Minutes 11.13.08

Minutes 11.13.08

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, Jason Franasiak, Kira Mayo, Debra Reed (secretary)  Guests: Animesh Jain,    John Jackson, John Voss

  1. ACT Curriculum Development Tool.    John Jackson and John Voss met with the Committee to demonstrate the progress in the ACT curriculum development tool and how it might be useful in developing the "Next Generation" School of Medicine undergraduate curriculum.  ACT was originally designed with funding from a Robert Wood Johnson grant to be used by residency programs for curriculum development.  The program helps to develop competency based curricula.     The system was not originally designed to deliver content to the learner but with further development might be adapted for such use.  It is designed to share resources and enhance collaboration among curriculum developers.  The system helps to see redundancy or omissions in a curriculum through detailed reports.  For further information about the ACT program, please contact John Jackson jmj5g@Virginia.EDU or John Voss jv4w@Virginia.EDU

  2. Next Generation" Medical Education Discussion.    A subgroup of the Curriculum Committee met last week to discuss how to proceed with development of the new integrated curriculum.  Members present at the first meeting were Dan Becker, Wendy Golden, Linda Waggoner-Fountain, Bill Wilson, and Veronica Michaelsen.  A second meeting with Mo Nadkarni and Don Innes was held.

    The Committee developed principles on how to proceed:

    1.   TAM should be responsible for development of appropriate teaching methods to be applied to the new curriculum - case-based, lecture, small group, team-based, etc. Thus we have divided our work into two parts - 1) determining the best structure for the curriculum, and 2) determining the appropriate learning/teaching methods to be applied - case-based, lecture, small group, team-based, etc.
    2. Current curriculum content is generally appropriate as assessed by the USMLE Content Outline. Minor adjustments - increases/decreases in depth and breadth; additions and subtractions - are needed.
    3. The issue is not what students are learning as it is when and how it is learned.
    4.  A systems based structure allows high level integration

    There must be weekly patient (or in some cases simulated/standardized patient) encounters

    6. There should be an introduction - a foundations course - Principles of Medicine (including human behavior, the doctor/patient relationship, decision sciences, principles of biochemistry, genetics, histology, physiology, anatomy, immunology, microbio/viro-logy, pathology, pharmacology, and epidemiology) and should be completed by winter of the first year.

    The Systems are: Musculoskeletal, Nervous, GI, CV/Pulm/Renal, Endocrine/Reproductive, and Heme

    8.   Each system includes representatives from Anatomy & Medical Imaging, Epidemiology, Cell & Tissue, Decision Sciences, Ethics, Physiology, Biochemistry, Human Behavior/Psychiatry, Pharmacology, Genetics, Immunology & Microbiology, Pathology, History & Physical Exam, Cultural & Social Issues, Neuroscience, and Public Health Policy & Practice.
    9.  In parallel and integrated with the Systems is a Practice of Medicine weekly session with patient encounters. [Here interviewing skills and physical exam skills are introduced and practiced.]
    10. There must be a continuum of the science, clinical skills, and professionalism from the Principles of Medicine into Practice of Medicine and clerkships and advanced clinical training. The student should be presented within and across each period with multiple examples of knowledge, skills, professionalism, and decision making.  
    11. The amount of "structured" time should be limited to allow preparation for learning teams, small group work, etc.  

    An illustration of the interconnectedness of the systems approach in which students learn by building connections of knowledge, skills, and attitudes from different areas of medicine.

    Development of the new integrated curriculum will begin with the following draft.  Number of weeks and participants in each section will be adjusted as the curriculum is developed.


Next Generation Cells to Society Curriculum

Cells to Society                                                     

            Human Behavior
            Microbiology: Bacteria/Viruses
            General Pathology
            General Pharmacology
            PoM (Interviewing/Patient Stories) 
            Social Issues in Medicine/Exploratory
            Public Health


Musculoskeletal System
            (e.g. Anatomy, Physiology, Biochemistry,
            Immunopathology, Genetics, PM&R,
            Pathology, Pharmacology)
            PoM (Sports-medicine; musculoskeletal exam)
            Social Issues in Medicine/Exploratory

Nervous System
            (e.g.Anatomy, Physiology, Biochemistry
            Genetics, Pathology, Pharmacology
            Toxicology) Intro Psychiatric Medicine 
            PoM (add Neurological & Psychiatry exam)
            Social Issues in Medicine/Exploratory

 Gastrointestinal System
            (e.g. Anatomy, Physiology, Biochemistry,
            Genetics, Microbiology, Pathology,
            Pharmacology, Parasitology)
            POM (add GI/abdominal exam)
            Social Issues in Medicine/Exploratory

            (e.g. Anatomy, Physiology, Microbiology
            Immunopathology, Biochemistry,
            Genetics, Pathology, Pharmacology)
            PoM (add CV, Pulm, & UT exams)
            Social Issues in Medicine/Exploratory

            (e.g. Biochemistry, Physiology, Genetics
            Pathology, Pharmacology)                
            PoM (add Heme components)
            Social Issues in Medicine/Exploratory

Endocrine & Reproductive
            (e.g. Anatomy, Physiology, Biochemistry,
            Genetics, Pathology, Pharmacology)
            PoM (add Reproductive & 
            Social Issues in Medicine/Exploratory

System Synthesis                                             
            Study and take Foundations & Systems
            Basic Patient Care Skills?

Thanksgiving Break                                 

Winter Break

Summer Break  (research and/or vacation)  

There was general agreement on the principles outlined above and the discussion centered on:

1) What parts of the curriculum might need to be "front loaded" into the Intro section?

2) The knowledge, skills, and attitudes learned seem to be generally appropriate, but that first we must repackage for better integration and then determine what learning methodology is most effective.

Donald Innes