Robert D. and Patricia E. Kern Institute for the Transformation of Medical Education

Kern Institute Clinical Learning Environment Pillar

The Clinical Learning Environment Pillar focuses on innovating the many ways in which our students learn in the different environments and team settings.
Curriculum_Intro Component

Clinical Learning Environment Pillar Initiatives

Interprofessional Education

Led by Erica Chou, MD and Jordan Cannon, MS

The definition of Interprofessional Education from the World Health Organization states that interprofessional education occurs when students from two or more professions learn about, from and with each other to enable effective collaboration and improve health outcomes. MCW has been fortunate to partner with many different schools and programs to provide opportunities for all of these students to participate in IPE. Dr. Chou’s goal over the next 1-2 years is to develop a cohort-based, longitudinal thread that will focus on the competencies of IPE, including teamwork, communication, roles and responsibilities, and value and ethics. This will allow the interprofessional students to work together throughout their educational program with the hopes of creating a future workforce that is prepared for interprofessional practice, as improved health care collaboration has been shown to improve patient outcomes.

Reflection and Narrative Medicine in Residency

Led by Kathlyn Fletcher, MD, MA

Dr. Fletcher is working on understanding and improving the clinical learning environment. Because she is also the program director for the internal medicine residency, she is especially interested in the influence of graduate medical education on the clinical learning environment and how to improve the clinical learning environment for residents. She has started working on these issues by interviewing other program directors about their use of reflection and narrative medicine in their programs.

Stressful Environment Management

Led by Jeff Fritz, PhD

As a member of the Kern Institute, Dr. Fritz has focused his energies on the incorporation of practices from business schools and engineering schools into medical education. These have included areas of emotional intelligence, leadership studies, design thinking and management of a stressful environment (wellness/wellbeing). The desire is to apply best practices from other highly stressful environments to improve medical practitioner health (reduce burnout and suicide rates among physicians) and ultimately improve patient care. The efforts have been explored with others at the Kern Institute and NTN partners at Vanderbilt University Medical Center and Dartmouth Geisel School of Medicine.

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Clinical Learning Environment

Led by Martin Muntz, MD

The Clinical Learning Environment is essentially anywhere students (and other learners) learn about patient care – this ranges from the bedside to the team rooms, and from the emergency department to the operating room to the clinic to the hospital wards. The CLE optimization project is focused on identifying and reporting key metrics in the CLE, mitigating challenges to learning and patient care (like learner mistreatment and macroaggressions), identifying exemplars who role model key character traits, and developing skills and processes to react to and report challenging events and behaviors in the CLE.

Communication Skills Training

Led by Mary Ann Gilligan, MD

Applying her area of expertise in communication skills training. Dr. Gilligan has surveyed the state of communication skills training as it currently exists within the MCW medical school curriculum and is working on a curriculum development plan that would take communication skills training here to the next level. The curriculum will be integrated across all years of the curriculum which will require close coordination with course and clerkship directors. Faculty who are involved with the formal communication skills curriculum will require training and support to ensure high fidelity. In addition, because so much of the communication skills training students receive occurs informally in the workplace, faculty development for all faculty will be required in order to reinforce and validate content and skills emphasized in the formal curriculum and address more advanced skills and issues.

Diagnostic Clinical Reasoning

Led by Jayshil Patel, MD

Diagnostic errors are considered the blind spot of healthcare delivery and account for significant morbidity and mortality. In majority cases, cognitive errors are responsible for diagnostic errors. A thorough understanding of the clinical reasoning process underpins correct diagnosis, which is required for timely and efficient management. Dr. Patel's aim is to create awareness of and teach the components of clinical reasoning by de-constructing it into (a) the semantics (b) the science and (c) the skills required.

Learning Communities

Led by Kurt Pfeifer, MD

As a member of the Curriculum and Student pillars, Dr. Pfeifer is working on the incorporation of learning communities at MCW. By providing regular meetings with longitudinal continuity of faculty and student peers we hope to foster mentoring environments that will be ideal for meeting the Kern Institute's Triple Aim. Specifically, the learning communities will include well-being, leadership, cultural curiosity, mentorship, and coaching to nurture character and caring in our medical students. Transforming medical education will require developing complete physicians who are personally and professionally fulfilled, and learning communities will provide such focus on the whole student. Given the broad goals of learning communities, we are interfacing with virtually all members of the Kern team, both inside MCW and at our NTN partners, and are working with course directors in developing pilot studies of various concepts related to learning communities. We also currently have two M2 students engaged in projects evaluation the implementation of learning communities on our campus. We have much exciting work to do and would welcome other interested students and faculty to join our efforts.

Feedback Curriculum

Led by Sally Twining, PhD

Dr. Twining, in collaboration with Pat Hurlbut, MEd, Marty Muntz, MD and Travis Webb, MD, is working on feedback curriculum. In the Fall 2018 Semester, we introduced a pilot project in the M2 year that asked students to self-evaluate and give peer feedback relative to non-medical knowledge competencies. The results are being evaluated and plans for the next academic year are being formulated.

Basic Science Integration

Led by Sally Twining, PhD

Dr. Twining, in collaboration with Pat Hurlbut, MEd, Marty Muntz, MD and Travis Webb, MD, is working on basic science integration into the clinical years. For this project, integration of basic science education with clinical science, is important for long-term understanding of pathophysiology and treatment of disease. We are pursuing, with the help of Kathlyn Fletcher, MD, plans for integration of basic science in the resident led Department of Medicine Noon Report which is attended by medical students, residents and faculty.



Marty Muntz, MD

Member, Community & Institutional Engagement Pillar, Kern Institute


Erica Chou, MD

Member, Clinical Learning Environment Pillar, Kern Institute


Kathlyn Fletcher, MD, MA

Co-Director, Graduate Medical Education Pillar; Member, Clinical Learning Environment Pillar, Kern Institute; Professor of Medicine


Jeff D. Fritz, PhD

Member, Clinical Learning Environment Pillar, Kern Institute


Mary Ann Gilligan, MD, MPH

Member, Faculty and Clinical Learning Environment Pillars, Kern Institute


Jayshil Patel, MD

Member, Clinical Learning Environment Pillar, Kern Institute


Kurt Pfeifer, MD

Member, Student and Clinical Learning Environment Pillars, Kern Institute


Kaicey von Stockhausen

Program Manager I, MCWfusion Learning Communities