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RIME is an ongoing initiative to implement a co-designed pre-clerkship curriculum focused on the spiral delivery of patient-centered clinical presentations rooted in generalism, while providing opportunities for creativity, self-regulated learning, and professional identity development through active learning.

Why is the CSM UME Pre-Clerkship Curriculum being redesigned?

Medical schools have a moral obligation to be socially accountable and ensure that future physicians can address unmet needs to improve overall societal wellbeing (WHO, 1995; Health Canada, 2001). This means medical schools must do more than training physicians to be “professionals” who are clinically knowledgeable and possess technical skills, but rather cultivate physicians who are change agents who collectively will improve health and wellbeing in the communities they serve. To do this, medical school curricula should be proactive in anticipating the dynamic and emergent needs of society.

Aims

Aims

  • Refine the organization, structure and delivery of curricular content in line with contemporary pedagogical practices.
  • Stimulate creativity through active learning activities integrated across the clinical presentation spectrum.
  • Cultivate critical consciousness and critical thinking
  • Foster student agency through increased opportunities for self-regulated learning and discovery
  • Prioritize career exploration and actualization 
Pedagogical Principles

Pedagogical Principles

  • Spirality – key concepts presented repeatedly with increasing layers of complexity
  • Generalism– focus on the diagnosis and management of diverse, undifferentiated and often complex clinical problems, and delivering a comprehensive range of services.
  • Patient-centered – the patient’s social context and their unique experiences integrated into concepts presented
  • Integration – embedding content and concepts traditionally underemphasized and compartmentalized into the clinical content

Timelines, Team & Contacts

  1. Early Days

    2006  
    Last major reorganization of the pre-clerkship curriculum

    2017
    The UME Curriculum Review Task Force completed a holistic review of the UME program.  The creation of an ongoing Curriculum Review Committee to provide a repository for suggestions for curriculum change was among the recommendations.

  2. Last few years

    2018-2020  
    A small team comprised of the UME Director of Teaching Innovation, the UME Manager of Academic Technologies, a PhD student in Medical Education, and 3 UME students used Design Thinking methodology to better understand the pain points prior to defining the problem(s) to solve. The initial goal of RIME was to inform small-scale curricular changes through end-user engagement. Early activities included:

    • 120+ hours of direct lecture observations 
    • 12 hours of small group observations
    • 179 interviews + 9 focus groups
    • 289 comments from the Wishing Well
    • 316 unique insights from students, faculty, master teachers, administrators, and course chairs
    • 48 responses to the virtual clerkship survey during COVID-19
    • Individual meetings with course leadership, administrators, faculty, and students
    • Presentations of preliminary insights locally through various UME committees (eg. Pre-Clerkship Committee, Clerkship Committee, Master Teacher program), the O’Brien Institute for Public Health, and the Office of Health and Medical Education Scholarship
  3. Recently

    2021

    In February 2021, approval was received from UMEC to determine the desirability and feasibility of creating a new pre-clerkship structure and curriculum rather than multiple small-scale curricular changes, as was initially planned. 

    A sub-committee comprised of UME faculty and staff began to meet monthly to consider the desirability and feasibility of a curricular overhaul.  Consultation meetings with Course/Unit Chairs and internal CSM stakeholders were held to advise about the process and obtain feedback.

    Starting in June 2021, the RIME Curriculum Working Group spent four months developing a proof-of-concept for a new curriculum based on 12 Units organized around clinical presentations, mapped to MCC objectives. Upon review of this proof-of-concept, a motion of operational feasibility was passed and approved at UMEC in October 2021, recognizing that complete curricular renewal is possible within the current accreditation standards.

  4. What are the next steps?

    The RIME sub-committee will continue to engage with all key stakeholders in the UME and broader CSM community to continue co-creating a reimagined structure and delivery of curricular content.

    The new curriculum will be implemented in July 2023, with faculty development sessions to begin in Fall 2022 to ensure that preceptors are fully engaged and aware of the new curriculum.

RIME Sub-Committee

The RIME sub-committee reports to UMEC and is responsible for overseeing the work of the RIME Working Groups, and was responsible for assessing the overall desirability and feasibility of redesigning the curriculum.  The sub-committee is currently comprised of 3 Co-Chairs (Dr. Rahim Kachra, Mr. Mike Paget, & Dr. Allison Brown) and the leads of the 8 RIME Working Groups below. Three UME students were involved in the initial stages of this process.

RIME Working Groups

As we move forward to further develop the curriculum, multiple working groups have been formed and will continue to consult and develop curriculum prototypes, content, and strategies for implementation. 

Curriculum & Clinical Presentations
Dr. Sylvain Coderre (Lead)
Dr. Sarah Anderson
Dr. Amy Bromley
Dr. Kevin McLaughlin
Dr. Doug Myhre
Siavash Zarezadeh (Class of 2023)

Student Assessment
Dr. Janeve Desy (Lead)

Program Evaluation & Accreditation
Dr. Adrian Harvey (Lead)
Gretchen Greer

Rhythm
Shannon Leskosky (Lead)

Health Equity & Structural Competency
Dr. Tito Daodu (Co-Lead)
Dr. Allison Brown (Co-Lead)

Wellness
Dr. Kannin Osei-Tutu (Co-Lead)
Dr. Teresa Killam (Co-Lead)

Professional Identity
Dr. Melinda Davis (Lead)

Medical Skills
Dr. Glenda Bendiak (Lead)

Family Medicine Liaison  
Dr. Rabiya Jalil

Week-by-Week Curriculum Design
Dr. Hanan Bassyouni
Dr. Glenda Bendiak
Dr. Murray Lee
Dr. Patrick Lee
Dr. Joshua Low (PGY2 IM)

The following is the working draft of the weekly schedule for the new curriculum:

Working Draft - Weekly Schedule

The Self, Society, and Social Accountability Course will introduce students to the patients and populations they will serve. They will learn about ways they can effectively contribute, including scholarship and collaborative practice, and will be introduced to the importance of professionalism and physician health.


Clinical skills will focus on the fundamental skills of communication and physical examination, through interactions with standardized patients. These skills will be aligned with key aspects of anatomy, procedural skills, and course content, to aid in understanding and retention.

Work to further refine the curriculum will continue with the Day-by-Day Working Group, which will operationalise the vision for spirality and integration in the curriculum. This will ensure that various elements of the new curriculum become longitudinally diffused into the curriculum, including domains such as, but not limited to: anatomy, clinical skills, Indigenous health, structural competencies, and activities under the portfolio of ’Self, Society, and Social Accountability’.

  

  1. Introduction to RIME Podcast

    RIME Podcast

  1. Conctact

    Please email rime@ucalgary.ca  or use the Feedback form below to provide comments on or inquire about RIME.

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