SOM Faculty Publish Study Describing Novel Curriculum

Medical students are presented with a case on Monday. Over the course of the ensuing week, they learn and discuss and discover the patient’s presentation, symptoms, condition, and treatment, culminating with an integrated understanding of the patient, their illness, and the underlying sciences on Friday. The students not only learn from the faculty - they learn from each other, and from sources across the breadth of the medical literature.

The Patient-Presentation Problem-Based Learning Curriculum (PPPC) is a foundation of the curriculum at the Hackensack Meridian School of Medicine - and a novel team-based way of teaching. The faculty who developed it have now published a paper in the journal Medical Teacher to explain how and why it works - and also how it might successfully improve medical education far beyond the Nutley campus of the school, founded in 2018.

The article “Expanding the scope of problem-based learning at Hackensack Meridian School of Medicine integrating domain-general skills with domain-specific content,” was authored by five School faculty members: Miriam Hoffman, M.D., the vice dean of academic affairs; Tovah Tripp, M.D., F.A.C.P., the director of PPPC; Ofelia Martinez, M.D., M.P.H., the assistant dean of medical education; and librarians Christopher Duffy, MLIS, and Peggy Dreker, MPA, MLS.

Each week of the pre-clerkship curriculum is framed with a weekly patient case and provides the clinical scaffolding for everything learned that week, according to the paper. It allows the students to integrate and apply material from the basic sciences, clinical sciences, and health systems science, and builds their skills in clinical reasoning, information gathering, and team collaboration, as the work progresses through the week. The curriculum is primarily student-driven, culminating in students working together to integrate what they have learned throughout the week and apply it to the patient case.

An example would be during a week of learning about the thyroid, the case might be a 28-year-old female with weight loss and palpitations and also hyperthyroidism. Together it suggests the autoimmune Graves disease complicated by a pregnancy. Over the course of the week, the students would learn the basic anatomy and science of the thyroid and its workings. But they would also learn survey design and sampling as part of the health systems science content; and the clinical skills of thyroid exams, oral presentation and case write-ups would all factor into the teaching sessions over the week, according to the study. Gradually, the patient’s condition comes into focus, all within a clinical context, and the students thus have a better grasp of health - and health problems.

“PPPC is unique through its comprehensive integration across longitudinal curricular threads, including knowledge acquisition, information mastery, feedback, professional identity, teamwork, and clinical reasoning,” write the authors. “This ensures a direct link between weekly activities, underlying principles, and philosophies.”

“PPPC serves as a critical mechanism and infrastructure to develop cognitive integration, clinical reasoning, and high levels of application of knowledge, which are central goals of our curriculum,” added Vice Dean Hoffman. “Using the layered analysis, this paper demonstrates how PPPC and its instructional methods and design were directly driven by foundational guiding philosophies and principles.”