UR Receives Nearly $1.7M to Develop Groundbreaking Curriculum

September 18, 2000

Within just the last two months, the University of Rochester School of Medicine and Dentistry has received five grants totaling nearly $1.7 million to support the school's new Double Helix curriculum. These grants, which have come from a variety of sources including the federal government, are in addition to another $1.5 million the medical school has received in the last two years-all directed toward the development of the groundbreaking curriculum.

"We are thrilled to have received such tremendous support for the Double Helix curriculum. The awarding of the grants reaffirms our belief that we are taking medical education in the right direction. And at a time when competition for funding is fierce, we are pleased to see the creativity and innovation of our faculty recognized at the national level," says Edward M. Hundert, M.D., dean of the medical school. "Other top medical schools around the country are already starting to adopt the principles of the Double Helix curriculum. The University of Rochester is truly a national leader in this area and it is wonderful to see this recognized by federal agencies, foundations, and others."

Hundert has led the sweeping reform of the medical school's curriculum. Named after the intertwining strands that comprise DNA, the Double Helix curriculum integrates basic science and clinical medicine throughout all four years of medical school, with students learning to care for patients as they learn the biological and social sciences which are fundamental to understanding diseases and their treatment and prevention.

The proposals that received funding were developed through the medical school's Curricular Affairs Office, whose mission includes seeking external funds to support innovations in medical education.

The most recent grants awarded support the development of a number of features unique to the Double Helix curriculum, including a comprehensive "Professional Competency Assessment" that goes far beyond evaluating clinical skills, and the Ambulatory Clerkship Experience, which places medical students in community physicians' offices. Money is also being directed to the creation of "evidence-based medicine" modules designed to teach medical students how to integrate clinical expertise and research results. Another grant will provide a distinctive new approach to teaching end-of-life care.

The medical school has also received grants to develop one of the first courses that will teach medical students how to educate patients about nutrition; a course that teaches and assesses empathy; courses that look at women's health in new ways; and a class on spirituality.

"We believe very strongly in this curriculum and the vision of our faculty. We are pleased that top-level funders have recognized the unique and pioneering aspects of our program. Our faculty is second to none, and these resources will enable them to prepare our graduates with new levels of skill and thoughtfulness in integrating basic science and clinical medicine, and in their ability to communicate with patients," says Elaine F. Dannefer, Ph.D., associate dean for curricular affairs.

To date, the first two years of the medical school curriculum have been converted to the Double Helix curriculum. Implementation will continue over the next two years to include the third and fourth years of the curriculum.

Plans are also in the works to apply the Double-Helix principles to the medical school's graduate medical education programs. Just as the new curriculum integrates basic science and clinical medicine in the training of medical students, hopes are to better integrate the two in the training of residents.

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BACKGROUND ON THE FIVE MOST RECENT GRANTS AWARDED

Development of a Comprehensive "Professional Competency Assessment" of Medical Students

Funded by: Department of Education, Fund for the Improvement of Postsecondary Education

Primary investigator: Edward M. Hundert, M.D. dean

Co-primary investigator: Ronald Epstein, M.D., associate professor of medicine and psychiatry

Amount of funding: $467,500

Grant money will be devoted to the development of an innovative two-week Comprehensive Assessment that will assess the full range of competencies expected of a medical school graduate-from clinical skills and scientific knowledge to accessing and critiquing new information to teamwork and self-reflection. By integrating these elements into a comprehensive assessment, the two weeks at the end of the third year of medical school will move from looking at mere "clinical competence" (is the student doing the right thing for the patient?) to evaluating "professional competence" (does the student understand why it's the right thing for the patient based on underlying basic and social sciences?).

General Medicine in Ambulatory Clerkship

Funded by: Department of Health and Human Services Health Resources and Services Administration

Primary investigator: Kathy Markakis, M.D., Department of Medicine, director of Ambulatory Clerkship

Amount of funding: $388,800

Money will support further development of the curriculum's Ambulatory Clerkship Experience (ACE)-a 57-week course that begins in the second half of the first year and continues through the entire second year. The course is designed to teach all of the ambulatory elements of family medicine, general internal medicine, pediatrics and relevant subspecialty knowledge crucial for primary care practice. Students gain clinical experience in community physicians' offices. They then can use these experiences to drive their learning of the basic and social sciences that underlie modern clinical practice in the "basic science strand" of the curriculum, taken in parallel with ACE.

Family Medicine in the Double Helix Curriculum

Funded by: Department of Health and Human Services Health Resources and Services Administration

Primary Investigator: Ronald Epstein, M.D., associate professor of medicine and psychiatry

Amount of funding: $510,000

This grant supports preceptor recruitment for ACE and the first phase of the Comprehensive Assessment-a two-week review of medical students' professional competencies that will take place at the end of the second year. Money will also go toward developing within the ACE curriculum topics such as prevention, domestic violence, delivery of bad news, care of the chronically ill and mental health problems.

Early Introduction and Evaluation of Medical Student Skills to Practice Evidence-Based Medicine

Funded by: National Board of Medical Education

Primary Investigator: Robert Holloway, M.D., Ph.D.

Co-primary investigator: Donald Bordley, M.D., professor of medicine

Amount of funding: $59,907

Evidence-based medicine (EBM) is the integration of individual clinical expertise with the best available current evidence from research. It is a new set of skills designed to help clinicians ensure that patients receive the correct type of care and information precisely when they need it and want it. Grant money will help to create EBM evaluation modules that would take place during the first two years of the student curriculum.

An Integrated Biopsychosocial Approach to End-of-Life Training

Funded by: Greenwall and Nathan Cummings

Primary investigator: Timothy Quill, M.D.

Co-primary investigator: Elaine Dannefer, Ph.D.

Amount of funding: $273,612

This grant will allow for the introduction of a new biopsychosocial model of end-of-life training that will be fully integrated with the basic science and clinical medicine curriculum throughout the four years of undergraduate medical education. The goal is to better prepare physicians with the knowledge, skills and attitudes to care for patients facing the end of their lives.

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Susan Fandel
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