Corporate education (CE) is not a term traditionally associated with medical school, but for all new students at Duke-NUS it precedes anatomy, physiology and cell biology. Before so much as speaking to a patient, they’re immersed in a world of conflict resolution, group negotiations and network building. The terminology may come from business school, but the principles will help define them as physicians. Beginning in the very first week, the CE module provides the platform on which the ethos of Duke-NUS is to be built.

“The delivery of healthcare is no longer an individual sport,” says Dr. Craig Stenberg, Associate Dean of Student Affairs and Admissions at Duke-NUS, explaining that physicians more than ever must cooperate and work in multidisciplinary care teams. By studying managerial and teamwork skills, students are also learning effective strategies to approach the challenges they will face throughout their medical school education and career, he says. “The CE experience sets the stage for the learning environment. It helps the students to develop critical and creative thinking skills and the facility to work with others.”

Laying the foundations
The CE module is a 2-day retreat at the beginning of the 2-week foundations program at the start of Duke-NUS Graduate Medical School. Students are divided into teams and embark upon a series of discussions and roleplays designed to help them learn how to resolve differences of opinion, settle conflicts and overcome cultural communication issues. The implications of these team-building exercises are not merely theoretical: the students will remain in the same learning teams for the entire first year, giving them plenty of opportunity to put their newfound skills into practice. Guidance is on hand during this experience from the faculty and a group of senior students, who fly in from Duke University School of Medicine in Durham, North Carolina to share their wisdom and experience with the juniors.

 
Duke-NUS students work and study in the same learning teams for the whole of the first year. The Corporate Education module teaches them how to perform as a unit and play to the strengths of each individual member - skills which will prove essential if the teams are to achieve academic success.

The class of 2013 comprise 56 students, the largest batch as to date.


With the teams and principles established, the foundations course concludes with the White Coat Ceremony, when students formally accept their calling into the medical profession. Friends and family come from all over the world to watch the dean and vice-dean place the coats on the students, who recite a modern version of the Hippocratic Oath. “We were the first to introduce this in Asia,” says
Dr. Stenberg. “It’s been a very important part of the culmination of the beginning phase of students’ training in medicine. There’s seldom a dry eye in the house.”

The birth of corporate medical education
  For Professor Robert Kamei, Vice Dean of Education at Duke-NUS, the foundations course is a personal highlight of the school’s new and innovative curriculum. He was closely involved in the decision to introduce CE, beginning with a chance meeting in Durham with one of the directors of Duke CE – a global company founded in July 2000 by academics from Duke University's Fuqua School of Business. Duke CE specializes in providing adult learning and development services, and Professor Kamei quickly realized that their values and methods were aligned with his. All parties signed on, and Duke CE became part of the Duke-NUS curriculum.
"We basically live in our teams – we think together, we perform together, we study together and we party together," says Ms. Padmastuti Akella (far right), a new first-year student at Duke-NUS. "Especially being an international student – my teammates are my family."
Professor Kamei sees the CE module as just a small part of the bigger picture at Duke-NUS. While other medical schools use traditional methods to deliver vast amounts of educational material, Duke-NUS has purposefully recognized the importance of the ‘hidden curriculum’ – those core values for the school that define an organization’s real identity. Beyond simply learning core content, it was critical to create a learning environment that would enable students to learn how to study, think and grow for themselves. “Physicians need to continue to learn after medical school,” says Professor Kamei. “They need to be able to take a problem that they’ve been faced with, learn about it themselves, discuss it with their peers and come to some logical conclusion that makes sense for their patient. So we give the students not only the academic skills to learn medicine but also the creative thinking and teamwork skills that are going to be necessary. We want our students to have the leadership abilities to be able to implement some of the brilliant things that we know they’ll come up with.”

The CE program complements the team-based learning environment, known as TeamLEAD (Learn, Engage, And Develop), which forms the core of the first year curricular delivery strategy at Duke-NUS. Besides helping them to learn the material, the team-based approach also requires students to develop their personal skills and learn important lessons about human interaction, according to Dr. Stenberg. “A lot of interesting dynamics emerge when you ask groups to come to answers. Students learn very quickly that it’s not necessarily the one who is most confident or most inclined to share that has the correct answer. Sometimes there may be students who are a bit shyer or less inclined to speak up, but who nevertheless may be in a better position to help the team come up with the right answer. They have to develop a collective sense of judgment about how they’re going to come together and process the various answers,” he says. Thus, the CE program gives the students the skills to maneuver through these team dynamics more effectively.


Building success
The inclusion of CE in the new curriculum initially raised a few eyebrows, but so far the decision appears to be paying off. The latest exam results show that at the end of the first year, Duke-NUS students performed at or above the US national average on an examination which covers the basic science content taught in medical schools, written by the National Board of Medical Examiners. What makes this score remarkable, however, is the fact that Duke-NUS covers the basic sciences in one year, while other US schools take this same test at the end of their 2nd year.

Ultimate proof, says Professor Kamei, will come once the first students graduate after the full 4 years. But for now he remains confident that the right values are being instilled, and that this unique fusion between business and medicine will prove to be a success.

“For the first year or two, I don’t think the students really understood why Duke CE was here because they didn’t have a context of how highly we value teamwork. But now groups of students who have finished the first year have acknowledged that they struggled at times working as a team, and that their grade suffered because they didn’t really understand how to communicate and work together. Because the junior students hear this from their seniors, they understand now how important this is. The whole Duke CE piece keeps getting better and becoming a bigger part of our story,” he says.
  
The traditional lecture-based method of medical education has been discarded at Duke-NUS and replaced with the novel, forward-looking TeamLEAD approach. Rather than simply delivering information from behind a platform, faculty members work alongside student teams to guide them to the appropriate material and help them learn how to process it for themselves. Here,Professor Pierce Chow introduces a
session for 3rd year students
Mr. Lim Kheng Choon and teammates
Mr. Chia Ghim Song and Ms. Lim Miao Shan.
 
 
Corporate education: the students’ perspective