Table 4.
Integrated curriculum map (in-progress) of aligned, competency-based 24-Hour Movement Guideline content in the Queen’s University Undergraduate Medical Education curriculum.
| Canadian 24-Hour Movement Guidelines for Adults content | Queen’s Competency Framework31 | |||||
|---|---|---|---|---|---|---|
| Learning Event Objectives | Learning Event Title: Description (Format) | Assessment Type: (Duration) | Course (Term, Semester, Year) |
Added Instruction Time | Queen’s Outcomesa | Queen’s Competenciesb |
| Describe the benchmarks for promoting health via physical activity, sedentary behaviour, and sleep in accordance with the 24HMG |
Introduction to Health Promotionc: Customizable module slides to introduce the 24HMG (lecture) and instructions to compare and contrast different prevention strategies per the recommendations of each age category (small group learning) |
Summative: Exam (20 minutes, 5 questions) | MEDS123: Population Health (Term 2) | +5 minutes | Health Advocate 1.1.5 (Provide examples of disease prevention and the promotion of healthy behaviours in clinical practice) | 7. Responds to the individual patient’s health needs by advocating (supporting and speaking up) with the patient within and beyond the clinical environment |
| Health Advocate 2.1.1 (Identify the health needs of a community or population) Health Advocate 2.1.2 (Identify the availability of and access to resources for a community or a population) |
8. Identifies and communicates about community resources to promote health, prevent disease and manage illness in the communities and populations that will impact their practice | |||||
| Health Advocate 3.1.1 (Describe the role of physicians [individually and as represented by their organizations] to be socially accountable by advocating for individual and population health) | 9. Is able to identify and engage opportunities to demonstrate social responsibility and service | |||||
| Be able to discuss appropriate physical activity, sedentary behaviour, and sleep interventions to promote health and prevent disease |
Social & Structural Determinants of Health: Added module section on accessibility of physical activity, sedentary behaviour, and sleep interventions for all socioeconomic backgrounds (directed independent learning) |
Formative: Module completion grade Summative: Exam (75 minutes, portion of included questions) |
MEDS117: Health Determinants (Term 1) | +10 minutes | Health Advocate 1.1.1 (Apply knowledge of the determinants of health to a patient’s health needs and challenges respecting the importance of diversity) Health Advocate 1.1.2 (Identify obstacles to health care and access with a patient and family, and work toward solutions, respecting the diversity of the patient population) |
7. Responds to the individual patient’s health needs by advocating (supporting and speaking up) with the patient within and beyond the clinical environment |
| Give examples of recommended preventive care interventions on physical activity, sedentary behaviour, and sleep across age ranges at primary, secondary, and tertiary levels of prevention |
Prevention: 3 customizable slides on type 2 diabetes prevention strategies using the 24HMG: Primary prevention: Movement behaviour change program for teens Secondary prevention: Movement behaviour screening with risk assessment in adults Tertiary prevention: Movement behaviour change programs for adults with type 2 diabetes (lecture) |
Summative: Exam (60 minutes, portion of included questions) | MEDS115: Family Medicine (Term 1) | Net zero (replace 3 slides with example of COPD prevention strategies in 60 minute lecture) |
Medical Expert 1.1.3 (Identify the consequences of structural variability and/or damage or loss of tissues and organs associated with genetic variation and pathophysiological processes including, but not limited to, inflammation, infection, neoplasia, atherosclerosis, hematological disorders and trauma) Medical Expert 1.1.1 (For each major organ system, explain normal human structure [location, macroscopic and microscopic structure] and development, and demonstrate the ability to apply this knowledge to relevant clinical presentations) |
1. Articulates and utilizes the basic sciences to inform disease prevention, health promotion and the assessment and management of patients presenting with clinical illness |
| Medical Expert 2.1.5 (Select and prioritize medically appropriate diagnostic tests depending on the urgency of the patient’s condition, with consideration of risks, benefits and costs) | 2. Is able to perform a complete and appropriate clinical assessment of and provide initial management for patients presenting with clinical illness | |||||
| Be able to explain the evidence behind the integration of physical activity, sedentary behaviour, and sleep in preventive care interventions |
Prevention: Video on “The Whole Day Matters”, explaining the integrated nature of physical activity, sedentary behaviour, and sleep and the 24-hour paradigm (lecture) |
Summative: Exam (60 minutes, portion of included questions) | MEDS115: Family Medicine (Term 1) | Net zero (replace 10 minute video, “23 ½ Hours” by Dr. Mike Evans) |
Medical Expert 1.1.3 (Identify the consequences of structural variability and/or damage or loss of tissues and organs associated with genetic variation and pathophysiological processes including, but not limited to, inflammation, infection, neoplasia, atherosclerosis, hematological disorders and trauma) Medical Expert 1.1.1 (For each major organ system, explain normal human structure [location, macroscopic and microscopic structure] and development, and demonstrate the ability to apply this knowledge to relevant clinical presentations) |
1. Articulates and utilizes the basic sciences to inform disease prevention, health promotion and the assessment and management of patients presenting with clinical illness |
| Medical Expert 2.1.5 (Select and prioritize medically appropriate diagnostic tests depending on the urgency of the patient’s condition, with consideration of risks, benefits and costs) | 2. Is able to perform a complete and appropriate clinical assessment of and provide initial management for patients presenting with clinical illness | |||||
| Develop a non-pharmacological management plan for type 2 diabetes using the 24HMG recommendations |
Introduction to Pharmacological [and Non-Pharmacological] Management of Type 2 Diabetes: Customizable slides on approaches to type 2 diabetes management through physical activity, reduction of sedentary behaviour, and sleep (lecture) |
Formative: Optional non-graded quiz, 1 added question on Reading Assessment Test |
MEDS231: Endocrine and Renal (Term 3) | +5 minutes | Medical Expert 2.2.1 (Develop and implement an appropriate management plan for the clinical presentation, including prescribing non-pharmacologic, pharmacologic and interventional options) | 2. Is able to perform a complete and appropriate clinical assessment of and provide initial management for patients presenting with clinical illness |
| Learn how to teach diabetes self-care skills (including promoting physical activity and sleep and limiting sedentary behaviour) using motivational interviewing and brief action planning | Diabetes Expo: One of seven stations on diabetes self-care skills devoted to 24HMG promotion, taught by diabetes nurse educators and dietitians, with practice on applying motivational interviewing techniques to assess readiness and use appropriate 24HMG promotion strategies in a simulated scenario (Demo) |
Formative: Midterm (60 minutes) Summative: Final exam (180 minutes) |
MEDS231: Endocrine and Renal (Term 3) | Net zero (modify one existing expo station) | Medical Expert 2.2.1 (Develop and implement an appropriate management plan for the clinical presentation, including prescribing non-pharmacologic, pharmacologic and interventional options) Medical Expert 2.1.4 (Perform a focused and complete physical examination that is relevant to the specific patient encounter) Medical Expert 2.2.2 (Integrate preventive measures and health promotion relevant to a given clinical presentation) Medical Expert 2.1.6 (Correctly interpret diagnostic tests) |
2. Is able to perform a complete and appropriate clinical assessment of and provide initial management for patients presenting with clinical illness |
| Health Advocate 1.1.2 (Identify obstacles to health care and access with a patient and family, and work toward solutions, respecting the diversity of the patient population Health Advocate 1.1.5 (Provide examples of disease prevention and the promotion of healthy behaviours in clinical practice) |
7. Responds to the individual patient’s health needs by advocating (supporting and speaking up) with the patient within and beyond the clinical environment | |||||
| Determine risks for age and sex-specific conditions to guide history, physical examination, screening, and counselling on physical activity, sedentary behaviour, and sleep |
Mandatory Encounter on Preventative Care (MCC Presentation #74: Periodic health encounter/Preventive health advice): Log the role played, date, location, and practice setting of an encounter involving history, screening, and counselling on the 24HMG (clerkship rotation) |
Formative: One case reflection Summative: Four case reflections, one community reflection |
MEDS446: Family Medicine (Clerkship term) | Net zero (becomes the one mandatory logged encounter for MCC Presentation #74) | Medical Expert 2.1.3 (Elicit a history that is relevant to the specific patient encounter) Medical Expert 2.1.4 (Perform a focused and complete physical examination that is relevant to the specific patient encounter) Medical Expert 2.2.1 (Develop and implement an appropriate management plan for the clinical presentation, including prescribing non-pharmacologic, pharmacologic, and interventional options) |
2. Is able to perform a complete and appropriate clinical assessment of and provide initial management for patients presenting with clinical illness |
| Communicator 1.1.4 (Respect diversity and difference and communicate effectively with individuals regardless of their social, cultural or ethnic backgrounds) | 3. Effectively communicates with colleagues, other health professionals, patients, families and other caregivers | |||||
| Health Advocate 1.1.5 (Provide examples of disease prevention and the promotion of healthy behaviours in clinical practice) | 7. Responds to the individual patient’s health needs by advocating (supporting and speaking up) with the patient within and beyond the clinical environment | |||||
24HMG = 24-Hour Movement Guidelines; MCC = Medical Council of Canada
a
Only the CanMEDS roles that were deemed as relevant to the proposed 24HMG content are listed in Table 2. As the curriculum map is in-progress, it is possible that linkages to other CanMEDS roles could be identified and listed in the final curriculum map.
b
24HMG curricula were aligned with existing competencies at the Queen’s University UGME Competency Framework either by ensuring that the competencies associated with existing learning events that we modified remained applicable or by linking new 24HMG curricula to existing competencies that we deemed were most applicable. Additionally, 24HMG content will fill gaps within newer MCC presentations in preventive care, which will be incorporated into existing assessment plans. Questions will be developed for the MCC Qualifying Examinations Part I and II section on Health Promotion and Illness Prevention.
c
The learning events in Table 2 are a combination of (i) existing learning events in the Queen’s University 2019-2020 UGME curriculum that related to the 24HMG and have been modified by the authors (e.g., row 1, modified from row 3 of Table 1) and (ii) new learning events that have been developed by the authors as short pieces of content that can either be added to existing learning events or traded for content within existing learning events not related to the 24HMG.