Accelerating Change in Medical Education

Seeds sown to change medical education continue to bear fruit

A groundbreaking effort to catapult change in medical education is the focus of a new report on projects that, individually and as a whole, underscore the potential for transformation in the teaching of future physicians.

The 46-page monograph is a theme-by-theme description of the first four years of work by a consortium now numbering 32 allopathic and osteopathic medical schools—about a fifth of the nation’s total—that receive grants from the AMA Accelerating Change in Medical Education initiative. The consortium institutions represent 19,000 medical students—who eventually could treat as many as 33 million patients a year—but the initiative’s goal is to have a lasting, vastly broader effect on the teaching, training and lifelong learning of physicians.

“For many years there has been general consensus that medical education—based largely on an educational model more than a century old—has needed to change in order to address significant gaps in physician training and prepare new doctors to practice effectively in our 21st century health systems,” notes the monograph, titled “Creating a Community of Innovation.”

That community—the AMA Accelerating Change in Medical Education Consortium—got its start in 2013 when the AMA provided five-year grants of $1 million each to 11 medical schools. The initiative was expanded in 2016, with three-year grants of $75,000 apiece to 21 medical schools. The monograph reports on the design and progress of the projects to date. Funding continues until September 2018. In addition to detailed project descriptions, the monograph includes an annotated bibliography with details of more than 75 scholarly articles that have resulted from the consortium’s work thus far.

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    The projects emerging from the consortium can generally be grouped into one of six themes used to describe the activities of the initiative.

    Developing flexible, competency-based pathways. Some students—for example, an experienced nurse or physician assistant—may be able to complete a medical school education in less time than others. One program, for example, allows qualified applicants medical school entry at an advanced stage and, through a competency-based curriculum and rigorous assessment, provides the chance to graduate in less than four years. Other students may need more time.

    Teaching new content in health-systems science. This intersection of how health systems deliver care, and how patients receive and access it, is the focus of projects at many consortium schools and includes coursework, enhanced clerkships and student rotations at community health centers. The consortium’s work resulted in the 2016 publication of the Health Systems Science textbook and the creation of a health-systems science subject exam in the topic with the National Board of Medical Examiners.

    Working with health care delivery systems in novel ways. These programs can include placing medical students in immersive situations where they add and receive value through the experience of helping patients as part of a health care team. For example, in one program students work as navigators at a patient-centered medical home, in close contact with patients by providing information, care coordination and emotional support. At another school, students work as part of care coordination teams, providing assistance to patients with multiple chronic conditions in their homes.

    Making technology work for learning. A specially created, teaching version of an electronic health record, using authentic patient data that has been deidentified and misidentified, provides the opportunity for medical students to safely, but realistically, develop deep skills and understanding of this essential practice tool.

    Envisioning the master adaptive learner. These are programs designed to provide the basis for lifelong skills which, as one program describes, creates medical students “who learn, engage in guided self-assessment, and adapt to the evolving needs of their patients and the health care system throughout their careers.”

    Shaping tomorrow’s leaders. Programs use varying approaches—in the classroom and through coaching, seminars, and workshops and other means—to promote the development of collaborative leaders, who are effective communicators, and able to embrace changes and opportunities.

    Join the conversation about med ed’s future by tuning into the AMA Innovations in Medical Education Webinar Series and taking part in the Accelerating Change in Medical Education Community. You can also follow the conversation on Twitter using the #ChangeMedEd hashtag.

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