Curriculum

Educational Milestones

The WrightCurriculum Educational Milestones Chart shown below also may be viewed or downloaded as a PDF:

Dimension 1: Foundational Knowledge — Medical Knowledge

Goals

1.1  Master fundamental biomedical concepts, terms, processes, and system interactions
1.2 Describe the determinants of health
1.3 Utilize evidence in making clinical decisions

Goal 1.1

1.1 Master fundamental biomedical concepts, terms, processes, and system interactions

 

Phase 1
Foundations of Clinical Practice

Phase 2
Doctoring

Phase 3
Advanced Doctoring

Core Entrustable Professional Activity (EPA)

Milestones 1.1

a. Describe normal structure and function of the human body at the molecular, cellular, tissue, organ level and all major organ systems, outlining how anatomy, biochemistry, cell biology and physiology work together

b. Identify the major diseases and conditions and the ways in which they operate in the body

c. Use scientific principles underlying diagnostic methodologies

a. Apply knowledge of the expected changes in organ function as well as normal physiologic changes across the lifespan into the care of patients with core medical problems

b. Describe how the altered structure and function of the body and its major organ systems are manifest through major diseases and conditions

c. Describe the scientific basis for the diagnostic tests used in medicine

a. Integrate knowledge of the expected changes in organ function in the care of critically ill patients as well as normal physiologic changes across the lifespan

b. Explain the pathogenesis of major conditions related to area(s) of specialty/disciplinary interest

c. Integrate knowledge of diagnostic testing into patient care using principles of evidence-based medicine

EPA 3: Recommend and interpret common diagnostic and screening tests

Goal 1.2

1.2 Describe the determinants of health

 

Phase 1
Foundations of Clinical Practice

Phase 2
Doctoring

Phase 3
Advanced Doctoring

 

Milestones 1.2

a. Identify and describe the individual and population-level biopsychosocial determinants of health and how these determinants influence population health status

b. Recognize population-level health disparities that may impact access to healthcare, care of patients, and patient outcomes

a. Using available data, compare and describe the health status of the U.S. to the health status of other countries for key health indicators.

b. Identify determinants of health, risk factors and protective factors that influence the diagnosis of a specific patient with a health condition

a. Describe the population-level factors related to the spread of disease and interventions to control spread

b. Develop a treatment plan that considers the determinants, risk factors and protective factors to improve health

 

Goal 1.3

1.3. Utilize evidence in making clinical decisions

 

Phase 1
Foundations of Clinical Practice

Phase 2
Doctoring

Phase 3
Advanced Doctoring

Core Entrustable Professional Activity (EPA)

Milestones 1.3

a. Obtain, analyze, and synthesize information from the medical literature

b. Describe the fundamental components of basic, clinical and translational research

c. Define the fundamental statistical tools used in medicine

a. Develop a clinical question, identify relevant research findings, critically evaluate the validity and reliability of that research, and apply the findings to the care of patients

b. Incorporate pertinent biomedical information and research findings into clinical decision-making and identify barriers to implementation

c. Apply basic statistical approaches to clinical situations

a. Appraise and synthesize literature-based biomedical information to address diagnostic, prognostic and/or treatment questions in the clinical care setting

b. Effectively explain to patients how the relevant medical literature applies to their care

c. Determine applicability of literature findings to clinical scenarios by interpreting statistical analysis

EPA 7: Form clinical questions and retrieve high-quality evidence to advance patient care


Dimension 2: Application — Patient Care (Clinical Skills)

Goals

2.1 Conduct patient interviews and physical examinations
2.2 Diagnose patient health problems
2.3 Propose evidence-based health maintenance and therapeutic treatments

Goal 2.1

2.1. Conduct patient interviews and physical examinations

 

Phase 1
Foundations of Clinical Practice

Phase 2
Doctoring

Phase 3
Advanced Doctoring

Core Entrustable Professional Activity (EPA)

Milestones 2.1

a. Conduct an organized, comprehensive history and physical under supervision and recognize normal findings

b. Conduct a focused history and physical for select common presenting problems under supervision

a. Independently conduct an organized, comprehensive history and physical and recognize common abnormal findings

b. Independently conduct a focused, prioritized history and physical

a. Independently conduct a reliable history and physical and detect subtle physical exam findings

b. Demonstrate the ability to interview challenging patients

EPA 1: Gather a history and perform a physical examination

Goal 2.2

2.2 Diagnose patient health problems

 

Phase 1
Foundations of Clinical Practice

Phase 2
Doctoring

Phase 3
Advanced Doctoring

Core Entrustable Professional Activity (EPA)

Milestones 2.2

a. Generate a differential diagnosis by applying knowledge of the basic  sciences and pathophysiology

b. Define and explain ancillary diagnostics

a. Prioritize a differential diagnosis by applying knowledge of the basic sciences and pathophysiology

b. Propose appropriate ancillary diagnostics and summarize diagnostic results

a. After considering the differential diagnosis, make an informed diagnosis, in a variety of patient settings (emergent, urgent and routine health care)

b. Interpret results and prioritize next steps for appropriate diagnostic evaluation

EPA 2: Develop a prioritized differential diagnosis and select a working diagnosis following a patient encounter
EPA 3: Recommend and interpret common diagnostic and screening tests

EPA 10: Recognize a patient requiring urgent or emergent care, initiate evaluation and treatment, and seek help

Goal 2.3

2.3 Propose evidence-based health maintenance and therapeutic options

 

Phase 1
Foundations of Clinical Practice

Phase 2
Doctoring

Phase 3
Advanced Doctoring

Core Entrustable Professional Activity (EPA)

Milestones 2.3

a. Propose a treatment plan for common disease processes

b. Explain the three levels of prevention and the role of health promotion in increasing the health status of patients and populations

a. Develop a cost-effective plan of care under supervision

b. Identify and select relevant, evidence-based health promotion and education tools, as well as materials for common acute and chronic conditions encountered in the clinical setting

c. Demonstrate the ability, under supervision, to perform basic medical procedures

a. Apply knowledge of indications, contraindications and potential adverse reactions for a given therapeutic intervention, with attention to cost and quality for patient encounters in a variety of settings

b. Provide patient education regarding prevention, diagnosis, treatment plan, informed consents, and health promotion

c. Demonstrate the ability to perform basic medical procedures independently

EPA 10: Recognize a patient requiring urgent or emergent care, initiate evaluation and treatment, and seek help
EPA 11: Obtain informed consent for tests and/or procedures that the day 1 intern is expected to perform or order without supervision

EPA 12: Perform general procedures of a physician


Dimension 3: Integration — Systems-Based Practice

Goals

3.1 Connect knowledge of patient populations and health delivery processes in making diagnoses and therapeutic recommendations
3.2 Advocate for the humane, just, safe and prudent care of persons
3.3 Adapt to the complex economic and social structure of health care delivery

Goal 3.1

3.1 Connect knowledge of patient populations and health delivery processes in making diagnoses and therapeutic recommendations

 

Phase 1
Foundations of Clinical Practice

Phase 2
Doctoring

Phase 3
Advanced Doctoring

 

Milestones 3.1

a. Identify and differentiate the roles of clinical healthcare delivery and public health within a population health framework

b. Identify and explain population health goals c. Describe the value of community resources available for the care of patients

a. Describe the reporting process for disease surveillance

b. Describe the epidemiologic investigation process

c. Identify available community resources to improve the health of individuals and populations

a. Demonstrate an understanding of the clinical role of physicians in community-level preparedness

b. Evaluate population-based initiatives that can influence the health of patients and populations, reduce disparities, and/or increase equity

c. Refer patients to appropriate community resources as part of the treatment plan

 

Goal 3.2

3.2 Advocate for the humane, just, safe and prudent care of persons

 

Phase 1
Foundations of Clinical Practice

Phase 2
Doctoring

Phase 3
Advanced Doctoring

Core Entrustable Professional Activity (EPA)

Milestones 3.2

a. Explain the conceptual foundations of ethical patient care

b. Identify contextual factors that may affect the health status of an individual patient or population

c. Explain the impact of medical error and harm

a. Demonstrate behavior that conveys caring, honesty, genuine interest and tolerance when interacting with a diverse population of patients and families

b. Recognize the impact of contextual factors on patient care

c. Recognize the importance of effective communication in the prevention of medical errors

a. Discern when patient care is affected by ethical considerations and interact with the patient and health care team appropriately

b. Incorporate contextual factors into patient treatment or end-of-life plan

c. Implement a root cause analysis and propose steps to improve patient safety

EPA 13: Identify system failures and contribute to a culture of safety and improvement

Goal 3.3

3.3 Adapt to the complex economic and social structure of health care delivery

 

Phase 1
Foundations of Clinical Practice

Phase 2
Doctoring

Phase 3
Advanced Doctoring

Core Entrustable Professional Activity (EPA)

Milestones 3.3

a. Describe the legal and economic structure of the U.S. healthcare system

b. Identify issues related to quality of care, performance measurement, and improvement in the U.S. healthcare system

a. Recognize how the health care delivery system in which one works affects patient care

b. Recognize that improvements in systems can enhance quality of care and identify strategies to improve systems of care

a. Incorporate knowledge of health care systems into patient care.

b. Utilize improvement theory and methodology to develop and introduce a quality improvement project

EPA 13: Identify system failures and contribute to a culture of safety and improvement


Dimension 4: Human Dimension —Personal and Interpersonal Professional Development

Goals

A. Learning about and working with ONESELF - Personal Growth and Professional Development

4.1 Reflect upon one’s personal strengths and weaknesses to make changes in one’s behavior
4.2 Find one’s own meaning in medicine
4.3 Take care of oneself

B. Learning how to interact with OTHERS - Interpersonal Skills and Communication

4.4 Deliver effective patient presentations and document accurately in the medical record
4.5 Communicate and work effectively with others
4.6 Demonstrate leadership skills in a variety of settings

Goal 4.1

4.1 Reflect upon one’s personal strengths and weaknesses to make changes in one’s behavior

 

Phase 1
Foundations of Clinical Practice

Phase 2
Doctoring

Phase 3
Advanced Doctoring

 

Milestones 4.1

a. Integrate formative feedback from patients, peers, and faculty in order to modify behaviors

a. Seek and integrate feedback from patients, peers and faculty to better understand one’s development as a physician and as a member of the health care team

a. Seek out, learn from and model the attitudes and behaviors of physicians who exemplify professional and ethical behaviors

 

Goal 4.2

4.2 Find meaning in medicine

 
 

Phase 1
Foundations of Clinical Practice

Phase 2
Doctoring

Phase 3
Advanced Doctoring

 

Milestones 4.2

a. Define one’s personal commitment to medicine as a life of service

a. Develop the skill of self-reflection and apply the insights to one’s professional work

a. Identify connections between one’s own meaning in medicine and one’s role in health care

 

Goal 4.3

4.3 Take care of oneself

 
 

Phase 1
Foundations of Clinical Practice

Phase 2
Doctoring

Phase 3
Advanced Doctoring

 

Milestones 4.3

a. Identify factors that affect personal well-being

b. Distinguish between adaptive and maladaptive responses to stress

c. Recognize the importance of flexibility within the dynamic medical environment

a. Practice healthy self care

b. Engage in formal and informal self-awareness practices

c. Demonstrate flexibility within the dynamic medical environment

a. Cultivate mutually supportive relationships

b. Model healthy self-care habits.

c. Model flexibility within the dynamic medical environment

 

Goal 4.4

4.4 Deliver effective patient presentations and document accurately in the medical record

 

Phase 1
Foundations of Clinical Practice

Phase 2
Doctoring

Phase 3
Advanced Doctoring

Core Entrustable Professional Activity (EPA)

Milestones 4.4

a. Present patient history and physical findings in an organized format

b. Document patient history and physical findings in an organized format

c. Understand the importance of accurate and succinct procedural notes for patient safety and ethical care

a. Present patient encounters accurately and succinctly

b. Document patient encounters accurately in a timely, focused, and prioritized way

c. Document supervised procedures accurately and succinctly in the medical record

a. Adapt presentation of patient encounters to appropriate persons (consultants, families etc.)

b. Expand timely, focused, and prioritized documentation skills (consult reports, admission orders, prescriptions, plans etc.)

EPA 4: Enter and discuss patient orders/prescriptions
EPA 5:  Provide documentation of a clinical encounter in written or electronic format
EPA 6: Provide an oral presentation/summary of a patient encounter
EPA 12: Perform general procedures of a physician

Goal 4.5

4.5 Communicate and work effectively with others

 

Phase 1
Foundations of Clinical Practice

Phase 2
Doctoring

Phase 3
Advanced Doctoring

Core Entrustable Professional Activity (EPA)

Milestones 4.5

a. Identify roles within teams, and provide/receive effective feedback

b. Effectively assimilate in various teams, including interprofessional teams

c. Communicate clearly and empathetically in both written and verbal venues

a. Seek feedback on one’s communication skills

b. Effectively assimilate into the appropriate role and contribute to the health care team

c. Communicate with patients and families in a timely, clear, empathetic, and humble manner

a. Model effective and collaborative communication skills

b. Perform appropriate patient handoffs with all members of the healthcare team

c. Communicate pertinent patient information in a succinct manner

EPA 4: Enter and discuss patient orders/prescriptions
EPA 8: Give or receive a patient handover to transition care responsibility to another health care provider or team

EPA 9: Participate as a contributing and integrated member of an interprofessional team
EPA 11:  Obtain informed consent for tests and/or procedures that the day 1 intern is expected to perform or order without supervision

Goal 4.6

4.6  Demonstrate leadership skills in a variety of settings

 

Phase 1
Foundations of Clinical Practice

Phase 2
Doctoring

Phase 3
Advanced Doctoring

Core Entrustable Professional Activity (EPA)

Milestones 4.6

a. Identify characteristics of and contribute to the development of a high functioning team

b. Identify leadership opportunities that complement career development plan

c. Seek appropriate role models for leadership opportunities

a. Meaningfully contribute to the clinical team

b. Refine leadership goals and pursue opportunities that complement a career development plan

c. Reflect upon optimal characteristics of role models

a. Demonstrate a commitment to collaborative skills in a dynamic team-based environment

b. Apply leadership skills to attain career goals

c. Serve as role models for junior medical students

EPA 9: Participate as a contributing and integrated member of an interprofessional team


Dimension 5: Caring/Valuing — Professionalism

Goals

5.1 Care deeply about becoming an excellent physician through a life of service
5.2 Care and support others in the profession
5.3 Value and behave in a manner consistent with the highest ethical standards of the profession

Goal 5.1

5.1 Care deeply about becoming an excellent physician through a life of service

 

Phase 1
Foundations of Clinical Practice

Phase 2
Doctoring

Phase 3
Advanced Doctoring

 

Milestones 5.1

a. Create a physician mission statement

a. Demonstrate commitment to personal and professional improvement and integrate one’s mission statement into daily activities

a. Use experiences to refine personal mission statement and commitment to a life of service

 

Goal 5.2

5.2 Care and support others in the profession

 

Phase 1
Foundations of Clinical Practice

Phase 2
Doctoring

Phase 3
Advanced Doctoring

Core Entrustable Professional Activity (EPA)

Milestones 5.2

a. Identify factors that affect the well-being of colleagues

a. Promote colleagues’ well-being through modeling and communication

a. Contribute to an environment of well-being within the health care team

EPA 7: Form clinical questions and retrieve high-quality evidence to advance patient care

Goal 5.3

5.3 Value and behave in a manner consistent with the highest ethical standards of the profession

 

Phase 1
Foundations of Clinical Practice

Phase 2
Doctoring

Phase 3
Advanced Doctoring

 

Milestones 5.3

a. Identify the basic principles of medical ethics

b. Recognize the humanistic core of professional values

c. Demonstrate respect for the human condition

a. Demonstrate the highest standards of individual and team-based ethical behavior that is patient-centered, culturally sensitive, and socially just

b. Apply knowledge of medical ethics to clinical situations

a. Demonstrate leadership in improving the ethical standards of the profession and the community

b. Demonstrate commitment to human dignity, social justice, and the common good

 

Dimension 6: Learning How to Learn — Practice-Based Learning

Goals

6.1 Develop a personal plan to become a better medical professional
6.2 Stimulate intellectual curiosity to question and advance knowledge through scholarship
6.3 Appropriately utilize evidence-based resources to address uncertainty in medicine and gaps in knowledge/skills

Goal 6.1

6.1 Develop a personal plan to become a better medical professional

 

Phase 1
Foundations of Clinical Practice

Phase 2
Doctoring

Phase 3
Advanced Doctoring

 

Milestones 6.1

a. Create an action plan for learning and career development

a. Broaden action plan to integrate the clinical practice of medicine

a. Re-evaluate and modify action plan to include acquisition of knowledge and skills deemed essential for postgraduate training in chosen specialty

 

Goal 6.2

6.2 Stimulate intellectual curiosity to question and advance knowledge through scholarship

 

Phase 1
Foundations of Clinical Practice

Phase 2
Doctoring

Phase 3
Advanced Doctoring

 

Milestones 6.2

a. Identify and assess the literature in an area of scholarly interest

a. Identify and begin to work on a scholarly project

a. Complete and present a scholarly project

 

Goal 6.3

6.3 Appropriately utilize evidence-based resources to address uncertainty in medicine and gaps in knowledge/skills

 

Phase 1
Foundations of Clinical Practice

Phase 2
Doctoring

Phase 3
Advanced Doctoring

 

Milestones 6.3

a. Recognize that gaps of knowledge and ambiguity exist in medicine

a. Identify appropriate resources to address uncertainty in medicine and gaps in knowledge/skills

a. Utilize appropriate resources to address uncertainty in medicine and gaps in knowledge/skills

 

 

Last edited on 06/15/2017.