University of Virginia School of
Pediatric Pathology Conference Room, 4:00 PM
Present (underlined) were: Reid Adams, Robert Bloodgood,
Victoria Camerini, Anita Clayton, Al Connors, Lisa Coray,
Gene Corbett, Donald Innes (Chair), Howard
Kutchai, Nelle Linz, Nikhil Rao, Jerry Short, Bill Wilson,
Debra Reed (secretary)
- Clinical Connections. The Clinical Connections Planning
Group met today to review the previous sessions and plan the 2002-2003
programs. A tentative program follows:
Information Technology in Medicine
The Law and Medicine
Pain & Palliation
Open - possible Public Health Care
- The discussion, continued fom the previous week, focused on a
program to improve the teaching of clinical skills with an emphasis on
the physical exam. This program might take place at either the bedside
or in the clinic and would likely differ for each clerkship.
The goal is to improve the clinical competence of our medical
students.This would be achieved through increased contact of students
with dedicated "master" teachers. These "master teachers" in each
clerkship would practice clinically and have a major portion of their
time (and remuneration) dedicated to the clinical education of our
students. Success at "master teaching" activities should also form the
basis for promotion.
The amount of each Master Teachers time devoted to teaching was
discussed. Too little time might give the impression that this endeavor
is not worthwhile - too much and it becomes more difficult to fund -
figures from 25-50% were discussed.
The Curriculum Committee considered the difficulty of creating and
maintaining consistency between sites. It will be important that the
clerkship director define the job description of the "master teacher"
carefully delineating expectations and the amount of time to be devoted
to hands-on teaching.
Don Innes met with Mike Rein Director of the Internal Medicine
Clerkship. Dr. Rein confirmed the need for improved third year
instruction in physical diagnosis and enthusiastically supported the
concept of a teaching attending. In Internal Medicine, approximately 18
students participate in each rotation while at the University of
Virginia Hospital with another 6 at away sites. This proposal would
probably be limited to in-house initially, however, the away sites
already have faculty whose primary role is teaching.
The Committee discussed a ward model "master teacher" program with a
ratio of 1 teaching attending:2 students for 2 hours each week. In the
two hour period the teaching attending would see a variety of patients
with the students examining, presenting and discussing findings with
the attending. Patients selected by the attending and/or the student's
patients would be the subject of this bedside teaching. Emphasis would
be on the proper acquisition and application of physical examination
skills. Discussions would include the nature of the physical finding,
the implied pathophysiology, the differential and the diagnostic
In the clinic model "master teacher" program one teaching attending
would work with 2 students for 2 hours each week in the clinic. The
student and teaching attending would see a variety of patients with the
students examining, presenting and discussing findings with the
attending. Patients selected by the attending would be the subject of
this clinic teaching. Emphasis would be on the proper acquisition and
application of physical examination skills. Discussions would include
the nature of the physical finding, the implied pathophysiology, the
differential and the diagnostic significance.
Methods of evaluating the program would include the CPX exam, fourth
year students exit interviews and possibly a one-year-out survey of
students and their residency programs.
The "master teacher" program is not meant to replace current lectures,
ward and clinic duties. It is to be a supplement focused on physical
diagnosis, history taking and development of diagnostic skills. This
program should not replace or interfer with current student
responsibilities on the wards and in the clinics.
The Curriculum Committee discussed piloting this program in the
Internal Medicine and possibly the Surgery Clerkships. The committee
will solicit ideas from clerkship directors for "master teacher"
program plans within their disciplines.