University of Virginia School of Medicine
Surgery Conference Room, 4:00 p.m.
Present (underlined) were: Reid Adams, Gretchen Arnold, Eve Bargmann, Daniel Becker, Robert Bloodgood, Gene Corbett, Wendy Golden, Donald Innes (Chair), Howard Kutchai, Marcus Martin, Chris Peterson, Jerry Short, Bill Wilson, Brad Bradenham, Emily Clarke, Debra Reed (secretary) Guests: Ruth Gaare Bernheim, Nora Lee
2005-06 Mulholland Report. Nora Lee, editor for the 2006-07 Mulholland Clinical Clerkship Report, met with the committee to outline and discuss the findings in the recently published 05-06 issue of the report. Copies of the report were presented to the members of the Committee. Ms. Lee outlined information contained in the Executive Summary. Clerkship evaluation scores have remained generally consistent from year to year. The 2004-05 overall rating was 3.57(SD?) and the 2005-06 rating 3.69 (SD = .61). This continues a slight upward trend evident from 2001-02 onward. Ninety-four percent of students gave the clerkship experience an "A" or "B" rating in 2005-2006, an indication that students are satisfied with their medical education.
Noted that the data in this report is more than a year old. The 2006 -2007 clerkships are complete and we are two months into the 2007-2008 clerkships at this time. Much has changed since the 2005-2006 students took their clerkships. Some themes continue to present challenges and require work on the part of the clerkships. Several are bulleted below.
Attending faculty and residents on the clerkships must be made aware of the clerkship objectives and must use them as guides to their teaching and evaluation of students
Attending faculty and residents should make clear specific (personal) expectations they might have of students
Schedule more "chalk talks" or lectures from the residents in all clerkships
Improve performance feedback, especially on the inpatient rotations
Increase emphasis on Passport completion
Increase teaching and practice of clinical skills in the clerkships (with more hands-on experience with real patients)
Ensure comparable educational experiences and equivalent methods of evaluation at all sites.
Engage students as meaningful participants in patient care teams
The Roanoke Psychiatric Medicine clerkship is to be congratulated for receiving the highest scores. Patient diversity is generally not a problem, although the Veteran's Administration Hospital and Western State patient populations are limited. Similarly, living conditions at away sites while improving need constant monitoring and advocacy. Professionalism standards appear to be high with only rare reports of unprofessional behavior. The Advocacy Committee monitors and promotes professionalism. The Curriculum Committee will revisit this report at a subsequent meeting and is willing to help in any way to address concerns outlined in this report. Students should work through their representatives on the Curriculum Committee.
DX RX Course and A Program Proposal. Ruth Gaare Bernheim, Course Co-Director along with Tom Massaro, submitted a proposal and budget for the 07-08 DX RX Program. The proposal suggested that the DX RX: Health Care System program be centered in the Division of Public Health Policy and Practice in the Department of Public Health Sciences in order to coordinate medical school courses, electives and lectures on public health and health policy. The one week course has for the last year taken place at the end of the fourth year, this year it will be placed at the beginning of the fourth year.
The current DX RX program consists of a one week required course for rising 4th year students, a one day required Rx DX introductory session for rising third year students during the Transition Course and other electives and informal faculty discussions on public health/health policy during the third year and fourth year.
A budget of $10,000 for 07-08 was presented. This budget would include a $2,000 stipend for each of the Co-Directors, $500 each for the faculty team/discussion leaders, and $1,000 for copying/technology support. They are also seeking a one-time $5,000 sum for the extra one-week course in 07-08 due to the change in the curriculum.
The strength and challenges of the program were outlined. The program has been well received since its inception three years ago. Moving the one week course to the beginning of the fourth year rather than the end will allow interested students more time to explore the topics presented further during their fourth year elective period. Group discussions were well-received in 06-07 and more are planned for 07-08.
The Curriculum Committee would like to see the thematic material of Dx & Rx expanded into first and second year courses, especially PoM1 and 2. The issues raised might be incorporated into some of the cases presented in these courses. The Committee would like to see public health taught as a curriculum "theme" across multiple courses. Ruth Gaare Bernheim was asked to meet with the Principles of Medicine and Clinical Medicine Committees to discuss way to incorporate public health policy into appropriate courses. DX RX program co-directors would act as an "integrators" and "thematic advisors" for the other course directors whenever opportunities present for integration of public health education in their courses. Dan Becker suggested that UVA School of Medicine students who study in underserved communities around the world might be a good resource for discussions of public health policy in the United States versus that of other countries.
The Curriculum Committee applauded this valuable course and suggested that the "public health and health care policy" educational activities be centered in the Department of Public Health and be broadened to include organization of thematic material across the four years of the curriculum. The budget of $10,000 was endorsed by the Associate Dean for Curriculum. Additional funds for the double classes in 2008 will be sought.
Note: Clerkship grades have all been received as of June 4, 2007. The clerkship directors are to be congratulated on meeting the requirement to submit evaluations within five weeks of the end of the rotation. The full policy is at