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- About Us
Past, Future Converge to Shape
Healthcare Education on the Prairie
By Richard N. Van Eck, PhD
Last September, we welcomed the future healthcare workforce for North Dakota into the new 325,000-square-foot University of North Dakota School of Medicine and Health Sciences building. As
impressive as this building is, both outside and in, the real story lies in its design. People and teaching practices are the lifeblood of a learning institution—no amount of steel, concrete, and glass can teach students. That is why we designed our building around the best evidence-based teaching practices, and why our people, supported by this space, represent a new era in healthcare education.
As forward thinking as this building is, it represents less a change in direction than an amplification of our culture of teaching innovation that has been decades in the making. The School was among the
first to fully integrate problem-based learning (patient-centered learning) into the medical curriculum in 1998 and, in 2006, to mandate an Interprofessional Healthcare course for thousands of students. These are not the only examples of how our building and curriculum are reflections of our core beliefs and practices.
The medical curriculum recently adopted the Association of American Medical Colleges’ new set of physician guidelines, the Physician Competency Reference Set (PCRS). Domain 7 of the PCRS focuses on interprofessional collaboration—the ability of health professionals to interact in teams to provide the best possible patient care. Our building is designed to support interprofessional education (IPE).
Our professional programs used to be located in different buildings across campus. Now, all nine are collocated, making interprofessional exposure an everyday occurrence. Under the leadership of Senior Associate Dean for Education Dr. Gwen Halaas, we designed eight interprofessional student-learning
communities (LCs) with group collaboration rooms, quiet study spaces, clinical exam practice spaces, open community gathering spaces, and kitchens. Students from all programs are randomly assigned proportionately to each LC for the duration of their studies. The SMHS is the first U.S. healthcare educational provider to institute LCs on this scale, and we just collected our third round of data on the impact LCs have on interprofessional collaboration. What we learn will inform healthcare education practice nationally.
Like healthcare itself, teaching also continues to evolve and so do we, as evidenced through our history of innovation and the design of our classroom and learning spaces, all of which emphasize active learning (AL). AL maximizes group interaction around problem solving under the guidance of an
instructor who facilitates rather than lectures. Meta-analyses have shown unequivocally that AL produces powerful learning outcomes across multiple domains and settings.
While AL can be implemented anywhere, careful design of space can facilitate AL, which is why our 200-plus seat auditorium allows chairs to be rotated 360 degrees so learners in adjacent rows can easily collaborate. Four of our large classrooms have tables with monitors for students to use in collaborative problem solving, and all simultaneously support group work as well as whole-class
collaboration and direct instruction. Even our 25-seat classrooms have flexible furniture that allows them to be reconfigured on the fly, and all classrooms allow distance and on-campus students to
interact via cameras and microphones.
These examples show the intersection of space and teaching, but the new building also promotes systemic integration of teaching strategies. The American Medical Association invited the SMHS to join its Accelerating Change in Medical Education consortium of 32 innovative medical and health science schools based on our telemedicine rural healthcare simulations, which combine IPE and AL approaches. Our state-of-the art simulation center, led by Dr. Jon Allen, is the site for these simulations, which involve students in five professions and follow the trajectory of a patient with a myocardial infarction from the ER to rehabilitation in-home to an end-of-life scenario in a long-term care facility. A telemedicine consult with a cardiologist is integrated throughout via “robots” (iPads on wheeled carts controlled remotely) in order to reflect the needs of rural healthcare settings. See the photo above.
Many more challenges are on the horizon, of course. Our adoption of PCRS will necessitate new educational outcomes around payment models; the use of big data for population and individual health; and the integration of wearable, networked health devices like fitness trackers, glucose monitors, and even joint replacements into medical practice. Promoting and measuring attitudes such as empathy, professionalism, and healthcare professional wellness (e.g., combatting burnout) cannot be done the same way we deliver and measure medical knowledge. Novel approaches such as gamification, interactive online simulations, artificially intelligent tutoring systems, and social learning theory are just a few of the other innovations we are considering.
Thanks to the leadership of the SMHS and UND, the generosity of our alumni, and the people of North Dakota, we have the building, people, and means to meet these challenges, and we can’t wait to see what the future brings!