University of Virginia School of Medicine
Clinical Medicine Committee,
Present: Heald, Pearson, Short, A. Innes, D. Innes, Herrington, Maughan, Coray, Juel, Adams, Robertson, Coray, Wilson
The meeting was called to order at 5 PM. The first agenda item was discussion of the calendar for the upcoming year. This calendar is similar to that of the current clerkship year, and does include 7 Clinical Connections sessions. Three of the Clinical Connections sessions will include Office of Student Affairs activities (electives meeting, "match" information, transition course). There had been concern raised about sessions occurring on Fridays, and whether students need to return to their clerkship sites for Saturday. This will be left to each individual clerkship schedule to determine. The calendar was approved for adoption.
The next item for discussion concerned problems related to grading on the clerkships. Specific issues included the need for consistency between sites and among clerkships, the apparent "grade inflation" that has occurred, and the requirement to pass each component of a given clerkship to pass the clerkship. Dr. Pearson related his recent experiences in reviewing student grades and files as part of writing the "Dean's letters" for residency applicants. He distributed a grade distribution from the clerkship year for the class of 2003. Most students received grades of "B" or better, but there was a wide range of percentages of "A" grades among the clerkships. He felt that the system used on the Medicine clerkship, which used scores from previous clerkship years as a benchmark, was effective. This system also takes into account the expected improvement during the clerkship year. He expressed concern that there seems to be a diminishing amount of evaluation material, particularly narrative comments, on the evaluations. Students need more feedback during their clerkships and as part of the grading process. There was also concern that there may be inconsistency regarding whether a student needs to pass each of the various components of the clerkship (written and/or oral examination, clinical evaluations) to pass the clerkship. It was mentioned that students cannot be required to take a re-examination following the clerkship if they have received a passing clerkship grade; requirements for retesting come from the Student Promotions Committee. It was recommended that each clerkship internally review their grading process and define the components of the clerkship which need to be "passed" in order to achieve a passing grade. It was also suggested that there be a meeting of the Clinical Medicine Committee devoted to the issue of grades and grading.
There was also discussion of the "timeliness" of submission of final clerkship grades. This has been a problem in the past, but was particularly difficult for the 4th clerkship quarter of this past year. There are deadlines in the University Registrar's Office that must be met. It is possible that putting the student evaluations "on line" could help speed up the process and make it easier to offer reminders to faculty who are late.
The Mulholland Society directory is available in print form and "on line".
The new LCME guidelines are "on line" at the following site: http://www.lcme.org/pubs.htm .
The next visit of the LCME will take place in 2006, and will be preceded by an 18 month "self-study". Anticipated changes in the curriculum should be in place well before the beginning of the self study period. Members of the committee were encouraged to visit this site and review the LCME standards and requirements.
The meeting was adjourned at 6:05 PM.
William G. Wilson, MD
Chair, Clinical Medicine Committee