Longitudinal Curricular Themes
Longitudinal Curricular Themes (LCT) are relevant, interdisciplinary curricular topics that are designed to encompass the skills and attributes that will make the College of Medicine student an excellent physician. The themes are interwoven into the four year curriculum and are meant to augment the integrated content. The College of Medicine is dedicated to integrating the following themes into the curriculum:
Ethics & Humanities
Medical ethics seeks to teach a method of inquiry. In this innovative curriculum, students move from basic ethic principles to a critical thinking framework in order to apply their skills and knowledge in topics and cases relevant to the human body, systems-based or clerkship curriculum.
- Discuss and review central moral, philosophical, and social issues in medicine and health policy.
- Reflect on physicians’ traditions and responsibilities in developing and implementing health care delivery.
- Develop critical skills for evaluating and responding to the moral and philosophical claims, arguments, and goals frequently encountered in medicine.
- Formulate, present, and discuss particular positions on moral issues in health care.
- Discuss relationships between moral, professional, and legal obligations of physicians.
- Develop basic skills in logic and critical thinking in medicine.
- Discuss academic mentorship, how to get it, and how to give it.
- Discuss principles of professionalism and their role in the practice of medicine.
- Demonstrate knowledge of the theories and principles that govern ethical decision making, and of the major ethical dilemmas in medicine.
The Gender-based Medicine LCT seeks to advance the medical student’s capacity to identify and address sex and gender-based differences in health care needs. The curriculum also encourages students to become sensitive to diversity and cultural and social factors including gender and gender power relations which affect health and illness worldwide.
- Discuss basic gender concepts: gender power relations, gender roles, access and control, manifestations of gender bias, gender equity and equality, gender as a social determinant of health.
- Explain sex and gender differences in normal development, health and illness (pathophysiology and psychopathology) as they apply to prevention and management of health problems:
- Compare differences in biological function, development and pharmacological response in women and men
- Discuss the pathophysiology, etiology, differential diagnosis and treatment options for conditions that are more common, more serious and/or have interventions that differ by sex/gender
- Discuss the pathophysiology, etiology, differential diagnosis and treatment options for conditions that are specific to each sex/gender.
- Effectively communicate with patients, demonstrating awareness of the doctor-patient power differential and gender and cultural differences. This will be demonstrated, for example, through use of language by the physician that minimizes power imbalances, validates patient experiences and minimizes gender stereotypes.
- Perform a sex-specific and gender-appropriate history and physical examination.
- Discuss the impact of gender-based societal and cultural roles and beliefs on health and health care of patients.
- Discuss the impact of gender-based societal and cultural roles and beliefs on the health and well-being of physicians.
- Identify and assist victims of physical, emotional and sexual violence and abuse.
- Assess and counsel patients for sex- and gender-appropriate reduction of risk, including lifestyle changes and genetic testing.
- Assess and critically evaluate new information through a ‘gender lens': identifying gender biases and gaps and adopting best practices that incorporate knowledge or sex and gender differences in health and disease.
- Discuss the differential impact by gender of health care delivery systems on populations and individuals receiving health care.
In concert with the AAMC’s Medical School Objectives Project, the Medical Informatics LCT has identified objectives and topics relevant to a practicing physician. The curriculum focuses on the skills and attributes that will advance the student in their role as researcher, clinician, educator/communicator, manager and life-long learner.
- Bethany Ballinger, M.D.
- Nadine Dexter, MLS
- Using Evidence Based Medicine (EBM) principles to develop information habits to maintain currency.
- Demonstrate basic computer skills and how to manipulate and use information in common computer applications.
- Demonstrate the ability to utilize mobile devices and determine which mobile software is best suited to various tasks.
- Demonstrate knowledge of information resources available at the health sciences library and their use to support life long learning.
- Use a clinical encounter to formulate a “Patient Intervention Comparison Outcome” (PICO) /clinical question.
- Demonstrate the ability to use MEDLINE to conduct literature searches to locate articles.
- Critically review a published research report/article.
- Demonstrate fluency with electronic health records systems.
- Identify resources available for patient education.
- Discuss the role of the Personal Health Record (PHR) in communication with patients.
Nutrition plays a major role in healthcare today. The Nutrition LCT has been integrated into the medical school curriculum to train physicians who can effectively provide nutrition care for the prevention and management of chronic diseases.
- Robert Karch, M.D., M.P.H., FAAP
- Explain nutritional guidelines and recommendations and recognize their limitations.
- Explain steps in converting macronutrients to usable form of energy, ATP, including digestion, absorption and metabolism.
- Recognize that nutrition, physical activity, and health lifestyle behaviors can have direct, substantial, and long-term effects on growth and development, health maintenance, and disease prevention and treatment.
- Conduct an appropriate nutritional assessment on all ambulatory and hospitalized patients, including those with acute or chronic disease as well as healthy individuals of all ages.
- Conduct an appropriate physical examination in a patient of any age, including anthropometrics; select appropriate laboratory tests and procedures to diagnose and treat nutritional conditions such as over- and under-nutrition in hospitalized and ambulatory patients. Identify appropriate nutritional therapies.
- Apply nutrition recommendations specific to disease state when appropriate.
- Recognize common drug nutrient interactions.
- Demonstrate skills to counsel patients to make informed nutritional decisions consistent with adopting and maintaining a healthy lifestyle and with establishing appropriate dietary, exercise and behavioral goals.
- Employ effective culturally sensitive counseling techniques matched to the patient’s level of motivation and readiness for change, with appreciation for various behavioral change theories.
- Recognize how personal, environmental, and social factors interact and impact on eating behaviors and overall nutrition.
- Demonstrate sensitivity to biomedical and nutritional changes as well as psychological, life stage related, cultural, religious, social, and ethical issues that affect patient care.
- Recognize the importance of using a multi-disciplinary team approach in nutritional health care.
- Demonstrate thorough understanding of application of evidence based information in addressing nutritionally related questions for health and disease; as well as answering questions related to contemporary trends in food and nutrition.
- Demonstrate a personal commitment to serve as a positive role model for patients by maintaining a healthy personal lifestyle, and by taking responsibility for your own health.
- Recognize role of food in environmental and socially conscious issues.
- Effectively communicate with patients to provide accurate nutritional information and dispel misinformation, including information about dietary supplements, nutraceuticals, functional foods, and fad diets for weight loss, disease prevention and treatment.
Geriatrics and Principles of Palliative Care
Almost one out of eight Americans is 65 years of age and older. This number will more than double during the next 30 years. The management of multiple chronic illnesses and geriatric syndromes requires a different approach than the traditional “curative” medical model. To ensure our students have an appreciation for the nuances of caring for the aging population, the college has developed curricula that seeks to improve the student’s sensitivity and knowledge regarding geriatric issues.
The Principles of Palliative Care curriculum was designed to enhance the medical student’s skills and knowledge regarding the relief and prevention of suffering in patients with advanced or life-threatening illnesses.
- Explain the impact of age-related physiologic changes on drug selection and pharmacologic effects of medications.
- Define and distinguish the clinical presentations, diagnostic evaluation, and management of delirium, dementia, and depression in older adults.
- Assess and describe baseline functional abilities (such as activities of daily living) by collection of history from multiple collateral sources in older adults.
- Assess and describe fall risk and balance disorders in older adults, developing diagnostic and treatment strategies where needed.
- Define and differentiate among types of advance directives, health care proxies, and code status in local health care systems.
- Identify age-related physiologic changes in various organ systems.
- Discuss palliative care and hospice treatment options in the context of end-of-life care.
- Assess and provide diagnostic and palliative treatment strategies for pain and non-pain suffering consistent with older adult patients’ goals of care.
- Identify potential hazards of hospitalization for older adult patients (including functional decline, delirium, medication side effects, malnutrition, pressure ulcer, and hospital acquired infections).
- Explain the clinical indications, risks, , and possible alternatives to indwelling urinary catheters in older adults.
- Explain risks, indications, and alternatives to physical and pharmacological restraint in patients with dementia and delirium.
- Define and distinguish the clinical presentations, diagnostic evaluation, and management of unintentional weight loss in older adults.
- Identify potential safety hazards that increase the risk of falls in older adults.
- Identify basic concepts of palliative care and its role within the continuum of care.
- Discuss the etiology of pain and the diagnostic and therapeutic strategies for evaluation and management of pain.
- Identify the pathophysiology and management options of other common distressing symptoms at the end of life (such as dyspnea, nausea, dysphagia, stomatitis, etc.).
- Identify the psychological symptoms associated with advanced/terminal illness (such as depression, anxiety, restlessness, agitation, etc.).
- Identify basic ethical & legal issues surrounding end-of-life care (such as advance directives, feeding & hydration, withholding & withdrawal of treatment, etc.).
- Explain the concept of patient-centered care.
Culture, Health, and Society
Physicians care for individuals from a wide variety of backgrounds. The delivery of high-quality healthcare that is meaningful, acceptable, accessible, effective, and cost efficient requires a deeper understanding of the sociocultural background of patients, their families, and the environments in which they live. The Culture, Health, and Society LCT encourages students to reflect on their own cultural values, assumptions, and beliefs and identify how those values can influence the provision of clinical care and the patient-doctor relationship.
- Demonstrate knowledge of the social determinants of health, population health concepts, and key national and global population health initiatives.
- Define health disparities and health equity and discuss the impact of efforts to eliminate disparities, in the US and globally, in the following areas: racial/ethnic, gender, LGBT, disabilities, age, geographic, and low social/economic status.
- Demonstrate knowledge and skill in cultural competency as defined by Betancourt 2002 as the “ability of systems to provide care to patients with diverse values, beliefs and behaviors, including tailoring delivery to meet patients’ social, cultural, and linguistic needs”.
- Demonstrate knowledge and skills in cross-cultural communication and linguistic competence, with particular emphasis on basic medical Spanish.
Patient safety has become a national topic since a 1999 Institute of Medicine report estimated that medical errors kill almost 100,000 people per year. Follow-up surveys of medical schools found that young doctors in training did not feel they received enough in-depth education in patient safety. In response to this issue, the WHO (World Health Organization) developed a patient safety curriculum to be taught in medical schools. UCF College of Medicine was invited to become a pilot site for evaluation of the patient safety curriculum along with 10 medical schools in countries across the world.
- Understand the complex interaction between the health care environment, doctor and patient.
- Aware of mechanisms that minimize error, e.g., Checklists, clinical pathways.
- Know the main sources of risk in the clinical workplace.
- Understand how personal limitations contribute to risk.
- Promote risk awareness in the workplace.
- Understand the nature of error and how healthcare can learn from error.
- Understand the harm caused by errors and system failures.
- Aware of principles of reporting adverse events.
- Understand the relationship between human factors and patient safety.
- Apply human factor thinking to the workplace environment.
- Understand the importance of teamwork in healthcare.
- Know how to be an effective team player.
- Understand prudent antibiotic and antiviral selection.
- Practice correct hand washing and aseptic technique.
- Always use methods to minimize transmission of infection between patients.
- Know the medication most commonly involved in prescribing and administration errors.
- Know how to prescribe and administer medications safely.
- Know the procedures for reporting medication errors and near misses in accordance with local requirements.
- Be able to describe the principles of quality improvement.
- Know how to perform improvement activities and use of tools.
- Understand principles of good communication and its role in effective health care relationships.
- Communicate with patients and carers in ways they understand.
- Involve patients and families in discussions about their care.
- Maintain privacy and confidentiality.
- Develop strategies to deal with the difficult or vulnerable patient.
- Understand principles of open disclosure.
- Ensure patients and families are supported after adverse events.