Minutes 05.20.04

Minutes 05.20.04

UNIVERSITY OF VIRGINIA SCHOOL OF MEDICINE
CURRICULUM COMMITTEE
Minutes
05.20.04

Surgery Conference Room, 4:00 p.m.

Present (underlined) were: Reid Adams, Eve Bargmann, Robert Bloodgood,  Anita Clayton,  Gene Corbett, Carl Creutz,  Donald Innes (Chair)Vern Juel, Howard Kutchai, Chris Peterson, Jerry Short, Linda Watson,  Bill Wilson, Brian Wispelwey, Michael Richardson, Nnaemeka Anyadike, Debra Reed (secretary)

  1. Clinical Skills Educator

    Clinical skills education is a central and critical element of undergraduate medical education. In an effort to improve students’ skills education during the clinical clerkship year, we propose the creation of a “Clinical Skills Educator” faculty position. It is suggested that the program be piloted in the Internal Medicine clerkship.

    The essential task required of this designated faculty member will be to meet with medical students weekly in small groups while they are rotating through each inpatient clerkship. The emphasis during this educational session will be upon the learning of clinical skills, particularly patient interviewing, physical examination, case presentations and basic clinical testing and procedure performance skills. This format will also provide an opportunity to discuss professionalism, medical ethics and any of a number of professional skill issues relating to the basic objectives of medical education at the University of Virginia . Teaching by the Clinical Skills Educator (CSE) is to supplement, not replace, teaching at morning rounds, the operating room, other clerkship learning and patient care opportunities.

    Students 
    All students in their clerkship year

    Faculty 
     Selected for expertise in clinical skill education

    Content
    The Clinical Skills content and process must be standardized for each clerkship; based on the UVA Competencies Required of the Contemporary Physician. Students and faculty must be familiar with the Competencies.
    Student-centered clinical skills teaching and practice with real patients, both bedside and outpatient

    Schedule
    All clerkships would develop CSE programs to achieve a uniform experience for all students on a clerkship
    Students in small groups  [2 – 4 students] 
    Two hours per group session 
    All students have one [or more] session[s] weekly for 4 weeks
    Faculty assigned to a 4-week block [4-weeks is preferred for reasons of continuity; 2-weeks may  be acceptable]
    Daily scheduled sessions (~1-3; 3-5pm )

    Format
    The format should be a blend of student selected patients (patients the student has examined) and patients selected by the CSE to demonstrate a particular finding or set of competencies. Activities will include brief case presentations, history and physical examination, case debriefing with short related discussions using teaching points from each case.  An optional activity is to include brief, evidence-based discussions to bring closure to issues raised in prior case discussions.

    Evaluation
    An evaluation process to be undertaken during the pilot will include both student and teacher assessment of session content and value, and case logging.

    Pilot: Internal Medicine Clerkship

    Uniform experience for the ~12+ students on the General Medicine section of the Internal Medicine Clerkship 

     

    Groups

     

    A

    B

    C

    D

    (E)

    Total

    Students

    3

    3

    3

    3

    (3)

    12  (15)

    Faculty Hours x 1 session/week

    2

    2

    2

    2

    (2)

    8  (10)

    Faculty Hours x 2 sessions/week

    4

    4

    4

    4

    (4)

    16  (20)


    4-week period; 12 or 15 students; 3 students per 2-hour session; 2 days per week Faculty requirements:  16 or 20 hours; 0.3 or 0.4 FTE
    Single CSE for entire/majority of the 4-week period for continuity [or rotate]
    Develop a cadre of faculty selected for their clinical skills expertise and teaching ability


    Monday

    Tuesday

    Wednesday

    Thursday

    Friday

    A

    C

    E

    B

    D

    B

    D

    A

    C

    E

     

    A

    C

    A

    C

     

    B

    D

    B

    D

     


    Systematic Content Plan:

    Presentation and Charting Skills
    -Review write-ups with CSE providing formative assessment

    General History & Physical Examination Skills
    -Communication – patient – health care team
    -Vital Signs
    -Cardiovascular
    -Pulmonary
    -Gastrointestinal
    -Dermatologic
    -Musculoskeletal
    -Endocrine
    -Geriatric


    Core Clinical Interpretive Skills:
    -EKGs
    -Acid-base
    -Urinalysis
    -CBC
    -Routine chemistry


    CSE Faculty Development
    Review the Competencies Required of the Contemporary Physician as a basis for the content and process of clinical skills learning.

    The importance of content and process standardization to achieve proficiency

    Content and process specifics for faculty

  2. Clinical Skills Assessment project is proceeding with the development and assessment (in person and video) of skill evaluation and formative feedback mechanisms as part of a comprehensive skills education program. Observing faculty and students well recognize the need for improvement of clinical skills.

  3. Study of the effects of the change from A,B,C,D grades to H/P/F on performance and wellbeing are proceeding with an apparent positive trend; no academic decline.


Donald Innes