Minutes 08.26.13

Minutes 08.26.13

Clinical Medicine Committee
August 26, 2013


Megan Bray, Yvonne Newberry, Huai Cheng, Laurie Archibald-Pannone, Peter Ham, Catherine Casey, Wanda Hudson, Pamila Herrington, Nassima Ait-Daoud Tiouririne, Meg Keeley, Gene McGahren, Anneke Schroen, Amita Sudhir, Chris Ghaemmaghamii, Guillermo Solorzano, Binit Shah, Ashley Shilling, Stephen Collins, Brian Wispelwey, Evan Heald, William Wilson, Robert Boyle, Anne Chapin, Allison Innes, Darci Lieb, Nancy McDaniel, Thomas Jenkins, J, Donald Innes, Karen Knight, Sylvie Moore, Matt Dickerson, Carolyn Engelhard, Derrick Thiel, Mary Grace Baker (SMD 2014)

Members Present: Bold
Guests: none


  1. Patient Safety Curriculum in the Clerkships

    From July meeting: Email Peggy Plews-Ogan with the patient safety concepts that your clerkship will cover each rotation (AIM, Heald only director that responded).

    Key concepts not covered will be assigned to a clerkship and director will be notified.

    Patient Safety Concepts that need to be covered in the clerkships

    Human factors
    Team function/communication in patient safety
    Handoff of care
    Culture of safety
    Error reporting
    Disclosure and Peer support:
    Patient/family role in patient safety
    Infection control (hand-washing, central line infections, c. diff.)
    Escalation of care and topic of appropriate supervision
    Medication safety
    Transitions in care
    How we use data to improve safety in each specialty

    Patient safety tools that can be used to support and teach the concepts

    Central line checklist
    Surgical checklist Surgery Clerkship is doing this item
    Tracking systems
    Handoff of care tool
    Sepsis best practice alert
    DATA tools
    SBAR or other communication tool
    Medication reconciliation
    Read back
    Hand-washing audits
    Root Cause Analysis
    M&M Medicine Clerkship is doing this item, required for students
    Disclosure tool (Ask/tell/ask) and resources

    EMR safety tools
    -          Alerts (drug drug interactions, allergies, drug monitoring alerts)
    -          reminders (health maintenance, best practice)
    -          decision support  ( example=sepsis)/

    The curriculum and learning objectives for patient safety are posted on the Curriculum web page of the SOM. All clerkships should link to it from their web page.

    Additional resources for education:

    Especially the resources for M1-3s from University of Illinois


  2. Discussion of Graduation Questionnaire item

    All Clerkship directors, co-directors and directors of surgical selectives were asked if they were ever made aware of a student being pressured for sexual favors in return for a grade. All responded and none had any knowledge that this had ever happened on their clerkship.
  3. LCME preparation: ED2 lists and sign off

  4. Clerkship Reviews will be conducted early Fall. The directors will conduct a self-study and members of the Curriculum Committee will be assigned clerkships to review. Findings will be presented to the Curriculum Committee.'

  5. Other business

    a. Critical Review of Medical Literature: It has been observed by faculty and Clerkship directors that the current clerkship students appear less prepared to do critical review of literature than previous classes. This appears to be related to the change in curriculum which will be addressed via the Curriculum Committee. The skills can be broken down into components which include how to choose and article, how to critique an article and practice of those skills. It was recognized that faculty development will be needed. It was recognized that even expert clinicians have variable skills in this arena and that students need to also learn about and utilize resources that perform the critical review of a topic.

    Discussion points
    ·         Population medicine is introduced early in the curriculum. It is difficult for a beginning student to critically read an article that is beyond their medical knowledge. This skill needs to be learned and practiced across the curriculum with items in Foundations, CPD, Transition and Clerkships.
    ·         A new Thread Leader has been identified for Epidemiology
    ·         There are opportunities for learning and practice of these skills in Medicine, Neurology and Emergency Medicine.

    b. Weekend Rounding for current second year students. Pediatrics, Psychiatry and Medicine Clerkships were recognized for providing this opportunity. Dr. Wispelwey remarked that this is known to be a valuable experience and it should not be voluntary. Currently this activity would not be covered in the required activities for the students in the pre clerkship phase of their studies.

    c. Matt Dickerson was introduced as a new member of the committee. He is the interim Director for IT support for Medical Education.

    d. Discussion of process and rules for absences
    ·         Excused Absences must be approved by the College Deans.
    ·         Students may still approach the Clerkship Director with a schedule request. If there is flexibility in the clerkship schedule and duties then it is up to the Clerkship Director as to whether or not the request can be honored. If there is no flexibility and the student is expected for clinical duty then the request is declined.
    ·         From the Student Handbook:

    Students may miss required academic activities for health related reasons (see Absences due to Illness), compelling personal or family issues (e.g., death in immediate family, participant in wedding), professional meetings (e.g., participant in meeting – poster, presenter, panel), or public service (e.g., jury duty). They must notify the course, system or clerkship director as well as the immediate faculty instructor by e-mail or in person. If a student misses more than 2 contiguous days, she/he must also notify their Student Affairs Dean and the Office for Student Affairs (som-studentaffairs@virginia.edu). The course, system or clerkship director will determine how and when the student can make up the time and activities that have been missed. (8/2000; 8/2010; 1/2011)



 Nancy McDaniel, Co-Chair, recording of minutes

Action Items

  1. Patient Safety concepts not covered will be assigned to a clerkship and director will be notified.
  2. Work group to discuss Clerkship Requirements will be formed and report back to next meeting
  3. Joint Clerkship Meeting October 23, 2013. Jordan Hall. Please put on your calendars and plan to attend.


Next Meeting:  September 23th meeting: please forward any agenda items.