Minutes 01.19.06

Minutes 01.19.06

University of Virginia School of Medicine

Curriculum Committee Minutes

01.19.06

Surgery Conference Room, 4:00 p.m.                        

Present (underlined) were: Reid Adams, Gretchen Arnold, Eve Bargmann,  Daniel Becker, Robert Bloodgood,  Gene Corbett, John Gazewood, Jennifer Harvey, Donald Innes (Chair),  Howard Kutchai, Marcus Martin, Chris Peterson, Jerry Short, Bill Wilson,  Anthony DeBenedet, Sixtine Valdelievre, Debra Reed (secretary) 

  1. 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.

  2. 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.

  3. 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)

Donald Innes
dmr