Bologna backstage - experiences from behind the scenes of the reforms of the Basel medical curriculum.

ABSTRACT

Based on a six-year degree in medical studies which was characterized by a series of lectures without an over-arching concept, Basel decided to embark on reforms in 1995. The first wave of reforms (1998-2003) produced a hybrid curriculum structure with PbL teaching units, organized according to organ systems, in years 1-4 of medical studies, which met the demand for "clinical content in the pre-clinical phase". A focus on General Practice medicine was achieved by implementing the "One to one tutorial" in the 3rd and 4th year of studies. Fixed weekly schedules provided space for instruction in the three learning dimensions - cognitive, affective and psychomotor learning - implemented in four longitudinal competence strands. The compulsory elective subject area "Early patient contact" was integrated into the elective degree courses of the Bachelor's degree by creating projects. From 2006 to 2012, the demands of the Bologna Declaration were implemented and a Bachelor's and a "consecutive" Master's degree program developed and then implemented. The PbL teaching units which had come in for criticism were replaced in the Master's Degree by the "Clinical Case" and in the Bachelor's degree by the "Tutorial on Scientific and Clinical Reasoning". To strengthen scientific competences, the "Science Month" and the compulsory elective subject area "Scientific Competences - Flexible Offers (WIKO.flex)" were introduced. Further curricular adjustments resulted in the development of an externally accredited integrated emergency curriculum, the establishment of feedback OSCEs and the intensification of the Skills Lab offer. In addition to content, organizational framework conditions for curricular development were key Thus, the massive expansion of places on medical degree courses also had an impact on curriculum structure and examinations. In 2017, PROFILES, the new Swiss competence framework, was published, which presents curriculum planning with new challenges as a result of the introduction of the EPA concept. Due to the flexible structure of the curriculum, the faculty feels confident it will be able to handle these challenges. The re-accreditation of the degree program in 2018 provided important stimuli for the strengthening of interprofessional teaching and a focus on the competent handling of an increasing number of patients asking for complementary medical treatments.