University of Virginia School of
Medicine
Curriculum Committee
Minutes 04.27.00
Present (underlined) were: Reid Adams, Robert Bloodgood, Anita
Clayton, Al Connors, Gene Corbett, Joanna Goldberg, Donald Innes
(Chair), Steven Meixel, Jerry Short (Acting Chair), Rob Williams, Bill
Wilson, Debra Reed (Secretary) Guest: Marcus Kauffman
- John Gazewood and Jerry Short are meeting with Jay Scott to discuss
reimbursement for the POM mentors. Reimbursement for ICM tutorial
leaders is $3000 per semester for an approximately 2 hour per week time
commitment. In negotiating reimbursement for POM mentors, it should be
noted that POM will require a 3-4 hour time commitment per week for 34
weeks. Levels of reimbursement between medical faculty and non-medical
faculty will also be negotiated.
- Gene Corbett and Marcus Kauffman presented results of the first
phase of their study, "A Study of the Learning and Teaching of Clinical
Skills at the University of Virginia School of Medicine." This study
has been undertaken by Gene Corbett to fulfill the medical education
research requirement of the Harvard-Macy Physician-Educators Program.
The data was collected during July and August of 1999 with faculty and
students from the Class of 2000 participating. Students and faculty
were polled on a series of 36 selected clinical skills. Skills were
grouped into areas of:
- Patient Communication, Engagement & Education - (4 skills
total) - ex. Engage a shy/reticent patient in an interview.
- Physical Examination - (6 skills total) - ex. Observe &
interpret a jugular venous pulsation
- Diagnostic Skills- (9 skills total) - ex. Perform a lumbar
puncture
- Therapeutic Skills - (11 skills total)- ex. Perform basic
cardiopulmonary resuscitation
- Clinical Testing - (6 skills total) - ex. Justify, order and
interpret blood urea nitrogen and creatinine tests
- Students were asked to rate their level of skill, how well
they thought each skill is being taught, and how important each skill
is to the practice of medicine. Faculty were asked to evaluate student
performance on each skill, how well they thought the skill is being
taught and the importance of the skill. Sixty-oneone fourth'year
students responded to the surveysurvey (out of 140) and 163 (out of
435) faculty members responded. Of the faculty responding, 69.4% had
weekly contact with the students, 70% had been teaching for more than
five years with 19.7% of the responses from generalist physicians and
80.3% from specialists. Expectations of student performance varied
between the generalist and specialist with the generalist having higher
expectations of the skill level of the students than the specialist. Of
note, none of the skills in question were felt to be mastered by 100%
of the student respondents and faculty rating of student performance
was generally lower than students estimation of their own performance.
Students may lack confidence in their skill level due to their lack of
practice of the procedures.
Data from this study will be reviewed by the Curriculum Committee and
discussed further at a subsequent meeting.
- Jerry Short distributed the data on clerkship evaluations for the
years 1996 - 2000. While most data remained steady, there were
clerkships that scored much higher consistently and much lower
consistently that their peer clerkships. Establishment of a threshold
that would spark Curriculum Committee intervention was discussed.
Inquiries about teaching methods might also be made at the clerkships
where the scores are consistently high and this information shared with
the other clerkships. The most highly rated clerkships are those where
a single MD is responsible for teaching one student or a small group of
students, e.g., the PCAM clerkship and the Psychiatry clerkship in
Roanoke. Expediting the evaluation process should also be looked into.
Delays in publishing the Mulholland Clerkship Report hinder timely
improvements by the Clerkship directors (although Clerkship directors
have access to the student evaluations, on which the report is based,
immediately after each clerkship period.).
- Bill Wilson proposed a possible grading alternative - that of
Pass/Fail but with the addition of a class percentile rank for each
student that would be made available to residency program directors.
Concern was raised about the narrow distribution of grades in many
courses making differences in percentile rank appear more significant
than they are. Al Connors described the Case Western plan with
Pass/Fail grading in Years 1, 2, and 4 and Honors/Pass/Fail grading in
Year 3. This plan did not appear to hurt students' residency
placements. Grading will be discussed further at a subsequent
meeting.
-Jerry Short
-dmr
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