Minutes 11.29.07

Minutes 11.29.07

University of Virginia School of  Medicine
Curriculum Committee

Pediatric Conference Room, 4:00 p.m.                       

Present (underlined) were: Reid Adams, Gretchen Arnold, Eve Bargmann, Dan Becker, Robert Bloodgood, Gene Corbett, Wendy Golden, Donald Innes (Chair),  Howard Kutchai, Marcus Martin, Chris Peterson, Jerry Short, Bill Wilson, Brad Bradenham, Emily Clarke, Sixtine Valdelievre,  Debra Reed (secretary) 

  1. A  "Medical Anatomy Curriculum Study Group"  (Members: Spencer Gay, Don Innes, Melanie McCollum, Peter Ham, Joe Northrup, Jessica Rosen, Robert Reily, Brad Bradenham, Matt Semmler, Troy Buer, Kristy Davis, Jerry Short) for assessing the need for anatomic knowledge, skills, and attitudes in the contemporary practice of medicine and the current state of anatomy teaching, trends, and anticipated developments (5-10 years) has been formed.

    The goal of the group is to complete work on this project by March 2008. The assessment should determine how our students can best learn the anatomy that they need for the competent practice of medicine. Given the limitations of time, facilities, and faculty the committee is to describe a core course in gross and developmental anatomy coupled with anatomy electives that will create an effective and efficient learning environment for our students to learn necessary anatomic knowledge, skills, and attitudes?

    What core clinically-relevant dissection is necessary to meet UVA expectations of a competent medical student?
    What basic functional anatomic knowledge and skills should the competent physician know?
    Expansion of Anatomy electives seems likely. What are the relevant areas for study? Suggestions for design?
    How are radiographic images and high quality anatomical models best integrated into the learning environment?
    Please include an assessment of laboratory facilities:
    - technology enhancement for display of radiographic images and  electronic dissection
    - space for laboratory dissection, for model study/storage, and for potential increase in class size
    - Consider, if appropriate a change of name for the course from "Gross and Developmental Anatomy" to possibly "Anatomy and Medical Imaging" or "Functional Anatomy".

    Various other Cell Biology faculty closely associated with the Anatomy course will meet with the group during these discussions.  The need to minimize exposure to formalin vapors must also be considered in light of recent measurements from the Office of Environmental Health and Safety.

  2. Anatomy Access and Rules of Professional Behavior Committee. This group will meet Friday, 11/30/07.  The original and primary purpose of this committee is to formulate a policy guiding access to the anatomy dissection laboratories.  The policy report is to be provided to the Dean in February 2008. 

    The current interim policy in place as of mid-fall 2007:
    "Only students, faculty and other authorized UVa personnel are allowed in the gross anatomy laboratory space.  Under no circumstances may a student bring an unauthorized visitor into the laboratory. Violation of this policy will be regarded as a serious breach of professional conduct. All requests to bring visitors into the lab should be directed to Dr. Iwanik or Dr. McCollum. Requests should be restricted to members of the health care community."

  3. Don Innes along with Bob Bloodgood is developing job descriptions for the first and second year course directors.

  4. Emily Clarke received her Gold Humanism Honor Society pin and certificate and was congratulated by the entire Curriculum Committee.
  5. Task Force on Anesthesia Experience Report.  Members:  Chris Peterson, MD, Chair, Evan Heald, MD, Bob Bloodgood, PhD, and Emily Clarke, SMD '08.

    The Department of Anesthesia proposed that the Curriculum Committee consider requiring a Clerkship in Anesthesiology for all medical students.  Dr. Ed Nemergut presented the proposal at the Curriculum Committee meeting on March 8 with Drs. George Rich, Gene McGahren, and Hilary Sanfey contributing concurring opinions.  An Anesthesia experience is currently required; it consists of 3 days within the 8-week Surgery Clerkship.   The Surgery Clerkship Directors have requested that the experience be removed from the Core Surgery Clerkship, as it shortens the amount of time for the students to learn what they need to know about Surgery. 

    After that meeting the Task Force was appointed and charged with answering two questions:
    Should an experience in Anesthesia be required or elective for UVa SoM students?
    If required, where in the curriculum would the experience be best placed?

    The Task Force communicated by e-mail and also held three meetings on April 17, May 17, and November 20.  The Chair met with the current and former Directors of the existing "Anesthesiology Experience during the Surgical Clerkship" on October 23.

    Educational Assumptions:
    The required portion of the School of Medicine Curriculum is focused on helping students acquire concepts and skills that are generally useful to all physicians.
    Students who desire experiences that are more specialized (less generalizable) can do so through electives.

    All elements of the curriculum relate to the published "Competencies Required of the Contemporary Physician".

    Whenever possible, learners are actively engaged while acquiring and practicing skills and applying knowledge.

    Changes that lengthen the current 40 required weeks of Clerkships should not be undertaken without demonstration of un-met educational needs.


    The Curriculum Committee should assure that, somewhere in the required portion of the curriculum, medical students acquire an appropriate level of competence in the following basic skills: 

    1. Pre-anesthetic patient assessment
    2. Immediate post-anesthetic assessment
    3. Airway management and ventilation by mask
    4. Regional and local anesthesia
    5. Pain management
    6. Fluid management
    7. Management of shock (various forms)
    8. Establishment of peripheral venous access

    Options for placement of instruction about these skills include:

    1. A new (probably 2-week) 3rd year core clerkship
    2. A 4th year required experience
    3. Incorporating it into the existing clerkships, assigning each skill to the most appropriate clerkship.
    4. The Department of Anesthesiology should implement a two-week Selective similar to the proposed Clerkship.

    In conclusion, we are in consensus that some elements of the proposed "Anesthesia and Basic Skills Clerkship" are important and relevant for every physician yet we do not feel that we can recommend a particular solution for placement of instruction about these skills without considerable additional discussion by the entire Curriculum Committee.

    We recommend that the Curriculum Committee consider establishing guidelines for Departments proposing additions such as this one to the required clinical curriculum. These guidelines should include requirements to show that

    • the proposal meets educational needs not being addressed in other clerkships or required experiences,
    • § there are explicit links between clinical content and the basic sciences,
    • measurable behavioral objectives for medical students that relate to the "Competencies Required of the Contemporary Physician" are specified, and
    • appropriate evaluation methods are delineated.

    The Curriculum Committee thanked the Task Force for a thorough and well-thought out review of the Anesthesiology issue.    The Committee will discuss these findings at a subsequent meeting, meet with the involved departments, and recommend how best to place the list of basic skills and clinical issues related to anesthesia and important for every physician into the School of Medicine clinical curriculum.

  6. Nominations for Curriculum Committee service have been solicited (See October 26 Round Table) and presented to the School of Medicine Faculty Senate for a vote to elect two new members. As new members begin Committee service, current members who have exceeded the term limits (under either the old or new policy) will step down, the oldest first.

    October 26 Round Table    
    Seeking SOM Curriculum Committee Nominations

    This is an open call for faculty nominations for the School of Medicine Curriculum Committee. These nominations may be for others or self-nominations. The committee is seeking [two] new at-large members; each will serve a two-year term with an option for a single renewal of an additional two years. After rotating off the committee for one cycle, former members are again eligible to serve on the committee.

    Nominations are presented to the School of Medicine Faculty Senate and the senate will vote to elect the new members. Terms of appointment for the new members will begin as of January 1, 2008.

    Please send me nominations by November 1, 2007.

    CURRICULUM COMMITTEE MEMBERSHIP: The Committee is comprised of a minimum of six and no more than eight at-large faculty members and two student members. Term for at-large faculty is two years, with one consecutive renewal. Two at-large members are elected from the general medical faculty by the School of Medicine representatives of the Faculty Senate to assure direct faculty participation and a broad faculty perspective to the decision-making process, independent of departmental or central administration points of view. The remaining at-large faculty members are selected for their sustained interest and activity in medical education and for their independent points of view. Of the two student members, one shall be a representative of the Mulholland Society and one of the Student Medical Education Committee. The remaining members of the committee are members by virtue of their position:

    Associate Dean for Curriculum (Chair)
    Chair, Clinical Medicine Committee*
    Chair, Principles of Medicine Committee*
    Associate Dean for Office of Medical Education Support
    Associate Dean and Director Health Sciences Library,
    Director of MERI (Medical Education Research Institute),

    * Elected from and by the membership of the Clinical Medicine and Principles of Medicine Committees, respectively.

    All Committee members are expected to contribute to the Committee's activities and attend at least 2/3 of regular meetings. While the Principles and Clinical Medicine committee members represent their disciplines and focus on basic science or clinical education, service on the Curriculum Committee requires a primary commitment to the general well being and advancement of medical education at UVA.

    The members elected from the General Faculty should have a demonstrated interest in undergraduate medical education and be willing and able to serve on the Curriculum Committee.

    - 09.27.07 

Donald Innes