Minutes 09.10.09

Minutes 09.10.09

University of Virginia School of  Medicine
Curriculum Committee

Pediatric Conference Room, 4:00 p.m.                       

Present (underlined) were: Gretchen Arnold,  Dan Becker, Robert Bloodgood, Megan Bray, Eugene Corbett, Thomas Gampper, Wendy Golden, Donald Innes (Chair), Keith Littlewood, Veronica Michaelsen, Mohan Nadkarni, Chris Peterson, Jerry Short, Linda Waggoner-Fountain, Bill Wilson,  Mary Kate Worden,  Lisa Herrmann, Evan Lapinsky, Debra Reed (secretary)

  1. Proposal Requesting Dual Degree Status for the MS-CR Program in Public Health Sciences

    Don Innes presented an overview of a proposal requesting dual degree status for the MS-CR Program in Public Health Sciences.  The Master of Science Program in Clinical Research (MS-CR) provides training to health and medical professionals who desire and need quantitative and analytic skills in patient-oriented and translational research, as well as more traditional clinical investigation.   Rationale for the program:  although still early in their training, some medical students may know that they want to pursue a career in academic medicine and patient-oriented research and as such may wish to pursue additional training in clinical investigation during their undergraduate medical school years.  The program is now available as a "pull-out" program after the third or fourth year of medical school, but it would be more attractive, and useful, to students if they could integrate the MS-CR degree with their formal medical school training. 

    Members of the Curriculum Committee would like assurance that the program would not take the place of any of the required elements of the traditional medical school curriculum.  Questions were also raised about financial aid and whether other institutions had similar degree programs.  Don Innes will bring this to the Dual Degree Committee to obtain answers to these questions and report back to the Curriculum Committee. 

  2. "Next Generation" Cells to Society Curriculum.  A graphic representation of the developing "Next Generation" Cells to Society Curriculum timeline was distributed to the Committee along with a tentative Hematology System grid. 

  3. Clinical Performance Development Course (CPD) - Corbett 

    The goal of CPD is to ensure that each medical student achieves basic clinical competency as defined by the 12 objectives of medical education at the University of Virginia.

    This requires a coordinated instructional process that allows students to learn, evaluate and refine their clinical skill performance development throughout the four-year curriculum. 

    During the 4 year curriculum, CPD will comprise three clinical development phases, involving the student in a continually increasing level of clinical method development:

    1. Preclerkship (~56 weeks)
         ~ 18 weeks parallel to Molecular & Cellular Medicine
         ~38 weeks parallel to the Organ-System blocks
    2. Clerkship (~50 weeks)
    3. Advanced Clinical Performance Development (~55 weeks)

    Throughout each of these phases, clinical education experiences will serve to increasingly and continually advance students learning and demonstrated clinical performance in each of the twelve basic clinical competency domains

    Current courses to be integrated into CPD Phase I:

            POM 1 
            POM 2 
            Psychiatric Medicine (some) 
            Social Issues in Medicine (some) 
            Transition Skills Course


    1. Continuous, integrated, longitudinal course
    2. Weekly clinical themes that link coursework to weekly clinical experiences 
    3. Weekly clinical skill learning and practice sessions
    4. 4-year overall mentoring program
    5.  Self reflective & CPD tracking learning portfolio
    6. Developmental skill assessment process

    Clinical Theme Map: The  key link between CPD and all other course work will be a clinical theme map developed with each course/system.  The early stages of such a map were shared with the Committee.

    The CPD will be comprised of weekly half-day clinical experiences in preclerkship phase.

    To include some combination of:

    1. Case discussion / problem solving (~POM 2)
    2. Real patient experiences
    3. Standardized patient experiences
    4. Simulated clinical experiences

    The CPD is designed to be a 3-4 hour experience one afternoon each week.  Some activities may be better suited to a large group so these activities may involve scheduling one hour at the beginning of a week for the whole class and 3 hours for the small group exercises for the rest of the week.  Other weeks will require four hours of small group activities.

    The Clinical Skills Menu has been adapted from the AAMC Clinical Skills monograph (see organ-system skills lists) www.aamc.org/meded/clinicalskills/

    This abbreviated list, specific to the UVA School of Medicine has been developed by the Working Group on Clinical Skills Education.  This list will be shared with the Curriculum Committee by e-mail attachment.

    The case discussion theory involves:

    1. Initial observation
    2. Initial hypothesis generation
    3. Further observation and inquiry
    4. Iterative hypothesis generation & evaluation leading to clinical management

    A CPD example for the Hematology System (3 week block):

    1. RBC (clinical theme: weakness)
    Skills: specimen handling, venipuncture, perform hct, indices calculations, microscopic observations...
    2. Coagulation (bleeding easily, swollen leg)
      Skills: skin exam, leg exam, coag measures, blood typing, radiology techniques...
    3. WBC (swollen lymph node)
      Skills: Heme phys exam (lymph node, spleen, liver, skin); wbc microscopic, pt interview, "bad news" interviewing skills, end-of-life communication skills...

    Each physician mentor would be required to commit to a period of ~18 -24 months.  Each non-MD faculty mentor would commit for ~6 months.  The actual number of mentors necessary to run this program will be slightly higher than what is required in the current curriculum. 

    Questions regarding student group assignments and whether students would be able to move in/out of their specific groups if problems arose were discussed.  

    A preliminary discussion of a "college" system, dividing each class into four colleges with a separate "Dean" for each, was briefly discussed.  This college system could be linked to the CPD groups and their afternoon (Monday-Thursday) assignment.  This concept will be explored further.  The Committee discussed how the smaller student groups in the colleges would allow the "Deans" of each college to get to know the students better, to better help students with early career choices and to address academic problems should they arise. 

    It should be noted that the CPD is not just about "hands on" clinical skills development but rather "hands on" and "brains on" clinical skills development.

  4. The Curriculum Committee will meet again on 9/17/09 and will discuss the overview of the "Next Generation" Cells to Society Curriculum as well as the learning objectives for the courses/systems. We hope to have further information on the Curriculum Evaluation effort.

Donald Innes