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Leader: Robert Kalayjian, M.D.
Design Team Members:
Drs. Donald Anthony, Ro= bert Bonomo, Bryan Davis, Neil Greenspan, Howard Meyerson,
Timothy O’Brien, Nora Singer, and Zahra Toossi
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Overview
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Strengths
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Challenges and Action Plans
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BLOCK 5 WEEK-BY-WEEK CURRICULUM (Fall, 2007)
WEEK 1: Patterns of Immune System Function
Patterns=
of
cellular and humoral immunity, including lymphoid development, cytokines,
antibody structure and function, gene rearrangements and complement
biology.
WEEK 2: Immunity at the
Molecular and Cellular Level
Mechanisms of immunit=
y,
patterns of immunopathology, T cell mediated immunity and antigen <=
/span>presentation, the ele=
ments
of mucosal immunity and autoimmune disease processes.
WEEK 3:=
Hematopoiesis a=
nd the
Host
Normal
hematopoiesis, to include red blood cells, platelets, and granulocytes. No=
rmal
and abnormal coagulation and thrombosis also will be covered.
WEEK 4: Aberrations in
Lymphoid Development
Normal
macrophage and phagocytic cell development and function, lymphomas, acute
leukemia, and stem cell and plasma cell disorders.
WEEK 5: Bugs and Drugs&=
#13;
Bacterial pathogens,
principles and mechanisms of antimicrobial therapy, as a window to underst=
and bacterial physiology.=
WEEK 6: Clinical Syndro=
mes
and Major Microbial Pathogens I
Mechanis=
m of
sepsis, clinical syndromes associated with skin and soft tissue infections,
mycobacterial infections and tuberculosis, fungal infections, and
viral infections due to DNA viruses (emphasizing human herpes viruses).
WEEK 7: Major Microbial
Pathogens II
RNA virus
(emphasis on influenza), exploration of HIV disease and its
immunopathogenesis, Malaria and an overview of infectious diseases that are prevalen=
t in
the developing world.
WEEK 8: Clinical
Immersion
Students=
will
become proficient in performing sexual histories and in conveying bad news=
to
patients; they will interact with hospitalized patients with serious
infections, and with either outpatients who have chronic WEEK 9: The Balance bet=
ween
Self and Non-Self
Builds on
immunopathogenic responses introduced in week 2, clinical manifestations of
autoimmunity encompassed by rheumatic diseases that include SLE,
scleroderma, , inflammatory arthritis, inflammatory myopathies, vasculiti=
s,
ankylosing spondylitis and Sjögren's syndrome.
WEEK 10: Skin as a Windo=
w to
the Immune System and Barrier to Infection
Inflamma=
tory
and bullous skin diseases, reexamination of mucosal immunity, normal skin
anatomy, physiology and its role in host defense.
The primary goal of Block 5 is to introduce and to integrate basic
immunologic mechanisms with diverse manifestations of human disease includ=
ing
immune deficiencies, autoimmunity, excessive immune activation, and
uncontrolled proliferation of immune cells. Important secondary themes
included hematology and clotting in health and in disease, an overview of
microbiology with major clinical syndromes of infectious diseases, and
principles of antibiotic therapy. This block also presented the opportunit=
y to
reinforce material from previous blocks (including inflammatory bowel dise=
ase,
and multi-organ involvement with sepsis).
=
•Optimal learning
resources for Immunology, Microbiology and Infectious Diseases:=
Challenge: Readings in immunolog=
y,
microbiology and infectious diseases were not sufficiently concise and
represented a consistent source of frustration to students. Students regul=
arly
turned to suboptimal reading sources that were of lower quality. Action Plan: <=
/span>Identify more concise
sources in immunology, microbiology and infectious diseases, and use updat=
ed
syllabi in selected sections to
•Time Constraints:
Challenge: The
team underestimated the difficulty in presenting an overview of microbiolo=
gy,
clinical syndromes of infectious diseases and antibiotics within the 2 ˝ w=
eeks
that this was allotted, while at the same time trying to cover selected
pathogens/ syndromes in detail (TB, endocarditis, malaria, HIV, sepsis).
Immunology was another area that required additional time to adequately co=
ver
essential topics. Action Plan: 1) Substitute Interactive Sessions for IQ cases during fir=
st
weeks of ID and Immunology sections. 2) Make better use of Thursday Review
Sessions to elaborate on topics introduced earlier in week. 3) Reduce and/=
or
move Research & Scholarship time slot and use that time for Block
content.
•Other improvements=
: Include at least one
pediatric IQ case; Greater emphasis on infectious diseases that students a=
re
more likely to encounter during their career; Move Clinical Immersion Week=
to
second last week of block so that students have exposure to all concepts p=
rior
to clinical experiences.
=
•Faculty: The section leaders w=
ere
consistently engaged and genuinely committed throughout the planning stage=
s,
expending formidable energies in organizing the curriculum. Faculty were
generally perceived by students as approachable, committed and interested =
in
student learning.
•Clinical Immersion=
: The immersion experi=
ences
provided most students with meaningful contact with patients who had disea=
ses
about which they had just learned, e.g. infectious diseases, hematologic
malignancies, rheumatologic, dermatological diseases. Students practiced t=
aking
a sexual history with standardized patients, and engaged in journal club
discussions of topics that addressed current and ethical conflicts relevan=
t to
the block.
•Assessment: Weekly SEQs were favo=
rably
perceived by students as a tool to reinforce learning. Students generally =
did
well on the SSEQ exam, which was intended to be challenging.
<=
/span>
•Pharmacology: =
Pharmacology was a ma=
jor
emphasis throughout the block. A list of key drugs was included at the end=
of
each section and many drugs (antibiotics, immune modulators, anticoagulant=
s)
were integrated into IQ cases and SEQs.
•Presentation of
Material: The
Inter=
active
Sessions
were generally well organized and clearly presented. The IQ cases stimulated in-depth
learning, and began to equip students with skills in differential diagnosi=
s.
Students also received detailed Learning Objectives at the end of each s=
ection
to focus their readings and studying. Thursday Review Sessions were used to elaborat=
e on
important content that was merely introduced earlier in the section.
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Goals and Objectives
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