Minues 12.09.04

Minues 12.09.04


Present (underlined) were: Reid Adams, Eve BargmannRobert BloodgoodAnita ClaytonGene Corbett, Donald Innes (Chair),  Howard Kutchai, Marcus Martin, Chris Peterson, Jerry Short, Linda WatsonBill Wilson, Brian Wispelwey, Nnaemeka Anyadike, Michael Richardson, Michael Rein (guest), Debra Reed (secretary) 

  1. Clinical Skills Educator: The Teaching Attending.  Eugene Corbett and Michael Rein presented a proposal to establish and fund clinical skills educator positions in the Medicine Clerkship.

    Basic clinical skills education is an essential element of undergraduate medical education. In an effort to improve students’ skills education during the clinical clerkship year, a “Clinical Skills Educator” faculty position is herein proposed to be piloted in the Internal Medicine clerkship. The task of this designated faculty member will be to meet with medical students weekly while they are rotating through the inpatient portion of clerkship, giving particular emphasis to the development of their basic clinical skills. Faculty will be selected for their interest and expertise in medical student clinical education.

    Faculty responsibilities will include:

          Session management (8 or 16 session hours per week)
          Clinical skills teaching
          Student performance evaluation and feedback
          Student records review and feedback
          Submission of summary student evaluation document
          Maintain session case log

    The basic clinical skill areas should include patient interviewing and history-taking, physical examination, case presentations, clinical record keeping, and interpretation of clinical tests and radiological imaging. It is expected that related skill issues such as professionalism, medical ethics, and medical economics will also be addressed as the opportunity arises. The teaching and practice of basic clinical procedures (e.g., arterial or iv draw, obtain an ecg or peak flow, NG tube insertion) will continue to remain primarily the responsibility of the ward residents and attending physician.

    Students will be expected to bring cases from their ongoing ward experience to each session. Whenever possible, teaching should center upon case-based clinical skill learning, and include both classroom and bedside activities.

    Each student will be required to select at least one patient from their service for each session. Activities should include brief case presentations, bedside history and physical examination, case debriefings/discussion, radiological/test review , and review of student clinical notes (usually in the succeeding session after faculty review). The time allotted to each activity should be at the discretion of the faculty with the goal of repeatedly addressing all of these areas over the month. Time should also be budgeted in each subsequent session for a brief discussion of pertinent evidence-based case material which the student may be assigned to research independently between sessions.

    The following represents weekly core curricular elements for this experience:
    Observed student history-taking
    Observed and practiced physical examination, e.g.,
    Head and neck examination
    Pulmonary examination
    Cardiovascular examination
    Abdominal examination
    Time-specified case presentations
    Review and feedback of  student notes
    Initial Hx and PE
    F/u chart notes
    Selected test and image interpretation, e.g.,
    Organ-system chemistry
    Arterial blood gas
    Chest xray
    Observed patient communication and professionalism skills 

    Studentswill participate in pairs- 4 hours per student pair per week (2 sessions, 2 hours each)

    Each student will have 16 hours per month.

    Faculty (1 or 2) will be assigned to a 4 week block with 1 or 2 scheduled sessions daily (1-3 and 3-5pm ).

    For purposes of evaluating the content of the clinical skill sessions, a final evaluation form will be provided for both student and faculty completion.

    Funding for faculty will be the standard equivalent clinical FTE reimbursement based upon 16 hours of session (8) and preparation/reviewing time (8) per week.

    Curriculum Committee Discussion:

    Program, if approved, would be piloted in the Medicine Clerkship Spring (March/April), 05, with full implementation in Medicine by Fall, 05.

    The same curriculum can be used at the Roanoke and Salem sites. Bedside interaction is a key feature of this program.

    It was suggested that faculty be recruited and trained by Drs. Rein and Corbett. 

    Compensation issues are on the table in budget negotiations and should be in place soon.

    Whether this program or other individualized programs of a similar nature would be
    implemented for the rest of the clerkships was discussed.
  2. Geriatric Subspecialty in Medicine.  Mike Rein announced the addition of a new Geriatrics subspecialty training area in Medicine.  Of the first six available slots, five have been filled.  Students in this subspecialty will act as junior housestaff and will be able to follow their patients when they leave the hospital.
  3. Dr. Michael Rein was congratulated for receiving the 2005 Robley Dunglison Award. Michael is an exceptional teacher and an inspiration for students in all areas of medicine.

The next meeting of the Curriculum Committee will be Thursday, January 6, 2005 , at 4:00 in the Surgery Conference Room.   Agenda: 1) Dr. Claudette Dalton will discuss the second year Preceptorship Program 2) Begin review of Practice of Medicine program.

Donald Innes/dmr