University of Virginia School of Medicine
Curriculum Committee
Minutes 04.13.00

Pediatric Pathology Conference Room, 4:00 pm

Present (underlined) were: Reid Adams, Robert Bloodgood, Anita Clayton, Al Connors, Gene Corbett, Joanna Goldberg, Donald Innes (Chair), Steven Meixel, Jerry Short, Rob Williams, Bill Wilson, Debra Reed (Secretary), Guests: John Gazewood, Brian Wispelwey

1. The Curriculum Committee is holding a second "open house" for faculty and student input in Primary Care Center Classrooms A and B, from 3:00 p.m. until 5:00 p.m. on Thursday, May 4, 2000. Members of the Curriculum Committee will be present to listen to ideas and concerns regarding the School of Medicine curriculum from both faculty and students. An e-mail notice will be sent to all faculty and medical students from the 1st and 3rd years.
   
   
2. Don Innes reported that he updated the Dean's Executive Committee on the Curriculum Committee's progress last week. Comments and from the Executive Board were positive. An article from the AAMC Office of Governmental Relations provided by Bill Knaus entitled, "Changes to Medical School Curriculum Urged at Hearing on Complementary and Alternative Medicine" was distributed to the Committee.
   
   
3. The primary agenda item was an update on the PoM course. John Gazewood has agreed to be one of the PoM course directors. A second director will be Brian Wispelwey whose expertise and name recognition are important especially as PoM and ICM are to become a continuum PoM-1 and PoM-2. The organization and administration of PoM will require a huge amount of time and energy, thus a third major position is proposed (to be named later). While the concept of 3 directors may appear unwieldy, this combination offers opportunities and manpower and frees Dr. Wisplewey to devote energy to the rejuvenation of ICM into PoM-2. Dr. Gazewood has been involved in the planning stages of the course from the beginning and is meeting with the committee today to outline course structure, plans for the course, and to solicit input and address concerns of the Curriculum Committee.
   
   The primary goal of the Practice of Medicine planning committee was to integrate DPI, Physical Diagnosis and Ethics and in doing so, make the Practice of Medicine Course more than a sum of its parts. The course will parallel Anatomy instruction in the first semester and Physiology in the second. The planning committee meets every other week. The POM course revolves around the doctor/patient relationship taught in the context of the patient encounter, instruction on how to do a good history and physical examination. This course should lay the groundwork for ICM (POM2) in the second year. The POM curriculum is still a work in progress and modifications will be made as the course progresses.
   
   Meeting space requirements are a constraining factor. At the present time, Andrew Lockman is reviewing current available space for small group and physical diagnostic procedures. The POM planning group originally planned to create groups of 8-9, however, a suggestion was made by the Curriculum Committee that small groups be composed of varying numbers of students (6-12) to make use of all available classroom space. Jerry Short is also working to locate additional small group rooms.
   
   Concern that students receive as much patient contact as possible during the first year was voiced. Patient contact is included in the curriculum as it is planned at the present time but may not be obvious on the schedule. This will become clearer as the schedule is fleshed out. Objectives for each POM session will be created and compared to the overall course objectives.
   
   The POM course is structured as a progressive course, starting with the framework for a patient interview and each week adding something new that builds on the previous week. Sequence of instruction on history and physical examination is important and should have a clear and distinct order.
   
   Recruitment and development of faculty mentors is a major focus of both the Curriculum Committee and the Directors of the POM course. Remuneration, promotion incentive and departmental support are absolutely necessary for recruitment. The POM course will try to retain as many of the current DPI physician mentors as possible. Faculty development is necessary so that each small group will have standardized history and physical instruction. In teaching the "medical interview" the distinction between listening to the patient and eliciting necessary medical information must be stressed. Mentors for this course will be required to spend a full afternoon per week with the students plus preparation time.
   
   Information management and use of technology in medical decision making are critical components of the curriculum. The Curriculum Committee expects the first year POM student to become familiar with the process of information management and technology in medical decision making. It was suggested that instruction on literature research be built into the small groups as much as possible. Teaching students to weigh and filter information in clinical decision making should be a part of the POM course instruction. Portions of what is currently Clinical Epidemiology should be considered for inclusion in the PoM-1 course.
   
   

-Don Innes

-DMR