Minutes 03.06.14

Minutes 03.06.14

University of Virginia School of Medicine
Curriculum Committee
Minutes – 03/06/14

Pediatric Conference Room, 4:00 p.m.

Present (underlined) were: Gretchen Arnold, Stephen Borowitz, Elizabeth Bradley, Megan Bray,  Donna Chen,  Peter Ham, Donald Innes (Chair),  Sean JacksonKeith Littlewood, Nancy McDanielBart NathanSabrina NunezTheresa Schlager, Neeral Shah, Amita SudhirLinda Waggoner-Fountain, Bill WilsonMary Kate WordenLee Eschenroeder, Derrick Thiel, Debra Reed (secretary)

  1. CPD-1c OSCE and passing score requirement
    One of the components necessary to passing CPD-1c is achieving a passing score on the CPD1C OSCE. All students who do not achieve the minimum passing score will have the opportunity to remediate. The student(s) who complete the remediation with at least a minimum passing score will be allowed to start clerkships if all other requirements are met.

    Students who fail to pass the remediation for CPD-1c clinical skills or do not complete the CPD-1c remediation will not be able to start Clerkships.

    All identified students for the SOM class of 2016 who did not achieve the minimum passing standard did attend remediation and all were successful in their remediation.

  2. Clinical Practice Examination

     The Clinical Practice Examination (CPX) is the primary objective means by which the UVa School of Medicine certifies that a student has met the School's expected level of competency for the clinical examination. All students must take and pass the CPX.

    Passing the USMLE-2CS is a minimal national standard, but is not a requirement for graduation from the School of Medicine (It is a graduation requirement that all UVa students must take the USMLE-2CS). Passing our CPX is what we have determined is the UVa required level of competency that all our students must meet to graduate.

  3.  Curriculum Committee members should review the Doc.com website listed below and we will add a discussion of this program to next week's agenda.

  4. Thread Leader for Microbiology/Immunology.  Ulrike Lorenz has resigned as thread leader for Microbiology/Immunology.  The Committee approved appointment of Dr. Jay Brown to this position.

  5. Standardized Cases for Clerkships.  At present the CLIPP cases in Pediatrics and the SIMPLE cases in Medicine are purchased and used to assure a comparable experience for all students in these clerkships.   Similar cases are also available for Family Medicine and Surgery.  The use of such cases would be especially helpful in Family Medicine where there are many different preceptor practices. The Familay Medicine clerkship director has used the cases successfully in the past. Peter Ham has been involved with the Society of Teachers of Family Medicine group that helps develop cases and can vouch for the quality of the cases and would like to use these in the FM clerkship to ensure that students have some exposure to the patient log requirements. Nancy McDaniel reports that Gene McGharen would also be interested in using the Surgery cases to ensure comparable exposure across the various UVa surgery teams.  The Curriculum Committee will seek funding in this year’s budget to expand this program to include Family Medicine and Surgery Cases.   The Committee emphasized the value of the cases to clerkships that have students in multiple sites.  In Pediatrics this has been helpful with seasonal illnesses not all students will see during their rotation.

  6. EMS Observer Shift with Charlottesville/Albemarle Rescue Squad CARS.  Don Innes reported the response from Lynne Fleming, University Counsel, regarding the liability issues associated with this activity.

    If the activity is a required part of the EMS clerkship, has specific educational learning objectives and is assessed, the Commonwealth’s liability coverage would apply.    Amitha Sudir developed the following objectives that were approved by the Curriculum Committee.

    At the conclusion of their EMS observer shift with CARS, students should be able to:
    -Describe the initial assessment and stabilization of patients in the field
    -Describe how pre-hospital medicine differs from hospital medicine
    -Describe how volunteer providers of pre-hospital care are an important part of the community and medical team
    -Describe the methods of radio communication between EMS and medical command
    -Compare the demographics of patients presenting by EMS with patients who walk in to the ED
    -Describe the situations and medical conditions that lead patients, families, and primary care providers to call EMS
    -Articulate the role of EMS providers in interacting with patients and families before they arrive in the hospital
    -Articulate the interaction of EMS providers with hospital personnel on arrival to the hospital

    The students will be assessed by adding questions regarding the activity to an examination. Other methods of assessment might include an oral or written presentation.  A sign off will be added to the Online Passport regarding this required activity.

  7. Geriatrics Clerkship Learning Objectives and Grading Rubric.  The Committee approved the learning objectives and grading rubric for the Geriatrics clerkship.    Dr. Cheng will be encouraged to continue to refine the learning objectives taking into consideration learning objectives from previous systems and clerkships.  Learning objectives in this rotation in the “post-clerkship” period could be similar to earlier objectives but should be more rigorous.

  8. Diagnostic Kits for Medical Students.  Nancy McDaniel reported that students are not purchasing the diagnostic kits because of 1) the cost and 2) they are being told by upper classmen that they are not necessary.  It was noted that the cost of the Diagnostic Kit is included in every student’s financial aid package.  Mentors report much lost time when students do not have the necessary equipment and are forced to share during activities in CPD.  The Committee agreed that this is a necessary requirement and students should comply.    The kit does not have to be new and could be purchased second hand from graduating students.  Nancy McDaniel, CPD Director, will look at the individual components of the kit to make sure it is complete and that all items are necessary, i.e. sphygmomanometer.

  9. Foundations of Medicine (FoM) Review.   Elizabeth Bradley outlined the recent review of the 2013 FoM course.   The System Leader response was distributed and reviewed by the Committee.

     Conclusions 2013:
    1.  The Faculty: A strength of Foundations of Medicine is the faculty. Students commented repeatedly on the dedication, responsiveness, and expertise of the faculty who taught in this System.
    2.  Organization and Sequencing of Content: Though the students were please with the variety of topics to which they were exposed, they felt that like content should be grouped together rather than spread across the System. Students felt it was disjointed. Regular “Big Picture Overview” sessions to tie material together are indicated.
    3.  Building a Foundation: It seems the title of the course is apropos, as many students commented that they felt they had a good foundation at the conclusion of the course on which to build further knowledge. The breadth of coverage and integration of material supported this outcome.
    4.  Patient Presentations and Clinical Context: The patient presentations were very well received by the students and provided a clinical context in which to learn the foundational material. As always these patients provide memorable and meaningful experiences for the students.

    The Committee asks that the System Leaders continue to refine this new course, laying out the “big picture” as well as relevant introductory material.  The System Leaders are asked to work with other Systems Leaders, both CTMD and other organ systems, to expand the basic science material into those systems.   Leaders were also encouraged to develop more team teaching activities for the second generation of the course. 

    Student comments about the Epidemiology thread should be taken into consideration when planning for 2014. Epidemiology lectures should not all be on Friday before formative or summative examinations.  Epidemiology material should be incorporated into active learning experiences. 

    Drs. Laurie Archbald-Pannone and Mary Kate Worden are to be congratulated for newly organizing a streamlined but rigorous foundations course.  The Committee is confident in their continued leadership of Foundations of Medicine.

  10. Cells, Tissues and Mechanisms of Disease (CTMD) Course Review.  Elizabeth Bradley outlined the recent review of the 2013 CTMD course.   The System Leader response was distributed and reviewed by the Committee.

    Conclusions 2013:
    1.  System Leadership and Faculty: The students repeatedly commented on the supportive and caring nature of Drs. Nunez and LeGallo. They felt they were hard working, dedicate, and responsive to the students. They also commented that they were able to keep their sense of humor throughout the System, even amidst challenges. The System Leaders as well as the instructors were praised for their high quality and enthusiastic teaching.
    2.  Organization and integration of material: Students felt that a strength of this System was in how the content was organized and integrated. They felt their learning was supported by the flow of material within and across weeks, but they felt that the first two weeks of the System could be made even more cohesive. 
    3.  Resources: Student comments indicate that the resources in CTMD could be posted in a timely manner, and that some could better address the assigned learning objectives. Additionally, the students would like to have more practice questions available to them.
    4.  Level of engagement: The students commented that this System had a good balance between active and passive learning sessions, and that this balance was supportive to their learning.

    System Leaders were asked to provide the resources a week in advance and more closely align them to learning objectives; continue to expand the practice questions available to students.  Both Foundations and CTMD should work together to bring more cohesion especially in the areas of genetics and cancer and histopathology.

    Drs. Robin LeGallo and Sabrina Nuñez are congratulated for newly organizing a rigorous course and linking histology and pathology – thus Cells, Tissues and Mechanisms of Disease.  The Committee is confident in the continuing leadership of Drs. LeGallo and
    Nuñez for Cells, Tissues and Mechanisms of Disease.  

  11. Clerkship Learning Objectives Review.  The Curriculum Committee subgroups that recently reviewed the clerkships have been asked to review the learning objectives of the clerkship they reviewed for appropriate content. 

Donald J. Innes, Jr., M.D.
Debra Reed