July 9, 2015

New programs help medical students hone clinical skills

There is a lot of discussion on the national health care front about how best to equip future physicians to care for the patients of tomorrow. Faculty at Vanderbilt University School of Medicine (VUSM) are right in the middle of the debate.

There is a lot of discussion on the national health care front about how best to equip future physicians to care for the patients of tomorrow.

Faculty at Vanderbilt University School of Medicine (VUSM) are right in the middle of the debate.

“Historically when students were on a rotation within the hospital they were imbedded within the clinical team with no outside responsibilities,” said Bill Cutrer, M.D., M.Ed., director of Learning Communities and Curriculum 2.0 Immersion Phase co-director for VUSM. “With the creation of Learning Communities and Foundations of Health Care Delivery (FHD), students are leaving their clinical teams on specific afternoons to participate in these activities.

“It’s really important that faculty members and residents understand why this is happening,” he said. “We feel that these additional courses are a valuable use of the students’ time. As we consider the future of health care, we think about the skills we are teaching in these two longitudinal programs as an absolute necessity for the students to thrive in the ever-changing health care environment.”

In 2013 Vanderbilt implemented Curriculum 2.0. Tagged as a system of lifelong learning, the deeply integrated curriculum requires flexibility and teamwork on the part of faculty and allows students opportunities to individualize their training.

As part of the new curriculum, Learning Communities and FHD were introduced two years ago to supplement the interaction students received during clinical rotations. Both programs span the entire four years of the medical school experience.

“As we look at health care and all of the things that we think need to be fixed or all of the things that could be better about health care, we are targeting specific skill sets we think that future physician needs to have,” said Cutrer, assistant professor of Pediatrics and Anesthesiology.

“Rather than hoping that students obtain certain skills along the way, we wanted to explicitly help them develop particular skills.”

Cutrer said fostering the development of skills that improve empathy, cognition and leadership as well as the quality, cost and overall delivery of health care is paramount as students enter their future training and practice.

The Learning Community and FHD experiences are offered during two half-day sessions each week, which takes students out of the clinical setting — a significant change from previous educational formats.

However, as part of the overall curriculum revision, students will have more time in the clinical environment than prior years.

“We are hoping that these strategically designed classroom activities will enhance the students’ clinical experiences,” said Bonnie Miller, M.D., associate vice chancellor for Health Affairs and senior associate dean for Heath Sciences Education.

“By exposing them to FHD content areas, we hope that they will view health care delivery systems with a critical new lens,” she said. “And we believe that their Learning Community experiences will embed essential skills of reflective practice, self-awareness and leadership.”

Learning Communities, the academic component of the VUSM Colleges program, focus on helping students develop as professionals by providing the consistent teaching presence of the College Mentors.

Cutrer said students acquire fundamental skills that include a strong ethical foundation and approach, robust cognition and clinical reasoning as well as explicit leadership skills development.

The FHD program seeks to integrate systems knowledge with clinical care, to create and nurture self-directed workplace learners, and to prepare professionals with system-level skills necessary to provide care that is safe, effective, patient-centered, timely, efficient and equitable, said Jennifer Green, M.D., co-director of FHD.

“FHD aims to teach students about patient care and our health care systems in a new way,” said Green, assistant professor of Internal Medicine and Pediatrics. “We are shifting toward a wider lens of care — moving beyond diagnosis and treatment — to thinking about how care is actually delivered to patients and exploring how our current systems both help and hinder the goal of improved health for our patients.”