Joint Clerkship Meeting Winter 2012
(Charlottesville, Fairfax, Richmond, Roanoke & Salem)
Wednesday, February 8, 2012 University of Virginia School of Medicine

Minutes

Attendees:  Evan Heald, Sage Claydon, Ashley Shilling, Kumal Patel, Mayuri Lakdawala, Nancy McDaniel, Don Innes, Huai Cheng, Elisabeth Wright, Peter Ham, Veronica Michaelsen, Rhonda Miller, Sandi Lunetta, Brian Wispelwey, Pamila Herrington, Priscilla Potter, Barbara Haskins, Allen Blackwood, Yvonne Newberry, Megan Bray, Allison Innes, Jill Clarke, Alane Celli, Amita Sudhir, Gary Collin, Enrique Perez, Medhi Kazemi, Eugene McGahren, John Jackson, Maureen McCarthy, Jasbir Mavi, Tananchai Lucktong, Alicia Freedy, Dan Harrington, Eugene Corbett, Meg Keeley, Casey White, Lisa Rollins, Fern Hauck, Kathleen Pridgen, Anneke Schroen

The Joint Clerkship meeting was convened at 10:00 am at the University of Virginia. 

Mulholland Clerkship Report Kathleen Pridgin, Mulholland editor for Family Medicine section, presented the Mulholland Clerkship Report. Please see attachment for individual clerkship recommendations.

Educational Research and Instruction Casey White, our new Associate Dean for Educational Research and Instruction, was introduced. She outlined the need for medical education research and the importance of faculty and student participation in such projects.

Working Group on Clinical Skills Development Nancy McDaniel presented the Working Group on Clinical Skills Development Summary Report along with recommendations to the clerkships.

Residents as Teachers Lisa Rollins addressed the group on continuing efforts to facilitate “Residents as Teachers.” She is making good progress with Susan Kirk in GME.

Electronic Passport John Jackson outlined plans for the new Electronic Passport that will be used for the Class of 2014 beginning in February. A “How to” is located at Faculty Source; Faculty Tools; Complete and Sign Requirement Checklists in Oasis

http://www.med-ed.virginia.edu/FacultyTools/howto/RequirementChecklist.cfm

Integration and Longitudinal Evaluation The concept of a 12-week block system was introduced and clerkship directors were asked to discuss what and how to institute longitudinal elements throughout the 12 week blocks during lunch.  These 12-week clerkship blocks are:

After lunch, the groups presented their suggestions for integration.

Peter Ham spoke for the Psych/FM/Neuro group and suggested:

1) some items that could be integrated – pain management, humanism, how to run a family meeting, keeping history taking on target

2) alignment of the passports is necessary to evaluate

3) multiple sites for the FM clerkship do pose logistical difficulties with continuity of patient care

Brian Wispelway spoke for the Med/Geri/AIM/Med Subspec group suggesting:

1) Use of telemedicine facilities here at UVA and at Salem for communication with multiple sites

2) Having a student follow a patient from clinic to inpatient to nursing home should be considered but does present a scheduling issue over the 12 week block

Yvonne Newberry spoke for the Pediatric/OB-GYN group noting that these two specialties do not cross over other than “hand-off” of the newborn.  It might be possible for a student to follow a mother through pregnancy and delivery and the child through the nursery but will be challenging to schedule in a 12 week period. 

Eugene McGahren spoke for the Surgery/Perioperative and Acute and Surgery Specialties and suggested:

1) use of the SIM center to teach workshops on suturing techniques and other procedural skills applicable to all clerkships in block

2) during the prenantal  trauma patient portion of the Acute Medicine clerkship invite the OBGYN students to attend as well
3) identify concepts that should be taught over the multiple disciplines

Continuitiy in the Clerkships Kumal Patel noted that he still follows a nursing home patient he met during his clerkships.  Whether this could be something all students experience was discussed.

Meg Keeley noted that continuitiy with patients is successful when students take a proactive role.  It can be limiting if the number of patient inpatient stays, clinic visits, etc. are small during the period the student follows the patient.  Whether students could be assigned a clinic afternoon once per week in each block and then a follow-up inpatient afternoon was discussed. While some students may achieve this patient integration outside the official curriculum, it should be more formalized and consistent, however, this would probably require patient permission.

It was suggested that “artificial” way to insure continuity might be developed through the Simulation Center.

Joining Forces Initiative Fern Hauck discussed Cultural Competency and the inclusion of Military Culture in this curriculum thread.  The University of Virginia SOM has agreed to participate in the Joining Forces Initiative – Improving the Health Care of America’s Veterans and Families.”   This is a national initiated launched by Michelle Obama and Jill Biden.  Maureen McCarthy from the Salem VA offered assistance with this curriculum thread and to provide pocket cards that assist physicians in taking history from a military person or military family member.  Many veterans and their families seek medical attention outside of the VA system so students should be prepared to deal with their health issues in many settings.  Dr. Hauck distributed a list of military health resources available to all on the web.  A CPD case is in development to specifically address military health issues.  Dr. Hauck also noted that there are many other cultural elements outside of the religious/language/geographic elements that may need to be identified in the medical school curriculum. 

Meg Keeley prepared clerkship directors for the Class of 2014 beginning clerkships February 2012.  She briefed the clerkship directors on what to expect from this class. This class, the first to experience the Next Generation Curriculum, will expect learning objectives, resources to fulfill these objectives and timely and appropriate evaluation of their progress.   Activities during the transition course (beginning 3/13) were outlined. 

Clerkship directors were also reminded that the class of 2014 will have electronic passports only.  Those finishing up their clerkship year (Class of 2013) will still use the paper version of the passports.  Clerkship directors were also urged to remind their teaching faculty that the SMD14 students are at the beginning of their clerkship year and will be at a much different point in their education than the SMD 2013 class that is finishing the clerkship year.  The SMD 2013 class will be asked to mentor this class during this overlap period. 

Dan Harrington provided a brief report on the state of the clerkships at Roanoke Carilion.    There are three programs active at Roanoke Carilion at the present time, two medical schools and one osteopathic school.  This presents scheduling challenges as each school’s students will have different rotational schedules. Adjustments and cooperation will be needed.

Mayuri Lakdawala reported on the Pediatric clerkship at Bon Secours and noted that faculty, hospitalists and students enjoy this new clerkship site with no significant problems noted.  Most of the hospitalists teaching in this program are former academic faculty and greatly enjoy the student interaction.   Sage Claydon added that the OB/GYN clerkship is also going well and faculty and students are fully engaged.

Medhi Kazemi from the Salem VA reported on the multiple new teaching programs (i.e. rural health) being used at the Salem VA as well as shared with other institutions.

The next meeting of the Joint Clerkship Committee will be held at the University of Virginia on Wednesday, 10/17/12.