University of Virginia School of Medicine
Clinical Medicine Committee
Members present (underlined)
Donald Innes; Adams, Reid; Rein, Michael; Maughan, Karen; Doyle, Lisa; Herrington, Pamila;Herbert, William; Juel, Vern; Wilson, William; Short, Jerry; Mohrmann, Margaret; Owens, Gary; Innes, Allison; Petri, William; Squillace, Susan; Simmons, Josh; Schalet, Benjamin; Corbett, Eugene; Beacham, Karen
- The Clinical Medicine Committee met at 5 PM on Thursday, November 16, in the Peds Pathology Conference Room.
We discussed the change in the "start date" for the 3rd clerkship block, to begin January 3. This date was chosen because of a state memorandum regarding January 2 possibly being a holiday, and the need for consistency among clerkships and sites regarding the day on which the clerkship began.
The continuing problem of late submissions of final clerkship grades to the Office of Student Affairs was discussed. Dr. Allison Innes gave some background regarding the need for more timely submission and the requirements imposed on the School of Medicine by the University Registrar. It was generally felt that the "rate-limiting" step in the processing of final clerkship grades was the delay in receiving evaluations from attendings and residents. Evaluations from UVA-based faculty and housestaff were felt to be more promptly returned than those from non-UVA sites. The possibility of "on-line" grading was mentioned; this is being done on a pilot basis on one clerkship, and it was felt that there were still problems with timeliness of completion of the evaluations. Possible strategies to improve this situation were discussed, including having individual students take their evaluation to attendings or residents and have them completed. Because some sites have committee-based evaluations, with substantive narrative comments, this approach might not work in those sites. Dr. Innes felt that the Office of Student Affairs would rather have a complete grade sheet for all students than a partially completed sheet (with some grades submitted later). A combination of strategies, including increasing the number of reminders to faculty and housestaff and having some students carry the evaluation forms was recommended.
Dr. Short reviewed the summary report from last year's CPX examination. He commented on the important information that can be derived from that report which might be used by the clerkship directors and other course director in improving their clerkships or courses. Student comments on their evaluation of the CPX mentioned that this was a different experience for them, and that they had not had that much independence of practice while on the clerkships. Based on the CPX results, communication skills tended to be better than clinical skills, and this might be useful in improving the teaching of clinical skills. Dr. Short suggested that each clerkship director look at the case from their discipline, both in general terms and also at the specifics of the case to determine if there is need for improvement in the educational process. The report which has been prepared by Dr. Doyle contains much useful information, and the Dr. Wilson commended her on its preparation and for the work that she does with the CPX program.
- The issue of electives in the 3rd year of medical school was revisited. This possibility had been favorably received by this committee and by the Curriculum Committee. The discussion focused on how this will actually happen. Dr. Rein mentioned that it may be possible for some students to elect to take an elective during what would have been the subspecialty month of the medicine clerkship, and to then take that month later. The question regarding the timing of the written exam, which is currently an NBME shelf exam, was raised. Dr. Wilson mentioned that it might also be possible to "split" the Pediatrics clerkship and take one month later, but that the exam (an in-house exam) would be given after the completion of the total Pediatrics experience. The possibility of moving the month of family medicine into the 4th year for some students was also discussed. One of the concerns about that was the difficulty in having enough preceptors and sites if extra students will be trying to take Family Medicine (or other clerkships) at the same time. It was noted that our clinical rotations are heavily subscribed now, and that there is frequently little flexibility in scheduling of students. The committee felt that electives in the 3rd year could be offered on a "case-by-case" basis. The Electives Committee will be asked to review the existing electives and to make a recommendation to the Clinical Medicine Committee about which electives might be available for 3rd year students; most electives have traditionally been taken by students who have completed their required clinical rotations.
The status of the "passports" for the documentation of clinical skills was discussed. Four clerkships have submitted passports in either draft or final form, and the Psychiatry passport was also completed. The drafts were distributed to the members of the committee for their review and comment. It was noted that this is an ongoing process and may need to be refined on a regular basis.
The meeting was adjourned at 6:05 PM.
William G. Wilson, MD
Chair, Clinical Medicine Committee