University of Virginia School of Medicine
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) Guest: Anne Mounsey
Family Medicine Clerkship Review. Co-directors Anne Mounsey and Karen Maughan were complimented on submitting an excellent review. Anne Mounsey represented the clerkship joined with the curriculum committee to discuss the review.
When asked about cultural competency in the Family Medicine Curriculum, Dr. Mounsey noted that while they did previously cover this in a workshop, it had been discontinued due to poor evaluations. It is being redesigned (Please see section F5.) to focus on specific goals (obesity in ethnic minorities) and hopefully will be better received.
It would also be beneficial to the program if PDAs could be provided to the preceptors along with training in how the students are to use them.
Family Practice does not have a problem with recruitment or retention of preceptors. A large pool of preceptors allows for careful selection and evaluation (by students and faculty) of preceptors, and retention of only those effective teachers.
Comments from one medical student asked to review the Family Medicine Passport were discussed:
[Rather than]"observe" a skin exam… better would be to require the student to describe a rash to the physician using proper terminology. [Include procedures] such as a pelvic exam, breast exam, testicular exam (breast and testicular are in surgery, but I felt there were actually more opportunities to perform these exams on my family rotation). Some required phlebotomy on the family rotation could be useful as well.”
Family Medicine distributes guidelines to their preceptors. The Curriculum Committee expressed an interest in the guidelines and would like to share these with the other clerkship directors through the Clinical Medicine Committee.
Dr. Mounsey noted that the departmental and administrative support for the Family Medicine Clerkship was excellent.
The Curriculum Committee thanked Drs. Mounsey and Maughan for an excellent review and praised them for a well run Family Medicine Clerkship. The clerkship fulfills an important place in the clerkship environment addressing, in cooperation with AIM, essential physical examination, communication and cultural skills in the ambulatory setting.
Semester 1 of the Medical Curriculum. (Bob Bloodgood) Dr. Bloodgood outlined the 05-06 changes to the Semester 1 Medical School curriculum:
Gross Anatomy, Biochemistry and CTS/Physiology ran only until Thanksgiving
Gross Anatomy and Biochemistry changed from 3 to 2 exams
Molecular & Medical Genetics moved to the fall
Only 1 course (MMG) taught in 3 week period from Thanksgiving to Winter Break
Cells to Society
To evaluate the impact of these changes many sources of data were reviewed such as student performance data from individual courses; data from medical student evaluations of individual courses; results from Nov 2005 survey (same one used for Pass/Fail grading study – Wellness Survey); notes from “town hall” meeting of Associate Deans with 1st year class and a survey done of 1st year class by 1st yr reps to the Principles of Medicine Committee.
Academic performance data:
Fall >04 (Class of >08)
Fall >05 (Class of >09)
84 % (56-98%)
87 % (70-98%)
Med & Mol Genetics 90.0% (78-99%) 91.4% (76.7-97.9%)
Comparison of Survey Data from Classes of 2007 and 2009 A Summary [Data collected before Thanksgiving] included the following questions:
"Overall, I am satisfied with the quality of my medical education" dropped from 3.63/4.00 to 2.96/4.00.
"My current level of satisfaction with my personal life during the last month of medical school" dropped from 3.95/5.00 to 3.15/5.00.
All of the questions on the DuPuy Wellness Survey showed a consistent (albeit sometimes small) drop in Wellness during Semester 1 of medical school.
Conlusions from Evaluation of Fall Year 1 of New Curriculum
Student performance (scores on individual courses) was as high as in previous year [less low scores]
Number of course failures was down (from 4 to 0)
Student feedback suggests increased stress between August and Thanksgiving, especially associated with Gross Anatomy
sment of courses down somewhat for Gross Anatomy, Med & Mol Genetics and CTS/Physiology and up dramatically for Biochemistry
Students liked the experiment in taking a single course between Thanksgiving and Winter Break
The Principles Committed identified potential sources of increased stress between August and Thanksgiving
Addition of Exploratory
Decrease in number of exams in Biochemistry and Gross Anatomy
Increased pace of the material in Gross Anatomy (more hrs/week of Gross Anatomy)
Scheduling (overlap of amino acid metabolism with head and neck anatomy)
Comments made by some faculty and 2nd year students to the 1st year students
The Committee discussed the following possible Strategies for Reducing Stress in 1st semester of Year 1
Change timing of the Exploratory
Eliminate cumulative honors
Eliminate the experiment of a single course between Thanksgiving and Winter Break so as to spread some or all of the other Fall courses (esp Gross Anatomy) over the entire Fall
Adjust the schedule within the period between August and Thanksgiving
Make adjustments within individual courses
The Principles of Medicine committee developed three recommendations:
(1) Exploratory: Recommend that the exploratory not be required for any particular student during the 1st semester of the 1st year
(2) Cumulative Honors: Recommend that cumulative honors be eliminated from the pass/fail grading system with the Class of 2010.
(3) Schedule for Sem 1 of Year 1: Leave the current (new) schedule in place.
The Curriculum Committee discussed numbers (1) and (3) at today’s meeting and unanimously endorsed both measures.
Due to time constraints, the Cumulative Honors program will be discussed at a later date. Fall semester course directors are asked to work together to optomize their courses to ensure a more balanced student workload. Dr. Bloodgood reports that the Fall 06-07 schedule is now being developed and should be ready in a few days. Conflicts with the MSTP program will also need to be addressed.