User's Guide

Specific Suggestions for Use of Collaborative Curriculum Project (Preclerkship) Component

Our focus was developing a description of competencies that (we believe) all students should achieve prior to beginning their clerkship year (using the ACGME domains). We focused on clinical competencies, at the whole person or above in Engel's hierarchy. We stayed away from areas usually taught in the traditional basic sciences. Since much of an existing preclerkship curriculum might be filled with basic science content, one can augment the curriculum with the clinical focus provided in the preclerkship resource.

The Competencies document is organized by six ACGME domain files at
http://fammed.musc.edu/fmc/data/Preclerkship/
Each domain begins with a paragraph that summarizes the more detailed learning objectives that follow.  Providing those paragraphs to medical students would be one way to begin to introduce them to the areas of competency that they'll hear a lot about in residency.

The competencies document is fairly detailed, and includes components we hope will be helpful to directors who are developing a course (or subset): exemplary educational resources, assessment methods, and implications for faculty development.

The detailed description of competencies in each domain could be used as a checklist for:

• Students' self-assessment (this could be daunting if your curriculum hasn't included clinical experience early, but could be used as a tool to communicate the necessity for such an experience if that does not exist)
• The course master or curriculum committee that coordinates the M1-2 years
• M3 clerkship directors to use to assess students' skills on entering the clerkships
• The committee that coordinates an end-of-M2 clinical skills assessment or OSCE

We hope that the sweep of our document emphasizes key areas that transcend the individual domains:  being patient-focused; physician's responsibility to monitor and improve outcomes; self-awareness and professionalism; and commitment to life-long learning. Emphasizing these areas as a spectrum of developing skills could be helpful.

The Areas for Greater Emphasis document at
http://fammed.musc.edu/fmc/data/preclerkship/preclerk_priority_areas.htm
may help you in choosing what you can include during a limited focus for curriculum change and what you can't.

As one reads through our Competencies document,   the level of competency we say should be achieved prior to beginning the clerkship year may appear   ambitious.  Our rationale was that students should be aware of the need for building competencies in all these areas; and require an introduction in the early, most impressionable years to develop the requisite attitudes toward their importance (e.g., cultural and contextual competency; evidence-based practice). Further, it is designed specifically as a resource, and therefore is not prescriptive; faculty at different schools can decide to use all or parts as best fits their needs and local situation.

One last point about curriculum change and innovation drawing on the CCP resources.   Among the files comprising the "Competency based Curriculum Resource for Pre-Clerkship Education (using ACGME structure)"
http://fammed.musc.edu/fmc/data/Preclerkship/PreBudget.htm
is a file entitled BUDGET.   This section provides information concerning the budgetary implications of revamping a preclerkship curriculum which draws on the suggested competencies and resources. This section may be well worth reviewing earlier rather than later in the process of making curriculum revisions.

For questions or comments, please contact Webmaster or Ardis Davis

This page last updated October 22, 2004