What's a typical week going to look
like in the University Park program
that you guys have been designing?
Absolutely.
So for the first year or so, the week will be similar in nature.
Our students will spend about three mornings
in a clinical immersion.
It will be a longitudinal relationship
that they develop in either a family med or an internal med
clinic.
There will be several providers, but that location
will stay the same for them.
And their role will change but they
will be there consistently.
And that might be Monday, Wednesday, Friday morning.
So we'll stay with that.
To accompany that, then we have our IQ groups,
or inquiry groups.
We call them IQ groups, but their inquiry groups.
And those usually pair up nicely with the clinical immersions
that we have.
So we have three of those a week as well.
They will continue on for some time in the students education.
And they are Monday, Wednesday, and Friday afternoons.
So you can see that Tuesday and Thursday there
is a lot of free space in there, or white space in there
for our students to take the time
to do independent learning.
But kind of over the year or the year
and a half of the beginning part of that curriculum,
we also have some other components interspersed.
Anatomy sessions, collaborative science tutorials,
and other extracurriculars that I
am sure our medical students will become involved in.
And you yourselves, of course.
Because a reminder to our viewers,
you're going to be taking this very curriculum that you've
designed.
You mentioned these longitudinal immersions and IQ groups.
Tell me a bit more about those.
Yeah, so essentially we're coming in,
as Morgan says, several days a week to the same clinic,
to the same primary care clinic.
And the core thing they we're trying to build there is trust.
So initially in the first month of medical school,
an incoming medical student does not
have all the medical knowledge they need to be a doctor.
That would be an unreasonable expectation on our students.
But they do have a variety of other skills
as a means of gaining additional skills along the way
and gaining trust along the way within their healthcare teams.
So the plan is not just to have the students
work with one doctor and shout at them
or try to clerk with the doctor or anything like that.
At the beginning we'll be doing a lot more patient navigation,
care coordination sorts of skills.
In addition to learning about other members of the health
care team.
And finding ways to gain those skills,
and in doing so, learn more about the health care system.
So learning some nursing skills and doing some grooming
with nurses as a means of patient interaction.
Getting an opportunity to spend time
in between the rooming that the nurses would normally do
and when the provider comes in, to have one on one time
with patients from the very beginning.
Even if you don't have the medical knowledge,
you can still learn someone's story.
You can do patient navigation work.
And you can gradually learn to get
your medical skills and your narrative medicine skills
going that way.
And then when the provider comes in,
you can start out by maybe doing more assisting roles.
And over time work into a more clerkship role there.
And the key to all of this is exposing our students
very early on to many patients.
And many patients in a primary care setting,
such that they'll have a wide variety of medical issues
that they're trying to work with.
And so that will help our students,
hopefully have intrinsic motivation and curiosity
to then go out and say, I met a person today.
And that person is struggling with pancreatic cancer.
And I don't know a lot about pancreatic cancer,
as a first year medical student but I want to.
So they walk in the classroom, they walk in their inquiry
groups, they walk into their white space of study time,
and they have questions that they want to answer,
not that the textbook tells them to answer
or a worksheet tells them to answer.
So there's so much interesting to unpack there, Tom.
The first is this idea of learning
inter professional roles.
A lot of us struggle in medical education
with how to offer meaningful inter professional education.
Because of course, we all work in health care
and inter professional teams.
You're going to be embedded in a inter team
and learning with inter professional colleagues
from the beginning.
So that's exciting.
And then it sounds like you're also
going to add some value to these clinics.
I'm thinking I would love to have an extra set of hand
in my clinic to help room patients,
get patients where they need to go,
navigate our complex system.
So is that part of the design as well?
Absolutely.
I think both of those things are core
to what we're trying to do in our clinical immersion.
So as you said, with the health systems understanding,
oftentimes in courtship roles and in medical schools,
the worry-- well, one thing that we're concerned about
is that medical students will act kind of as mini doctors
that eventually grow up into big doctors.
And that's one thing that they need to learn how to do.
But that's not the only thing they need
to learn how to do in a clinic.
They need to learn what everyone else is doing in the clinic.
Because they're part of a health care team now more than ever.
And so understanding what the nurses are doing
and how that affects the patient.
Understanding what people at the front desk are doing
and how that affects the patient.
Care coordination, nurse practitioners,
physician's assistants, there's all kinds
of people working as part of helping that patient.
And so to work with those people,
to understand those roles, and to understand
the inner connections between them, and that doing so
will help us as we grow up into, hopefully,
clinicians they can navigate that team
and work as one of the leaders of that team.
So tell me more about these inquiry groups
in the afternoon.
Is it pure discovery learning?
Saw that patient suffering from pancreatic cancer,
I'm going to go look up a resource.
Or are some of them set?
How is that going to work?
So an inquiry group is when we meet Monday, Wednesday,
and Friday in the afternoon after our clinical immersions.
And a group of students will meet with a faculty mentor.
And we'll sit down and we'll bring back patient cases
that we saw in the previous week that interest us
and that we have questions about.
And we vocalize these together as a group.
And we decide upon a couple that we
think are interesting to discuss throughout the coming
week on Wednesday and Friday.
And throughout this process we're
writing clinical case summaries to get some practice
on actually doing a history and physical in a safe environment,
where our mentor knows that we don't have the best
skills so we can get some practice there.
And we're also coming up with some learning objectives
with our mentor.
And the idea is that we use these learning objectives
as shared jumping off points.
So that everyone can have an equal footing
on what we're studying in our white space on Tuesday
and Thursdays.
So that when we come together on Wednesday Fridays,
we can have a general idea of what everyone wanted to cover.
But then we can go deeper.
And after our sessions on Wednesday and Friday,
we can ask more questions that we can answer on our own time.
What's also really exciting about these inquiry
groups is that the contractual basis for our learning
are our patients.
We're not learning from textbooks.
We are meeting patients, we're engaging with them
in the health care practice, understanding
all the comprehensive dynamics that are
going into their health care.
And after meeting these patients,
we develop these clinical case presentations
that can allow for elaboration and expansion
of our curiosities.
And it's liberating as a learner to be able to explore that.
Instead of just being confined to what
my assigned scripted learning objectives are.
And so our curriculum is very asynchronous in nature,
which as science people, may seem uncomfortable.
But it's actually quite the opposite.
It's exciting, because you never know what
you're going to see in clinic.
So it's galvanizing in a sense because it's not typical.
I think also by rooting it in the patient case
presentation as opposed to a specific list of diseases,
you'll be able to expand that patient presentation
to compare and contrast and to learn about other diseases that
may not have come up in your patient practice.
Yes.
So that begs the question, we are in an internal medicine
or family medicine, a primary care sort of setting,
there are going to be diseases or things inevitably
that we will not come across, more obscure conditions.
You know, like Wilson's disease or PKU.
And a lot of people that are learning about our curriculum
are curious about the sort of breadth and depth
of our curriculum.
How robust is our curriculum?
How well as our curriculum going to prepare medical students
as any other medical school?
And to address these potential gaps
where these obscured conditions have to be learned,
have to be addressed, we have the collaborative science
tutorials.
Yeah, so tell me a little bit more about those.
Absolutely.
So as I mentioned earlier and as Vanessa has been alluding to,
we're very conscientious about these potential gaps.
And one of the concerns we've had this year
was actually basic science.
Most of, if not all of our faculty mentors,
are clinicians.
And so how do we account for that learning
and that expertise that we need to look to sometimes because we
have questions.
And then we have more questions and then more questions.
And we want answers.
Part of what we're doing is we're
looking at a model in which we use maybe a session
every couple of weeks and then a capstone course
that will invite faculty from Penn State's main campus, as
well as our colleagues in Hershey,
to really dive deeper into those diseases that we may not see.
Or even diseases that we may have or patients
we may have worked with.
Being that we have the clinical immersions up front,
it gives us a little bit of scaffolding, right?
So we can build on that learning that we've had.
So we see even a diabetic patient,
we didn't read about that--
we didn't read about them in a book, we've met this patient.
Taking it a little bit further with a biochemist.
You know, I remember Mr. Jones.
And now I want to keep pushing it further,
can you help me do that?
And so that's one of the ways, is
kind of focusing on that basic science.
And making sure that we get those
answers that we want that we may not
get from the IQ group session.
Another good example are the anatomy sessions
we're working to put together.
We're collaborating with, again, faculty from Hershey, but as
well as faculty from main campus.
Something that we haven't really talked about,
but we have a very small campus and limited resources.
Which again, we have to be very conscientious of.
And so being a team or partnering up of people
is something that we really enjoy doing.
And it kind of goes back to inter professional learning
as well.
But utilizing some of the facilities on campus
to do cadaveric dissection.
Also, we have an Echopixel, which
is kind of like a 3D machine you can use CDs of scans of imagery
and kind of work with that.
Maybe working with some ultrasound, so
SonoSite, SonoSim.
And kind of using all these resources to address those gaps
and to continue to further our knowledge so
that we make sure that we're comfortable with what we're
doing.
And at the end of the day are ready to practice and take
care of patients.