| Director's Message |
Look Back, Look Around and Look Forward
A report from the Association of American Medical Colleges (AAMC) documents emerging trends in medical education, medical research and health care, with a focus on their particular implications for medical educators.
Scientific Advances: Scientific advances of the past fifty years continue to drive changes in medical practice and health care delivery.
Population Change: The changing demographics, size and distribution of the American population means more people seeking a wider range of preventive, acute and chronic care.
Individual Health Expectations: The public expresses an increasing sense of entitlement to health care as well as higher expectations of the health care system.
Demand for Health Care: Economic prosperity and expanded health insurance coverage provides opportunities for more people to access the health care they want and need.
Medical Practice Specialization: Practicing physicians tend to become more specialized in their care delivery; this is driven both by professional and patient factors.
Technological Advances: New science and technology have revolutionized health care and required physicians to master new knowledge and skills and maintain mastery throughout their careers.
Health Care Teams: With increased specialization effective health care requires a team of physicians and allied health professionals as well as organizational infrastructure and interpersonal skills to support collaboration and coordination.
Physician Workforce: There is a need for more physicians and a system that supports physician productivity to meet the increased population and their wide ranging health care needs.
The report authors reemphasize the social contract of medicine: physicians as agents of society, licensed by society, to serve the needs of society. The report goes on to list recommendations based on the implications of these trends for medical education.
These trends and many of the implications outlined in the report are familiar to all of us despite the fact that this report, The Coggeshall Report, was released in 1965, around the time of CHM's founding.
As part of the CHM fiftieth anniversary, the next few editions of Vital Signs will include some articles that look back at our educational program, reflecting on where we have been, where we are now and where we are heading. In this edition, we focus on our admissions program, in the Spotlight section below.
Brian Mavis, PhD
Associate Professor and Director
Office of Medical Education Research and Development
College of Human Medicine
- 3D Printing Now Available at the MSU Library
3D printing has grown from a small, niche industry to a technology that has taken the academic and medical world by storm! Medical professionals and educators are using 3D printers to create scale models for head and neck surgeons to practice on before complex surgeries, to print organs and prosthetics, to demonstrate normal and abnormal anatomy in the classroom and much more.
The MSU library wants to explore partnerships with other units and departments on campus, including those in CHM, to work on 3D scanning, modeling and printing projects. This can be for lab use, teaching tools, student projects and other educational applications. Interested in learning more?
Please visit: https://www.lib.msu.edu/node/3605/
- MSU AT&T Faculty- Staff Instructional Awards
To enhance teaching and learning at Michigan State University, IT Services holds an annual awards program funded by AT&T to recognize and encourage best practices in the use of instructional technology. The entry deadline is Friday, February 6, by 5 p.m.
This awards program recognizes outstanding contributions to the use and development of information technology for teaching and learning in credit-bearing courses at MSU. First place awards will be given for best fully online course, best blended course, and best use of technology to enhance an online, blended, flipped, or in-person course.
To see application details, visit http://attawards.msu.edu/how-to-enter
- IAMSE Educational Scholarship Grant
The International Association of Medical Science Educators (IAMSE) wishes to encourage and support scholarship in medical science education and will provide a research grant each year for up to $3000. Submit applications by January 15, 2015.
Preference will be given to new projects. Funding is for a 2-year period. Mid-year progress reports will be submitted to the IAMSE Educational Scholarship Committee. The results of funded projects will be presented at an IAMSE meeting. Any publications resulting from IAMSE-funded research have to be acknowledged on the publication. If the research project involves human subjects, a letter of approval from the host Institutional Review Board stating that the project is approved or that approval was not necessary will be required prior to disbursement of funds.
For more information about eligibility, application and submission process, visit:
- Allowing Medical Student Documentation in the Electronic Health Record
Electronic health records (EHRs) provide opportunities to improve patient care and increase the accuracy of communication. For the full potential of EHRs to be realized, they must become part of the educational experience from the beginning. Medical students need to have hands-on experience-including entering and retrieving information in the medical record-as a first step toward preparation for residency and beyond. The Compliance Advisory, Electronic Health Records (EHRs) in Academic Health Centers, encourages institutions to educate medical students about documenting and using electronic health records while minimizing the compliance risks.
For CHM Admissions its Mission, Mission, Mission
The Early Years of Admissions
The admissions process at Michigan State University's College of Human Medicine (MSU-CHM), from day one, was different. Conceived in the mid-60s during a time of major social unrest, MSU-CHM wanted to address the concerns that many also had about medicine; namely, that it was impersonal, sometimes dehumanizing, and, not to mention, unrepresentative of society at large. Our mission focus was "serving the primary health care needs of the people of Michigan." Diversity in the learning environment reflecting the diversity of the people of Michigan was seen as essential to the mission. Diversity in admissions work was broadly defined to include rural and inner-city students as well as other facets of diversity such as non-traditional students and non-science majors. The admissions process during this time period was known for taking risks, and it was not uncommon for early entering classes to look different from the classes of other medical schools: more women, more non-traditional students, more minorities underrepresented in medicine.
Drawing upon the decision-making literature and judgment theory, the admissions process moved to an even more standardized evaluation model to systematize its selection process. An evaluation form was devised for each stage of the admissions process, multiple evaluators were used, and a large number of non-academic criteria were assessed. Two one-hour interviews assessing 10 categories were conducted for each applicant invited to interview. We fine-tuned the selection process every year while seeking ways to be more effective. We wanted more from those we admitted. Looking beyond test scores, we were looking for those candidates "who would bring strong scientific knowledge to bear on medical problems in a humane and compassionate way." MSU-CHM was already doing holistic reviews well before it became fashionable and acceptable.
CHM Enrichment Programs
The committee's ability to select students based upon mission fit has been supported by a variety of special programs. The ABLE program continued to be of immense value for students on the cusp of academic readiness. The committee was able to refer disadvantaged students with good mission fit for further academic preparation while offering conditional admission.
The Medical Scholars Program was developed in the 1990's on the hope that aspiring physicians might be better able to maintain their empathy and energy if they were educated in a supportive environment that accepted or perhaps nurtured interests outside of the biological sciences. The program was popular but with the 2008 recession and evolving awareness that Medical Scholars were difficult to differentiate from our regularly accepted students, it was phased out.
Still interested in mission fit and a diverse learning environment, the Office of Admissions designed Early Assurance programs. Partner undergraduate institutions in our communities agreed to seek and develop students who may typically be disadvantaged in the medical school admission process but with career goals consistent with the CHM mission. This program admits students using the regular process but a year early. It advantages students with additional attention from their undergraduate institution, relief of admissions-related pressure and expense, and a relationship with CHM during their senior year.
During this time the Rural Physician Program flourished and expanded, while the Leadership in Medicine for the Underserved program was initiated. More recently there was been increased interest in combined degree programs. Most notable is the Program in Public Health that supports student interest and the CHM mission through options for a certificate or MPH degree. The MD/PhD program emerged from moratorium to be offered as a combined degree offering.
Admissions Adopts the Multiple Mini Interview Format
Over the last five years, CHM Admissions has solidified its commitment to an admissions process that uses principles of holistic review in selecting incoming medical students. While accomplishments listed on a medical school application and discussed during an interview remain a key component in the decision-making process, the evaluation of personal characteristics consistent with becoming a successful doctor continues to be challenging.
In order to provide a more structured evaluation of applicant personal characteristics, the admissions committee agreed to transition our interview format three years ago from one that placed heavy emphasis on a semi-structured, one-on-one interview to a process based on a series of eight highly-structured, short (eight-minute) "interview" stations specifically designed to evaluate personal characteristics, such as compassion, cultural sensitivity, maturity and self-awareness. This approach is called a multiple mini-interview (or MMI). Our MMI follow-up data documents improved applicant satisfaction using the MMI over traditional interviews. It is our hope that future data will show that the MMI results in improved academic performance and professional conduct of our students. Admissions at CHM has always tried to keep abreast of new approaches that respect the individuality of our applicants and provides us with information for better mission-focused decisions.
Why Do Students Choose CHM?
Each year the Association of American Medical Colleges (AAMC) surveys all matriculating U.S. medical students, and included are questions related to the factors that influence students' choice of medical school. In 1987, the top three factors identified by matriculants were CHM's curriculum, geographic location and general reputation. It is noteworthy that medical school curriculum was not among the top three reasons for the national sample of matriculants. The results of the 2013 survey again identified the CHM curriculum as the most important factor influencing students' decision, and again this was not reflected among the top three choices of matriculants nationally. There are three factors tied for the other top rankings: geographic location, residency placement of graduates and desire to attend an in-state school.
While the wording and response choices of the questionnaire items have varied over time, the consistency of the results is impressive. Over 26 years, the CHM curriculum and geographic location have remained important features for students considering CHM for their professional education. For students attending CHM, these factors outweigh many other considerations. In the end, there is something to be said for mission, mission, mission. (Contributed by John Molidor, Christine Shafer and Joel Maurer).
Digital Literacy for Educators and Learners
The Association of American Medical Colleges Group on Information Resources (AAMC-GIR) has developed a digital literacy for educators and learners toolkit. The toolkit was authored by a team of physicians from AAMC-member institutions who specialize in the study area of digital professionalism.
The toolkit contains case studies that come from their own collective social media experiences and curriculums. It is designed to provide a starting ground to help physicians overcome the familiarity gap with social media so that they may facilitate meaningful discussions around this topic with their students and colleagues.
The entire toolkit includes case studies, guiding questions, educator notes and suggested guidelines to help learners and facilitators get the most effective use of the resource.
Current cases in the toolkit include:
- The Rude Anesthesiologist
- Image of the Profession
- Free Speech vs. Professionalism
- Friending Patients on Social Media
- The Political Resident
- The Screaming Baby on Facebook
Additionally, each one of the case studies are structured as follows:
- Case Commentary - This section serves as a high-level assessment of the case that helps identify general discussion points that are pertinent to the case. These are presented so that faculty with limited social media experience can facilitate a directed group discussion.
- Educator Notes - This section directly addresses the case-specific guiding questions. They serve as a starting point for discussion; more questions can always be added.
- Bottom Line - This section includes the take-home points or learning objectives for the case.
- Toolkit Considerations - These suggested guidelines will help both learners and facilitators get the most out of the toolkit.
- Bibliography and Summaries - This section includes a curated and annotated reading list that provides further background, context, and commentary for each case.
The toolkit is available online through the AAMC, and will be one of a variety of toolkits that are part of this digital literacy project. For more information and to download the toolkit materials, visit:
Geraud Plantegenest, MA
Manager, Blended Curricular Learning Resources (B-CLR)
Office of Medical Education Research and Development
517-353-3455 | [email protected]
| CHM Program Evaluation|
Using Portable Ultrasound Technology to Teach Anatomy
The increasing use of ultrasound by physicians to support rapid patient assessment and diagnosis has prompted many medical schools to adopt the use of portable ultrasound equipment as part of their educational programs (ref1). A recent survey of U.S. medical schools found that 62% had integrated ultrasound training in their undergraduate medical curriculum (ref2), most commonly in the third year. Among the 82 schools represented in the survey, 39% reported ultrasound training in Year 1 and 35% reported it in Year 2. There is evidence to suggest that ultrasound training in Year 1 can improve student learning of anatomy (ref3) and physical exam skills (ref4). There are published examples of integrated ultrasound curricula for medical students (ref5, ref6). A brief video demonstrating ultrasound education for medical students is available here.
In fall semester 2013, John Fitzsimmons designed a supplemental curriculum to pilot test the feasibility of portable ultrasound technology for teaching anatomy. The goal was to determine the educational utility as well as the resources required. The first step was to see if this tool can aid in learning anatomy, and maybe physiology and pathology as well during the preclinical curriculum.
The objectives for these sessions focused on identification of anatomical structures. For example, at the end of this session the student should be able to acquire an image of and identify the:
- thyroid gland, the lobes and isthmus
- external and internal jugular veins and the IJVs confluence with the subclavian vein
- common carotid artery, the carotid sinus and the bifurcation into the internal and external carotid arteries.
- strap muscles of the neck
Dr. Fitzsimmons conducted the 60 minute sessions with the assistance of a technician provided by the device manufacturer. At times, clinical faculty provided additional assistance. Other than space requirements not many resources were needed during the pilot program. For each session he spent about 5 minutes introducing very basic principles of ultrasound and how the image is obtained. Then time was spent showing the students how to image a variety of regions and structures. Students were then given the probe so that they could practice with their colleagues. They were asked to locate and identify the structures initially shown. Many times the students ventured beyond this list and discussed closely related anatomy.
A follow-up questionnaire was sent to participating students to determine their perceptions of the experience. The results of the survey, based on 116 respondents, are summarized below. After the pilot curriculum, students generally felt very confident in their ability to identify a wide range of anatomical structures. 85% of respondents felt that ultrasound (US) instruction should be a regular part of the anatomy course; 72% thought it should be part of the physical examination course. 97% found the US experience to be positive and 97% enjoyed the US training.
The trends in the literature and the number of medical schools integrating US into their educational programs shows that many colleges see this to be a feasible skill to teach in their undergraduate medical curriculum. The student response to this pilot program was very positive and they valued this addition to their medical education. Some students have expressed interest in additional experience by developing an elective. For MSU to move forward, additional ultrasound units will be needed, as well as additional faculty time for development and instruction.
| Faculty Development|
How to Develop a Curriculum
Opportunity to Participate in Pilot Test of Online Tutorial
Using the materials from its nationally recognized Primary Care Faculty Development Fellowship Program, OMERAD has created a self-paced course that includes short instructional videos and downloadable worksheets on:
Do you teach a course or workshop that you would like to improve? Do you have an idea for a new seminar or an elective that you would like to design? You may want to participate in the pilot test of How to Develop a Curriculum: A Self-Paced Tutorial.
The benefits of taking this self-paced course are:
- Conducting a needs assessment
- Analyzing feasibility
- Designing a curriculum (goal, objectives, content, and instructional and learner assessment strategies)
- Evaluating a curriculum
- You can take this course from your home or office when it is convenient for you
- When you finish the course you will have a curriculum designed and one unit of it developed, and a plan to help you develop the rest of it
We are going to pilot test the tutorial over a five-week period from January 12 to February 16, 2015. If you would like to participate, email us at [email protected] so we can register you for it. The course will be provided in Desire2Learn, MSU's learning management system. You must have an MSU NetID to access the course.
|Hot Off the Press|
- Yelon SL, Ford JK, and Anderson WA. 2014 Twelve Tips for Increasing Transfer of Training From Faculty Development Programs. Med Teach 36: 945-950.
- Obando C, Maurer J, Plantegenest G, Dokter C. The Use of E-learning Modules to Improve Student Knowledge in Obstetrics and Gynecology. MedEdPORTAL Publications; 2014. http://dx.doi.org/10.15766/mep_2374-8265.9920
The Office of Medical Education Research and Development is a unit within the College of Human Medicine at Michigan State University. Its mission is to improve medical education and related service programs through evaluation and research consultation, relevant instruction, and programs of faculty development.
Established in 1966, OMERAD is the oldest continuously operating office of medical education in the United States.
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