University of Virginia School of
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)
- Social Issues in Medicine Exploratory (SIM)
update. It appears that attendance for SIM lecture
series has been great. Wendy Golden attended a few of the
lectures and reported that they were well-received by the students and
quite good. At this point, only four days into this phase of the
first year, Genetics is encountering no problems with the addition of
the SIM lectures.
Clinical Skills Educator (CSE) program update. There was a one-time budget supplement made for this program. The program was designed and budgeted to have four students per preceptor but during Fall ‘06 often had two students to one preceptor, increasing the cost. While no evaluation of the program has been received, it appears to be working well. Many students noted in their clerkship evaluations the significant amount of time spent with an attending. This program will be reviewed at the end of the Clerkhship year. Current plans are to extend the program for the 2007-2008 clerkship period with a fixed budget.
2007 - 2008 academic year. Members were asked to begin thinking about the 07-08 academic calendar and whether any adjustments needed to be made. Class, exam, holiday, and start/end dates will be reviewed. This will be discussed further at the next meeting.
H&P into POM-1. Folding the H&P into POM-1 and allowing students to learn from analysis of the presentations of others - somewhat like the Intro to Psychiatry course and a related suggestion that the physical exam be a one-on-one with the POM-1 instructor was discussed. After discussion, the Committee agreed that the program is best located in the second year and in POM-2 where it allows students to continue to work on interviewing and exam skills with a one-on-one relationship, and where they are able to begin to integrate their expanding medical knowledge base into the process of the history, the physical and the write-up and presentation. Howard Kutchai noted in an e-mail that the first year students lack the background to do what has been done in the 2nd year.
Students learn a great deal from listening to each other present. Such presentations might be integrated into POM-2 groups or into another small group.
The focus should be on improving the quality of H&P preceptor interaction. Allowing senior residents and fellows to participate in the H&P activity would increase access to instructors. Kavita Sharma noted in an e-mail that we have some great residents in Internal Medicine as well as fellows in the various subspecialties who could probably commit more time and likely more energy to this activity. While there is no replacement for the experience of attendings, most of our residents are very skilled in the physical exam and H&P's and should be able to evaluate and supervise a 2nd year medical student.
Change to LCME Standard ED-1 & 1a. The Committee discussed development of subcommittees to assess, plan and evaluate the various themes/content in the curriculum such as nutrition, profesionalism, clinical skills education that run throughout the four years. The Committee agreed that a group made up of people not directly involved in the various programs might be more effective. This might offer a "fresh prospective" on these areas.
The Committee was asked to forward ideas on how best to comply with the revised ED1 and 1a standards to Don Innes firstname.lastname@example.org. Jerry Short noted that it is much easier to develop a new curriculum based on these standards, but far more difficult to retrofit an established program to the new standards. Outcomes must be evaluated for this information to be useful.
Chris Peterson provided a copy of an article entitled "Educational Strategies to Promote Clinical Diagnostic Reasoning." NEJM, 355:2217, November 23, 2006. This article is available on the web at: http://content.nejm.org/cgi/content/full/355/21/2217 The Committee agreed it would be best to determine how to apply these standards to one theme such as Clinical Skills and if successful use that as a model. Faculty development seems to be key in improving student clinical skills training. All faculty who teach students in the first through fourth years should be made aware of the proper methods for H&P skills. Faculty development might be an activity the Academy of Distinguished Educators would be interested in taking on.
Note: A presentation at the Fall AAMC meeting suggested that self-assessment has not been a very useful tool in evaluating outcomes. People who most need help and improvement in a given area are usually the same individuals who are least likely to correctly self-evaluate.
Medical School at Virginia Tech/Carilion. The Roanoke Times reported today that Carilion and Virginia Tech are discussing the development of a medical school in Roanoke. Impact of this new school on the UVA program was discussed.