The New American Medical School

Photography by Bill Timmerman, Joe C. Aker, and Jeremy Bittermann

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While medical education is constantly evolving, the building of new medical schools in the U.S. happens in waves. And we happen to be in the midst of one of those waves. Approximately 40 new medical schools were built between 1960 and 1985 at the urging of organizations such as the American Medical Association and American Association of Medical Colleges (AAMC). After the number of medical school graduates doubled, concerns grew that there were too many doctors. As a result, no new schools were established during the next two decades, according to a 2009 report by the Josiah Macy Jr. Foundation. In 2002, though, in response to a perceived physicians’ shortage to come, AAMC called for 30 percent more medical school graduates by 2020 to meet the demands of an aging population. Nationwide, institutions have embarked on creating new, enlarged, and upgraded medical education facilities in recent years.   

Unlike other academic teaching buildings, medical education buildings demand spaces specifically designed to address a complex and evolving curriculum that stresses teaching based on systems, such as cardiovascular and respiratory, rather than on subjects, such as pathology and anatomy. To support this change, CO Architects has rethought the traditional lecture hall and laboratory complex to design facilities with varied scales of classrooms, laboratories, learning studios, and clinical skills training environments, as well as amenities and social spaces that serve students and staff. We consider what we call “The New American Medical School” to be one that transforms educational interior environments in ways that will have a radical impact on the conduct of the disciplines. This new model for medical education facilities is driven by an emphasis on technology-rich, problem-based, and hands-on learning modalities.

Communities of exchange and discovery
The evolving medical teaching paradigms engender brand-new programs from inception, which integrate the full cross-section of learning spaces, integrated technologies, and social fabric to educate the next generation of physicians. Interdisciplinary health sciences education buildings now more commonly integrate multiple compatible curricula under one roof. These buildings emphasize shared space and team-based learning. In the past decade, CO Architects has built eight integrated health buildings nationally, and three more are currently in design. Simulation laboratories are essential in integrated health buildings, and these spaces reflect redesigned emergency rooms, operating theaters, and clinic settings to complement the sophisticated simulation techniques that are central to hands-on training. All of these projects have created communities of exchange and discovery that are vital to modern medical teaching.

Form follows curricula in the latest healthcare education buildings. The Liaison Committee on Medical Education (LCME) changed the requirements for North American curricula to offer more clinical technique in the first two years. The goal is to get doctors involved early in patient training, to reduce the number of errors and issues that have sometimes plagued doctor-patient interaction. Learning environments are now designed as virtual hospitals with realistic clinical settings so doctors and nurses learn together in preparation for how they will work together.

In the Health Sciences Education Building at the Phoenix Biomedical Campus, which serves students from both the University of Arizona and Northern Arizona University, CO Architects designed mock patient and operating rooms equipped with computerized mannequins (or patient actors), and adjoining observation areas allow evaluation by instructors and peers. A doctor who graduates from a program in a facility with this type of realistic clinical setting is more likely to be comfortable counseling patients.

At Methodist Institute for Technology, Innovation, and Education (MITIE) in Houston, a virtual hospital, procedural training suite, and research core are housed together to facilitate collaborative research and training efforts. An interactive theater—equipped with technology from ImageStream Medical—allows physicians to observe procedures occurring in the surgical training areas in real time.

Classrooms are designed differently now as “learning studios” to actively de-silo programs and emphasize group learning. The Health Sciences Education Building at the University of South Carolina School of Medicine, Greenville, advanced a team approach by using technology-enabled active learning (TEAL), which was pioneered at Massachusetts Institute of Technology (MIT). CO Architects designed the learning studio as a flexible open space to accommodate various table arrangements for students working in groups to solve professor-delivered problems, with information visible on multiple projection screens.

Besides classrooms, healthcare education buildings today include an increased number of spaces like lounges and coffee bars, enticing students to stay in the building beyond class time and encouraging more informal discussions. Locations along corridors—which had been strictly utilitarian—are ideal locations to establish more lounge-like areas. Walkways with gathering areas traverse the atrium, literally connecting disciplines located on either side in the Collaborative Life Sciences Building—a facility that is a partnership of Oregon Health & Science University, Portland State University, and Oregon University System—in Portland, Oregon. For schools to appeal to a new demographic and encourage a sense of community, their buildings must promote balance and healthful living in program, design, and construction. 

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