Basic Science for Careers.  (Debra Perina)  Debra Perina outlined preliminary plans for the Basic Science for Careers course.  This course will be piloted as an elective in 06-07 with full implementation planned for the spring of 2008.

Vision
Create a course in the undergraduate medical curriculum following 3rd year core clerkships to review, expand, and focus on basic sciences as applied to a particular discipline

Course Goals
Relate basic science to individual student’s chosen discipline (future residency) focusing on application of basic science principles used in daily practice of the chosen discipline
Highlight basic science concepts from Principles of Medicine courses in the post-clerkship/pre-electives period
Motivate and mentor students in their chosen field(s)
Increase student interest in academic medicine
Stimulate critical thinking to enhance their understanding of disease and ability to integrate this into patient care.
Enhance clinical reasoning and decision-making abilities
Promote greater self-sufficiency of students in the clinical setting

Format
4 week required course for all students
Given May of 3rd year following core clerkships
Prior to elective rotations, residency applications, “audition rotations,” USMLE-2

3 types of teaching venues

General sessions

Topics with universal relevance
Entire student group

Major topics in clinical practice with universal relevance relating closely to basic science
An integrated and more sophisticated treatment of material from 1st and 2nd years
6 sessions, ~ 3 hours each (~18 hours/student)
Students required to attend all General sessions

Topics:
Fluid and Electrolyte balance and acid base disorders
Drug-Drug Interactions
Appropriate Antibiotic Prescribing
Evaluating Clinical Research
Bench to Bedside- answering patient care issues in real time
Homeostasis – Maintaining human system wellness preventive medicine

Specialties sessions

Topics with career/specialty-oriented groups
~10-15 students per group
Venue for student presentations
Focused topics with career oriented relevance
#20 sessions, ~3 hours each
Students must select 10 sessions, but may attend more
~30 hours/student

Content:

Topics specific to clinical discipline
Case vignettes format
Some cases from those identified by students
Relevant Basic Science illustrated
Current manuscript discussions
Discuss limits of knowledge and identify future research questions

Possible Pairings for Specialties sessions:

Surgery  - Anatomy
Pediatrics - Cell Biology
General Internal Medicine - Microbiology
Anesthesia - Pharmacology
Emergency Medicine - Biomedical Engineering
Family Medicine - Biological Physics?
OB/GYN - Molecular Genetics
Cardiology - Electrophysiology
Vascular Surgery  - Fluid Mechanics
Sports Medicine - Biomechanics
Pain Management - Neurophysiology
Perinatal and Infertility - Physiology
Toxicology - Biochemistry
Pediatric Infectious Disease - Microbiology

Applied sessions

Cinical scenarios
~0-15 students per group
Venue for student presentations and case management
Cases developed from specialties
Students manage case alone
Immediate feedback from faculty
Promote critical thinking and independent decision making
~5-10 students/group
Students attend 7 applied sessions (must sign up in advance) May attend more
Students given case problem in advance to research management
Students have access to resources to solve patient management questions

Faculty
General and Specialties sessions jointly taught by clinician and basic scientist
All sessions are case vignette format
Applied sessions taught by clinicians
Clinician leads case presentation
Basic scientist discusses relevant concepts in context of case 

Required Resources
Manpower
Faculty
General Session Directors                     12
Specialties  Directors                            40
Applied Session Directors                     21

Facilities
Large lecture hall for General Sessions
7 Intermediate-sized rooms for Selective Sessions
18 Small group rooms

Student Responsibilities
Identify specific cases or questions developed from their experience during core 
clerkships to discuss in sessions
Attend all General sessions
Attend 10 Specialty sessions (must sign up in advance of course). May attend more
Attend 7 Applied sessions (must sign up in advance of course). May attend more
Total class time commitment ~ 20 hours per week

Benefits to Students
More in depth exposure to specialty areas
Relate basic sciences to future practice setting
Provides discussion of relevant current literature
Enhances overall understanding of specialty which could enhance residency selection and interview process

Benefits to SOM
Greater specialty involvement with interested students
Recruitment tool for specialties 
Enhances understanding of basic science relationship to clinical patient care
Raise awareness of unanswered questions for future research interests of students
Stimulate interest in academic careers
Improve standing of UVA residency candidates
Improve USMLE-2 performance
Incorporates AAMC objectives:
Self study, Independent learning, Small group teaching, Information retrieval

Next steps…..
Develop Steering Group to refine content and address ongoing questions
Actual scheduled time within total curriculum
Are 4 weeks needed?
Possible pairing with other rotations
Refine specialty selection and basic science groupings
Pilot course with a select group of students with follow-up impact study (2 week elective) in Spring 2007.
Measure impact of course by surveying participating students and selective directors benched against control group of students who did not participate in the course
Obtain Departmental Chairs support
Identify all session leaders
Budget for space and resources 


The Committee congratulated Dr. Perina on her outstanding work on this project.   The Committee had a brief discussion regarding  the timing of the course – whether in May as originally designed or in March immediately after the clerkship period;          practical issues such as grading/remediation and space requirements;          recruitment and compensation of enthusiastic faculty; use of computer based learning in the course.

The Committee endorsed the case based format of the course.  It was suggested that some small group interaction be structured into the General Sessions to enhance student interest.   Use of real or standardized patients or the patient simulator was also encouraged.

Dr. Perina asked the Committee to send their thoughts or suggestions regarding the course to her via e-mail dgp3a@Virginia.EDU.

Sixtine Valdelievre highly endorsed the proposed program and volunteered to serve as one of the student members of the Steering Committee.

Mentorship Program.  John Gazewood noted that the faculty mentor program will begin this week.  Four sessions are planned for this year.   Recruitment of enough in-house faculty was difficult so some students will need to travel to Orange or Stony Creek.    He is hopeful that more UVA faculty will volunteer as the program becomes more visible.

Curriculum Committee meeting agenda for the next few months was outlined.

Address recommendations from the UVA Self-study Subcommittee on Education for the M.D. Degree.

Exploratory placement in the curriculum? -time? -extent? -modifications/true "exploratory"? integrate with physician experience? -other ?

Recommendations for first year fall 2006 following evaluation of the Fall semester of the first year, and options from the Principles of Medicine Committee. 

Clerkship evaluation form is due to the Curriculum Committee by 2/3/06 .  The Committee will review the submissions and arrange interviews with the Clerkship Directors beginning in February.

Clerkships– Neurology integration; Medicine scores; Surgery anesthesia curriculum; Psychiatry and Ob/Gyn curriculum focus

Selectives – program description, curriculum, evaluation (student/program) in Internal Medicine (Acute Cardiology, Coronary Care Unit, Digestive Health, Geriatrics/Palliative Care, MICU, Cardiovascular Emergencies, Acute General Medicine (Roanoke), Infectious Disease), Obstetrics and Gynecology, Psychiatry, and Surgery (ENT, Neurosurgery, Ophthalmology, Orthopedics, Plastic Surgery, Urology)

Clinical Skills Education Program – Michael Rein

Ethics Rounds – Walter Davis

Electives - monitor the content, depth, breadth, current relevance [ED-37] Meg Keeley, John Jackson

Reflections program – Dan Becker/ Margaret Mohrmann – program structure

Clinical Connections – future

Program structure –schedule, full day/1/2 day

Organization – CME director, Medical director, Clinical Connections committee

Evaluation (student/program)