Minutes 04.12.07

Minutes 04.12.07

University of Virginia School of  Medicine
Curriculum Committee

Surgery Conference Room, 4:00 p.m.                       

Present (underlined) were: Reid Adams, Gretchen Arnold, Eve Bargmann,  Daniel Becker, Robert BloodgoodGene CorbettWendy Golden, Donald Innes (Chair),  Howard Kutchai, Marcus Martin, Chris Peterson, Jerry Short, Bill Wilson,   Brad Bradenham, Emily Clarke,  Debra Reed (secretary)    Guest:  Melanie McCollum

  1. Jordan Hall Lecture Halls.   Richard Allen, Ron Hoadley, Melanie McCallum and Jerry Short have discussed the musty smells in the Jordan Hall lecture halls and the environment in the Anatomy lab.  They have requested an inspection by the Environmental as soon as possible as a prerequisite to developing short-term and long-term remedies.  The $19M HVAC renovation of Jordan Hall is in the planning stages and will probably take two years to complete.

  2. Clerkship Coordinators Meeting.  The Clerkship Coordinators met on 4/9/07 with staff from Student Affairs and Medical Education.  John Jackson reviewed the clerkship web sites, using Neurology as an example because of their clearly defined goals and expectations.  All clerkships were encouraged to review and update their sites.  John discussed "Mobile Medicine" with the groups.  He also showed RefCards and encouraged clerkships to consider adding cards.  He noted that an overview of the resources for PDAs will be given to all medical students.  The new Oasis model was demonstrated and discussed. 

  3. Instructional videos.  A new website has been developed by John Jackson's group that repackages the video instruction developed here at UVA so that the videos are downloadable to students' IPODs.

  4. Gross and Developmental Anatomy Revisions for 2007.  Melanie McCollum met with the Committee to outline plans for the 2007 Gross and Developmental Anatomy course.

    Issues of Concern:
    a)     Sequence of instruction and conflicts with other courses (head and neck anatomy)
    b)    Volume of content and pace of instruction
    c)     Lab time vs. lecture time?
    d)    Quality and completeness of handouts
    e)     Role of faculty
    f)     Student assessments
    g)     Medical imaging

    Plan of Action:
    a)   Sequence of instruction:  Move head and neck anatomy earlier in course
    b)   Content/Pace:  Review content and eliminate material of little or no clinical value, as well as material required only by specialists.  Eliminate difficult, unsatisfying dissections.
    c)   Lab/lecture time:  Reduce the total number of lectures; redistribute the time gained to "Prelab Overviews," Laboratory exercises, and "Postlab Discussions."  Postlabs will be case-based, faculty-driven discussions that will rely heavily on the Audience Response System (ARS).
    d)   Handouts:  Replace with a list of highly specific learning objectives keyed to the required textbook, lab manual or Course Director approved handouts.  Prelab and Postlab objectives will be culled from the Unit's master list and assigned to each dissection exercise.  Postlab objectives will be the primary focus of Postlab discussions.
    e)   Role of faculty:  Shift from being primary information source to being guide for/facilitator of student directed learning in lab exercises, postlab discussion and small group discussion of clinical cases.
    f)    Student assessment:  Improve and standardize exam questions - improve discrimatory power of exams.
    g)   Medical imaging:   introduce "Imaging Case of the Week" online instructional tool (currently in development) and increase proportion of total grade devoted to imaging exercises.

    Dr. McCollum wants the students to have "anatomical knowledge for success."  Students will be quizzes more often in hopes of identifying at risk students earlier in the course.  Students in the group did not see a problem with moving the Head and Neck anatomy section.  Other course directors in courses such as Biochemistry believe this would be valuable to them as well.  There will be a slight increase in the use of prosection rather than dissection. 

    Eugene Corbett mentioned a recent article in The Clinical Teacher on new visual methods for teaching anatomy - What lies beneath: the in living anatomy teaching, Patten D: The Clinical Teacher 4(1):10-14, March 2007. 

    Melanie McCollum discussed the potential use of new software in Anatomy education based on the Visible Human.  While the program would be very useful, it is expensive.

    Brad Bradenham questioned whether the lab handouts would still be available since they had been helpful to him in the Anatomy Course.  Dr. McCollum said they would still be available in a different but consistent format.

    Students will be able to see the more specialty specific dissections during their fourth year elective in Anatomy.

    It was suggested that perhaps in years to come the name of the course be changed to "Anatomy and Medical Imaging".  

    The Curriculum Committee endorses the changes proposed by Dr. McCollum and will be interested in learning how they are received in 07-08.

  5. Working Group on Clinical Skills Education.  

    Gene Corbett proposed development of a working group on clinical skills education.  There is a need to better coordinate curricular activities in an effort to establish a more integrated clinical skills curriculum. The purpose of the working group (WGCSE) is to facilitate the achievement of a four-year developmental clinical skills curriculum in the School of Medicine which ensures that each student meets a defined level of basic clinical performance proficiency prior to graduation.

    In order to achieve this goal, two administrative steps are under consideration:

    1. Establish a "Working Group on Clinical Skills Education" under the aegis of the Curriculum Committee. The purpose of this group is to integrate, coordinate, and initiate improvements in clinical skills education activities throughout the four years of the undergraduate medical curriculum;

    2. Link the working group to the Practice of Medicine Committee. This representation will serve as a resource to facilitate development of clinical skills education exercises, such as skills workshops and skills assessments in all clerkships.

    With the establishment of the WGCSE, a number of "next step" tasks can be more effectively addressed:

    1.  Link clinical skills teaching and assessment activities throughout the four years of the curriculum;
    2.  Create a more standardized clinical skill development process that reflects the 12 objectives of undergraduate medical education;
    3.  Expand formal clinical skills teaching throughout the clinical years, thereby addressing the learning of a wider variety of basic clinical skills;
    4.  Expand opportunities for specific skills assessments and remediation;
    5.  Enhance faculty and resident educational development with emphasis upon clinical skills teaching in small groups and in bedside rounding;
    6.  Establish a database for tracking and evaluating clinical skills education outcomes.

    As with all curricular processes, this is a work in progress. It is likely that the content and priorities of this curricular effort will change as the process of making developmental clinical skills education more explicit continues to unfold. 

    Proposed Membership/Representation:
    1.     Practice of Medicine I
    2.     Practice of Medicine II
    3.     Clinical Medicine Committee
    4.     Electives & Selectives
    5.     Professionalism
    6.     Simulation
    7.     Instructional technology/computer support
    8.     Clinical Skills T&A program (SP program)
    9.     Program evaluation
    10.   Student representative, 4th year
    11.   GME / recent post GME
    12.   Chair

    The Curriculum Committee agreed that this was an excellent proposal.  The necessary clinical skills required for the School of Medicine have been defined in the 12 learning objectives as well as the individual clerkship passports.  The Committee would like to see this Working Group meet with all the relevant course/clerkship directors involved in clinical skill education, determine what is being taught and evaluated now and offer suggestions and help in implementing future clinical skills curriculum development.  Faculty development would also be looked at by the group. 

    The Clinical Skills Educator program was mentioned and the possibility of expansion of this program into the other clerkships. The Committee suggested that if time permits, it might be helpful for members of the Working Group to shadow a student on individual clerkships for a morning or two to determine what is actually being taught.

  6. The next meeting of the Curriculum Committee will be held on 5/3/07.


Donald Innes