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Embracing change, evidence-based medicine COM's focus by Cindy Abole Public Relations Exploring change, especially in the way today’s students learn medicine while establishing a culture that creates and molds physicians to achieve as clinical investigators and lifelong learners is a goal of College of Medicine (COM) Dean Jerry Reves and college leaders.   Reves and top medicine faculty’s outlook is their response to a June American Association of Medical Colleges (AAMC) clinical research report, which revealed recommendations in the way medical schools and teaching hospitals can enhance medical school curricula through developing more clinically-prepared physician-scientists who are capable of providing bench-to-bedside research methodology within the practice of medicine to enhance patient care.      “Today’s medical school curriculum has not experienced a dynamic change in decades that reflects the way the field of medicine has grown and evolved,” said Reves, M.D., commenting on today’s “one-size-fits-all” attitude throughout medical education and the need for physicians to stay current in their knowledge of scientific discoveries and technology advances. “There is a desperate need for change in the way medical students learn and are taught.”      The recommendation came from the AAMC Task Force II on Clinical Research’s 2006 report, “Promoting Translational and Clinical Science: The Critical Role of Medical Schools and Teaching Hospitals.” The group looked at best practices at several academic medical institutions for training and support of translational and clinical scientists, review of data relating to federal support of research training and federal grant award  trends, plus other categories. The report supplements earlier AAMC findings made by the task force on clinical research and clinical research in medical education.   Reves, along with the college’s curriculum and research leaders, have focused on three of the nine AAMC report recommendations to adopt: encouraging medical schools and teaching hospital programs to adopt translational and clinical research curricula as part of medical student training; embracing evidence-based medicine processes as an accreditation requirement; and accelerating pathways to create more trained physician-scientists.   To accomplish this, COM is considering widespread reform from traditional learning to a more integrative learning approach that prioritizes a medical student’s clinical experience and training within the first two years of study. Additionally, it will support a continued focus on the value of medical discovery and teaching of basic science through research methods. These changes will provide the tools and techniques for evidence-based learning within the medical school curriculum.      Clinicians, who are trained in the evidence-based learning processes use analytical skills and improved decision-making capabilities in their approach to patient care. Physicians first approach to patient care is to establish a clinical question. Next, they search medical literature and resources for published discoveries and information and determine how to use and apply that evidence in the treatment of that patient.            According to Reves and the college’s curriculum leaders, the changes are expected to produce a more knowledgeable, skilled physician trained in basic science and clinical medicine who can interpret information from professional clinical journals and other credible sources to understand disease and guide their approach to medical treatments and diagnosis.   “In short, we will prepare medical students to become lifelong learners, investigators and teachers in the art of medicine,” Reves said.   “This is an exciting time and rare opportunity for MUSC,” said Yusuf Hannun, M.D., Ralph F. Hirschmann professor and chair, Department of Biochemistry and Molecular Biology who also heads the college’s research advisory committee. “Under Dr. Reves’ leadership we’ve anticipated a move in this direction and discussed ways of how MUSC can potentially become a national leader in preparing our next generation of physicians trained in evidence-based medicine and who acquire the skills for advanced self-learning. This concept has the potential to capitalize on the huge and enlarging foundation of basic science and new methods for evidence-based learning in medicine.” AAMC Recommendations on Clinical Research: “Promoting Translational and Clinical Science: The Critical Role of Medical Schools and Teaching Hospitals” (June 2006) Every future physician should receive a thorough education in the basic principles and translation of clinical research, both in medical school and during residency training. The Liaison Committee on Medical Education (LCME)should add education in translational and clinical research to the requirements for medical school accreditation and Accreditation Council for Graduate Medical Education (ACGME) should embed understanding of translational and clinical research within its required core competencies. Training in translational and clinical research should be accelerated through comprehensive restructuring so that these scientists can become independent clinicians and investigators at earliest possible time. Friday, Nov. 3, 2006 Catalyst Online is published weekly, updated as needed and improved from time to time by the MUSC Office of Public Relations for the faculty, employees and students of the Medical University of South Carolina. Catalyst Online editor, Kim Draughn, can be reached at 792-4107 or by email, catalyst@musc.edu. Editorial copy can be submitted to Catalyst Online and to The Catalyst in print by fax, 792-6723, or by email to catalyst@musc.edu. To place an ad in The Catalyst hardcopy, call Island Publications at 849-1778, ext. 201.