Course and Clerkship Structure
The Hackensack Meridian School of Medicine at Seton Hall University has the great advantage of having the ability to make intentional choices – both in the content we choose to teach as well as the methods and structure we choose to deliver that content.
Phase 1 (pre-clerkship) of the curriculum encompasses the first sixteen months and includes the basic science foundational content in conjunction with Human Dimension, Clinical Skills, and Health Systems. The innovative curriculum will integrate content from the Biomedical, Behavioral, Social, and Health System Sciences, with each week of Phase 1 framed by a patient presentation. As such, all material that a student learns will be placed in its clinical context, showing the student both why they are learning the material as well as how different concepts and ideas are interrelated.
Phase 2 of the curriculum will run 20 months and includes the clerkship and advanced clinical rotations portion as well as the of Human Dimension. The final phase of our program, Phase 3 provides students with an opportunity to select an area of further study that interests them. Possible options include but are not limited to duel degrees, certificate programs, research intensive concentrations, community-based projects, global health electives and entry into residency.
Longitudinal Content Overview
The innovative curriculum at the Hackensack Meridian School of Medicine at Seton Hall University is designed with longitudinal integration of basic science content and its application in the clinical context.
The sequential Sciences/Skills/Reasoning (SSR) courses will integrate content from the Biomedical, Behavioral, Social, and Health System Sciences. Each week of Phase 1 begins with a Monday morning patient presentation. All content that is taught that week will then be scaffolded in a structured concept map built around the weekly patient presentation.
Because the practice of medicine occurs in an integrated manner and not in silos, rather than have stand-alone courses such as pharmacology, we teach pharmacology in a longitudinal manner throughout the 16-months of Phase 1. All content is taught in a way that is relevant to the clinical presentation of the week.
Longitudinal content that is integrated throughout the SSR Courses includes clinical skills, Health Systems Science, and others. The Human Dimension (Community Immersion) course continues throughout the entire core curriculum. These provide students with immersion into community health, Social Determinants of Health, and early clinical practice.
Clinical Skills Training
Clinical skills is a central component of the SOM curriculum. Students will be immersed the developing and learning the knowledge and skills they need to be meaningful and effective members of the clinical team from the very beginning of the curriculum.
Phase 1 clinical skills will be in 3 distinct segments:
The initial part of the course will be presented during the first 18 weeks of Phase 1. During this period, students will learn to enable patient/family -centered therapeutic communication through creating effective dynamic interactions with patients, families, caregivers and everyone involved in the patient’s care. The foundational period learning objectives are essential for establishing rapport and trust, formulating a diagnosis, delivering information, striving for mutual understanding and facilitating a shared plan of care. The goal is to create equitable care for everyone (family/patient centered care). The student will develop the basic knowledge, skills and attitudes necessary for interacting with a patient, developing a therapeutic relationship, gathering information, performing a basic physical exam and problem-solving. This will utilize standardized patients, real patient, small group workshops, and simulation. The clinical skills training is tightly aligned with the skills students will need in their Human Dimension activities as well.
During the following 12 months students will learn more detailed aspects of the physical exam and specific symptom presentations in small group settings with standardized patients and task trainers as the primary teaching methodology. These sessions will be coordinated with the content students are learning in the Systems blocks of the SSR courses, so that common clinical problems are being addressed in their clinical and scientific contexts.
All students will have a longitudinal 1:1 clinical mentor for their longitudinal clinical experience in Phase 1. These will take place in the outpatient primary care setting, and will provide students the opportunity to apply and integrate the knowledge and skills they are learning throughout the Phase 1 curriculum.
Human Dimension Overview
The Human Dimension is at the heart of the SOM curriculum. Through the service-learning experiences and integrated curriculum, students will come to understand the many Determinants of Health – this includes the Social Determinants of Health as well as the personal, economic, and environmental determinants. Determinants fall under several broad categories: policy, social factors, health services, behavior, biology and genetics, and access.
In the Human Dimension, pairs of SOM students will be matched to 3 families in the communities we serve. They will follow these individuals, families, and communities longitudinally over the entire core curriculum, paying specific attention to three domains of health: social, behavioral, and medical.
The student will be develop a close relationship with the families and will become involved in all aspects of family members’ health, including the individual’s life, family, and community.
Activities in this course will include meeting with individuals and families in their communities and in various health care and community-based settings, meeting with peers and faculty mentor, and participating in small and large group teaching sessions.
The student teams will be closely mentored by a faculty member who will meet regularly with the student teams in a small group and review monthly themes as well as debrief and process the students’ experiences. Student case presentations and workshops will also take place in this setting. Students work in the Human Dimension will also provide the foundation for the scholarly capstone project all students complete in Phase 2.
Health Systems Science
Health Systems Science is Principles, methods, and practice of improving quality, outcomes, and costs of healthcare delivery for patients and populations within a system of medical care. It includes the factors that impact health outcomes beyond the basic and clinical sciences.
Health Systems content is critical in training students to be physicians and to shape the healthcare system to be one that address a three-part problem: (1) poor quality of healthcare outcomes, (2) poor value in the healthcare system, and (3) unacceptable healthcare disparities. Integrating this content with the other elements of the SOM curriculum will be a central way that the SOM achieves its mission and vision.
To be effective physicians and leaders in the current and future landscape, our students will need the knowledge and skill set that they will achieve through this longitudinal content area. Our graduates will understand all the aspects of a system, how systems operate, and how to set up structures and drivers in systems to truly get the health outcomes we want.
Within Phase 1, the learning objectives, teaching activities and materials created within this team will be integrated into both the Sciences/Skills/Reasoning courses as well as the Human Dimension. The content learned in Phase 1 will be built upon in the Phase 2 curriculum as well.
Health Systems content is divided into three areas:
- Structure and Function of Healthcare Systems
- Students will learn how healthcare systems and systems that affect health are structured; how they work; and what the drivers in a system are. This includes Health policy and financing, health law, medical ethics, healthcare disparities, and the Determinants of Health.
- Information and Data
- Students will learn how to understand, use, and generate information and data. This will include training in Epidemiology and biostatistics, Evidence-based Medicine/Information Mastery, and research methods.
- Systems-based Practice
- In this area, students will integrate much of what they have learned in the prior two areas to think about the practice of medicine and the promotion of health (or disease) as occurring within a system. Students will learn and analyze what those systems are, and how can they be created to promote health (or disease) for all.
This will include Public Health, Population Health, Quality Improvement, and technology in medicine. Interprofessional education and practice as well as systems science will be included in this area.
Interprofessional Education (IPE)
Interprofessional collaboration is an essential cornerstone of modern health care, and the School of Medicine has developed an extensive set of objectives related to interprofessional education and development of interprofessional teamwork skills. An explicit goal of the decision to co-locate SOM with the Seton Hall College of Nursing (CON) and the Seton Hall School of Health and Medical Sciences (SHMS) is to provide opportunities for students from different health profession disciplines to train together. Additionally, we have collaborated with and plan to expand collaboration with the School of Law, the Department of Social Work, and others.
This will occur through formal and informal activities, both on the Interprofessional Health Science Campus and outside of its walls within the clinical environment and the community.