University of Virginia School of  Medicine
Curriculum Committee
Minutes
11/09/06

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,  Devin Mackay, Kavita  Sharma,  Debra Reed (secretary)  Guests:  Anne Chapin,  Peter Volsky

1. Results of the USMLE CS2 Exam (June, 05 - June, 06). USMLE Step 2 Clinical Skills examination results were reviewed with Anne Chapin. We discussed clinical skill development factors influencing student performance on CS2. All UVA USMLE 2CS takers have passed. The exam is focused on a Pass/Fail determination. http://www.med-ed.virginia.edu/handbook/pdf/usmle2cs-06b.pdf
   
   The instruction of history taking and physical examination skills begins in the first year course PoM-1; however, there is minimal exposure or reinforcement of these skills in PoM-2. [It is hoped that the Patient Clinician Encounter Program (spring year 1 and fall year two) would, as the program develops, allow additional practice.] H&P skills are part of the Passport checklists. Much of clerkship H&P teaching is done by residents. In the new Clinical Skills Educator program in General Medicine an attending physician provides observation and formative assessment of clinical skills including history taking, physical examination, interpretation, and presentation.
   
   Third year clerkship directors are asked to meet with Anne Chapin to discuss the USMLE CS2 and CPX.  A review of the H&P skills checklist used in PoM-1 & 2 and her knowledge of the H&P evaluation methods may help the clerkship directors design more practice time and formative evaluation (especially real time feedback) into their clerkships. 
   
   Students get minimal exposure to a test similar to the USMLE CS2 from the CPX examination during the third year. First Aid for the CS2 examination outlines scoring criteria for the examination. Close attention should be paid to the time allotted for each part of the examination, easing test anxiety, and balancing the history and physical examination required/necessary in light of time constraints. 
   
   The Committee agreed that more practice for the students, both in the form of standardized patient exercises (clerkship assessment and training workshops, Life Saving Workshop, CPX) as well as practice in the wards/clinics with a knowledgeable educator is necessary. Faculty development of bedside and workshop teaching methods were thought to be integral.
   
   
2. Assessment of new Curriculum.  Bob Bloodgood presented findings regarding the new grading system and new curriculum at the Fall AAMC meeting.  The entire presentation is available on the web at:
   
   http://www.people.virginia.edu/~rab4m/PassFailGradingStudy.pdf
   
   Dr. Bloodgood updated the Committee on the most recent results of the survey data of the medical students performed after the first semester of first year.  These results were compared to results from the previous three years.    
   
   "Have you been under or felt you were under any strain, stress or pressure during the past month?"
   
   
   

   Semester	Class 2006	Class 2007	Class 2009	Class 2010
   	Graded, Old	P/F, Old	P/F, New	P/F, New
   1	47%	30%	52%	36%

   
   
3. Lecture attendance.  The Curriculum Committee's policy on Student Participation in Education Activities does not address lecture attendance.  The policy is posted on the Curriculum website: 
   
   http://www.healthsystem.virginia.eduparticipation.cfm
   
   The Committee decided no policy on lecture attendance was needed.    
   
   
4. Second Year Student Issues.  Members of the second year class have corresponded specific issues to Dean Garson.   Many of the student issues have been dealt with in plans for adjustments for the 2007-2008 second year schedule.  Plans are to move the beginning of Psychiatric Medicine two weeks earlier to decrease afternoon activities just prior to exams.  Pathology will also make adjustments to their schedule to place Neuropathology lectures prior to the tutorials.  The January start date will remain at 1/4/07 as it was moved to this date from 1/8 prior to the beginning of the Fall semester to help alleviate afternoon intensity in January and allow for more study time prior to the final examination period.  The transition course this year unfortunately will fall on the weekend of the Foxfield races.  Efforts were made to readjust the schedule but proved impossible due to the lack of access to Nursing School rooms, faculty to staff the course, and because of disruption to the Transition course. 

Donald Innes
dmr