At the beginning of the 21st century, more than half of individuals already diagnosed with cancer can be expected to survive for more than 5 years, and for some types of tumors survival exceeds 75%. These survival gains have occurred due to more complex multi-modal therapies and promise to increase with the growth of genomic interventions. Health care providers must be familiar with the late effects of cancer treatment and be able to offer preventive care and health promotion strategies to patients who experience cancer as a chronic disease. While medical school curricula have traditionally focused on the diagnosis and treatment of cancer, and more recently on its prevention, few, if any, have focused on the long-term care of chronic disease particularly related to cancer (Ludmerer, 2000' AAMC, 2000; Stoeckle, 2000; Cohen, 1998). The overall goal of this proposal is to develop, implement, evaluate, and disseminated a coordinated, four year, multi-disciplinary medical school curriculum on cancer as a chronic disease through a collaborative effort among the University of California, Los Angeles (UCLA), and San Francisco (UCSF) Schools of Medicine, the Charles R Drew University of Medicine and Science. Curricular materials will be guided by a set of recommended competencies developed by an Expert Consensus panel from the three sites and include problem-base learning cases, multi-media we-based problems, a targeted preceptorship experience, and exercises to develop skills in behavior change and risk assessment. Curricular materials will be implemented and evaluated at all three sites for purposes of quality improvement (formative evaluation) and outcomes assessment (summative evaluation). Results for the intervention groups will be compared to historical controls. Measures will include performance on the Web-based problems, analysis of reflective essays, a Knowledge and Attitude Questionnaire, and a clinical skills Objective Structured Clinical Examination station. Successful development of the four year integrated curriculum in cancer survivorship will help to educate future physicians for better health promotion and disease prevention for patients with cancer as a chronic disease.
