University of Virginia School of Medicine
Curriculum Committee
Minutes 11.04.99

 Pediatric Pathology Conference Room, 4:00 p.m.

 Present (underlined) were: Reid Adams, Robert Bloodgood, Anita Clayton, Al Connors, Gene Corbett, Joanna Goldberg, Donald Innes (Chair), Steven Meixel, Jerry Short, Bill Wilson, Robb Williams, Debra Reed (Secretary)

1) Discussion centered around the items that will be worked on for Fall, 2000.

1. Restructuring. Scheduled course activities are limited to mornings until noon and two afternoons per week. A common lunch hour and activities period for years one and two, is incorporated for the purpose of creating an environment conducive to the development of appropriate professional attitudes and social skills.
   All courses are strongly encouraged to engage students in problem solving casebased approaches to learning as appropriate. Courses are encouraged to employ faculty from multiple disciplines as appropriate.
   
   
2. All courses and clerkships must have both a basic science and clinical director.
   
   
3. A "Practice of Medicine" (POM) course will be implemented merging elements of the DoctorPatientIllness (DPI), Physical Diagnosis, Human Behavior, Ethics and Introduction to Clinical Medicine (ICM) courses into a single course (Parts 1 & 2) across two years. Primary to the course are weekly [biweekly] patient encounters. The program should be sequential, developing and building on an expanding base of skills and knowledge and experience. Students should work primarily in small groups with physicians and social scientists as faculty members.
   
   
4. Implement a ClinicalBasic Science Review Program for the third and fourth years as an important start to lifelong learning in the practice of medicine.
   
   
5. Implement a management process by which the Curriculum Committee through the actions of the "Principles" and "Clinical" committees is responsible for ensuring an integrated curriculum throughout the 4 years of medical school. The content, coordination, integration and pedagogy of courses, clerkships and electives will be reviewed on a regular basis.
   
   Concern was voiced regarding the rest of the items on the original "curriculum proposal" list. These items are still very much under consideration. While they could not be implemented by year 2000, work will need to begin in the near future for inclusion in future years. Task forces will need to be created to address each proposal.
   

2) The committee agreed to pilot a process of obtaining objectives (main points) for each lecture within a course. A searchable database of what's being taught in each lecture/course will be helpful in the revitalization efforts. It was suggested that the Committee arrange a workshop for teaching faculty to give guidelines and help faculty write these objectives. The objectives will be organized and coded (USMLE or other). Different tactics will be used to obtain these initial objectives and each will be evaluated for difficulty and effectiveness after completion. This will help in determining the best strategy for obtaining objectives for the entire curriculum. Jerry Short and Robb Williams were asked to oversee this pilot effort.

1. Student volunteers will be asked to create a list of the main points of lecture in a given course which will be submitted to the lecturer/course director for revision. Robb Williams will canvas the students for volunteers for this project.
   
   
2. Course Directors and lecturers in the new Practice of Medicine Course will create the course and lecture objectives as the course is defined.  
   
   
3. Objectives already in place for the Genetics course will be reviewed and coded.
   
   

3) Bill Wilson updated the Curriculum Committee on the activities of the Clinical Medicine Committee (CMC). The CMC met last week. Implementation of the ClinicalBasic Science Review Program for the third and fourth years was discussed. Initial reaction from the CMC members regarding this monthly program was positive. While this has the potential to be an extremely effective teaching tool, it will require much work. There is some concern regarding logistics since many students are on rotations out of town for either 3, 4 or 6 week periods of time for clerkships. UVA's telemedicine program might be utilized. Requiring the students to attend a specific number of these sessions (but not all) was discussed as well as having 4th year students present poster or even formal platform presentations during these monthly programs. This program might be initially implemented with one per quarter, then expanded to the once a month schedule. The CMC will meet again next week.

4) Gene expressed the need articulate a vision of the application of our curriculum ideas to guide the faculty in joining together in an education program. A thought sheet was distributed.

The concept of two parallel 2 curricular processes (the principles and the clinical aspects of medicine) over 4 years has been articulated. The creation of the "principles" and "clinical" oversight committees sets this in motion. These two learning areas encompass everything in the curriculum, including the electives & the proposed exploratory programs.

The discussion centered on designation of committee responsiblities for the curriculum.

Placing the PoM I&II courses under the CMC links the PoM course with the clerkships. It is after all the PoM of the first 2 years which is responsible for preparing the students for clerkship practice. Placing the PoM courses under the PMC links the PoM course with the basic sciences of the first 2 years.

Similarly placement of the Basic Science Clinical Review was discussed. Should it be centered in the CMC or the PMC?

Both the PoM course and the Basic Science Clinical Review program bridge the basic science and clinical disciplines. Each needs representation on both the CMC and PMC. As originally proposed, the PoM course was represented on both the CMC and PMC, and the Basic Science Clinical Review program on the CMC. Note that it is proposed that all courses and clerkships must have both a basic science and clinical director.

It was suggested that the first year "principles" disciplines be designated under the curricular/learning area "human structure & function" to emphasize the educational purpose of the individual courses and provides a goal-oriented framework within which an integrated first year "principles" curriculum can occur. Consider placing the second year "principles" courses under the rubric "human illness & therapy" for similar reasons. Such designations tend to lock us into a pattern of thought and perhaps should be avoided for now. For instance, consider some element of pathology in the first year.

Furthermore if each course has a basic science and clinical director and if the committees themselves have some degree of mixed faculty integration (basic science and clinical) and if we design the 4 year curriculum with specific guidelines for time/scheduling allottment for each of these 2 learning areas, we will have a curriculum overview plan that articulates in a practical way what have already said we want to achieve. This curriculum administrative design allows us to work toward an integrated 4 year curriculum wherein both basic and clinical science are continuously involved.

5) The committee was asked to be prepared to discuss implementation plans for the year 2000 curriculum revisions at the 11.11.99 meeting.

 Donald J Innes, M.D.