CPM Spring 2020 - 13

daup h i n c m s .o rg

medical information. This is particularly
relevant since the USMLE-1 exam now
almost universally includes clinical stems
in the questions.

lectures are now usually video recorded. a full day every two weeks. Another model
Some students choose, rather than attending of multi-disciplinary longitudinal education
lecture, to view the recording at a later time. rotates different specialties by the day. To
This allows stop/start viewing and rewind integrate, longitudinal education could
to review more intensively. Enterprising rotate different disciplines by the day rather
Clinical instruction and clinical contact are and multitasking modern medical students than by the four, six, or eight-week period
offered to a much greater extent earlier in also sometimes simply use the audio of so that a student is experiencing a different
student development than was the case in the lecture and listen to it at double speed specialty every day. To provide continuity
previous decades. There are now numerous while exercising on a treadmill! This is some of these programs will allow back and
opportunities for clinical contact and learn- definitely a generational change in medical forth movement, for example, to follow-up
ing in American medical education. At Penn education. More recently, with the onset patients who may go to the operating room.
State Hershey these elements are included of the COVID-19 pandemic, classes have
by early introduction to systems-based moved online.
Another cutting-edge development in
education and patient navigation, in
medical school education is the completion
which students assist patients in accessing Another evolving change in medical ed- of medical school in three years. Penn
services and health resources. Students ucation is the development of residency State Hershey is one of the small number
also experience clinical skills instruction competencies, and the beginning of their of schools that has integrated accelerated
that is introduced in the first semester of migration into medical school education, programs into education over the past
the first year, with observed and critiqued as recommended by the Association of five years and this is an option that is
patient contact. Basic science integration American Medical Colleges. Penn State available in five specialty fields. In this
is also "back loaded" into the clinical years Hershey is currently on the leading edge program a student commits no later than
to increase cross integration of learning. I of integrating this transition. The AAMC the beginning of the second semester of
should mention that standardized patients recommends the evolution of grade- based the first year to an accelerated curriculum
('actors" who are given scripts to follow in educational testing with courses over a finite for completion of medical school in three
presenting as patients) are an increasingly period of time to include a more competen- years and a commitment to a particular
utilized resource in student education. cy-based skills development assessment, in discipline and that discipline's residency
Students practice history taking and physical which the development may vary over time. at Penn State Hershey at the same time. If
exam skills on this cadre of trained stan- The AAMC recommends skill competency the student is motivated, and committed to
dardized patients and sometimes address assessment in the same categories that the discipline, it can be an excellent choice
practice issues as well.
are used by residencies currently, which in saving a year of education and the cost
are patient care, knowledge for practice, of that year of education.
A more intensive advising system has practice-based learning and improvement,
emerged at Penn State Hershey over the interpersonal and communication skills, I do need to comment on what has remained
years and now includes a smaller number of professionalism, and systems-based practice, the same. Patients' need for a trusted,
trained faculty advisors to provide academic and suggest the addition of interprofessional accessible, and competent clinician has
advising as well as clinical skills instruction collaboration and personal and professional not changed. And clinicians-in-training
in small group settings, and in faculty development. Medical schools are invited continue to display the dedication and
offices and hospital settings. This provides to add additional elements and Penn State caring that gives me optimism for the future.
individualized clinical advising in small Hershey has added the areas of medical
groups of one, two, or three at a time, in humanities and critical thinking
There have been enormous changes in the
the first and second years of medical school.
practice of medicine and medical education
It also provides professional development Another change in medical education is over the last several decades. It has been a
through advising sessions and exercises such the evolution of the older block-based joy to me, as well as an adventure, to have
as personal improvement projects.
education to longitudinal style education. experienced these changes in both practice
When I was in medical school, each of the and education. It causes us to wonder, does it
Technology, of course, has changed the clinical clerkships in third and fourth year not, what substantial changes may appear in
nature of learning as well. An example of had a finite period of weeks, typically four practice and education over the next several
this is computer-based information that to eight, which I would spend in a partic- decades. But that is another adventure!
is often used to supplement face-to-face ular field. Now many schools, including
education. Some humanities courses, for Penn State Hershey, are experimenting
example, require students to review material with longitudinal education. The family
online prior to a large group presentation, medicine clerkship is entirely longitudinal,
followed by small group sessions. The with students assigned to family medicine
Central PA Medicine Spring 2020 13

http://www.dauphincms.org

CPM Spring 2020

Table of Contents for the Digital Edition of CPM Spring 2020