Midway through planning to revamp its entire first-year curriculum for fall 2004, the School of Medicine implemented this year Molecules and Cells, a new interdisciplinary class modeled in the direction of the broader curriculum revision.
Officials planned the course as the first of three classes that will eventually comprise the first year, each designed to integrate concepts of basic science with one another and add clinical relevance to first-year medical school courses.
The class debuted this fall - replacing biochemistry, cell biology and genetics - and has suggested to medical school administrators some of the problems that the new integrated classes may face, particularly in light of questions raised about the quality of the Curriculum Committee's planning efforts.
"Molecules and Cells is a prototype headed in the direction of the new curriculum," said Dr. Emil Petrusa, associate dean of curriculum assessment. "The plan for Molecules and Cells looked pretty good on paper. It was the implementation that ran into problems."
Calling the problems with organization and congruency standard issues in any first-time class, administrators remain optimistic about the future of the class.
"The problems come into fact, that any time you do something the first time out, there's going to be glitches, you're not going to meld it together like you'd like, and some of that happened," said Dr. Edward Buckley, associate dean of curriculum development.
Last winter, the professors who coordinated biochemistry, cell biology and geneticsâ??the three classes that have previously comprised the first block of classes for first-year medical students - began discussing integrating the classes into Molecules and Cells. Dr. Mariano Garcia-Blanco, one of the Molecules and Cells course directors, said the discussions were motivated in part by the professors' association with the Curriculum Committee, which is overseeing the impending curricular overhaul set for 2004. However, they stemmed primarily from a desire to communicate the overlap of various scientific fields, he added.
"The Curriculum Committee provided a structure and a mandate that this be done," he said. "But the bottom line is that these classes have been taught together, and the divisions between the sciences are starting to become more and more vague."
Garcia-Blanco and his class co-directors, biochemistry chair Dr. Christian Raetz and cell biology associate professor Christopher Nicchitta, developed lectures over the next several months that attempted to integrate the concepts of the traditional classes and combine them with relevant clinical applications so that students would understand how basic science classes related to actual patients.
The directors planned class time together and frequently sat in on other professors' lectures, but the class encountered several unexpected obstacles. Many students saw the class as disorganized and lacking congruency.
"I appreciate that they were trying to give us more clinical information," said Jennifer Grad, a first-year medical student. "I think that a lot of the disorganization was because there were three course directors and no one overseeing it all."
However, students' major complaints centered around the tests. None of the three tests reflected the interdisciplinary nature of the class or the clinical emphasis of the lectures, students said.
"People felt that they had learned a lot of material going into the exams, and people didn't feel that the exams reflected that," said Sujay Kansagra, a first-year medical student and class president. "Students actively complained about it. We wrote a letter to the faculty and let them know how we felt."
Administrators and faculty say many of the problems are related to a lack of educational support and they hope to have more help coordinating lectures and developing tests in years to come. The medical school has recently hired someone full-time to assist with such problems, but faculty members say more are needed.
"We basically need more support," Nicchitta said. "What we're looking for is for the medical center to fund a person who attends every lecture, takes notes on every lecture and who can assist in the formation of tests."
Buckley said the course's quality was not high enough to recommend reforming the whole first-year curriculum in the same style, but it was not designed that way, he said.
"Not enough effort was put in at the time to put it as a test, but I think the concept, even from the instructors' standpoint, was such that this does make some sense," Buckley said.
Next year the class will have a fourth director who will oversee the clinical integration and test development. "We will look at what students said [in evaluation forms], but in the end, we're going to do what we think is best, whether students like it or not," Garcia-Blanco added.
Mike Miller contributed to this story.
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