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4 COMMUNIQU SUMMER 2015 by Laura Probyn Most of us dont stop to think about whether the foundation of our home is sturdy when we walk through the door. Yet a solid framework is a vitally important aspect of any structure. In academia a solid curricular structure is no different. The curriculum especially for medical students is a vitally important underpinning of the educational experience setting the stage for future success in clinical settings. The MSU College of Osteopathic Medicine recently instituted a considerable curricular update. Though not a complete overhaul the effort did require signicant input from a number of individuals. Though the pre-clerkship section has only been in use since members of the Class of 2016 embarked on their studies in 2012 early measures are showing that it is achieving its goals of helping students learn and prepare for clinical experiences before and after graduation. An initial external metric used to determine curricular success is the students scores on the rst level of the Comprehensive Osteopathic Medical Licensing Examination COMLEX which is taken after completing the rst two years of medical school. Passing the four- component series of COMLEX examinations Levels 1 2CE 2PE. and 3 which assess osteopathic medical knowledge and clinical skills is an important step toward obtaining state licensure to practice medicine. We have almost all of the Class of 16s COMLEX Level 1 scores back and I can share with you that the performance of this class has clearly beneted from the implementation of the changes we made says Senior Associate Dean Donald Sefcik. Although we wont receive the nal update from the National Board of Osteopathic Medical Examiners NBOME until Spring 2015 based on improvements in our rst-time pass rate and our mean and discipline-specic scores I am condent that our efforts will translate into an even better ranking in comparison to the performance of other colleges. The effort began in 2009 when Dean Strampel charged Mary Hughes chair of the Department of Osteopathic Medical Specialties with leading a planning effort to set the stage for a revised preclerkship curriculum. She convened a task force that met weekly for over a year to identify curricular needs for medical students in their rst two years of study. This was all done voluntarily without any decrease in other duties to facilitate the work or increase in pay which is really quite a demonstration of the dedication of the faculty to the process and the changes to be made Hughes says. I initially created the master plan and prepared it as a discussion piece and then as a committee we would hammer it out I would go back to the computer and modify and come back with further revisions and so it went week after week until we had a Year 1 and 2 revision she notes. The total committee was approximately 33 as some people came and others went over time. We eventually were given some administrative support which helped us along as well. I cooked dinner weekly and I think it was the homemade chocolate chip cookies that kept them coming back every week At the conclusion of those meetings Hughes and her team passed the planning document on to R. Taylor Scott the MSUCOM director of pre- clerkship curriculum. Scott marshalled an implementation task force to begin the work of putting the plans into use. There were some fundamental changes that we made to the curriculum mainly in terms of integrating content Scott said. We tried to get out of silos of information and to integrate more and thats not limited to preclerkship. We found that there are some concepts that while they can be introduced in the preclerkship curriculum they are most appropriately applied in the clerkship curriculum. A WORK IN PROGRESS Revised curriculum provides students with integrated experiences The implementation of the revised preclerkship curriculum in 2012 for the incoming rst-year students occurred at the same time that the second-year students and those in their clerkships third- and fourth- year students continued their studies with the pre-existing product i.e. legacy curriculum which required some Herculean academic juggling. Scott added that managing the logistics was as much if not more of a challenge than implementing the actual content. There was a whole scheduling issue of the legacy curriculum and people being really familiar with that for example they knew what would happen in Semester 6and then this whole incoming revised thing that was new. That was a huge challenge he noted. The revised curriculum expanded on the colleges previous course series that began with rst-year classes in basic sciences then moved into studies of the human bodys systems. The revision seeks to further integrate the learning in the preclerkship years by adding a clinical component in the form of the EVOLVE clinics that are presented in the Osteopathic Patient Care course series which is also new and a longitudinal curriculum to integrate clinical skills doctorpatient relationships ethical issues professionalism and multiple objective structured clinical exams for practice. Within the classroom setting there are even deeper structural changes as departments implement the ipped classroom concept into some courses a model that Hughes integrated into her respiratory systems course several years before the revised curriculum was launched. In this educational model instead of attending a lecture students study materials that can include text or recorded audio or video presentations before coming to class. When they arrive at class they may take a test before beginning work that doesnt involve a faculty lecture but does feature small group discussions and interactions with faculty members as the students use the materials they have learned recently to solve real world problems they will face. Its an approach to learning that the student is not used to says Gail Riegle associate dean of academic programs. Most of our students have gone all their life in a passive learning environment. In my view the ipped classroom is doing a much better job of preparing students for what they are going to face in the profession because to keep up with whats going on in medicine youre not going to be competitive in a passive lecture systemyou have to read and understand. Active learning is key. In Hughes view in the beginning students were not thrilled with the new experience. As you can imagine the students were initially quite up in arms as this was their last big class before going to the clinics she says. They had mastered the binge and purge exam phenomenon complained to the dean etc. but they did bear with us and for the most part were very engaged and more so each week. At the end many comments revolved around this is the way we should be taught and I received a teaching award from the Class of 2012 for this course. The ipped classroom concept has been applied to varying degrees within departments afliated with MSUCOM. And just as some students are more comfortable than others with the very different format faculty members nd differing degrees of comfort with the idea. It places different demands on the faculty Riegle points out. Some enjoy it others dont. Hughes did not have the chance to sit back and rest on her laurels once the preclerkship curricular revision planning was completed. The dean asked her to repeat her leadership with a committee working for a revision of the curriculum for third- and fourth-year students. This was a much different committee but used the same format just different players she says. We had hospital-based faculty via FEATURES