Six Months in, Trinity School of Medicine's Dr. Linda Adkison Talks Current Progress, Future Plans.

Dr. Adkison moved to St. Vincent in February of this year when Dr. Skelton transitioned his fulltime focus to his responsibilities as chancellor and, as her reputation as "that lady walking everywhere" among locals in Kingstown may already suggest, she hasn't wasted any time getting to work.

Dr. Adkison's overriding philosophy is as tenacious as Trinity itself, which is possibly why she's proved to be such a great fit: if you aren't improving and everyone else is, you're ultimately falling behind. This is unacceptable in something as critical as healthcare where the students are ultimately responsible for the lives of their patients. New and developing levels of excellence in medical education are good for Trinity School of Medicine and its students; excellence has a ripple effect throughout the greater healthcare system and quality of life for the recipients of that care. There's an idealistic abstraction at play that is both relatable and appealing to faculty and students alike. This is a key component of her leadership: any veteran in education can tell you that student and faculty buy-in is exactly what's needed to prudently and consistently update any curriculum. Faculty must continuously stay abreast of changes in their fields and transmit these changes in the education model, while leading students to new levels of learning; students must trust the faculty direction and become actively engaged in the process.

A major first move has been the development and implementation (with Dr. Paula Wilson and alongside Dr. Richard Scott in Baltimore, MD) of a rigorous and stabilized clinical rotations track for Trinity students. A rarity in international medical education, Trinity's core rotations are now scheduled a year out for its students, offering the predictability to schedule further electives during their third and fourth years of medical school.

On campus in St. Vincent, Trinity's basic sciences curriculum is transitioning to an active learning environment with an ever growing amount of interdisciplinary courses (often styled as "problem based learning" or "team based learning" in the United States), specifically using shared courses and case presentations (a practice that's normal in US, and unique in the Caribbean). This development in clinical education is the evolution of assessing students' competencies to assessing skills they need on the first day of clerkship and residency training. Known as entrustable professional attributes (EPA), developed by the American Association of Medical Colleges, these EPAs are being introduced to students early in clinical skills training while continuing into clerkship assessment.

This problem based approach to learning means students quickly overcome any personal hesitations to speak up and draw conclusions in a group setting, a necessary skill for physicians in rotations, residency, and beyond. (A practice that is further supported by Trinity's clinical experience, a pillar of the education that is remaining thoroughly intact). In turn, that leads to basic sciences students more comfortably discussing medical complexities with both their peers and their patients, effectively demonstrating how well the knowledge has taken root--this is critical for informal faculty evaluation. If you know where a students' strengths and weaknesses are at an induvial level, and Trinity's class size means individual approaches are not only possible but encouraged, you can shore up those challenged areas and improve their understanding as needed.

As a result of these changes in particular, new faculty have been hired, and will continue to be hired, to fill the teaching needs. While Trinity has always sought excellently credentialed instructors for its students (MD/PhD candidates are the norm), and that trend continues, the search has expanded to now also include professors offering specific experience with, and interest in, other pedagogical methods. This infusion of new talent and new ideas will blend well with the talents of current faculty at Trinity School of Medicine, yielding an even stronger medical education program.

Dr. Adkison is quick to point out that the medical community, as a whole, operates on this principle of growth and development, but it's worth mentioning that her various placements on accreditation boards throughout her career have been a major boon. They allow her to evaluate best practices at various institutions from across the United States and apply them to Trinity. While these practices are in no way secret, they are at the same time not often openly discussed. Her exposure and responsibility to evaluate these practices has her and her colleagues uniquely suited to drive the state of medical education at Trinity.

Trinity is a school established to provide a continuing answer to the physician shortage faced by the US, Canada, and the world. By striving to improve and adding best practices from the cutting edge of academia, Trinity School of Medicine not only contributes to the solution of the shortage itself, it is providing an influx of smart, dedicated, engaged doctors. If there is a singular goal for which all medical schools strive, it's that. More care at a higher level of quality.

Despite all of these reforms, with so many to come, what is Dr. Adkison's greatest challenge? "Walking up the [incredibly steep] hill to campus in the midday heat."