USU Alum Helps Move UCF School of Medicine Curriculum Online

By Vivian Mason

In April of this year, retired U.S. Air Force Colonel (Dr.) Jeffrey LaRochelle, a graduate of the Uniformed Services University of the Health Sciences (USU), was recalled to military service to help combat the COVID-19 pandemic in New York City. 

For two months, he cared for patients, first at the Jacob Javits Center in Manhattan and then at Queens Hospital Center, along with other Air Force and Army service members. 

“Patients were in the hallways…everywhere,” said LaRochelle. “I’ve never seen anything like it in the civilian world. Four weeks later, things started to slow down a bit. Our last weeks in New York allowed the regular hospital staff to take much needed time off.”

Now, back in Orlando, Florida, LaRochelle is assistant dean of medical education and professor of medicine at the University of Central Florida (UCF) College of Medicine. He has always been guided by a simple motto: “Integrity first, excellence in all you do, and service before self.” Even before he left for the New York deployment, he was assisting leadership with efforts to put the UCF medical school curriculum online to help students continue their medical training. “As I was walking out the door, we were dealing with all of the first- and second-year learners,” he explains.

[Image Credit: Courtesy of USU]

LaRochelle, who earned both his MD and MPH degrees from USU, is used to dealing with medical students and residents. As the former director of USU’s Introduction to Clinical Medicine and Integrated Clinical Skills, he was responsible for the delivery and application of clinical skills education in the pre-clerkship period predominantly through the use of simulated patients at the National Capital Area Medical Simulation Center.  He also served as the National Capital Consortium Internal Medicine residency associate program director, and was lauded for his efforts throughout his active duty career.  In 2012, he received the Air Force “MF” special experience identifier award from the Surgeon General, which recognized his excellence in academic teaching. In fact, LaRochelle’s expertise in developing and evaluating curriculum in clinical skills and clinical reasoning grounded in educational theory had a positive influence on his current position at UCF.   

“The leadership skills required of an officer are directly applicable to this position, and the mentorship, education and training I received at USU have been the foundation of my ability as an educator.”

As one of two assistant deans of medical education, he oversees the first two years of the medical school curriculum that includes the foundational sciences, clinical skills, and medical interviewing before students head off to their clerkships. He works very closely with all of the educational leaders in the different modules, as well as being involved with all the curricular events and interdisciplinary measures. 

“We basically shut down all face-to-face learning activities across the entire spectrum of schools,” says LaRochelle. Much of this conversion to an online curriculum required innovation, creativity, perspective, and thinking outside of the box to work within the virtual world without a real physical classroom. Well-received results have assured students that their education will keep them on track for graduation. 

“It’s been a lot of administrative work to get things done, and I sit on various committees as well. My passion is developing appropriate curriculum for learners. Part of my role, too, is transforming our four-year curriculum, which is basically reshaping the entire medical school curriculum,” LaRochelle said. “The silver lining to our COVID response, so to speak, has been that new content and course work have been created and added to the curriculum, along with forward-thinking ways to deliver it.”

Creating improved virtual learning environments and virtual educational delivery platforms allowed maximization of student participation and engagement. Work-from-home protocols were established, and informational technology support was ensured, including team chats, group meetings, and video calls. However, a major challenge has been delivering content that requires more in-person contact, like some of the clinical reasoning and clinical skills activities. Some of this can be accomplished through a telehealth-style platform, but taking a blood pressure or learning the fundoscopic exam is not readily accomplished virtually.

The curriculum was then moved around so that the required physical exams and face-to-face encounters will take place in the spring. “We transitioned the entire medical interviewing curriculum and most of the small group sessions related to clinical reasoning into online encounters. This required more faculty, and we have learned that these online small groups are more challenging to precept and typically take longer to deliver the same information,” he added.

All of the clerkship students were brought back in mid-August, and the first- and second-year students are largely working online with some face-to-face educational activities around the cadaveric anatomy lab and via physical exam skills encounters. However, students have been exposed to telemedicine/telehealth, which has been incorporated into the curriculum, as well as simulation and alternative opportunities for learning. Student–faculty groups were also established to promote engagement among students with the curriculum and with each other during a time of physical distancing.

“I’m on a task force that’s just generated a data-driven approach to a phased reopening of how to bring learners back to various areas. What we realized is that there are many different risks with bringing two to three students together in a small room with a patient. It’s a different risk as opposed to having a large group of students sitting in a lecture hall,” LaRochelle said.  “Basically, we figured out what we could do to mitigate the various risks in the different areas where we teach. It’s not just risk to the student, it’s risk to the faculty, staff, patients, and vulnerable populations. So, we have to think about not only what we’re going to do with learners, but also with everyone who’s involved in the education process.” 

Col LaRochelle with the Internal Medicine ward team at Queen's Hospital Center. [Image credit: Courtesy of Jeffrey LaRochelle, University of Central
Florida]

UCF faculty continually reevaluates all aspects of its programs to make sure that students are equipped with the skills and education to meet constantly changing healthcare needs. UCF’s School of Medicine is working to fill in the gaps by offering tools and resources that will help ensure that they produce well-trained physicians. 

Despite all of this transitioning, how are the students adapting to these changes? LaRochelle replies, “They’re doing okay. But, we’re concerned about the physical distancing, which can be a little difficult. We don’t want the students to be socially isolated. Class cohesiveness is missing. We need to get them all back together again and socializing.” 

Dr. LaRochelle admits, “At some point in time, you’ll actually have to touch somebody in medical school. Hopefully, we can get this under control and get the students back into the classroom.” He adds, “At the end of the day, medicine is still a social science. It’s one person sitting in a room who needs help and another person who’s willing to give that help. I’m always concerned about that social aspect―that humanistic part of the practice of medicine.”

Dr. LaRochelle acknowledges that, “it’s been an interesting process to figure out what’s the right way to move forward. But, do any of us really know?” Society and medical education will be transformed by this pandemic, and transformations are never easy.