Integrated Curriculum: A Dissection of the Bachelor of Clinical Medical Practice Degree Programme at the University of Witwatersrand, South Africa

Presented by Scott Smalley, PA-C, Clinical Associate University of Witwatersrand Division of Rural Health Department of Family Medicine IAPEA Conference, September 2013

History

• Bachelor of Clinical Medical Practice Degree

• Three-Year Bachelor Degree’ Started in 2008

• Accepts High School leaver students (age 19 years old)

• Qualified to practice medicine as a Clinical Associate, under supervision of a doctor

• Education Task Force established in 2005 to set Exit Outcomes, approved by Health Professionals Council of South Africa

• Three Universities began the Clinical Associate Programme, each with different curriculums

Integrated Curriculum

Search of Medical Education Journal, Journal of the Association of American Medical Colleges, Journal of American Academy of Physician Assistants

“A Dissection of the BCMP Programme at Wits”

• Only three academic courses; YEAR 1, 2 & 3

• Integration of:

• Teaching Methodologies

• Medical Subject disciplines

• Teaching, Learning and Practice

• Content spirals throughout three years

SCMD 1001: The First Year

• Academic year is 41-45 weeks

• 60 Students per course (year)

• Yr 1 & Yr 2 Divided into 4 teaching blocks

• Yr 3 is traditional 2nd year of Physician Assistant program with 6 clinical rotations, each 5 weeks in length

• Year 1 is an Integrated Curricular Model • Traditional lectures in classroom

• Tutorial Based Learning with medical cases

• Patient Based Learning with students run

• Medical Skills & Procedures in skills laboratory

• Supervised Clinical Practice in hospital wards & OPD

Yr 1: Block 3 Patient Case Model

Yr 1: Week at a glance Monday Tuesday Wednesday Thursday Friday

All Students: TBL/Lectures on Patient Case Model- Genitourinary System Anatomy & Physiology

Group 1 & 2: Clinical Practice – OPD at Lilian Ngyoi Clinic

Group 1 & 2: Skills: Male Genital Examination

Group 3 & 4: Small Group Cases in Class – UTI, STI’s

All Students: TBL/Lectures on Patient Case Model- Laboratory Investigations, Medical Conditions Pharmacology,

Group 3 & 4: Small Group Cases in Class – UTI, STI’s

Group 3 & 4: Skills: Male Genital Examination

Group 1 & 2: Clinical Practice – OPD at Lilian Ngyoi Clinic

YEAR 2 BCMP Curriculum

YEAR 2: Case Based Learning

YEAR 2: Teaching, Learning & Practice

• Integration of

• Medical knowledge

• Patient Consultation Skill

• Documentation

• Laboratory Studies & Interpretation

• Clinical Procedures & Examinations

• Medical Pharmacology & Therapeutics

• Ethics

• Professionalism

• Counselling

YEAR 2: Clinical Experience

• 12 weeks in block 2 following Adult Medicine

• 9 weeks in block 4 following Maternal Health & Paediatrics

• 6-8 students at a clinical site- District Hospital

• Rotate through appropriate clinical areas

• Students meet weekly for self-run groups: • Patient Based Learning

• Peer-2-Peer Presentations

• Tutorial Based Learning Groups

• CME, Afterhours in Casualty

• Student Portfolio of logged Pt consultations, procedures

Clinical Manager Comments

• “Theoretical knowledge is excellent” • “Good clinical skills” • “Their knowledge is beyond their years – exceptional” • “They are able to do ward rounds which freed me up

for theatre” • “Thorough with patient history and documenting”

Conclusion

• “New knowledge and understanding arise through working on the problem rather than in the traditional approaches in which the new knowledge is a prerequisite for working on the problem.”

Learner centred approaches in medical education

John A Spencer, senior lecturer in primary health care and Reg K Jordan, professor of medical education. BMJ. 1999 May 8; 318(7193): 1280–1283.

Thank You