Joint Clinical Medicine Meeting -
Charlottesville, Fairfax, Roanoke & Salem
Wednesday, March 25th, 2009
University of Virginia
|Allen Blackwood||Daniel Harrington||Elizabeth McCuin|
|Brad Bradenham||Evan Heald||
|Megan Bray||Joy Hilton||Amanda Murchison|
|Bev Brown||Allison Innes||
|Randolph Canterbury||Donald Innes||
|Anne Chapin||John Jackson||Andrew Pfeffer|
|Jill Clarke||Animesh Jain||Claire Plautz|
|Eugene Corbett||Mehdi Kazemi||William Rea|
|Alicia Freedy||Megan Keeley||Jorge Rivera|
|David Geldmacher||Amy Kryder||Ashley Shilling|
|Aval-Na'ree Green||Tananchai Lucktong||Jerry Short|
|Peter Ham||Sandi Lunetta||Amy Tucker|
Welcome - Randolph Canterbury, Senior Associate Dean for Education|
New Clerkships 2009-2010
Geriatric Medicine - Aval-Na'ree Green
During the 2-week Geriatrics Clerkship, students will participate in the ongoing, daily care of older patients with a wide variety of acute and chronic illnesses and abnormal physical findings. Each student will be paired with a primary geriatric physician mentor who will provide clinical teaching and ongoing feedback to the student. Additionally, each student will be responsible for his or her own panel of patients at a skilled nursing facility. Throughout the clerkship students will work with a variety of geriatric focused health professionals as part of the interdisciplinary care team. This includes nurse practitioners, therapists, certified nursing assistants, and social workers. It is expected that throughout the course of the 2-week clerkship students will be involved with and responsible for admission assessment, discharge planning, ongoing care and management, writing orders, and working with families. Students will also participate in clinical skills workshops providing instruction and practice of skills pertinent to the care of older adults. As with all other clerkships, students and faculty will use a Clinical Skill Passport to assist teaching and learning of several geriatric focused skills. Faculty will use the PassPort to guide teaching and feedback to students, and students will use the Passport to track their learning needs more effectively.
Perioperative & Acute Care Medicine - Ashley Shilling and Claire Plautz
This 2-week course will teach medical students basic clinical concepts and skills through direct patient exposure, focused didactics, problem-based learning sessions, and programmed procedural training. Focus will be placed on peri-operative medicine, pharmacology and physiology, crisis management, and cardiac resuscitation, as well as essential clinical skills including airway management, wound care, ECG and radiograph interpretation and intravenous access. Passport-directed objectives and competencies will be mastered within the high-yield specialties of Anesthesiology and Emergency Medicine.
The Curriculum at the Carilion Clinic School of Medicine -
Dan Harrington reported the sad death of Dr. Elizabeth Vogel, who was instrumental in developing our educational programs. She and Dr. Mark Greenawald developed the a number of professional development offerings:
|"Resident as Teacher" curriculum
Physician Leadership Academy
Faculty Development Fellowship
Distinguished Educators Society planned
Scholars Program planned
Applications for Pulmonary and ID Fellowships have been submitted to the ACGME. In addition there are plans for development of Cardiology, GI, Critical Care, Surgical Critical Care, Psychosomatic, and Addiction fellowships. A Program Director for Emergency Medicine Residency has been hired and an application forwarded to the ACGME. A Pediatric Residency is in the planning stages.
The new Virginia Tech Carilion School of Medicine and Research Institute is under construction at the Riverside Center. It will be a four year medical school with 42 students per year in a patient centered curriculum using a modified PBL format. All students will be required to complete a research project and thesis.
Currently VTC is a candidate school with an LCME visit in February
2009 with an anticipated decision from LCME in June 2009. The first
class is expected to enroll August 2010. The 4 domains of study are
threads throughout a 4-year curriculum and include: Basic Science,
Clinical Science, Research, and Interdisciplinary.
Core Clerkships, Selectives, & Electives - Meg Keeley, Allison Innes, Jill Clarke
Move of the Surgery Selectives to the 3rd year.
|a.||Assigned/scheduled by lottery in OASIS|
|b.||Evaluations done same way as for 4th year students - paper selective evaluation form|
|c.||Evaluations are due 2-weeks after end of the rotation|
Revew of the 4th year
|b.||ACE Electives (review & discuss breakdown of what SMD 09 chose to do)|
|c.||New Electives (Wilderness Medicine Immersion & RAM Clinic both with Dept. of Emergency Medicine - Guatemala, Newborn Nursery, Semester @ Sea; Translation Research with the BME department, Calls of Medicine in Biomedical Ethics/Humanities, Health Policy Scholars Program, Human Rights Elective, Geriatric Clinic Elective, Vulnerable Pediatric Population Elective)|
Student Medical Education Committee Focus - Brad Bradenham, Andrew Pfeffer, and Animesh Jain
Brad Bradenham outlined the purpose of the Student Medical Education Committee is:
- "To encourage & help evolve better methods of teaching and learning medicine at UVA."
- "Facilitate dialogue among students, and between students and faculty, on issues relating to medical education."
- "To help facilitate institutional memory and transparency"
There will be one representative per clerkship. Clerkship reps will
meet with clerkship directors and try to provide real time feedback for
each of the clerkships. A 3rd Year Reps will also meet as a
group to discuss broader 3rd year issues, e.g.,
3rd Year Grading Survey. A "history of the clerkships" is a
possible project for the coming year.
Luncheon Clerkship Workshop Meetings - "Calling Attention to Basic Science Principles in the Clerkships" or How to Integrate Basic Science Material into the Clinical Years
- Surgery - would not want to initiate new didactic lectures but
would encourage lecturers to include basic science reference into their
current lectures. Physiology and pharmacology information
would be a good fit for integration into current Surgery lectures e.g.
how drugs work (mechanisms) and how that relates to the
physiology of the disease process. Student might be asked to
research these topics and present their findings to the team. The
goal is not to dilute the clinical information in the didactic sessions
but rather to enhance it.
- Pediatrics - also would not want to initiate new didactic lectures
and there is already basic science information in their didactic
sessions. To clearly delineate during lectures what information
is basic science material would make it more visible and apparent to
- OBGYN - During student presentations, encourage students to provide
basic science correlations - i.e. clinical connections during the basic
science years in reverse. Attendings should be encouraged to
"think out loud" when reviewing cases - mentioning pertinent basic
- Neurology - Increase neuroscience participation in case based
learning modules much as neurology is included in neuroscience.
- Medicine- Basic Science is not just "information" regurgitation but
should be tool to enhance "best practice." Encourage students and
faculty to include current literature when discussing mechanism of
disease and site relevant clinical trials whenever possible. In
determining the "best practice" in taking care of a particular patient
describe why treatment works or why it doesn't. Provide "cheat
sheet" for faculty with germane clincical trials for intergration and
discussion on the floors.
- Family Medicine - Has received very positive feedback from
preceptors on how students often provide them with current and relevant
basic science information because they are "closer to the basic
sciences." Pharmacology, physiology and epidemiology would
be logical areas to expand into during family medicine case
presentations or didactic lectures. Ask students "why" - what is
the underlying medicine - have student make the basic science
- Acute Care/Anesthesiology - Simulation Center cases would be
perfect opportunity to enhance basic science instruction with no
detriment to patient care. Anesthesiology by it's nature creates
discussion of pharmacology and physiology issues.
- Geriatrics- pharmacology and age associated changes in physiology
would be very appropriate lines of discussion.
Implementation of clerkship enhancements is made difficult the fact
that students are taught by multiple attending physicians. If
basic science information is to be consistently included in the
clinical years, appropriate faculty development and materials should be
provided for all faculty.
Clinical Skills: Student Readiness for Clerkships - Gene Corbett
IDEAS TO BETTER PREPARE STUDENTS FOR CLERKSHIP YEARS
- CD's noted that students seem to have a lack of repetitive exposure
to procedures such as inserting NG tube and IVs, taking BP, history
- Student motivation needs to be enhanced. Self-learners must
be created in the basic science years and
- Students need to feel "ownership" of their own education and be an
integral part of the team. Repetitive exposure to skills such as
history taking is very important throughout medical school.
- Just talking to a real or simulated patient repeatedly during the
first two years would enhance student ability to feel comfortable with
- Students need to think about the "why" in their medical
- Now the first two years are more "passive" learning but with the
new curriculum should become more "active" learning.
- Videotaping of clinical skills is a very effective teaching method
and should be enhanced. Feedback from an attending is
- More patient contact should be arranged in the first two years -
establish a minimum number of patients each student should talk to or
- Help students to appreciate the psychosocial issues they will see
when they go out on the clerkships.
Attached is the AAMC monograph - Clinical Skills
You can also download it at https://services.aamc.org/Publications/index-page?fuseaction=Product.displayForm&prd_id=141&prv_id=165
Next Generation Curriculum - Don
Progress report on the New Medical Education Building now 28% complete and on time for completion February 2010.
Next Generation Curriculum: Why?
- Scientific teaching - instructional decisions are evidence based
- Learner centered environment - How does the student learn this subject best?
- Integrated learning - learn by building connections to ideas, skills, people, etc.
- Advanced technology available in the New Medical Education building - simulation, standardized patients, learning studio
- USMLE integrated Gateways A & B
- Attract students to a contemporary interactive curriculum
- Education Task Force
Fall 2009 Meeting Date - The fall meeting will be October 21, 2009 at the Salem Veterans Administration Hospital in Salem, Va.