Changing The Way Doctors Learn
The Medical Education Research Unit at Mount Sinai has developed a curriculum that has changed the way doctors are educated and has proven that these changes actually improve patient outcomes. Its a true win-win for Mount Sinai, its physicians and patients, and it is revolutionizing the way medical school graduates are trained.
Residency training programs give new doctors just out of medical school their practical training. Called “residents,” these new doctors take care of patients under the supervision of experienced physicians. They also attend lectures on disease and treatment. Mount Sinais residency training programs are unlike any other in the country, thanks to a progressive research project that began in July 2005.
The hospital is reexamining the skills needed to be a good doctor. Medical knowledge is obviously important, but there are other essential tools for taking care of patients and their families and working effectively within the medical community. “We want to produce young physicians who are compassionate and well rounded, who understand the larger medical system and are committed to self directed learning,” said Gloria Weinberg, M.D., director of the Internal Medicine Residency Training Program at Mount Sinai.
Can these doctors communicate with their patients and colleagues? Are they listening to their patients? Do they understand their role in the hospital setting? Do they have good people skills? Are they treating all the staff and patients in a professional way? Do these doctors continue to learn throughout their careers? These are the kinds of questions being asked.
In the past, residents were evaluated by their supervising doctors and their peers. At Mount Sinai, they are evaluated by their patients, their peers, their supervisors and the nurses and staff with whom they work.
Patients enjoy being part of the process, offering feedback about their experiences and helping mold better doctors. Nurses are asked whether the residents have been professional in taking care of paperwork and writing orders. The residents themselves are asked whether they feel confident in their technical abilities and their personal skills. Dr. Weinberg says the answers are often surprising and they provide an opportunity to better mentor young doctors and identify their strengths and weaknesses.
This new approach also gives doctors in the program a chance to broaden their views on what it means to be a good physician. “The program enables the students and their teachers to change and encourages them to be more flexible,” Dr. Weinberg said.
The new and innovative educational program at Mount Sinai adapts to the students so they can spend more time concentrating on areas in which they feel deficient. The curriculum includes the most common diagnoses that the residents will encounter and reflects the reality of what residents see on a daily basis. “This is called a practice pattern-based curriculum,” said Richard Isaacson, M.D., director of the Research Unit in Medical Education. “A lot of this is common sense. Young doctors are really excited and willing to do this. They see that both their patients and their education benefit from the new curriculum. Everyone really wins.”
The Research Unit has set out to prove that this new curriculum actually improves patient outcomes. “Doctors make patient choices based on evidence-based medicine,” Dr. Isaacson said. “That means doctors use the treatments and procedures that are proven to be effective. Its no surprise then that an evidence-based curriculum would be developed to train doctors.”
The research indicates that the changes developed at Mount Sinai have affected patient outcomes in a positive way. “This is an area of research that hasnt been explored,” Dr. Isaacson said, “so theres great interest in what were uncovering. This is research that can be adapted to fit any specialty, is flexible, a no-brainer and free for anyone to use.”
In July 2006, the Accreditation Council for Graduate Medical Education will require all accredited residency training programs to show that they are making “data-driven” improvements. They must prove, as Mount Sinai has already done, that the way they train their doctors makes for better patient care. Mount Sinais Residency Training Programs and its Research Unit are blazing a trail that will improve health care across the country.
