medical curriculum in a disruptive era: a reflection · adaptive curriculum is the key and it...
TRANSCRIPT
ARDI FINDYARTINI
Department of Medical Education & Medical Education Center IMERI
Faculty of Medicine Universitas Indonesia
MEDICAL CURRICULUM IN A DISRUPTIVE ERA: A REFLECTION
Outline • What the future holds
• Attempts to prepare future medical graduates: FMUI experience
• Future recommendation
Technological advances impacting healthcare and the magnitude of disruption
Paradigm shift in health care
Care will be provided in many locations
Care will be provided by newly constituted healthcare teams
Care will be delivered based on a growing array of data from multiple sources, accessible large data sets,
and artificial intelligence
The interface between man and machine should be carefully
managed
Wartman SA, Combs CD (2019). Reimagining medical education in the age of AI. AMA Journal of Ethics 21 (2): E1460152.
NEW LITERACIES
Data Technology
Human
The ability to read, analyze, utilize information (big data) in the digital world
The ability to understand mechanical (system) work; use the application technology
Humanities, communication, design
Aoun JE (2017). Robot-proof: Higher education in the age of artificial intelligence. Cambridge, Massachusetts, The MIT Press.
SMART Medical
Education
Personalised
Participatory
Predictive
Preventive
Hood, L. Lee Hood. Nat. Biotechnol. 2011, 29, doi:10.1038/nbt.1809.
Adaptive curriculum
Personalised learning
Frequent formative assessment and constructive feedback
Student centered process
Supportive teachers
The use of technology in learning
Analysis of students’ performance
Continuous improvement
Mark Quirk & Heidi Chumley (2018) The adaptive medical curriculum: A model for continuous improvement, Medical Teacher, 40:8, 786-790
What have we attempted to prepare future graduates?
Adaptive, personalized curriculum
Nurturing collaboration skills and cross cultural competency
More electives and of a wider range of disciplines
Project-based learning approach
The (new) medical curriculum
More focus on generic, transferable skills
“big data” of students and learning analytics
Self-awareness Self-regulation of learning
Adaptability
Feedback-seeking behavior
Power point courtesy of dr Diantha Soemantri
FMUI current undergraduate medical curriculum
Taking high-school leavers
5.5 – 6 year program: 3.5-4 years of preclinical studies and 2 years of clinical training
Regular and international class programs (total student body: 250 students/cohort)
Research placement, research activity, elective programs
#1 Selecting future medical students and supporting the transitions in medical school
• Selection methods focusing on cognitive ability
• ++ Selection for non-cognitive ability: Multiple Mini Interview or Situational Judgment Test
Communication skills
Critical thinking skills
Motivation & self-awareness
Personal & professional
identity
#2 Supporting students across medical training and assuring their well-being
Palupi R, Findyartini A (2019). The relationship between gender and coping mechanism with burnout events in first year medical students. Korean J Med Educ; 31(4): 331-342.
Francis T and Hoefel F (2018).‘True Gen’: Generation Z and its implications for companies. McKinsey& Companies. https://www.mckinsey.com/industries/consumer-packaged-goods/our-insights/true-gen-generation-z-and-its-implications-for-companies
Zimmerman B. Becoming a self-regulated learner: an overview. Theory into Practice 2002;41(2):64-70 Panadero E. A review of self-regulated learning: six models and four directions for research. Frontiers in Psychology 2017;8(422)
Cognition Motivation Behavior Context
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158 171 180
147
23 24 22 29 15
2 8 10 3 4 11 8 7 12 9
0
50
100
150
200
250
Year 1 Year 2 Year 3 Year 4 Year 5
Undergraduate medical students’ motivation types of FMUI in 2018
High intrinsic high control (HIHC) High intrinsic low control (HILC)
Low intrinsic high control (LIHC) Low intrinsic low control (LILC)
Student support system
Mentoring
Findyartini A, Felaza E, Setyorini D & Mustika R (2018)
#3 Promoting development of ‘T-shaped professional’ since the beginning
Expert and highly skilled in medicine, but
able to “speak language of multiple
disciplines”
Transdisciplinary collaboration
Cross-cultural competency
Virtual collaboration
Self-regulated learner, growth mindset
NEXT... Ex
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eld
/dis
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Capacity to converse in the language of a broader range of disciplines
Davies et al (2011). Future work skills 2020. Institute for the Future for the University of Phoenix Research Institute
Sense of curiosity
Willingness to continue to learn
T-shaped professional
Interprofessional education course in
preclinical and clinical years
Multiprofessional education courses:
communication skills, health law and ethics,
research, basics of biomedical sciences
Liberal arts courses during the first year
Longitudinal empathy, ethics &
professionalism courses in preclinical
and clinical years
Community services and student
organization activities
Electives & student exchange
#4 Electives and international research placement
Electives in preclinical and clinical years (local, national, international)
Research placement
McKimm J, Wilkinson T. “Doctors on the move”: Exploring professionalism in the light of cultural transitions. Medical Teacher. 2015;37:837–843.
#5 ‘Big data’ of students and learning analytics
Descriptive analysis of
quantitative data
Descriptive analysis of
qualitative data
Explanatory modelling
Predictive modelling
Evaluative analysis
Chan T, Sebok-Syer S, Thoma B, Wise A, Sherbino J, and Pusic M (2018). Learning Analytics in Medical Education Assessment: The Past, the Present, and the Future. AEM EDUCATION AND TRAINING 2018;2:178–187
Courtesy of Medical Education Unit, Faculty of Medicine Universitas Indonesia, 2019
Progress test aggregate – evaluative analysis
0
10
20
30
40
50
60
70
80
90
AVPT11 AVPT12 AVPT13 AVPT14 AVPT15 AVPT16 AVPT17 AVPT18 AVPT 19 AVPT 20 AVPT 21 AVPT 22 AVPT 23 AVPT 24
Nila
i rat
a-ra
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rogr
ess
Test
2019
2018
2017
2016
2015
2014
2013
2012
2011
#6 Technology-enhanced learning adaptation
Simulation
Augmented reality
Virtual patients
Gaming
Intelligent tutoring system
Massive Open
Online Course
Picture courtesy of Neurology Residency Program, SIMUBEAR and Medical Technology Cluster IMERI FMUI
#7 Development of innovation capacity and techno-sociopreneurship
FKUI-IMERIOPENINNOVATION
1stOpenInnovaPon21-23Maret,21April20172ndOpenInnovaPon20-21April20183rdOpenInnovaPon27-28April2019
Picture courtesy of Module of Medical Techno Sociopreneurship FKUI 2019
Recognition of the competency in the
curriculum
Evidence based medicine course in
year 4
Research program for undergraduate
students
Elective course in bioinformatics
Introduction of computational thinking and its
relevance to medicine
Big data analysis in Academic Health
System Universitas Indonesia
#8 Evidence-based practice, research, computational thinking and big data
continuity with patients
continuity with faculty
continuity with peers
continuity with a healthcare system
authentic roles in patient care
exposure to undiagnosed patients; and
participation in a core curriculum relevant to their
practice.
Hirsh D, Walters L, Poncelet AN (2012). Better learning, better doctors, better delivery system: Possibilities from a case study of longitudinal integrated clerkships. Medical Teacher 34: 548–554 Poncelet AN, Mazotti LA, Blumberg B, Wamsley MA, Grennan T, Shore WB (2014). Creating a Longitudinal Integrated Clerkship with Mutual Benefits for an Academic Medical Center and a Community Health System. The Permanente Journal 18(2):50-56
#9 Longitudinal integrated clerkship in the district hospital and primary care centers
Picture courtesy of Preinternship module FMUI
Portfolio mapping for undergraduate medical students – courtesy of Medical Education Unit FKUI
Portfolio for personal and professional
development
Portfolio for assessment
Portfolio for learning
ASSESSMENT (Portfolio as EVIDENCE)
COACHING(Portfolio for REFLECTION)
OVERVIEW(Portfolio for PLANNING AND MONITORING)
Using portfolio: continuous guidance, feedback, monitoring
Supported by technology
More formative assessment
More narrative (qualitative) assessment and feedback
Put focus on the development of future work skills
Driessen E, Heeneman S, Van Der Vleuten CPM (2013). Portfolio assessment. In: Dent JA, Harden RM (eds). A Practical Guide for Medical Teachers. 4th edition. Churchill Livingstone Elsevier.
#10 ‘Smart’ assessment
#11 Faculty development
Adaptive roles of medical teachers?
Well-prepared and future-oriented medical and health professionals
teachers/faculty
System-based medical and health professions
education
Future medical doctors and health professionals
Medical Teacher
Information provider &
guide
Role model as teacher &
practitioner
Facilitator & mentor
Assessor & diagnostician
Curriculum developer &
evaluator
Manager & change agent
Scholar & researcher
Professional & enquirer into
own competence
Harden RM, Lilley P (2018). The eight roles of the medical teacher. 1st edition. Elsevier
Preparing the teachers - Which approach do we have to employ?
Online learning
Peer coaching
Peer and student feedback
Workshop and seminars
Fellowship and other
Longitudinal programs
Reflecting on experience
Learning by observing
Learning by doing
Work-based learning
Communities of practice
Mentorship
Y. Steinert (ed.), Faculty Development in the Health Professions: A Focus on Research and Practice, Innovation and Change in Professional Education 11,DOI 10.1007/978-94-007-7612-8_1, © Springer Science Business Media Dordrecht 2014
Picture courtesy of Department of Medical Education FMUI
Future recommendation
The future is here: identification of
healthcare need and our current resources is necessary
Adaptive curriculum is the key and it
involves all components of the
curriculum: students, teachers
and supporting staff, and the use of
technology
Three literacies: human, data and
technology should be developed in a balance manner in
the curriculum
Medical education now, then and the future
It’s always about PEOPLE
Patients and the community we serve
Students we educate Teachers and support staff we work and engage with
and CHANGE
and LIFE LONG LEARNING, as what medicine is
