Minutes 06.05.08

Minutes 06.05.08

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, Debra Reed (secretary)  Guest:  James Click

  1. Clinical Clerkship Report - June, 2006-June, 2007 - Mulholland Report.    James Click, current Editor, reviewed the Executive Summary results of the 2006-2007 report, the most recent period.  Overall average mean ratings for the clerkships dropped slightly from 3.69 to 3.52 in 06-07.  The breakdown of individual clerkship ratings for the Class of 2008 was discussed as well as trends of the past five years.  Family Medicine and AIM retain their position as the top two rated clerkships by students.  Other clerkships retained their positions from last year except for OBGYN which has shown marked improvement.  Individual clerkship sites (in and outside of UVA) often receive quite different scores.  Psychiatric Medicine rotation at Roanoke remains the highest scoring clerkship - when asked why the students like this site so much - it was noted that one faculty member does all the teaching at this site and students' work day is over at noon. 

    Teaching.  The consequences from the shortened resident work hours has been noticed by the students in many rotations. Students complain that often lectures are canceled without notice on clerkships.  Teaching, generally, was one of the highest scoring categories of the questions asked for most clerkships.

    Feedback.  Feedback from residents and attendings is deemed adequate.  Students are reminded that it is just as important for them to ask for feedback as it is for the attendings to provide it. The LCME requires that midpoint evaluation be assured.

    H&P Skills and Presentations.  Overall students believe that are given adequate opportunities to practice H&P skills and presentations.  

    Patient Diversity.  Diversity varies from site to site with the Salem VA rotations having the most limited patient population.  However, Salem rotations are lauded for giving the students much autonomy for patient responsibility.

    Procedure Training.  This remains the lowest rated area this year.   Students compete with residents who need to fulfill their own requirements for residency.  The use of passports has helped but the limited availability of procedures is noted by the students on some rotations.  Active procedure training seems to be somewhat site specific.   It has been suggested that more simulation models be added to the clerkships whenever possible. Students suggest  increasing the number of surgical and life-saving skills workshops.

    Outpatient Exposure.  Students feel adequate outpatient exposure is provided in most clerkships.  Due to the shortened (4 week) curriculum in Neurology and Psychiatry, course directors suggest outpatient experiences in these services would best be gained in selectives/elective time in the fourth year.

    Living Conditions.  Students continue to have multiple complaints about the living conditions at the Salem VA including lack of internet access in each room, unhealthy food selection and unsanitary room conditions. 

    Professionalism.  The results were unchanged from previous years.  When students are exposed to incidents of unprofesssional behavior, they are encouraged to consult with the Student Advocacy Committee.

    Conclusions.  Overall, the students tend to be satisfied with their third year clerkship experience.  The rotations were as an important part of their education as it bridges the classroom to the clinical setting.  However, there are many improvements that an be potentially made, and it is strongly suggested that the recommendations provided for each section be taken with much consideration for change.

    SMEC will work closely with the Mulholland Society to develop the next Clerkship report.  It is hoped that SMEC data will allow for more "near time" response to evaluations. 

    Factors that may have helped improve OBGYN's scores include the development of a full day orientation, adjustment of the lecture schedule, an edited orientation packet, and redefining end of clerkship practicum.  

    The Curriculum Committee is urged to consider individual clerkship sites and make recommendations to the Clerkships for improvements.

    The Committee discussed expansion of the Clinical Skills Educator program into the other clerkships.  Each clerkship director may be asked to develop a proposal as to how to use available funds to increase clinical skills education in their clerkship.

    Dan Becker noted that Mark Williams of Geriatrics just received a stellar review in JAMA for his book Geriatric Physical Diagnosis: A Guide to Observation and Assessment.   http://jama.ama-assn.org/cgi/content/full/299/15/1838

  2. Admissions/MCAT/ULMLE Outcome Data, AAMC Graduation Questionnaire, Course Evaluations.  Jerry Short updated the Committee on recent data  - MCAT /USMLE scores, AAMC Graduation questionnaire, and course evaluations.    

    MCAT scores remain consistently higher for UVA than the national mean in verbal, physical science and biology.  Overall USMLE scores for UVA SOM students for both Step 1 and 2CK remain above the national mean but the gap seems to be growing slightly narrower. Data on the number of failures of UVA SOM students taking USMLE Step 1 the first time was reviewed.  Comparative course evaluation scores from the first and second year courses was also reviewed. 

Donald Innes