School of Medicine Retreat Envisions Ideal Learning Environments

The UCSF School of Medicine held its annual Dean’s Leadership Retreat in January, this year dedicated to envisioning the ideal learning environment for health professions students, graduate students, graduate medical education trainees, postdoctoral fellows, faculty and staff.

Designed by a team led by Vice Dean Catherine Lucey, MD, the retreat attracted top faculty from throughout the University who gathered at the Presidio to take stock of the changes sweeping through both education and health care delivery and to find ways to leverage best practices in all of the areas where UCSF is providing education.

“We’re trying to ensure that UCSF remains a leader in education,” Lucey said. “This very dynamic environment requires us to periodically assess our current strategies and future opportunities so that we continuously look for new and improved ways to help our students, faculty, and staff learn.”

The School of Medicine is regularly ranked among the top five medical schools in the nation by U.S. News & World Report in both research and primary care.

Given the rapid evolution of knowledge, institutions focused on advancing health are looking for the best ways to support continuous learning by those in the midst of formal educational programs as well as those who have completed their training.

They are challenging the traditional boundaries between knowledge discovery and knowledge application. They are looking for new ways of connecting with so-called “digital natives,” those students who grew up on the Internet and have grown to expect technologically rich learning environments. And they are examining the curriculum with an eye toward trying to understand what is most important to teach, when everyone has access to endless information at their fingertips.

Dan Lowenstein, MD, professor and vice chair of neurology and director of the UCSF Epilepsy Center and the Physician-Scientist and Education Training Programs, pointed to the revolution that has come about since the advent of smartphones and other mobile technology.

“I beseech us to really look carefully at what we are asking our learners to learn,” he said. “I still think we are asking them to encode information that is no longer necessary.”

To address these and other questions, organizers invited a star-studded panel of educational leaders, including:

• Maggie Jonson, director of education and university relations at Google, spoke of how the company keeps its highly skilled workforce, which is spread throughout the world, up to date on its ever-changing technology.
• Al Adams, EdD, the former head of school at Lick Wilmerding High School, stressed the continuing need for values-based education even in the need a lightning-quick changes in technology.
• Helen Quinn, PhD, of Stanford University, who is chair of the National Academy of Science Board on Science Education, explained how students learn science.
• George Cacchianes, PhD, a science educator at Lincoln High School in San Francisco, described an extraordinary partnership with UCSF’s Wendell Lim, PhD, to train high school students in how to do basic science.

Cacchianes’ students have twice won top honors in the iGEM contest at the Massachusetts Institute of Technology, a kind of Olympics of biotechnology, competing against teams from Princeton, MIT, Oxford and Cambridge.

Cacchianes said his students have performed beyond his wildest dreams, and the warm welcome and the immersion experience they have performing novel experiments in Lim’s synthetic biology lab has been a huge part of their success. Mastering lab techniques and coming up with results built their self-confidence and pushed them beyond self-imposed barriers.

“They became less intimidated, less fearful about what their place might be,” said Cacchianes, who has 150 kids taking molecular biology each year, 80 percent of whom go on to study science in college.

The successful partnership between a leading lab at UCSF and a public high school demonstrates that for all of UCSF’s excellence, it still has a remarkably flat hierarchy, said Jeffrey Bluestone, PhD, executive vice chancellor and provost, who attended the retreat, along with School of Medicine Dean Sam Hawgood, MBBS, who will be UCSF’s interim chancellor beginning in April.

Bluestone said that many of the issues and ideas discussed at the retreat echo what came out of the long-term planning effort known as UCSF 2.0, which seeks to inspire the next generation of students and to redefine health sciences for the future.

Retreat participants broke into teams, based on their interests, and brainstormed about ways to respond to the new learning environment.

Nearly a dozen concrete proposals came out of this forum, including one aimed at finding ways of creating coherent, long-term training experiences for residents. The idea is to enable residents to work in the same location and specialty long enough to develop as clinicians. One example would be to take a more thematic approach to their training, such as through an integrated training program in rheumatology.

Another proposal looked at how patient care rounds are conducted in acute and critical care settings. The old model revolves around a physician and has a hierarchical construction that may marginalize contributions by professionals, such as nurses, pharmacists and physical therapists. A new model would put the patient at the center, surrounded by a team that includes all of the participating clinicians, as well as the family.

Still another idea was to create a semester-long course in which graduate students and health professions students would share expertise and learn to solve problems together. Graduate students would gain insights into the application of basic science constructs in the clinical environment and medical students would develop an understanding of how new scientific practices and constructs, such as precision medicine, whole genome sequencing and gene expression array/sequencing can be used to address unsolved problems. Mentorship by experts in discovery and clinical care would help students develop competency in team science on behalf of patients.

“It was an incredibly dynamic day,” Lucey said. “With advice from some of the world’s leading innovators in education, UCSF faculty, staff, students and leaders from all disciplines worked creatively to develop the next generation of ideas that will ensure that UCSF continues to provide the nation’s best learning environment for people committed to advancing health.”

The design team for the retreat included, Elena Fuentes-Afflick, MD, MPH, vice dean of Academic Affairs; Robert Baron, MD, associate dean; Lim; Helen Loeser, MD, MSc, academy director, Academy of Medical Educators; Lowenstein; Lucey; Kimberly Topp, PhD, PT, chair of Physical Therapy and Rehabilitation Science; Elizabeth Watkins, PhD, dean of the Graduate Division and vice chancellor of Student Academic Affairs.

Photos by Susan Merrell