Minutes 07/01/04

Minutes 07/01/04

University of Virginia School of Medicine
Clinical Medicine Committee

Members present (underlined): Rein, Michael F; Juel, Vern; Herrington, Pam ; Adams, Reid B; Corbett, Eugene; Wenger, Jennifer; Maughan, Karen L; Short, Jerry; Innes, Donald J; Innes, Allison H; Chapin, Anne E; Lieb, Darci G; Jackson, John M; Keeley, Meg M. ; Shenker, Joel; Wilson, William; McIntosh, Paul

  1. The meeting was called to order at 4:30 PM. in the Peds-Pathology conference room. Dr. Joel Shenker was introduced to the committee; Dr. Shenker will be the director of the Neurology Clerkship, taking over that position from Dr. Vern Juel. The positive influence that the Neurology Department has had on medical education was reviewed, and Dr. Shenker was welcomed to the committee.

  2. A synopsis of the new LCME accreditation standards, updated June 8, 2004 , was distributed. These new standards include a requirement for “quantified criteria” for the types of patients (real and simulated) that each student must see to achieve the objectives of the learning experience. There has been some discussion of these new requirements in list-serve groups of several of the national clerkship directors’ organizations, and there is concern about the vague wording of the requirement (are these “diagnoses” or “complaints”). There was discussion as to how the clerkships at UVA should address the new requirements. The committee felt that focusing on presenting complaints rather than final diagnoses was more in line with the learning objectives of third year students (for example, each student might need to know how to evaluate a patient with chest pain but may not necessarily work up an actual patient with an acute myocardial infarction).  The Surgery clerkship is in the process of modifying their rotation to help address variability in patient types seen on the different services. The Pediatrics clerkship will use a web-based national case-based learning program to provide uniformity in “critical thinking” exercises for all of the students, since the acute patients seen in a Pediatrics setting will vary with the time of year. All clerkship directors were encouraged to become active in the list-serves of their respective national groups so that we might learn from our colleagues elsewhere and might benefit from experiences that others have as their LCME site visits take place. No decision regarding our response to these requirements was reached, but it was felt that each clerkship should be in a position to pilot our responses by spring 2005.

  3. The subject of logbooks and other ways to track the patients to which our 3rd year students are exposed was discussed. This also fits in with the new LCME standards. John Jackson, who was out of the country and unable to attend, has previously mentioned a web-based/PDA-based program to allow for keeping track of diagnoses. This is being piloted on AIM and Family Medicine, and should be adaptable to other clerkships. PDAs are now being required of all 3rd year medical students.  John will contact colleagues at other institutions to see if we can access their diagnosis lists for our use; these could be adapted for our purposes and would save considerable time for clerkships interested in using this method of patient tracking.

  4. The new Praise Card and Concern Card were mentioned. Dr. Allison Innes had previously distributed the web address for these cards to the members of the Committee. The intent of this is to allow for praise and immediate positive feedback from faculty and house staff  to medical students, as well as to alert the Office of Student Affairs about possible concerns. The committee members were encouraged to share the web address with their faculty.

  5. The proposed Major Diseases of Our Time (MDOT) was discussed. This brief course would occur between the end of the 2nd year and the beginning of the 3rd year, and would highlight diseases that were felt to be important and/or representative. The purpose would be to provide some summation to the 2nd year and to prepare the students for the 3rd year. One format would be as a “board review”, where several diseases would be discussed in such a manner as to be a review for Step 1. Several members of the committee raised questions about the necessity and timing of such a course. Since it is coming around the time that most of our students are preparing for and taking USMLE Step 1, it was felt that there may not be great interest on the part of the students. It was mentioned that our students already do well on USMLE exams, with the UVA mean scores generally 10 points better than the national means, so that additional board preparation of this type may not be necessary for most students.  Most of the “major diseases” that have been mentioned are discussed in POM2 at some length.  Concern was expressed that developing this course would consume considerable faculty time, with questionable results, and would be a further incursion into time for independent study by our students. It was suggested that this idea be returned to the Curriculum Committee for further discussion.

  6. The meeting was adjourned at 5:40 PM .

Respectfully submitted,
William G. Wilson, MD
Chair, Clinical Medicine Committee