Minutes 05.08.08

Minutes 05.08.08

University of Virginia School of  Medicine
Curriculum Committee

Pediatric Conference Room, 4:00 p.m.                       

Present (underlined) were: Gretchen Arnold, Eve Bargmann, Megan Bray, Dan Becker, Robert Bloodgood, Thomas Gampper, Wendy Golden, Donald Innes (Chair),  Howard Kutchai, Marcus Martin, Mohan Nadkarni, Chris Peterson, Jerry Short, Bill Wilson, Kira Mayo, Jason Franasiak, Guests: Eugene Corbett, Seki Balogun, Walt Davis,  Debra Reed (secretary) 

  1. PoM-1 2007-2008 Review (Seki Balogun, Walt Davis)

    Dr. Balogun outlined the PoM-1 course themes: 
    Patient interviewing - basic and advanced 
    Physical examination 
    Medical humanism - cultural competency, sensitive topics (sexuality, substance abuse, breaking bad news & dying), geriatrics, narratives in medicine 
    Accessing medical information; pofessionalism - written and oral communication, problem solving 

    The Course has achieved consistently high ratings on the student evaluations.  In 2007-2008, 100% of the students gave the course a "B" or higher  (62% "A" and 38%  "B"). 

    Students were also asked to evaluate organization and content of the course and scores remained high.  While the "challenging content" score was slightly lower overall, Dr. Balogun believes that this reflects that the material is being well taught and is not especially difficult to learn.
    PoM1 eval
    Significant strides have been made to achieve integration with other courses.

    Greater than 90% of students self-report being comfortable or very comfortable with most skills learned in PoM-1.  Application of basic science skills was slightly lower at 84%.

    New Initiatives 2007 -2008 (Based on student feedback from 06-07)
    Lectures made more interactive: automated audience response units
    Accessibility of information 
    POM-1 website has been updated and expanded to include all course information 
    Printed handout was provided 1st semester 
    CDROM only handout  provided for the 2nd semester)
    Addition of session on review of systems
    Addition of faculty retreat 
    Teaching different course components 
    Group dynamics

    Course Strengths
    Small groups
    Patient contact activities 
    Hospital Interviews 
       Interviewing practice with SPs 
       4th year H and P
    Clinical Correlations
    Physical examination 
      Physical Exam modules/videos 
      Putting it all together session where the mentor demosntrates a full H&P 
      In group demonstration with 4th year student as patient

    Course Weaknesses
    Lectures were the least favored part of the course even when made more interactive
    (45%: excellent or good).   However, high grades were received in lectures with clinical correlation  (Mean 3.5/4 and above).
    Teaching of ethical issues in medicine in the traditional lecture format, ethics case presentations and ethics case discussions were not well received.
    Students panned the course for the accessibility of course information via the
    POM website, the CDROM and the printed material.

    Future improvements
    Move away from lectures or large group sessions and include more clinical correlations with actual/SP demonstrations.  Integrate more lecture material into the small groups. Further enhance use of the audience response system.  Introduce ethical principles with clinical cases rather than lecture applying principles to real life clinical situations. This "case of the week" might correspond to one of the other Basic Science courses. While first year students have limited knowledge of disease processes, clinical cases must be selected carefully for content so as not to overwhelm or frustrate the student.

    Course directors will attempt to incorporate the 12-item AAMC model for clinical competency in all PoM-1 activities.  
                    Engagement & communication skill 
                    Scientific understanding and application 
                    Clinical history-taking 
                    Mental & physical examination 
                    Differential diagnosis 
                    Clinical procedures and testing 
                    Information management 
                    Plan of care  
                    Clinical intervention 
                    Care in context (personal, family, ethical, social, cultural, etc)

    The Curriculum Committee applauded the course for it's consistently high evaluations and the course directors' commitment to further improving the course.

    PoM-1 has had no problems with availability of mentors for the course; however, non-physician mentors sometimes feel less "useful" in the second semester of the course as the exercises become predominantly clinical.  Course directors have made suggestions for better use of the mentors during this time period.

    Difficulty in finding patients for the student to interview on the floors was discussed.  Some units provide a daily list of patients who are appropriate for interviews to the PoM-1 office.  Others are not able to provide the list anymore due to time constraints and the noon discharge, which leaves the mentors searching for patients instead of observing the students during the beginning of the history taking exercise.  They should consider using patients at Health South, outpatients who are waiting during long testing procedures, outpatients who are willing to take the time to talk to a medical student in the PCC clinics and possibly patients in the ER who are waiting for admission for the PoM-1 H&P exercise. Other suggestions were to use the Teaching Resource Center to develop more interactive teaching exercises; inviting someone from the Center to speak at the next faculty retreat.

    Dr. Balogun and Dr. Davis were congratulated on running an excellent course
    and providing a thorough course review to the Curriculum Committee.

Donald Innes