Assistant Dean and Director: Professor Bankston

The Patient-Centered Learning Program

The academic program at the Northwest Campus is designed around the principle that the learning of essential basic science information should occur in the context of patient interaction, patient case studies, and practice of clinical skills. To that end, the faculty of the Northwest Campus have dedicated themselves to a student-centered and patient-centered approach that involves their widely acclaimed Problem-Based Learning Curriculum, the unique History and Physical Learning Center, the Steven C. Beering Library, externship opportunities with local physicians and hospitals, and the participation of 132 volunteer community physicians.

The Northwest campus Patient-Centered Learning Program provides an unique opportunity within the Indiana System for students to experience a different, and we think excellent, approach to medical student learning.

We welcome visits from prospective students who would like to learn more about our Patient-Centered Learning Program and to participate with our first- or second-year medical students in one of the case-based learning sessions described below. Please contact Dr. Pat Bankston, Assistant Dean and Director, pbanks@iun.edu, to schedule a visit.

Our Problem-Based (Case-Based) Learning Approach

For 19 years after its founding in 1972, Indiana University School of Medicine—Northwest offered a traditional first- and second-year medical curriculum. Beginning with the 1989-1990 academic year, the Northwest Campus introduced an innovative curriculum with heavy emphasis on problem solving and active learning. The highlights of this new curriculum include: (A) problem-based learning (PBL) sessions, where small groups of five to seven students meet three times a week for two hours to discuss and analyze patient cases in the presence of a faculty moderator. During these student-directed PBL sessions, students set learning objectives, generate and test hypotheses, share learned information, and apply knowledge of basic science principles to the care of patients; (B) small numbers of lectures presented by experienced faculty supplement the PBL sessions by providing helpful overviews of key concepts; (C) organization of the first and second year curricula into seven sequential “Steps” or units; this approach allows students to concentrate all of their studies to one subject at a time; (D) basic science laboratories in Gross Anatomy, Histology, Neuroscience, and Pathology provide active-learning experiences that reinforce and expand the knowledge base attained during PBL sessions and lectures; and (E) PBL sessions, lectures, and laboratories end by noon each day, allowing ample time for independent study and one or more afternoons per week for other patient-based activities.

The 7 Steps (courses) of the IUSM—Northwest PBL curriculum are:

1st Year

• Step 1 The Molecular Basis of Medicine (Biochemistry, Molecular Biology) 6 weeks
• Step 2 Human Structure (Gross Anatomy, Histology, Cell Biology) 11 weeks
• Step 3 Systemic Function and Drug Action (Physiology) 6 weeks
• Step 4 Neural Control and Disease (Neuroscience) 6 weeks
• Step 5 Medications and Disease (Pharmacology) 6 weeks

2nd Year

• Step 6 Invasion and Defense (General Pathology, Microbiology, Immunology) 11 weeks
• Step 7 Pathophysiology and Advanced Problem Solving (Introduction to Medicine, Systemic Pathology, Advanced Doctor/Patient Relationship) 24 weeks

Doctor/Patient Relationship (dispersed throughout the first-year)

Component Descriptions

Behavioral Scienc The Behavioral Science curriculum deals with systemic introduction to human development involving learning, conditioning and perception. Cases, including those used in Step 1 through Step 5, will be used to emphasize human behavioral studies regarding those concepts that are considered useful in understanding and treating disturbed behavior. The development of personality and the role of mental mechanisms in healthy and unhealthy adjustments are also reviewed.

Medical Ethics Medical Ethics consists of a series of seminars devoted to discussion of various topics such as disclosure, confidentiality, informed consent, and death and dying. Cases posing dilemmas that relate to step cases will be presented, along with abstract material to facilitate conceptual and ethical analysis.

History Taking and Physical Diagnosis The H & P Learning Center’s goal is to support medical education, evaluation, and research. It uses standardized patients to create simulations of history and physical findings of real patients. Standardized patients are individuals trained to present a patient’s history and physical examination findings in a consistent manner. They are also trained to evaluate the clinical and interpersonal skills of individual medical students. Students will be involved in many projects utilizing the H & P Learning Center and standardized patients during the Doctor/Patient Relationship course.

History Taking The fundamentals of history taking consist of five introductory history-taking sessions in the first half of the freshman year. To aid in the development of history-taking skills, students will be participating in several projects involving hands-on training with standardized patients in the H & P Learning Center. In addition to the introductory history-taking sessions, students will be involved in a series of preceptor visits. Each student will be paired with a local area family practitioner. The student will shadow the preceptor in a primary care setting. As the student develops history-taking skills, he/she will interview patients seen in the preceptor’s office. Preceptors will critique the student’s write-ups and provide feedback so improvement can be made on their history-taking skills. At the end of the history-taking instruction, students will be evaluated by standardized patients in the H & P Learning Center.

Physical Diagnosis The second term of the freshman year will continue with instructing the fundamentals of the Physical Examination. This portion of the curriculum consists of ten sessions. Each week a portion of the physical exam will be presented first by demonstration on a standardized patient, and then by having students pair up to practice. Standardized patients will also be used in a series of learning sessions in the H & P Learning Center. During this segment of the curriculum students will have an opportunity for hands-on experience in the physical exam. Students will examine standardized patients “from head to toe” in several H & P Learning Center Projects. The history and physical exam instruction will culminate in a testing session using standardized patients in the performance of a head-to-toe physical exam with history and health-risk appraisal in the H & P Learning Center.

Chronic Patient Program At the beginning of each academic year, freshmen students will be assigned one chronic patient to monitor and care for consistently for the two years they stay at the Northwest Center. Students will be expected to visit or speak with their patient on a weekly and/or biweekly basis. They also will be expected to keep a detailed journal of their experiences in treating their patient. In turn, the patient will utilize their medical student as a resource for questions concerning treatment, and as a means of emotional support. The intent of this project is to introduce students to the art of building a solid doctor-patient relationship. Students look to their preceptors for help and guidance during this experience. All students must report any significant patient comments or physical exam findings to the patient’s primary care physician. All charts and journals will be considered confidential material and only first names should be used when documenting any information about the chronic patients.

Discussion Series In addition to Behavioral Science, Medical Ethics and History Taking, and Physical Diagnosis, the Doctor/Patient Relationship will include a group discussion segment which has been characteristic of this portion of the curriculum since its inception at the Northwest Center. The Discussion/Brown Bag Series is designed to encourage group cohesion among students and to provide a mechanism for communication for both the students and the faculty. The discussion series will be interspersed with preceptor visits the first ten weeks of the freshman year. Sessions will consist of guest speakers, panel discussions, and student discussions. These sessions will be organized around topics which integrate the various components of the Doctor/Patient Relationship. The series may include such topics as professionalism, the Managed Care Plans, family systems, prevention and health maintenance, medical malpractice, the importance of community in health care systems, spirituality and cross-cultural issues in patient care, and issues in documentation and confidentiality. Faculty members involved in all areas of the Doctor/Patient Relationship will be encouraged to attend these sessions so all issues will be viewed from a variety of perspectives.

Our library, librarian, and library assistant help students gather information and provide a place to study.

To facilitate self-directed study, students have 24-hour access to the Steven C. Beering Medical Library and Medical Resource and Learning Center, which houses a Student Learning Center with 19 computer stations, audio-visual and computer-directed learning programs, and an extensive series of periodicals, textbooks, and other reference materials. A professional librarian and assistant are available to help students locate the latest in medical information to aid their studies. The library complex has ten comfortable study rooms for students and a lounge area for reading journals or medical literature. The Northwest campus is the only regional campus in the School of Medicine that maintains a large medical library and student study center of this nature.

Our Doctor/Patient Course facilitates learning of professional skills, values, attitudes, and behaviors important to our student doctors.

An important part of the IUSM—Northwest Patient Centered Learning Program is the Doctor/Patient Relationship course. One element of this course is eight weeks of exposure to patients in family practice physician’s offices beginning in the first week of medical school. A similar eight-week experience with specialty physicians begins the second year of medical school. Student clinical skills are taught by local doctors who instruct students in the fundamentals of doctor/patient interactions, patient interviewing, and many other aspects of primary care ambulatory medical practice. The topics “medical ethics” and “behavioral science” are also part of the Doctor/Patient Course.

The History and Physical Learning Center helps student doctors learn and practice interviewing and physical exam skills early in their curriculum.

To facilitate the Doctor/Patient Relationship course, the Northwest campus maintains for the exclusive use of its students a state-of-the-art History and Physical Learning facility, the largest and most extensive H & P learning facility of all the regional campuses. The facility has six private examination rooms for students to practice their skills with standardized patients (SPs). SPs are individuals trained to present a patient’s history and physical examination findings in a “standardized” manner and also to evaluate the clinical and interpersonal skills of the medical student examiners. Instruction and extensive practice sessions in H & P skills at IUSM—Northwest is offered during the first year of medical school (all other programs at IUSM teach these skills in the second year); thus, our students are uniquely prepared to apply their H & P skills to real patient experiences between the first and second years (summer externships).

Students follow an ill patient as the patient’s own student doctor for two years to learn the real life problems, family situations, financial difficulties, and changes that occur in the course of receiving medical care. In an exciting, innovative approach unique to our campus, medical students will be part of an “interprofessional health care team” together with nursing students and social work students from the College of Health and Human Services at IU Northwest. Some students become like family members, attending birthday parties, visits to the doctor, and surgeries. Through these interactions, each student learns about the humanistic side of medicine and gains knowledge of patient social, financial, cultural, and spiritual matters that may influence medical care and patient management.

Competency Education is an easy matter in our student-centered and patient-centered approach.

The Northwest Campus has been a leader in the implementation of the IUSM Competency-Based Curriculum, and all courses and all faculty participate in competency training and assessment. The goal of the Competency Curriculum is to develop and graduate physicians with characteristics that represent the highest aspirations of the profession. We expect our students to strive for the qualities of altruism, honesty, compassion, respect, responsibility, accountability, and excellence, and upon graduation to pursue their work as a virtuous activity and a moral undertaking. In other words, our goal for our students is for them to become virtuous physicians. At IUSM—Northwest, the patient-centered approach, the small student to faculty ratio, three-times-per-week small group PBL sessions, and H & P training with SPs allow multiple opportunities to teach competencies and to provide fair evaluations, feedback, and timely help if skills need improvement.

Scholarships available

A limited number of Northwest Indiana scholarships are available for eligible students attending the Indiana University School of Medicine—Northwest. Inquiries should be made to Dr. Bankston.

Summer Research Opportunities

A small number of research-oriented medical students are chosen each year to participate in the Summer Research Fellowship Program. Students in this program are awarded a stipend to work on biomedical research projects under the supervision of a campus faculty member in the summer between the first and second year.

Medical students at IUSM—Northwest are also welcome and encouraged to attend any of the numerous educational programs hosted by the Northwest campus, including (a) our annual fall and spring seminar series in basic and patient-based research; (b) visiting professor lecture-hour series presented by guest lecturers; and (c) any of the large number of additional medical-educational activities that are offered by seven local hospitals.

Student-Centered Approach

The philosophy of the faculty and support staff toward medical students is one of helpfulness and nurture of adult learners, as student doctors learn the knowledge, skills, values, and attitudes characteristic and unique to the special profession that they are entering. The faculty and support staff see themselves as partners, facilitators, and resources to help students realize their goal of becoming the best doctor they can be, for their own sake and that of their future patients.

Location and Facilities

Indiana University School of Medicine—Northwest is located on the Indiana University Northwest campus in the Glen Park area of the City of Gary and occupies approximately 35,000 square feet of a new building on the southwest corner of the campus. The safe and attractive campus is bounded on three sides by the Little Calumet River, the well-kept residential community of Glen Park, and the Gleason Golf Course. Students have 24-hour access to the building and all of its facilities. The new building includes a student lounge with a small kitchen area and refrigerator for personal food storage and preparation. Locker rooms and showers provide students with a place to freshen up after exercise or sessions in the gross anatomy laboratory.

The current undergraduate enrollment at the IU Northwest campus is approximately 5,000 students. IU Northwest has a student union complex with gymnasium and fitness center available for medical student exercise and a cafeteria for low-priced food. Cultural activities on campus are numerous, including an IUN-sponsored local drama group, the Northwest Theater, and the Northwest Indiana Symphony Orchestra. In addition, the numerous sports events, museums, ethnic neighborhoods, restaurants, and cultural attractions of Chicago are less than an hour drive from the campus. For those who prefer an escape to the out-of-doors, the Hoosier Prairie and the Indiana Dunes National Lakeshore, in addition to numerous parks in Lake, Porter, and LaPorte Counties, are outstanding areas for hiking, swimming, picnics, and cross country skiing.

Housing

Northwest Indiana offers a variety of housing opportunities within easy driving distance of the campus. IUN is a commuter campus and, as such, has no dormitories or other student housing. However, IUSM—Northwest maintains two apartment buildings directly across from the medical building with a limited number of apartments for reasonable rent to medical students. Arrangement to see the apartments is strictly by appointment only with Dawn Ilgenfritz, director of operations and finance, IUSM—Northwest, (219)980-6551, dilgenfr@iun.edu. Unscheduled visits cannot be accommodated.

For additional information concerning Indiana University School of Medicine—Northwest, please visit the website: http://iusm-nw.medicine.iu.edu or, write or contact:
Patrick W. Bankston, Ph.D.
Assistant Dean and Director
Professor of Anatomy and Cell Biology
Professor of Pathology and Laboratory Medicine
Indiana University School of Medicine—Northwest
3400 Broadway
Gary, IN 46408
Phone: (219) 980-6562
Fax: (219) 980-6566
E-mail: pbanks@iun.edu