University of Virginia School of Medicine
Curriculum Committee
Minutes – 03.03.11

Pediatric Conference Room, 4:00 p.m.

Present (underlined) were: Gretchen Arnold, Robert Bloodgood, Megan Bray, Troy Buer, Chris Burns, Donna Chen, Eugene Corbett, Thomas Gampper, Wendy Golden, Donald Innes (Chair), John Jackson, Keith Littlewood, Veronica Michaelsen, Mohan Nadkarni, Linda Waggoner-Fountain, Bill Wilson,  Mary Kate Worden,  John Hemler,  Christina Portal,  Nicole White,  Debra Reed (secretary)   Guest:  Selina Noramly

1. Announcements: 
   
   The Mulholland Report will be discussed by Trevor Posenau at the Curriculum Committee on 3/10/11.  An electronic version of the report will be sent to the Committee members on Friday 3/4/11.
   

   
   The Academy of Distinguished Educators Medical Education Week begins on Monday 3/7/11 and events continue through Friday 3/11/11.  Highlights of the week include:
   
   

   The ADE medical education poster session (corridor outside the Health Sciences Library) 3/7/11-3/11/11

   Tuesday, 3/8/1,  4:00-5:30 pm - Curriculum leadership meeting with Dr Bonnie Miller, the Senior Associate Dean for Health Sciences Education, at Vanderbilt U SOM and the 2011 Brodie Medical Education Scholar Awardee in the Medical Simulation Center Conference Room

   Wednesday, 3/9/11, 12:30 pm - Medical Center Hour in the Jordan Conference Center Auditorium – “Moral Distress in Health Professionals – A Call for Resilience or Retreat” – Dr. Bonnie Miller

   Wednesday, 3/9/11 5:00 – 7:00 pm – ADE medical education week social event in Health Sciences Library (5:00-6:00 pm poster presenters will be in front of their posters; 6:00 pm Randy Canterbury, Senior Associate Dean for Medical Education, will make brief remarks on medical education and Brodie Award Recipient, Bonnie Miller will be introduced and speak to the group.

   
   
   Members of the Curriculum Committee were encouraged to attend as many of these events as possible.
   
   Progress is being made on medical student call rooms.  Rooms now designated as call rooms are G401, 402, and G438.  Some construction will be needed. The estimated start of construction is mid-April with completion 12 weeks later.  If bunk beds are used in these rooms, they will accommodate 6 people.  Linda Waggoner Fountain noted that bunk beds have been associated with some serious injuries in the past and discourages use of bunk beds in these rooms. Most of the students using these rooms will be ACE students.  Whether the students in these selectives will obey the intern or the resident rules for on-call time restraints is not known.  Dr. Richard Pearson will be contacted to determine the rules.
   
   Clinical Service Work Hours Medical students rotating on clinical services (clerkships, selectives and electives) should be subject to the same principles that govern the 80-hour work week for residents. Clerkship, electives and selectives directors are responsible for monitoring and ensuring that duty hours are adjusted as necessary. Student duty hours should be set taking into account the effects of fatigue and sleep deprivation on learning and patient care. In general, medical students should not be required to work longer hours than residents*. (Curriculum Committee 9/9/2004; modified 12/18/2008)  * LCME Standard ED-38.
   
   
   The Clinical Connections program developed about 10 years ago by Reid Adams had its final session last week.  The program has been very successful but what was initially included in these sessions has now been moved to other areas of the curriculum.  Reid Adams, Course Director and Tammy Rogers, Course Coordinator deserve special thanks for all they have done to make this such a successful and well run program.
   
   Resident preparation for their roles in teaching and assessment Lisa K. Rollins of Family Medicine and Diane Farineau from the GME office have been contacted to update the Clinical Medicine Committee meeting on 3/14/11.  Linda Waggoner-Fountain noted that this standard is already being covered in most clerkships but documentation may need improvement. We need to be sure 
   
   

   ED-24. At an institution offering a medical education program, residents who supervise or teach medical students and graduate students and postdoctoral fellows in the biomedical sciences who serve as teachers or teaching assistants must be familiar with the educational objectives of the course or clerkship (or, in Canada, clerkship rotation) and be prepared for their roles in teaching and assessment.   The minimum expectations for achieving compliance with this standard are that: (a) residents and other instructors who do not hold faculty ranks (e.g., graduate students and postdoctoral fellows) receive a copy of the course or clerkship/clerkship rotation objectives and clear guidance from the course or clerkship/clerkship rotation director about their roles in teaching and assessing medical students and (b) the institution and/or its relevant departments provide resources (e.g., workshops, resource materials) to enhance the teaching and assessment skills of residents and other non-faculty instructors.  there should be central monitoring of the level of residents' and other instructors'  participation in activities to enhance their teaching and assessment skills.    There should be formal evaluation of the teaching and assessment skills of residents and other non-faculty instructors, with opportunities provided for remediation if their performance is inadequate. Evaluation methods could include direct observation by faculty, feedback from medical students through course and clerkship/clerkship rotation evaluations or focus groups, or any other suitable method. http://www.lcme.org/functions2010jun.pdf

    
   
2. Boot Camp for Medical Students.  Keith Littlewood distributed an  article from the SimEducation world reflecting experience at the Mayo Clinic with the boot camp concept.
   
   A 1-Week Simulated Internship Course Helps Prepare Medical Students for Transition to Residency.   Laack, TA, Newman JS, Goyal DG, Torsher LC: Sim Healthcare, 5:127-132, 2010.
   
   Keith Littlewood would like to explore offering a “boot camp” one-week elective at the end of the fourth year.    This experience would probably be in the period after match (mid-March) and the end of April.   The Committee endorses this pilot project and asked Dr. Littlewood to contact clerkship directors in Medicine and Surgery and Meg Keeley to develop this elective for next years graduating class.  Initial thoughts include offering a basic session with optional specialty days.
   
   The SIM Center may also want to work with departments to offer boot camp simulation activities in their introductory sessions.  Some residency programs, i.e. Pediatrics and OBGYN do similar activities already.
   
   The Committee believes that offering this experience would enhance our medical students skills prior to their residencies whether here or at other institutions.    Care should be taken to keep activities in the boot camp experience for medical students as generic as possible as institutions all have different rules and regulations on resident conduct.
   
   Members of the Curriculum Committee who are interested in this project should contact Keith Littlewood.
   
   
3. Policy on Recording Patient Interviews – John Jackson.  Gene Corbett asked that the SOM consider modifying the current policy so that CPD may make recordings of patient interviews.   John Jackson checked with University Counsel.  Their response/advice follows:
   
   

   1.	A signed release which clearly and explicitly describes the extent to which the recorded material will be used and made available is absolutely necessary.  It must be transparent as to the types of issues noted in #3 below.
   2.	Whoever would be working to enlist these patients must not exert pressure for consent.
   3.	" The patient should be guided to understand that distributing the interview throughout SOM could result in viewing by individuals who are her neighbors, members of her church, colleagues of herself/husband/children, etc."  Patients are not going to understand what it means to say "the patient interview will be distributed to SOM."  They must be put in a position to understand that this will involve a group of about 700-800 people and that this group could well include individuals who know the patient, but would not otherwise know anything about the patient's health situation or information.
   4.	You must have a competent plan to educate all persons having access to the audio/video material that download and redistribution is unacceptable and illegal.
   5.	You will need to sort out how destruction of this confidential information will be handled at the end of the year assuming the year-long cycling of material remains the same.
   6.	You will need to have a strategy for dealing with faculty who will want to hold onto these videos.

   
   After much discussion, this issue was tabled until Eugene Corbett could be present.   Many Committee members felt that the difficulties in clearing the legal hurdles would outweigh the educational benefit of recording these sessions.  Donna Chen will contact Allison Innes in Student Affairs to determine current HIPAA confidentiality policies and impending updates to these policies that affect medical education.     
   
   
4. MCM Fall Schedule.    The MCM Fall 2011 schedule has been discussed with the course directors, the Curriculum Committee and Randy Canterbury.  The plan at the point is to maintain integration and to incorporate what is now in the Microbes: The Essentials system into the MCM course, add a one week break in the fall and move some of the current MCM curriculum into individual Systems.  Systems would begin in January and one extra week would be added to the summer to enhance research opportunities for the students.  Some of the systems might need to be expanded slightly to incorporate the material removed from MCM, e.g. endo/reproduction.

Donald Innes
dmr