University of Virginia School of Medicine
Clinical Medicine Committee
Members present (underlined): Donald Innes; Reid Adams; Michael Rein; Karen Maughan; Lisa Doyle; Pamila Herrington; William Herbert; Vern Juel; William Wilson; Jerry Short; Eugene Corbett; Meg Keeley; Gary Owens; Allison Innes; William Petri; Susan Squillace; Ben Schalet; Mir Robertson
The Clinical Medicine Committee met at 4PM on Monday, April 22, 2002, in the Peds-Pathology Conference Room.
We discussed the status of the clinical passports. Some background information regarding the origin of the passports and the rationale behind their use was given. It is a means of documenting the successful demonstration of clinical skills on the individual clerkships, as required by the LCME. Alternatives to the use of the passports were reviewed. There is concern that some students are not completing the passports as expected, but are having them "signed off" at the end of the rotations. Part of the problem may be the lack of awareness on the part of faculty and house staff regarding the purpose of the passports. The student members present suggested that a "mission statement" on the passport may be helpful. It was also mentioned that the passports seemed to work better in situations were there was more continuity with attendings, particularly in outpatient settings. There is also inconsistency among the clerkships regarding who can "sign off" on passports. Since Neurology has the most experience with the passport program, Dr. Juel gave some background on how the passports were used on Neurology. There was discussion among the committee regarding whether the passports could be signed at the end of a rotation as a "summative" document, or whether individual items should be signed as they are performed. It was generally felt that the individual items should be signed as they are demonstrated or performed. The utility of the passports in enhancing student feedback was also discussed. The teaching faculty and housestaff should be informed about the purpose of the passports and of their roles in documenting the items on the passport. A memorandum will be prepared for distribution to the clinical staff, and individual clerkship directors are encouraged to bring this issue up in departmental faculty meetings.
The Advanced Clinical Electives ("ACE") were discussed. ACE are intended to offer our 4th year students a more intensive and extensive level of patient care responsibility than may be available on the 3rd year clerkships. We discussed whether the ACE can be ambulatory electives as well as inpatient experiences, and it was felt that certain ambulatory electives that gave continuity, advanced clinical responsibilities, and close contact with faculty might serve as ACE experiences. It was felt that ACE can be offered by all clinical services, not just those that offer required clerkships. ACE experiences need not be based in Charlottesville. Appropriate elective experiences at other UVA teaching sites could also be ACE experiences, as well as "away externships", provided that the level of responsibility was appropriate. These would need to be reviewed individually.
The student evaluation form was briefly reviewed. It is still in draft form, and will be further modified. and circulated to the Clerkship Directors for comment.
The importance of narrative comments on individual evaluation forms and on the "grading" evaluation form completed by the Clerkship Director at the end of the clerkship was emphasized. There will be a change in the format of the "Dean's Letter" for residency applications, and the narrative will be used verbatim. Clerkship directors were encouraged to work with their faculty to enhance the narratives.