Medical Education: A Tradition of Innovation Continues
For 25 years, Mark T. O’Connell, M.D., played a leading role in guiding the Miller School of Medicine’s innovative approach to medical education. His noteworthy accomplishments include revising the school’s curriculum, launching the regional medical campus in Palm Beach County, and designing the M.D./M.B.A. and M.D./M.P.H. programs.
Before retiring as Senior Associate Dean for Educational Development in June 2015, O’Connell spoke of his love of teaching.
“We get the opportunity to take incredibly bright, motivated, skillful medical students and help them grow and achieve,” he said. “It’s a reward in itself, and there is nothing like it.”
In the past year, the school’s medical education leaders have continued O’Connell’s tradition of innovation, while planning a new state-of-the-art teaching and learning facility to replace and markedly enhance the current educational facilities.
“We will continue to stay in the forefront of medical education,” said Laurence B. Gardner, M.D., Executive Dean for Education and Policy, who is now serving as interim Dean, while continuing to lead the Miller School’s education program. “We are committed to investing in the latest in learning technology, while building practical competencies and instilling the spirit of compassionate care in our undergraduate and graduate students.”
Here are some of the highlights of the past year, along with a look to the future.
Regional residency programs
Residents at the Miller School’s Internal Medicine Residency Program at Holy Cross Hospital in Fort Lauderdale will complete their first year this summer.
“We are training physicians in a variety of health care delivery environments,” said Gardner, noting that Holy Cross is a member of an accountable care organization, providing coordinated care to patients.
Last year, more than 1,300 doctors applied for the 18 available first-year positions. In July, those residents will begin their second year of training and be joined by another 18 first-year physicians. The community-based training program is led by Program Director Lisa C. Martinez, M.D. As part of their training, the residents will provide primary care through the Light of the World clinic, which offers medical services to disadvantaged residents.
Joan E. St. Onge, M.D., Senior Associate Dean for Graduate Medical Education, said the residency program is designed with an eye on what internal medicine will be like 10 years into the future.
“We looked at the challenges that we as internists see now, and that we feel maybe this program can address in a better way than how we were trained,” she said. “Hence, the unique schedule where residents will be in the hospital for four weeks, and in an ambulatory setting for two weeks. It will continue in that way through the whole program.”
The Miller School and Jackson Memorial Hospital also partnered with Holy Cross Hospital to launch a new residency program in emergency medicine.
“South Florida has a critical need for emergency physicians, and this allopathic program will help address that shortage,” said Gardner.
The first 15 emergency medicine residents were selected in March and notified of their placements on Match Day in March 2016. Both the faculty and residents rotate at Holy Cross Hospital, University of Miami Hospital and Jackson Memorial Hospital, gaining experience in varied settings, Gardner added.
Students at the Miller School’s Regional Medical Campus also do rotations in several specialties at Holy Cross Hospital, under the overall direction of Daniel Lichtstein, M.D., Regional Dean of Medical Education and the regional medical campus faculty.
“Our goal is to educate the next generation of physicians who have the skills and knowledge to care for patients in the new health care environment,” said Gardner. “We want our residents to become leaders in serving their communities.”
The Bernard J. Fogel Chair in Medical Education
In April, Alex J. Mechaber, M.D., professor of medicine and Senior Associate Dean for Undergraduate Medical Education, was awarded the Dr. Bernard J. Fogel Chair in Medical Education for his 18 years of outstanding service to the University of Miami Miller School of Medicine.
Mechaber is the second holder of the chair, named for the highly respected former Dean who served from 1981 to 1995. He succeeds O’Connell, who held the chair from 2007 until his retirement.
“I was both surprised and humbled when I was notified that I would be receiving the Fogel Chair,” said Mechaber, who graduated from the Miller School in 1994. “Bernie was my dean when I was in medical school, so to hold the chair named for him is especially meaningful to me.”
In his undergraduate education role, Mechaber led the creation of the Miller School’s Academic Societies, which emphasize cooperation in the learning process, foster leadership and provide a collegial environment for mentoring students.
His current administrative responsibilities include vision, oversight, budgeting and accreditation for all undergraduate medical education programs and their respective offices. He also serves as Acting Co-Director of the Educational Development Office and Academy of Medical Educators, which assist faculty with enhancing and developing curricula and improving teaching skills.
One of the innovative approaches to medical education is the development of the ’Cane Academy, an initiative that enhances traditional classroom sessions with short videos accompanied by learning objectives, self-assessment questions and supplemental content.
“We are embarking on a more blended-learning approach,” said Mechaber, who launched the initiative in 2014 with the engagement of an instructional designer with expertise in online technology. “Our goal was to help the faculty leverage educational technology by creating high-quality videos covering traditional lecture content, which our students can watch ahead of time. When they come to class, they can spend their time discussing the issues at a deeper level and solving problems.”
Last year, the ’Cane Academy approach was piloted through creating learning modules for the dermatology and ophthalmology courses for both M.D. and M.D./M.P.H. students.
“This approach can be particularly effective for covering content that doesn’t change from year to year,” Mechaber said. “It allows our faculty members to be classroom coaches and mentors, rather than lecturing while students take notes.”
David Faber, a fourth-year medical student and a medical education fellow in the 2014-15 academic year, worked with faculty members to prepare the videos. A new medical education fellow will be joining the school this summer to continue the process.
“The feedback from our students has been quite positive,” said Mechaber. “They appreciate the opportunity to engage the faculty in meaningful ways in the classroom.”
Under the direction of Amar R. Deshpande, M.D., associate professor of clinical medicine and Assistant Dean for Medical Education and Competency Assessment, the school is looking at the practical side of medical education for medical students and residents.
“This initiative reflects a national movement to be sure physicians have acquired and demonstrated specific skills before moving on to the next step in their education,” Mechaber said.
In keeping with that objective, the medical education leadership team is developing an online dashboard to help faculty members assess the progress of their students.
“This new platform will help them identify and compensate for any gaps in student knowledge,” Mechaber said. “After all, it’s better for students to know where they stand during the course rather than waiting to see their final grades.”
Gardner adds that delivering caring and compassionate patient care is one of the key competencies for medical students.
“We emphasize the importance of physicians being able to listen, understand and empathize with patients and families,” he said. For instance, student actors from the Department of Theater Arts portray “standardized patients” with various conditions and interact with medical students. “This collaborative approach benefits both groups of students, and we hope to keep it up and running for many years,” he said.
More than 100 members of the Miller School faculty are actively involved in a self-study program for the Liaison Committee on Medical Education (LCME), which accredits medical education programs leading to the M.D. degree in the United States and Canada.
“Our last review was in 2009, and the LCME team will be here on February 5-7, 2017, for a full review of our faculty, students, governance and curriculum,” said Gardner. “Preparing for the LCME is a year-long process with extensive faculty input, with 10 committees looking at what we do well and opportunities for improvement.”
LCME accreditation is a voluntary, peer-reviewed process of quality assurance that determines whether the medical education program meets established standards. Noting that the LCME reports to the American Medical Association and the Association of American Medical Colleges, Gardner said, “It is the most rigorous accreditation system in the world for medical schools.”
Planning a New Building
On January 28, University of Miami President Julio Frenk took part in a groundbreaking ceremony, hosted by Dean Pascal J. Goldschmidt, M.D., for the Miller School of Medicine Center for Medical Education. This leading-edge building was made possible by a $50 million gift from the family of Stuart A. Miller, former Chair of the University of Miami Board of Trustees, that continues the Miller family’s ongoing support for both UM and the Miller School.
“This building will incorporate robust technology features, flexible workstations and the largest auditorium on the medical campus,” said Gardner, who unveiled a conceptual drawing of the new center at the ceremony. “It reflects the Miller School’s unwavering commitment to transform lives through teaching, research and clinical service.”
In March, Jonathan Kanda, principal of CO Architects in Los Angeles, was selected to be the lead architect for the new building. Kanda has extensive experience in designing educational, clinical and research facilities for medical centers and other academic institutions.
“We have begun a series of meetings with CO Architects to discuss the use of this space, including assessment centers, technology and the integration of the medical library into the new building,” said Gardner. “Throughout this process, faculty committees are providing comments to their chairs, and there will continue to be extensive input from all stakeholders — especially our students.”
Mark T. O’Connell, M.D. – A Pioneer in Medical Education
Mark T. O’Connell, M.D., is a nationally recognized leader in medical education who made invaluable contributions to the University of Miami Miller School of Medicine before retiring in 2015.
“Mark O’Connell was a pioneer in advancing our educational curriculum, engaging faculty, administration and students in the process,” said Laurence B. Gardner, M.D., Interim Dean/Executive Dean for Education and Policy. “He was an active clinician and scholar, as well as a teacher during his 35 years at the medical school.”
O’Connell joined the faculty in 1981, and practiced primary care internal medicine, along with his research, teaching and administrative responsibilities. Five years later, he established the Office of Biomedical Computing, gaining national attention when he opened one of the first microcomputer learning labs and introduced medical computing into the curriculum.
In 1989, as director of the internal medicine clerkship, he introduced patient-oriented problem-solving and evidence-based decision-making into the curriculum. In 1992, as a founding member of the national Clerkship Directors in Internal Medicine, he led a national effort to standardize the internal medicine curriculum, and design and implement school-wide clinical competency-based assessments of students.
Three years later, he established the medical school’s Generalist Education in Medicine program and implemented the interdisciplinary community-based generalist primary care clerkship.
In 1999, he led the design and implementation of lecture recording and online video streaming, making the Miller School one of the first to offer such innovative learning resources to its students. Appointed Senior Associate Dean for Educational Development the same year, O’Connell was the primary architect of the Miller School’s curriculum reform, which was implemented in 2001.
He also oversaw the creation of the Educational Development Office and led the design and accreditation of the medical program at the regional medical campus in Palm Beach County, the development of the M.D./M.P.H. and M.D./M.B.A. programs, and the creation of a number of unique and innovative student initiatives, including the Academic Societies program and the Professionalism and Physicianship Advocacy Program.
Another of O’Connell’s accomplishments was the growth of student-run free and low-cost health fairs under the Mitchell Wolfson Sr. Department of Community Service, or DOCS. Through the series of health fairs, which stretch from the Keys to Broward County, DOCS sees about 2,000 patients annually, and provides long-term primary and specialized care to hundreds more at three student-operated, physician-supervised clinics.
After his 2010 appointment as Senior Associate Dean for Educational Development, O’Connell redirected his efforts to enhancing faculty development for educators, spearheading the creation of the new Academy of Medical Educators.
O’Connell was also a gifted teacher, who received numerous awards for teaching during his career. He was the first recipient of the Miller School’s annual Teacher of the Year Award in 1994 and a five-time winner of the George Paff Award for the Most Outstanding Clinical Teacher bestowed by Miller School students. In 2008, he earned the UM Faculty Senate’s Outstanding Teacher Award, and in 2011, he received the Alpha Omega Alpha Robert J. Glaser Distinguished Teacher Award from the Association of American Medical Colleges (AAMC). He also received the AAMC and Pfizer Medical Humanities Initiative “Humanism in Medicine Award” in 2007.
After receiving the first Bernard J. Fogel, M.D., Endowed Chair in Medical Education in 2009, O’Connell thanked a long list of past and present colleagues who helped him achieve “one of the most fulfilling careers I could have imagined.”