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Medical Educators Weigh Curriculum Changes to Address Threats of Terrorism

Medical Educators Weigh Curriculum Changes to Address Threats of Terrorism During the initial weeks and months after the September 11 terrorist attacks, medical schools and teaching hospitals responded with a flurry of special programs on emergency preparedness and anthrax exposure. Now they face perhaps the greater challenge of incorporating long-term curriculum changes that address the potential for future terrorist attacks. "In terms of educational issues, it was the beginning of the anthrax incidents to which medical schools responded very rapidly," said Deborah Danoff, MD, associate vice president of the Association of American Medical Colleges' (AAMC) Division of Medical Education. "But now we're at the next level. We have to determine what to do now to prepare for the future. We need a long-term plan." The looks of that plan remain somewhat of a question mark. Throughout the country, medical schools and teaching hospitals are taking a variety of approaches, depending on their geographic locations and the nature of their student populations. In Manhattan, for example, medical educators want to impart a realistic awareness of risk without inducing paranoia. "We're trying to plan how best to incorporate awareness of managing threats of bioterrorism, recognition of diseases associated with bioterrorism, and dealing with the physical and psychological consequences," noted Robert Holzman, MD, head of the Center for Health Information and Preparedness at New York University (NYU) School of Medicine. Framework emerges Holzman concedes that NYU's plans for teaching medical students about preparedness for bioterrorism and terrorist attacks "is a gleam in our eye right now." But a framework is emerging, and new course material probably will go into effect in the next academic year. "Our general approach is multipronged," he said. In the Department of Medicine, sessions that cover disaster management, recognition of diseases related to chemical and biological weapons, the role of health departments, and management of psychological stress may be incorporated into a course entitled "The Physician, Patient, and Society." Some scientific courses may be revised, too. "In the study of pathophysiology, instead of traditional examples we may use examples related to bioterrorism," Holzman said. "When we look at the mechanisms by which toxins produce and exert their effects, we may look at anthrax rather than diphtheria toxin." Faculty also would like to take advantage of NYU's considerable program in computer-based training to complement traditional course work. At other institutions, faculty and administrators have reassessed the content of infectious disease courses. "Prior to September 11, diseases such as anthrax received some attention, but now we've started to stress them," said Carl Chudnofsky, MD, chair of emergency medicine at Albert Einstein Medical Center in Philadelphia, which is affiliated with Jefferson Medical College of Thomas Jefferson University. Faculty at the University of California, San Francisco, School of Medicine resuscitated course content on smallpox. "As an infectious disease entity, smallpox had worked its way out of the curriculum," noted Helen Loeser, MD, associate dean for curriculum. "But because our second-year microbiology course is very clinically oriented, we put it back in." The big picture Most, if not all, medical students in the United States study some material on how radiation and chemical and biological agents affect human health. What's lacking, said Val G. Hemming, MD, dean of the F. Edward Hébert School of Medicine at the Uniformed Services University of the Health Sciences, Bethesda, Md, is an overall context of intentional use for destructive purposes. "No one has focused on issues that deal specifically with these agents being used to harm communities," he noted. At the request of Rep Steve Buyer (R, Ind) Hemming testified last November before a House committee. "The consensus of what was discussed is that every medical school does need to address these issues in its curriculum," Hemming said. "But how should it be done? My opinion is that it's not specific content as much as it is focus." Danoff of the AAMC agrees that a broad context is needed. "We need to consider not just the agents themselves, but physicians' communication skills and interactions with the public health community." The AAMC has convened a panel of 10 experts in bioterrorism and medical education that will recommend new objectives and strategies for medical schools. The recommendations are expected by late March or early April. Hemming believes the Liaison Committee on Medical Education (LCME) also should be involved. "The LCME should tell medical schools, ‘You need to focus part of your curriculum on these four, five, or six issues,'" he said. Nancy Nelson, MD, cochair of the LCME, said the accrediting body has "nothing active" on the issue, but would like to receive suggestions from individuals or groups on ways to address bioterrorism education in medical school curricula. In the meantime, Holzman of NYU said he expects minor curriculum changes rather than a major realignment. "We're not going to stop courses in histology to teach chemical warfare instead." (See http://www.aamc.org/newsroom/bioterrorism/start.htm for medical schools' responses to terrorism.) http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png JAMA American Medical Association

Medical Educators Weigh Curriculum Changes to Address Threats of Terrorism

JAMA , Volume 287 (9) – Mar 6, 2002

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Publisher
American Medical Association
Copyright
Copyright © 2002 American Medical Association. All Rights Reserved.
ISSN
0098-7484
eISSN
1538-3598
DOI
10.1001/jama.287.9.1099
Publisher site
See Article on Publisher Site

Abstract

During the initial weeks and months after the September 11 terrorist attacks, medical schools and teaching hospitals responded with a flurry of special programs on emergency preparedness and anthrax exposure. Now they face perhaps the greater challenge of incorporating long-term curriculum changes that address the potential for future terrorist attacks. "In terms of educational issues, it was the beginning of the anthrax incidents to which medical schools responded very rapidly," said Deborah Danoff, MD, associate vice president of the Association of American Medical Colleges' (AAMC) Division of Medical Education. "But now we're at the next level. We have to determine what to do now to prepare for the future. We need a long-term plan." The looks of that plan remain somewhat of a question mark. Throughout the country, medical schools and teaching hospitals are taking a variety of approaches, depending on their geographic locations and the nature of their student populations. In Manhattan, for example, medical educators want to impart a realistic awareness of risk without inducing paranoia. "We're trying to plan how best to incorporate awareness of managing threats of bioterrorism, recognition of diseases associated with bioterrorism, and dealing with the physical and psychological consequences," noted Robert Holzman, MD, head of the Center for Health Information and Preparedness at New York University (NYU) School of Medicine. Framework emerges Holzman concedes that NYU's plans for teaching medical students about preparedness for bioterrorism and terrorist attacks "is a gleam in our eye right now." But a framework is emerging, and new course material probably will go into effect in the next academic year. "Our general approach is multipronged," he said. In the Department of Medicine, sessions that cover disaster management, recognition of diseases related to chemical and biological weapons, the role of health departments, and management of psychological stress may be incorporated into a course entitled "The Physician, Patient, and Society." Some scientific courses may be revised, too. "In the study of pathophysiology, instead of traditional examples we may use examples related to bioterrorism," Holzman said. "When we look at the mechanisms by which toxins produce and exert their effects, we may look at anthrax rather than diphtheria toxin." Faculty also would like to take advantage of NYU's considerable program in computer-based training to complement traditional course work. At other institutions, faculty and administrators have reassessed the content of infectious disease courses. "Prior to September 11, diseases such as anthrax received some attention, but now we've started to stress them," said Carl Chudnofsky, MD, chair of emergency medicine at Albert Einstein Medical Center in Philadelphia, which is affiliated with Jefferson Medical College of Thomas Jefferson University. Faculty at the University of California, San Francisco, School of Medicine resuscitated course content on smallpox. "As an infectious disease entity, smallpox had worked its way out of the curriculum," noted Helen Loeser, MD, associate dean for curriculum. "But because our second-year microbiology course is very clinically oriented, we put it back in." The big picture Most, if not all, medical students in the United States study some material on how radiation and chemical and biological agents affect human health. What's lacking, said Val G. Hemming, MD, dean of the F. Edward Hébert School of Medicine at the Uniformed Services University of the Health Sciences, Bethesda, Md, is an overall context of intentional use for destructive purposes. "No one has focused on issues that deal specifically with these agents being used to harm communities," he noted. At the request of Rep Steve Buyer (R, Ind) Hemming testified last November before a House committee. "The consensus of what was discussed is that every medical school does need to address these issues in its curriculum," Hemming said. "But how should it be done? My opinion is that it's not specific content as much as it is focus." Danoff of the AAMC agrees that a broad context is needed. "We need to consider not just the agents themselves, but physicians' communication skills and interactions with the public health community." The AAMC has convened a panel of 10 experts in bioterrorism and medical education that will recommend new objectives and strategies for medical schools. The recommendations are expected by late March or early April. Hemming believes the Liaison Committee on Medical Education (LCME) also should be involved. "The LCME should tell medical schools, ‘You need to focus part of your curriculum on these four, five, or six issues,'" he said. Nancy Nelson, MD, cochair of the LCME, said the accrediting body has "nothing active" on the issue, but would like to receive suggestions from individuals or groups on ways to address bioterrorism education in medical school curricula. In the meantime, Holzman of NYU said he expects minor curriculum changes rather than a major realignment. "We're not going to stop courses in histology to teach chemical warfare instead." (See http://www.aamc.org/newsroom/bioterrorism/start.htm for medical schools' responses to terrorism.)

Journal

JAMAAmerican Medical Association

Published: Mar 6, 2002

Keywords: terrorism,schools, medical

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