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Medical Education
Bridges Curriculum

Gaining Ground: Foundational Sciences Retreat Part I

"I'm not used to thinking this way!" confessed a basic science faculty member. Her admission was out of delight, really, over an exercise that asked faculty to flip the way they usually think of teaching medicine.

This frame-shifting moment was just one of many at last month's Bridges Curriculum Foundational Sciences retreat, where around 100 clinical and basic science faculty leaders, as well as student representatives, met to workshop and experiment with the new Bridges Curricular roadmaps. This exercise was just one of three that got participants into the Bridges mindset: integration of basic, clinical and systems sciences and inquiry. All three activities had us place modules, units, mini-courses, intersessions, specialty clerkships, and other elements onto the curricular roadmap. With our collective imaginations and expertise in hand, each small group quickly began filling it up with color-coded post-its. The room bubbled over with ideas—there was inevitably not enough time to capture them all.

For example, the first exercise asked us to perform a simple operation: map an ascendant basic science concept from introduction, consolidation, application, to advancement, and from Foundations 1 to Career Launch.

Epigenetics, for example, really got the wheels turning. Why is it important? How does it impact how we teach diverse subject areas such as genetics, cancer, neurodevelopment and public health? We modeled spiral learning: visiting the subject with greater depth and breadth with each new clinical and scientific implication across the 4 years. At first, the task seemed daunting. How do you teach a phenomenon whose importance is just emerging? Then, we realized all the opportunity—from new paradigms in genomics and disease etiology (Foundations 1 level) to our own pioneering laboratories where students could contribute to original research (Deep Explore). Teaching to the frontier forces us to always consider it from a place of inquiry: the questions that it opens up and allows us to ask and hopefully answer.

The second and third exercise is where the standard (Flexnarian) model—starting with basic sciences and building from there—was completely flipped. This time we started with a clinical scenario, working laterally to identify social and clinical correlates.  Again, we designed teaching elements to match, but started from the Career Launch phase of the curriculum linking back to the basic science to serve the clinic, in the end.

As Vice Dean of Education, Dr. Catherine Lucey reminded us, the facts of medicine are out there for anyone to access. What matters are the values and skills needed to integrate the facts effectively. The first exercises demonstrated the importance of thinking and acting holistically, multi-dimensionally, and systemically, linking science and society in the clinic. Furthermore, with a constant eye on Inquiry at all levels and years of the curriculum, enabled each topic or case to open to the unknown. We performed Inquiry as a habit of mind and asked ourselves, what is just on the horizon? What has yet to be solved? What tools do students need to solve it?

Then finally, we launched a lively Twitter stream on what is #UniquelyUCSF. For those who don't speak in tweets, we convened around just a few examples of our community's strengths, such as Women's Health, Health Policy, High Value Health Care, LGBTQ Health, and Cancer Care. We imagined ways to play to our strengths in the curriculum, stamping our graduates as #uniquelyUCSF. With one eye to the frontier, we kept the other on enduring understandings, that is, the core values and concepts that we honor even as we continue to innovate into the future. It was delightful to see the twitter stream fill up with different voices that represent some of the best of what UCSF has to offer. 

Next Week’s Post: How these building blocks add up to a new paradigm for Medical Education for the 21st Century.