1982-1984 - Office of the Registrar - McMaster University

-The basis of the McMaster method is self-directed problem-basedlearning in small tutorial groups. This strategy is suited to twooverall objectives: efficiency and individualization. Nothing is moreimportant throughout a physician's career than being able to learnqUickly and relevantly. Problem-based learning, complemented byathorough conceptual grounding, is not only demonstrably the mostefficient approach to learning in such a broad field, but alsoencourages the tailoring of objectives to the individual student. Ourobjectives are not sequential in the usual sense: although severalthings are begun in Phase One, they are not really "completed"until much later.We consider that the traditional "informal" curriculum of medicalschool - covering professional roles, values and the socio-politicalc;ontext of medicine - is so important in the 1980's that it must beaddressed specifically. Thus, there is a deliberate emphasis uponthe relations of health and health care to society.In Phase One, students learn how to use the McMaster systemand become familiar with the academic and clinical resourcenetworks which they will use in subsequent phases.CONTENTIn the human biology area, the purpose is to learn how the humanorganism at all levels from cell to society relates to its environment.This requires exposure to several disciplines, and a careful balanceof broad conceptual frameworks with specific micro·models. Keyconcepts involve the principles of human ecology, homeostasis,phylogenetics and human development, and learning theory. Weare primarily concerned with the integration of ideas from threepoints of view. The informational base concerns the structure andfunction of the human body and of the human ecosystem. Technicalemphasis is upon clinical skills and interviewing, in which "handson"examination technique is blended with living anatomy andinteractional training.In health and health care, the purpose is to learn about thecontext of medicine and to establish a foundation in general healthstudies. Key concepts involve the characteristics of health, diseaseand illness, and' of both the socio-cultural and ethical dimensions ofhealth care. Social and technological developments will require thatphysicians of the next generation relate comfortably both withcommunity concerns and with electronic data management - thus,our attention to advocacy and fluency with modern informationsystems.Learning skills include critical analysis of eVidence, concepts andargument, problem-solving, evaluation, resource utilization, andteam operations. We devote a great deal of effort and attention toevaluation, which we view as one of the student's most importantlearning tools. With increasing levels of sophistication, students areable to monitor and assess their own performances more and moreably, with the result that continuing adjustments to objectives andcontent are made regularly and easily.PROGR,AMME OUTLINE FOR PHASE IIOBJECTIVESGenerally, to develop the student's understanding of fundamentalconcepts of cell, tissue, organ, and organism response to variousstimuli. More specifically Phase II leads the student to:(a) An understanding of the relation between the chemical, functionaland structural characteristics of a cell in respect to themaintenance of cellular integrity.(b) An understanding of how stimuli affect this relationship.(c) An understanding of the relationship between the alterations incells and the changes that occur in the tissues, organs and theorganism.In developing an understanding of the fundamental concepts ofthe response to stimuli of cells, tissues, organs and the wholeorganism, the student learns that variation is inherent in all theprocesses which constitute the maintenance of cellular integrity, theexternal stimuli affecting these relationships, and the alterationswhich occur in these relationships as a result of response to stimuli.CONTENTIn Phase II, students Ilre presented with problems the solution ofwhich requires an understanding of the universal concepts of themechanisms whereby cells, tissues and the organisms respond tostimuli. The subject matter is organized so the students, whatevertheir backgrounds, can study at a challenging level of detail. In eachHEALTH SCIENCESproblem area, the stud~nts are able to choose from a number ofspecific biomedical problems. Throughout the phase, students havesupervised contact with patients. This provides the opportunity todevelop basic clinical skills while at the same time learning the basicmechanisms of disease.PROGRAMME OUTLINE FOR PHASE IIIOBJECTIVESPhase III covers 40 weeks of the M.D. Programme. The main themein this phase is structure and function in health and disease with anemphasis on understanding the mechanism of disease, and relatingclinical symptoms and signs to basic physiological and pathologicalprocesses. In order to facilitate the achievement of the goals, PhaseIII is divided into different units based on an organ-systemapproach. In progt'essing through this programme, students:(a) Develop their ability to discern and to approach specializedbiomedical problems.(b) Learn how to derive on their own, and to use most effectively,the information they require to approach the solution of theseproblems.(c) Acquire an understanding of the integrated physical andbehavioural mechanisms important in maintaining the healthyfunction of the systems and of the alterations in those mechanismsthat give rise to dysfunction or disease.(d) Learn some techniques of clinical examinations and history-takingas a means of obtaining data in a clinical setting in preparingfor Phase IV.CONTENTThe students in Phase III are encouraged to integrate basic scienceswith clinical medicine through the use of problem-based learning. Avariety of learning resources are available to students to achieve theobjectives of the phase. Students are encouraged to seek andacquire knowledge indiVidually, using books and slide tape shows orutilizing resource people in small or latge group sessions. Eachorgan system in Phase III leads the student to relate the respectivesystem's anatomy, biochemistry and physiology, to its specializedpathological chemistry, abnormal physiology, special pathology,microbiology, epidemiology and pharmacology. -The behaviouraland sociological aspects of disease will also be dealt with in anintegrated way. The types of problems presented to students varyaccording to the particular organ system. In some cases, theproblems are based on signs and symptoms; in others, on physiologicalprocesses, and, in some cases, on particular and clinicalexamination . with in-depth assessment of problems related todisease models. The student refines general techniques of historytakingand clinical examination with in-depth assessment of problemsrelated to the various organ systems.PROGRAMME OUTLINE FOR PHASE IVOBJECTIVESThere are four Phase IV objectives:1. PROFESSIONAL RESPONSIBILITYThe acquisition of the authority to invade and intervene in thelives of patients carries with it the obligation to act responsibly:(a) Toward patients and their families:Students should be able, under appropriate supervIsion, to takeresponsibility for the evaluation and care of patients and theirfamilies. This is manifested by being there when the patient needshelp, by following through on tasks essential to good patient care,by being up-to-date on the patient's progress, by communicatingeffectively with patients and their families and by respecting thepatient's privacy.(b) Toward colleagues:Students should take responsibility for the education and evaluationof their colleagues. This is manifested by giving feedback andconstructive criticism to all other members of the tutorial group andclinical team (both students and faculty), by sharing new knowledgeand problem-solving strategies with them, and by collaborating inefforts to assess and improve the quality of care delivered on theClinical Teaching Unit.33