Minutes 04.08.13

Minutes 04.08.13

University of Virginia School of Medicine
Clerkship/Post Clerkship Committee
Special Meeting
Minutes 4/8/2013

Clerkship Leadership Present: Bray, Cheng, Herrington, Sudhir, Shah, Wilson

Others: D. Innes, McDaniel

Guest: L. Thomas

Discussion: there was extensive discussion regarding technical standards on the clerkships. The learning objectives are currently written to reflect subject knowledge during the core clerkships and surgical selectives.  There are no learning objectives specific to technical standards. Each clerkship does require that the students have ability to perform the following:

  1. Obtain history from patients
  2. Perform physical examinations
  3. Communicate in written and oral formats
  4. Perform tasks which require fine and gross motor skills including but not limited to standing on rounds and in procedures, assisting in surgery and procedures, phlebotomy

Issues related to a student with hearing disability on the clerkship would be related to above. The level of hearing loss and level to which hearing aids and sound augmentation would matter to the student’s education.

It was agreed that there would be no safety issues for the patient if communication was adequate. An ASL translator would need to be present at all times.  It is possible that situational awareness that comes from sounds (alarms, agitated patient, commotion) might be impaired.  Communication in the operating room or trauma room could be impaired as masks will prevent lip reading. There may be technologic solutions to these concerns.

It was stressed that adequate lead/preparation time would be critical so that clerkship faculty would be prepared for adaptation to the student’s need.

It was agreed that more information as to the nature and depth of the hearing loss and to what degree hearing aids can mitigate the impairment would be important.


Next Meeting 4/22/13 5 PM Pediatric Conference Room.

Agenda: Please discuss and plan respond to the following items from the Curriculum Committee:

The Committee discussed the Mulholland report focusing on the highlighted concerns where follow-up is needed.  Each Clerkship and Surgical Specialty must achieve the following:

  1. Clarity in scheduling and expectations especially on multi-site rotations is necessary.
    Review of the orientation/written expectations for the clerkships and specialty rotations shows OBGYN clerkship and the Urology and Plastic Surgery to be models. Request the clerkships and specialty rotations to use the OBGYN clerkship and the Urology and Plastic Surgery specialties as models.   This can be done with post-clerkship students on the Medical Education elective with faculty assistance writing and approving the expectations.  Good communication between the clerkship director and the teaching faculty at all sites is essential.

  2. Ensure formal mid-rotation feedback to the students.

  3. Ensure all clerkships at UVA are allowing/requiring students to write notes in Epic as approved at the Curriculum Committee meeting 2/21/13.

  4. Clerkships with varying patient populations (seasonal disorders, pediatric population as at Veterans Hospital) must address the lack of patient diversity, e.g. with UVA developed case studies, SIMPLE (medicine) or CLIPP (pediatric) cases.

  5. Define EPAs (entrustable professional activities) for medical competent students in each clerkship. Consider the following examples:

    Examples of EPAs for residents can be found at http://www.im.org/AcademicAffairs/milestones/Pages/EndofTrainingEPAs.aspx

  6. Ensure that all students are aware of procedures for reporting unprofessional behavior during clerkship orientation. This is done in the Transition but must be reinforced during each clerkship orientation.

  7. Arrange for UVA lectures and Internal Medicine morning report available by Webcam or Podcast to students at all clerkship sites whenever possible.

  8. Work with your departments and residency directors to strive for more medical student continuity with attending physicians when possible.  Consider assigning teaching physicians to work with students in an on-going manner.