West Virginia University School of Medicine

Medical Education Program Highlights West Virginia University School of Medicine (WVU SOM) has made major strides in the last decade in developing innovative educational experiences. An example is the implementation of 8 curricular threads that ensure deliberate vertical integration of content throughout the curriculum. Threads such as ultrasound have leveraged innovative technology to prepare learners for future practice. Diversity, inclusion, and health care disparities threads prepare graduates to treat patients from all backgrounds. The creation of the Mountaineer Accelerated Track To Enter Residency (MATTER) Track allows second-year students to apply for an accelerated curriculum that guarantees a residency position at 1 of 3 clinical campuses. Curriculum Curriculum description See Supplemental Digital Appendix 1—Curriculum Map—at https://links.lww.com/ACADMED/A927. Curriculum changes since 2010 The Curriculum Committee approved a new curriculum model with anticipated implementation in fall of 2020. The new curriculum seeks to: Expand content in emerging fields with increasing relevance for future practice and abridge content areas Rearrange content so normal physiology is integrated with organ system–based units Introduce content traditionally taught in the second year (microbiology/immunology, pathology, and pharmacology) to first-year foundations courses Use distance learning so students may engage in longer selective experiences between first and second years Realign clinical skills and basic sciences content between concurrent courses Reduce scheduled contact time to an average 18–20 hours/week Allow students to enter clerkships more expediently Medical education program objectives WVU SOM program objectives are based on the ACGME domains of competence. The SOM adopted the ACGME core competencies and program-level objectives (PLOs) in 2010. The Curriculum Committee requires that all courses and clerkships develop learning objectives aligned with PLOs. This process ensures that courses and clerkships learning objectives are aligned with both institutional PLOs and attainment of core competencies. Each course and clerkship syllabus states learning objectives, their alignment with PLOs, and methods of evaluation. The committee reviewed and updated the PLOs in May 2014 and again in 2019. The most recent review was completed in conjunction with implementation of the new curricular model. See Supplemental Digital Appendix 2—Program Objectives and Assessment Methods—at https://links.lww.com/ACADMED/A927. Assessment The Curriculum Committee referred to the MedBiquitous standardized vocabulary of assessment methods and encouraged course/clerkship directors to explore new ways to capture evidence of student learning and its development. We have made significant strides in furthering portfolio-based assessments. Academic advisors are leveraging this system to collect data and samples of students’ academic and professional performance. Students submit annual reflections about their goals and career aspirations. Advisors couple these reflections with other data such as NBME examinations, narrative assessments, and performance-based assessments, to help students identify fourth-year electives needed to address any deficiencies in the core competencies and provide a better transition to GME. Parallel curriculum or tracks The culinary and lifestyle medicine track aims to increase the number of physicians who have an understanding and appreciation of nutrition, food science and preparation, and lifestyle management. In the fourth year, students may sit for the national Culinary Medicine Certificate Exam. The global health track provides additional training for current students and also attracts students with an interest in global health. Graduating students are eligible to sit for the American Society of Tropical Medicine and Hygiene national exam. The rural health track begins the summer before program matriculation with a rural shadowing experience, followed by subsequent experiences during clerkships culminating with 2 months rotating in a rural medically underserved area of the state during the fourth year. The MATTER track provides students with a fast-track curriculum option to graduate earlier. The program trims off 1 semester and transitions students to select residencies at any of WVU’s clinical campuses. MATTER students complete the curriculum in 137 weeks as opposed to 153 weeks, with no additional or modified learning outcomes. This track seeks to present a career option for students who are committed to a MATTER specialty, address student debt by minimizing costs of medical education without losing academic quality, efficiently transition medical students into a residency program, and attract talented students to become resident physicians serving the needs of our communities. Pedagogy The SOM uses a broad range of pedagogical approaches, including: Problem-based learning: This is a case-based small-group course using peer teaching and requiring students to develop learning objectives. Public health: Students perform a self-directed learning exercise that includes locating and assessing a research article, presenting it online, and engaging peers in their presentation. Physical Diagnosis and Clinical Integration: This course sequence offers innovative simulation and standardized patient encounters including a male urologic teaching assistant and a gynecologic teaching assistant experience, in which specially trained standardized patients teach students proper exam techniques. These experiences occur in the David and Jo Ann Shaw Center for Simulation Training and Education for Patient Safety, accredited by the Society for Simulation in Healthcare in all 4 areas, a designation held by fewer than 25 of the 700 accredited centers. The third-year clerkships offer robust simulation experiences. Surgery offers a lines and tubes experience to help students understand proper utilization of the many surgical implements they will encounter. The Curriculum Committee has made an effort to reduce contact hours from about 22–24 contact hours a week to 20 hours per week, averaged across the semester. The reduction should further student wellness and enhance self-directed learning. Limiting the amount of contact time has challenged faculty to reconsider traditional pedagogical practices, for example, converting traditional 50-minute lectures to a series of 15- to 20-minute recorded didactics coupled with team-based learning, case-based large-group discussions, or simulations. Clinical experiences After completing the pre-Step 1 curriculum and taking the USMLE Step 1 examination, students transition to regional campuses. Approximately half of students remain in Morgantown, with the majority of their clinical experiences completed at WVU Hospitals in Morgantown. About 40% of students transition to the Charleston campus and complete most of their required rotations at the Charleston Area Medical Center, composed of 3 hospitals and ancillary clinics. Both the Morgantown and Charleston campuses contain the state’s only Level 1 trauma centers. Approximately 10% of each class transitions to Eastern and spend the majority of required clinical experiences at 2 rural hospitals in the WVUMedicine system. Required longitudinal experiences Eastern campus students rotate through longitudinal experiences divided into 2 modules. One includes family medicine, pediatrics, and obstetrics–gynecology clerkships; the other includes internal medicine, psychiatry, neurology, and surgery. The Eastern Division, in the eastern panhandle of the state, is associated with smaller, community-based hospitals. The integrated curriculum at Eastern allows for greater utilization of continuity clinic. Despite these differences, core content, learning outcomes, and required clerkship procedures and encounters remain the same across the 3 campuses, and students perform at an equal caliber to Morgantown and Charleston students on internal and national assessments. Clinical experience first encounter The SOM wastes no time integrating students into clinical experiences. Beginning in the first term, students in the Physical Diagnosis and Clinical Integration course complete 5 physician and 5 community shadowing experiences. A primary objective of the physician shadowing experience is to facilitate student comfortability in the clinical environment and around patients. Shadowing enables students to observe master clinicians and the communication skills they employ during encounters. Students can choose their community experiences from options including support groups, chaplaincy, community pharmacies, health departments, dental clinics, physical therapy, and other experiences. Required and elective community-based rotations All third-year students complete 4 weeks of their family medicine clerkship with a community-based preceptor. All fourth-year students complete the rural community–based care rotation, which requires completion of 4 weeks at a community clinic or hospital in any discipline. Students complete a number of community-based shadowings early in their medical education. Two student organizations have been developed to serve locally underserved populations. The Multidisciplinary Un-Sheltered Homeless Relief Outreach of Morgantown and the Charleston Homeless and Street Medicine programs focus on outreach specific to local homeless populations. All students must complete 100 hours of community service/service learning for graduation. Students embrace this expectation, often exceed the 100-hour requirement. The 2019 graduating class averaged more than 135 hours of service. Curricular Governance The Curriculum Committee is an autonomous decision-making body but relies on other organizational units for support. The Department of Medical Education provides administrative support for the committee including assessment resources such as experts in evaluation, curriculum mapping, and in general, educational expertise. The associate dean also interfaces with various groups to ensure potentially needed resources are taken into account and considered by individuals such as the associate dean for finance for things like the designation of new course or clerkship directors, expansion of threads, etc. Department leadership also serves as a representative and advocate for the MD curriculum at committees that address logistical issues such as management of academic space. See Figure 1—Curricular governance.Figure 1: Curricular governance.Education Staff Medical education leadership WVU SOM’s Department of Medical Education provides administrative and academic support for the MD curriculum. The department’s founding chair, Dr. Norman Ferrari, is also vice dean for education and academic affairs for the SOM. The department is composed of 3 divisions: CME, GME, and UME. A primary organizational function under the UME division is student services, under Dr. Scott Cottrell, associate dean for student services and curriculum. Student services provides various mechanisms and levels of support for students and delivery of the curriculum. See Supplemental Digital Appendix 3—Organizational Chart—at https://links.lww.com/ACADMED/A927. Department of Medical Education The Department of Medical Education serves a support role for UME, GME, and CME. Leaders of all 3 departmental divisions report directly to the vice dean. A primary function of UME is providing student services. An administrator with a background in social work directs the Office of Student Services, which helps ensure that wellness activities are closely aligned to support student needs. Faculty of the Department of Medical Education includes educators with either primary or secondary appointments who have demonstrated commitment and expertise in medical education in areas such as curriculum design, teaching skills, medical education research, simulation, or assessment. It serves as an academic home for full-time faculty and community-based faculty physicians who contribute to the SOM’s education mission. Faculty Development and Support in Education Professional development for faculty as educators Teaching Scholars Program: A 2-year longitudinal program for faculty members is offered by the Faculty Development Office. Summer Teaching Scholars Institute: The curriculum for the longitudinal Teaching Scholars Program is converted into a 5-day interdisciplinary emersion seminar. Role of teaching in promotion and tenure Quality of teaching is evaluated based upon student evaluations, peer evaluations, and evaluations by course directors. During promotion and tenure review, quantity and quality of teaching (and improvement) for the entire time at rank are considered. Outstanding faculty members are publicly recognized at the Dean’s Awards for Excellence ceremony each spring. Additional programs celebrating teaching excellence and providing opportunities for developing teaching skills are operated by the Faculty Development Program, including the Academy of Excellence in Teaching and Learning, the Teaching Scholars Program, and the Summer Teaching Scholars Institute. The WVU SOM Academy of Advisors mission is to “connect medical students with distinguished faculty who can offer advising, mentorship, and career development guidance.” The academy is composed of SOM faculty across a number of disciplines from the 3 campuses, offering training sessions and regular meetings each semester. Guest speakers at Academy of Advisors meetings discuss topics relevant to advising, assessment, evaluation, teaching, and supervision of medical students. Regional Medical Campuses WVU SOM is composed of 3 total campuses: Morgantown, the main campus, which includes instruction of all 4 years of the curriculum; and 2 regional clinical campuses for the third- and fourth-year levels. See Table 1—Regional Clinical Campuses.Table 1: Regional Clinical CampusesEducational experiences across sites All SOM required clerkships use a single online educational environment site, which presents a unified statement of the learning objectives and evaluation. Clerkship and rotation directors from the 3 campuses meet individually at least twice annually. The Assessment Subcommittee reviews evaluations from each clerkship and campus and designates remediation plans when any campus drift is identified. A single Committee on Academic and Professional Standards regularly reviews students’ academic and professionalism performance for all campuses, which includes ensuring consistent and comparable grading methods and assessments

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