Minutes 03.01.12

Minutes 03.01.12

University of Virginia School of Medicine
Curriculum Committee
Minutes – 03/01/12

Pediatric Conference Room, 4:00 p.m.

 

Present (underlined) were: Gretchen Arnold, Robert Bloodgood, Megan Bray, Chris Burns, Donna Chen, Eugene Corbett, Thomas Gampper, Peter Ham, Donald Innes (Chair), John Jackson, Keith Littlewood, Nancy McDaniel, Veronica Michaelsen, Mohan Nadkarni, Bart Nathan, Linda Waggoner-Fountain, Casey White, Bill WilsonMary Kate Worden, Jeremiah Garrison, Brandon Hunter, Courtney Chou, Guest:  Chris Peterson,  Debra Reed (secretary)

  1. Interprofessional Education. Chris Peterson updated the Curriculum Committee on the current and planned interprofessional educational (IPE) activities through May, 2014 funded in part by a grant from the Josiah Macy Jr. Foundation.   There are already more than 20 interprofessional education activities in the SOM curriculum.   The purpose of this grant is to develop innovative clinically relevant undergraduate and interprofessional experiences, fully integrate these experiences throughout the clinical/clerkship year, and assess the impact of these experiences on students’ achievement of defined IPE competencies.    Scheduling is the biggest obstacle in developing an interprofessional education curriculum between the Schools of Nursing and Medicine.  The School of Nursing is on a semester schedule and the School of Medicine is not.  Keith Littlewood, a co-investigator in this grant, noted that the Curriculum Committee should be actively involved in planning as this grant develops and interprofessional activities are designed for the SOM curriculum. 

  2. Medical Education Week. Bob Bloodgood reported that next week is Medical Education Week.  He distributed abstract booklets from the 8th Medical Education Research and Innovations Poster Session. Medical education posters will be exhibited for the entire week in the hallway outside the Health Sciences Library.   

    Curriculum Committee members are encouraged to attend the ADE medical education week social event that is being held in the Health Sciences Library on Wednesday, March 7th from 5:00-7:00 PM.  Food and drinks will be available. The poster presenters will be at their posters from 5:00-6:00 PM.  Dean DeKosky will make remarks on the state of medical education at 6:00 PM. Following the Dean’s remarks, this year’s Brodie Medical Education Award winner, Dr. Molly Cooke from UCSF, will be introduced.  

    Dr. Cook will be presenting a special education week Medical Center Hour on Wednesday, March 7th, at 12:15 PM in the Jordan Conference Center Auditorium. The topic of her talk will be: Preparing the Physician of 2030: We’re Doing It Now, Are We Doing It Right?

  3. Clerkship Reviews.  The Subcommittees appointed to review the clerkships outlined their summary reports to the Curriculum Committee.    Internal Medicine, AIM and Family Medicine were reviewed at a previous meeting.

    OB/GYN Clerkship.  Linda Waggoner-Fountain, Bart Nathan, and Gretchen Arnold reviewed the clerkship report and met with the Megan Bray, Clerkship Director, and Yvonne Newberry, Assistant Clerkship Director to discuss the OB/GYN clerkships.  The subcommittee noted that this is a very strong clerkship.  Scheduling difficulties often occur due to the widely varying numbers of students per rotation.  Scheduling challenges have also occurred with the closure of the Roanoke rotation and the gradual inception of Bon Secours.  There are two students per rotation at Bon Secours now with the hope that 4 – 6 will be possible in the future.  Housing in the Richmond area must be arranged.    The advent of Pay for Teaching in the clerkships will help the Clerkship Directors attract more teaching faculty.  Funding is always needed for suturing materials, to pay faculty to do OSCEs and to pay standardized patients for workshops.  Didactic lectures take place at all sites but might but consistency might be enhanced with the use of online sessions.


    Neurology Clerkship.  John Jackson, Mohan Nadkarni, and Mary Kate Worden reviewed the clerkship and met with Priscilla Potter, Clerkship Director.   The clerkship will work on establishing a self-evaluation procedure for the students.   Dr. Potter would like to see an effective Residents as Teachers program established across the board for all clerkships as well improved EPIC procedures for students.  Clerkship leadership has collaborated with leaders in Mind, Brain and Behavior to define learning objectives.  Directors will work with Psychiatric Medicine to integrate around joint teaching topics such as neurodegenerative disease, seizure disorders, conversion disorders, and dementia.  Didactic lectures will be migrated to on-line lectures with associated interactive case discussions with faculty to follow.  It was noted that a new Assistant Clerkship Director, Guillermo Solorzano, has recently been appointed.

    Nancy McDaniel, Chair of the Medical Records Committee, noted that a student patient note in EPIC has been developed.  This note will carry a large yellow banner at the top noting that the student note is not to be used to make patient care decisions and should not generate a charge to the patient.  Discussion is still going on to determine how to provide faculty review of these notes and how to generate feedback for the students.

    Psychiatric Medicine Clerkship. John Jackson, Mohan Nadkarni, and Mary Kate Worden reviewed the clerkship and met with Pam Herrington, Clerkship Director.    The clerkship does have problems with communications at the Western State site and will work on this.  Formal didactic instruction is also variable at the away sites and could be remedied with online presentations.   Online quizzes should also be implemented prior to case discussions at all sites to help achieve a consistent experience at all sites.  An improved EPIC documentation policy and a Residents as Teachers program across all clerkships would also be a benefit to this clerkship.  Directors will work with Neurology Clerkship directors to integrate joint teaching topics.

    Pediatric Clerkship.  Robert Bloodgood, Megan Bray and Peter Ham reviewed the clerkship and met with Bill Wilson, Clerkship Director.  The reviewers noted perennial problems with patient capacity.  Variable numbers of students in each clerkship period (any where from 18 to 28) can also dilute the student’s experience.  [Please see attached data.]  Providing a smaller number of slots available to the students in the lottery to even out the disparity was discussed and will be explored further by John Jackson.   This might reduce the number of students who get their first choice in the lottery but would markedly improve the clerkship experience for a large number of students.

    Surgery Clerkship.   Robert Bloodgood, Tom Gampper, and Keith Littlewood reviewed the clerkship and met with Eugene McGahren, Clerkship Director and Sylvie Moore, Clerkship Coordinator.    Reviewers noted that this clerkship is vigorous, well-directed and appears to be fulfilling the goals of 1) providing the third year medical student with exposure to common surgical problems, 2) developing basic clinical decision making skills in this patient population applicable to future practice, 3) providing technical skills appropriate for this year students, and 4) providing students an experience that allows them to evaluate surgery as a career choice.  The capacity of the three sites for this clerkship (UVA, Salem, Roanoke) to handle the expanded medical class size is getting stretched to the limit.  The Clerkship Director would also like to see enhanced Residents as Teachers programs instituted across all clerkships.  Reviewers would like to see the Life Saving Techniques Workshop better integrated into the Surgery Clerkship. 

    Geriatric Clerkship.  Donna Chen,  Donald Innes and Nancy McDaniel reviewed the clerkship and met with Huai Y. Cheng, Clerkship Director.  Dr. Cheng is very receptive to suggestions from the reviewers and has responded with a “To Do” list to address concerns of the reviewers.  More specific goals and objectives will be developed and distributed to students, faculty, nursing and resident staff.  The clerkship will strive to avoid duplication such as dementia and match the level of learning for third year medical students.  They will provide a mutual feedback in the middle of the two-week rotation and provide feedback to the Ethics teaching faculty.  Assessment and evaluation will be closely linked to goals and objectives.  Dr. Cheng hopes to have a faculty retreat a few times during the year and is seeking support for this venture from the Geriatric Division.

    Perioperative/Acute Care Clerkship.  Donna Chen, Donald Innes and Nancy McDaniel reviewed the clerkship and met with Ashley Shilling and Amita Sudhir, Clerkship Directors.    It s recommended that this clerkship be graded Pass/Fail due to the short one-week length of each portion of the clerkship.  The extensive use of simulation is applauded.    The assignment of students to a specific site the night before the experience seems to be a near unsustainable activity.  The group recommended assistance from the educational resident be solicited.  Interprofessional education between the School of Medicine and the School of Nursing in the sepsis simulation is strongly encouraged.   The group suggested that resident instruction in teaching and assessment be centrally managed but supplemented by addressing issues specific to the Perioperative/Acute Care Clerkship.

     

Donald J. Innes, Jr., M.D.
dmr