ConnectMidwest

With the current drive to reform health care, it was no surprise to see a presentation focused on changing the way medical education is taught. In the Midwest MLA/MHSLA conference Concurrent Session Competency-Based Medical Education, Dr. Rajesh Mangrulkar shared about the University of Michigan program "ENCORE: Ensure Competence, Inspire Excellence" - and I was fascinated.

According to Dr. Mangrulkar, ENCORE has several meanings, but he prefers "Ensuring Competence in Outreach and Research in Education". This self-directed, collaborative, flexible, competency (rather than curriculum) based, and outcome (rather than objective) based program identifies nine competency domains, each related to existing ACGME competencies.

The goal of each is to focus on "what residents should be able to do when they leave" the program. "ENCORE will be organized around a set of 126 clusters of patient symptoms, and work to create outcomes that students must be able to demonstrate." This view of education was so radical, he noted, that "opening the box on the medical education program was like opening a can of worms."

The standard four years of lecture and tests with clinical experience beginning in year 3 will be replaced by lecture, self-directed focused study modules including pod- and webcasts, practical experience beginning in the first year, and no specific time-line for completion. Part of the goal is to cover the new fields of medicine such as personalized medicine, the global impact of health and disease, systems-based thinking, and information management. Part is to incorporate the many ways folks learn, part to promote life-long learning and part to focus on practicality and excellence.

The project has just reached the stage of identifying which of the 126 modules are appropriate for the equivalent of year 1. Obviously LOTS of questions remain on topics such as: How long is too long? How will costs be handled? Evaluation and review? Continuing education? Are there modules we shouldn't have eliminated? In what new ways will librarians interact with students and residents? I'm glad there are librarians on the ENCORE team!

For a brief description of ENCORE, visit the UMHS Inside View, page 3, at:
http://www.med.umich.edu/insideview/Volume3/Issue6/Sep_Oct_2008.pdf

Thank you Clare for asking me to blog this!

Holly Ann Burt
Outreach and Exhibits Coordinator
NN/LM-Greater Midwest Region
http://nnlm.gov/gmr/
haburt@uic.edu