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Informatics Elements of a Medical School
Predoctoral Managed Care Curriculum

This document was written as a course assignment in May of 1996. We were asked to write about informatics components of a managed-care oriented medical school curriculum. I felt it would be of interest to other persons working on curricula for medical informatics and managed care, so I'm publishing it here. Please send comments and feedback to me (see footer).
See also a related presentation: An Information Age Curriculum for Medical Students.


I will present recommendations and topics in outline form. Note that groupware will emerge as a common element of many recommendations.


Evaluation must be done both of the curriculum and of the individual student. Informatics tools, including methods for capturing, storing, analyzing, and presenting evaluations can be implemented for both forms of evaluation. Evaluation is fundamental to curriculum design, indeed, many argue it should be the starting point for the entire process. An explicit understanding of goals and objectives will determine evaluation, and evaluation will influence content and methods. Informatics support for evaluation is fundamental.

Curriculum Development and Implementation

Informatics tools are applicable to both development and implementation. Electronic mail, web tools, and groupware applications can be used to gather data, solicit input, and publish results and plans.

Groupware may play a key role in both development and implementation. The primary criticism of problem-based learning, other than board scores, is its cost. In the past much teaching has been voluntary. As physician incomes fall, and clinical obligations increase, volunteerism may become limited. Even if physician salaries fall 50%, they will be too costly to employ for significant amounts of time as small-group leaders. This will be particularly critical as tuitions for medical education are forced down. Institutions such as Duke's Fuqua school of business [1] have used groupware solutions to do case-based learning in the MBA program. Similar strategies may be applicable to clinical problem-oriented education, and may allow a much greater student/teacher ratio and less contact time.

Computer-assisted instruction (CAI) has been felt to be applicable to medical student education. In practice, this has been problematic. The rise of the world-wide-web and Java, and emerging standards for multimedia and virtual-reality, may solve age-old problems with platform dependency and distribution. Web-based CAI should be evaluated and the possibility of medical school consortia evaluated.

Curriculum Content

Medical informatics, including information technology, has many implications for curriculum content, both as a topic and as a facilitator of other topics. I'll consider the range of possibilities in outline form, with selected comments.

Tool familiarity

Informatics Applications for Practice

operations research and systems analysis
diagnostic methodologies and testing
decision analysis and utility models
decision support
information retrieval
data analysis

Sociology and Ethics

(informatics related)


  1. Duke Fuqua Global MBA http://www.fuqua.duke.edu:80/programs/gemba/
  2. Leape L. Error in medicine. JAMA 1994 Dec 21;272(23):1851-7.
  3. Leape L, Bates DW, Cullen D, et al.. Systems analysis of adverse drug events. JAMA 1995 Jul 5;274(1):35-43.
  4. Elson R. Are Reminder systems a form of CME? JAMA 1995 Dec 20; 274(23):1836

Author: John G. Faughnan.  The views and opinions expressed in this page are strictly those of the page author. Pages are updated on an irregular schedule; suggestions/fixes are welcome but they may take weeks to months to be incorporated. I reserve copyright except where noted, if you want to repost or quote a page just ask. Anyone may freely link to anything on this site and print any page; no permission is needed for linking,  printing, or distributing printed copies.