University of Virginia School of Medicine
Curriculum Committee
Minutes 11.09.00

Pediatric Pathology Conference Room, 4:00 pm

Present (underlined) were: Reid Adams, Robert Bloodgood, Victoria Camerini,Anita Clayton, Al Connors, Gene Corbett, Joseph DuBose, (Travis Stork), Joanna Goldberg, Donald Innes (Chair), Jerry Short, Bill Wilson,Guests: Lisa Doyle, Seth Robinson, Debra Reed (Secretary)

1. New Curriculum Committee member Victoria Camerini, of the Department of Pediatrics, was welcomed to the Curriculum Committee. Dr. Camerini, from the Department of Pediatrics, is a graduate of Harvard Medical School. She completed her General Pediatric residency at Children's Hospital of Los Angeles and a Neonatology fellowship at UCLA. She maintains an active research laboratory working on gastrointestinal immunology and has a special interest in medical education.
   
   
2. CPX Results for Class of 2001 Lisa Doyle and Jerry Short reviewed the 2000 Clinical Practice Examination (CPX) Student Performance and Feedback. The CPX exam, administered at the end of the third year, is a performance-based assessment using eight simulated patients and computer exercises to assess student clinical practice and reasoning skills. The cases represent common patient complaints.
   
   The students clinical reasoning skills are assessed by comparing his/her decisions, rationale and interpretations with the criteria set forth by the case author. The criteria for passing are:
   

   1) patient encounter - students who scored above the 16th percentile on 5 or more cases passed the patient component.
   2) clinical reasoning exercise - students who performed "satisfactorily" (final diagnosis was accurate) on four or more cases passed the clinical reasoning component.
   
   

   For the class of 2001 - seven students (5%) failed to meet the minimum passing standard.
   
   

   Overall mean performance score were as follows:
   

   1) history taking 76%

   2) physical examination 61%

   3) clinical courtesy 82%
   
   

   As in the previous year, the physical examination was the weakest skill area. Out of the seven cases that required physical examination, the mean performance was above 70% in only one case.
   
   Overall CPX performance improved over the previous year. Mean scores increased 21% on history taking and 6% on physical examination. Mean scores on communication decreased by 1%.
   
   The Curriculum Committee suggested that a tape be made of a faculty member completing the interview and physical examination for all eight cases properly. The students would then be allowed to review this tape as well as their own tape after the examination period was complete. The CPX review should be presented and discussed with the PoM-1 course directors, the design team for PoM-2 and the clerkship directors.
   
   

3. Handheld computer devices for Medical Students Seth Robinson discussed the role of handheld computer devices in the medical school curriculum. Approximately 1/3 to 1/2 of the fourth year class is using some type of handheld computer device. These are used for answering a question on rounds to taking notes in a lecture. Students use them predominantly for personal organization (datebook, address, to-do, memos, school calendar, and PICs); reference material (drug reference, general medical reference); peripheral brain to keep track of patient information. In the future, Seth believes the student will have wireless access to web searches to Medline and full text access, ability to retrieve information from the Clinical Information System, access to portable dictation and digital patient notes.
   
   Support from the School of Medicine is needed to provide printing and syncing stations on the floors, to insure information is updated and formatted for use on the handheld devices, to set minimum requirements, to make recommendations on the base of software and assistance in negotiating price. Presently, software available includes Rx Ref, medical calculators, medical references, EBM, specific specialty references.
   
   The Curriculum Committee will ask Dr. Short and the Computers in Education Committee to formulate a plan to provide support for this valuable handheld information management technology for medical students.
   
   

 -Don Innes
-dmr