based Learning/Case Inquiry type sessions;
 --“Lecture free curriculum” (as of July 2017)
Expanded Coverage of Contemporary Topics/Skills 10 (8.2%)
 -- Medical Spanish (formal instruction as part of pre-clerkship curriculum)
 -- Pain Management
 -- Palliative Care
 -- Social Determinants of Health
 -- Health Systems Science (specifically cited in 4/10 schools)
 -- Course on Public Health and Health Systems
 --Population Health (specifically cited in 4/10 schools)
 --“Development of a primary care-population medicine program from up to 24 students each year, in which students will graduate with a medical degree as well as a Master of Science of Population Medicine—a Masters program that is currently offered nowhere else in the world. This is for students whom we expect to become national leaders in academic primary care.” (Warren Alpert School of Medicine, Brown University);
 -- Course on Cultural Competency
 -- Course on Translational Research
 -- Professional Development course
 -- Curra Personalis Curriculum (Georgetown University School of Medicine); 1-year fellowship for up to 10 medical students; followed by opportunity to participate in longitudinal developmental activities in years 2–4. See also: https://som.georgetown.edu/CuraFellowship##
Enhancing/Emphasizing Early Clinical Exposures 7 (5.7%)
 -- Having students work with community agencies…means of promoting service as well as inter-professional education;
 --“Students start seeing patients [by] week 2 of medical school.”
Establishing Longitudinal Experiences 7 (5.7%)
 -- Adopting a Hybrid, Traditional Block + Longitudinal Integrated Clerkship Model (Cooper Medical School)
 -- Four Year “integrated public health and the practice of medicine curriculum” –includes 1- public health/practice of medicine domains, including health disparities, medical economics, occupational & environmental health, etc.)
 -- Longitudinal Primary Care Component included in Primary Care Clerkship
 -- Longitudinal Integrated clerkship for students in primary care-population medicine program
 -- Thematically organized, expanded, 12-week clerkship blocks (ex: The Medical Approach to the Patient—medicine & neurology; The Surgical Approach to the Patient—surgery & emergency medicine; Women’s & Children’s Health (OB-GYN & pediatrics); Biopsychosocial Approach to Health (primary care & psychiatry);
 --“Longitudinal courses in ultrasound (4 years), ethics, population health, system health, medical decision making.”
Promoting Student Research/Scholarship 6 (4.9%)
 -- Incorporating a Capstone Course/Research Opportunity and/or Area of Scholarly Concentration extending throughout all four years of medical school;
 --“Introduction of 16-week mentored research experience culminated with an MD thesis for ALL students.”
 --Scholarly inquiry requirement for all students with 8 tracks including Design, Med Ed, Digital Health, Humanities and Healthcare systems among others." (Sidney Kimmel Medical College; https://www.jefferson.edu/university/skmc/programs/scholarly-inquiry/overview.html )
 --“Journey(s) curriculum created space for individual student passions and faculty innovations. It uses intersessions with choice of pertinent short pertinent topical faculty driven subjects. Individual journeys periods… [allow for] pursuit [of] one of five scholarly concentrations (Health Justice, Population Health & Prevention, Medical Humanities, Medical Education Research, Business Leadership and Patient Safety). Also has room for better development ... [of]…Individual Scholarly Project.” (Georgetown University School of Medicine)
Emphasis on Problem and/or Team Based Learning 6 (4.9%)
 -- Using small groups of students
Shortened Pre-Clinical Curriculum 5 (4.1%)
Eliminated Traditional (Letter) Grades 3 (2.5%)
 --Pass-Fail Pre-Clerkship Curriculum
Reinforcing Basic Science in Clinical Years 3 (2.5%)
 -- “Return to deep dives in Basic Science after early clinical entry” (Georgetown University School of Medicine)
Re-alignment of USMLE Step 1 Examination 3 (2.5%)
Optimized Assessments/Assessment Tracking 3 (2.5%)
 -- JustInTimeMedicine Software for dashboarding of all assessment data
 --“Introduced an arc of high-fidelity clinical skills assessment”
 -- “Longitudinal progress tests of clinical reasoning”
Curriculum Mapping 2 (1.6%)
 --“Standardization of pre-clerkship curriculum to standardized examination content outline and linkage of all materials (lecture objectives, quiz and exam questions, etc.) to this blueprint.”
Emphasis on Quality and Patient Safety 2 (1.6%)
 -- Lean Six Sigma Yellow Belt training for all M1 students (Cooper Medical School, Rowan Univ. NJ)
Pre-Clerkship “Boot Camp” 2 (1.6%)
Expanded Health & Wellness Initiatives 2 (1.6%)
 --“We launched a health and wellness initiative integrating nutrition, exercise, and mindfulness training into our curriculum”
Increasing Opportunity for Electives in MS-3 Year 2 (1.6%)
 --“Allow students to take electives during their clerkship year…. Giving students exposure to fields they would not ordinarily have exposure to with conventional clerkships.”
Three Year Medical School Track 1 (0.8%)
 -- Accelerated Competency Based Education for students interested in Primary Care (UC Davis)
Resurrecting “Old” Structures/Formats 1 (0.8%)
 -- Returned to stand-alone M1 Anatomy course; “students were not mastering anatomy content” when integrated during the first two years of the curriculum;
Technology Related 1 (0.8%)
 -- Issuing iPads to all students; “curriculum is delivered to the iPads and pedagogies such as flipped scurriculum utilizing i-book, interactive videos, and team-based learning are being utilized.”