Checking in with Dr. Alisa Wray: An Update on the Newly Reformed Clinical Foundations Curriculum

By Kathryn Uchida, UCI School of Medicine

In 2018, Dr. Alisa Wray adopted her new roles as UCISOM’s Clinical Foundations Course Director and Director of Clinical Skills Assessment, working with UCISOM’s administration to completely rethink and reorganize the Clinical Foundations curriculum. Clinical Foundations, or CF, is a four-year course aimed to improve medical student history taking, teamwork, empathy, and incorporation of basic science into clinical settings. Having previously served as director of CF for third- and fourth-year medical students, Dr. Wray used her knowledge of the medical school population and curriculum to better interweave topics covered in corequisite basic science courses and implement more opportunities for group work.

The reconstruction of the CF curriculum was a massive overhaul that required reviewing and rewriting every Standardized Patient, SIM, and ultrasound case, creating new team-based learning sessions, and rewriting individual and group readiness assessment tests. This overhaul was completed due to incredible efforts by Dr. Wray, the Dean’s Scholars (a group of faculty physicians dedicated to medical student education) and the UCISOM administration during the summer of 2018, and the new curriculum was implemented that fall. Dr. Wray has since made edits to the course every year. These edits have included accommodations for Covid-19 pandemic restrictions and fear in 2020, during which she was also a frontline worker in the emergency department.

One of the most significant changes Dr. Wray made was the introduction of Dean’s Scholars, physicians assigned to a small group of students to facilitate Standardized Patient sessions, small group learning sessions, and help connect clinical skills with basic science concepts. The implementation of Dean’s Scholars facilitates longitudinal mentorship and more intimate relationships with faculty members. Dr. Wray notes that while it wasn’t easy coordinating many physicians, the Dean’s Scholars make CF more fun for students and allow them to have an easily accessible mentor throughout their four years of medical school.

Dr. Wray notes that her greatest overall achievement as Course Director is the improvement in student satisfaction. Due to her efforts, CF made the leap in 2018 from the lowest rated course to the highest rated. She credits learning to ask for and accept student feedback during the overhaul process, which was crucial to the jump in course satisfaction ratings. Immediately after the new curriculum was launched, Dr. Wray created student feedback groups to better understand student perspectives and what changes worked or didn’t work.

Dr. Wray also balances her role as CF Course Director with her work at the UCI emergency department, as well as her role as Associate Director of UCI’s EM residency program. Working with both residents and medical students has clarified the importance of teaching medical students to obtain a history, the reasoning behind asking questions, and to realize that it’s okay to not know everything. Her many roles allow her to observe the longitudinal growth from student to physician, as well as to better understand the level of proficiency medical students must obtain before entering residency. She says she can maintain her impressive slew of positions due to genuine love for her work – “The job is fun. That’s probably the best thing about it – the medical students are fun, watching them go from first years who are terrified their first time talking to a standardized patient to seeing them as fourth years ultrasounding a trauma patient, and seeing all the students blossom into physicians.”