Minutes 12.06.07

Minutes 12.06.07

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. Basic Sciences for Careers Report.  An update has been received from Dr. Debra Perina on the progress of the Basic Science for Careers Development Committee. Since last meeting with the curriculum committee the following has been completed:

    1.     Eight 3rd year students have been recruited to for the BS4C steering committee
    2.     The committee met on November 16th with a discussion regarding format and content. Darci has sent a brief synopsis around to the group subsequently
    3.     A second meeting of the steering committee is scheduled for December 14th.
    4.     Dr. Perina gave a brief overview of the course and answered questions for the 3rd year class at the Nov 26th Clinical Connections. She invited email and did receive one email. Dr. Perina also asked for their top three residency choices to be sent to Darci so that she could try to tailor the small breakouts to their needs. Darci has graciously agree to collate them.
    5.     Dr. Perina redid the course description for the SOM website and sent it to Elis Clarke to post
    6.     Dr. Perina obtained commitments from one additional basic scientist and 5 additional clinicians to teach in the course and continues to recruit more.

  2. First and Second Year Course Director Job Descriptions.  The first draft of the job descriptions for the course directors, developed by Don Innes and Bloodgood is done.  This draft will next be sent to the Curriculum Committee and the Principles of Medicine Committee for additional work.  Chris Peterson asked that "orphan" courses such as Cells to Society be kept in mind when developing the job descriptions.

  3. Anatomy Discussion Groups.  The Anatomy Course  discussion groups looking at lab access policy and the gross anatomy curriculum in general met on Friday, 11/30/07.  A draft of the lab access policy developed by this group has been sent to the interested parties in the Cell Biology Department for input.

  4. Recommendations of the Task Force on Anesthesia Experience.  The report from the Task Force on the anesthesiology experience was discussed at length. 

    The Curriculum Committee agreed with the Task Force that medical students should acquire an appropriate level of competence in the following basic skills:

    o    Pre-anesthetic patient assessment
    o    Immediate post-anesthetic assessment
    o   Airway management and ventilation by mask
    o    Regional and local anesthesia
    o    Pain management
    o    Fluid management
    o    Management of shock (various forms)
    o    Establishment of peripheral venous access

    Options for placement of instruction about these skills include:

    A new (probably 2-week) 3rd year core clerkship
    A 4th year required experience
    Incorporating it into the existing clerkships, assigning each skill to the most appropriate clerkship.

    Note: The Department of Anesthesiology should implement a two-week Selective similar to the proposed Clerkship.

    The Committee discussed the options for placement of these skills.  Plusses and minuses were weighed on each option.   At the present time, the Surgery Clerkship has four weeks of General Surgery followed by two two-week periods of Surgery subspecialties. Two two-week periods of Surgery selectives are required. 

    The Committee discussed the addition of a required selective in the fourth year.  

    Also considered was a required "Survival Skills for Internships" selective which would include the above named skills as well as other necessary skills.  The Anesthesiology and Surgery Departments will be contacted before a final recommendation is made.  This selective could be piloted with the current third year students during the 08-09 year with full implementation in 09-10.  The selective should be heavy on skills and active learning and must be evaluated and monitored.

    The Committee plans to develop guidelines for departments proposing additions to the required clinical curriculum. These guidelines should include requirements to show that:

    o the proposal meets educational needs not being addressed in other clerkships or required experiences,
    o there are explicit links between clinical content and the basic sciences,
    o measurable behavioral objectives for medical students that relate to the "Competencies Required of theContemporary Physician" are specified, and appropriate evaluation methods are delineated.
    o Team building/leadership
    o Defining course & clerkship directors qualifications and responsibilities
    o LCME  - cultural competence
               - clerkship comparability
               - resident preparation for supervision/teaching

  5. Enhancing the Clinical Experience - Team Building/Leadership

    Steve Borowitz is promoting the use of "suspended" orders in CareCast to enhance the clinical experience for medical students. In CareCast we have the ability to put orders in as "suspended", meaning they are fully qualified and ready to go once they are activated.   Editing these orders should be easy - any field in the order (e.g. if it is a drug - could be dose, route, frequency etc) can be quickly changed.   Dr. Borowitz has proposed that medical students be allowed to "order" anything (including prescriptions in the ambulatory setting) in a suspended mode (as they do at the VA).  As they enter the orders, they will designate who the "signing" physician will be (this could be a resident, fellow or attending physician).   The completed order would then be routed to the "signing" physician's inbox where he/she could quickly pull it up, edit it if necessary and then "sign it" at which point it would become active.   This would even work for prescriptions in the clinic as well as all other forms of outpatient order entry.

    This will likely save time for residents and attendings if used properly and serve to make the medical student a valuable member of the team.    Steve Borowitz would like to implement this in the Pediatric Clerkhship in late January, early February.  The Committee strongly supports implementation of "suspended orders" and asks that he evaluate this program thoroughly and report back to the Curriculum Committee in early spring.
  6. The next meeting of the Curriculum Committee will be on 12/13/07 in the Pathology Conference room (Room 4893 - Old Medical School Building).

Donald Innes