Minutes 03.13.14

Minutes 03.13.14

University of Virginia School of Medicine
Curriculum Committee
Minutes – 03/13/14

Pediatric Conference Room, 4:00 p.m.

Present (underlined) were: Gretchen Arnold, Stephen Borowitz, Elizabeth Bradley, Megan Bray, Donna ChenPeter Ham, Donald Innes (Chair),  Sean JacksonKeith Littlewood, Nancy McDanielBart NathanSabrina NunezTheresa Schlager, Neeral Shah, Amita SudhirLinda Waggoner-Fountain, Bill Wilson,  Mary Kate WordenTom Jenkins, Derrick Thiel,  Debra Reed,  (secretary) Guest:  Whitney Roper

  1. Dual Degree – Medicine & Law.    A proposal to offer a combined medical and law degree has been developed by Meg Keeley of the School of Medicine and George Geis, Vice Dean of the Law School. As soon as the financial arrangements can be worked out between the two schools and final approvals have been obtained from the Deans and the Provost, the program will be instituted. This dual degree program is planned to be available the summer of 2014.  The committee discussed the proposal and approved it. 

    The Committee also discussed the current two-week elective short course sponsored by the Law School and offered to medical students.  The Committee supports expansion of such two-week programs with other Law School short courses for all medical students.  

  2. Doc.com  The Committee reviewed the Doccom  website and voted to recommend purchase for SMD 18 CPD 1 students as a pilot.   <http://doccom.aachonline.org/dnn/default.aspx

    Nancy McDaniel will obtain data through the OSCE assessments regarding the value of the program during the pilot year in conjunction with the Associate Dean for Medical Education Research and Instruction.  Funding for this program as well as for the purchase of standardized cases for Family Medicine and Surgery will be sought in the 2014-15 budget.

  3. Mulholland Report.  Whitney Roper, editor of the 2014 Mulholland Report, outlined highlights of the report.  Overall mean rating for the clerkship remains constant.

    Mulholland Mean Average 2014

    The Mulholland report makes the following recommendations:

    Refine survey structures for the Pediatrics, Surgical, and now Internal Medicine Clerkships so that data can be better utilized.

    Improve clerkship orientations and service-specific orientations.

    Improve “teaching teachers to teach” curriculum in an effort to minimize variability between residents.  Continue to increase variety of teaching opportunities provided. Consider engaging fourth year students in third year medical student education and creating a podcast curriculum to supplement that teaching we do receive on the wards.

    Explicit goal setting for the surgical subspecialties and communication of these goals to students.

    Close follow-up to evaluate the efficacy of the many recent changes made to the Neurology clerkship.

    Close follow-up to determine whether or not Internal Medicine Salem provides students with a comparable learning experience to that provided by Internal Medicine UVA.

    During Whitney’s presentation, general themes regarding the variability of learning objectives and orientation procedures were noted.  OB/GYN was praised for being the best in these two categories and it is suggested that other clerkships should model OBGYN.  Variability in clerkship experience depending on the attending/resident assigned to the student in various clerkships and surgical subspecialties was discussed.   

    Recommendations:
    More didactic material could be provided to students via podcasts that could be viewed during down time on the service. 

    Increasing the diversity of teaching opportunities, much like the Internal Medicine clerkship does (student morning report, chief resident lectures, physical exam sessions with mentors, laboratory experiences, etc.).

    Clerkships should do more to provide clearly delineated expectations to their students at the beginning of each clerkship.  

    All resident and attending physicians must know what is expected of the students. The teaching expectations of the resident and attending physicians must be clearly delineated by the clerkship director.  This will lessen variability of teaching by faculty and residents especially at some outside sites. 

    Lack of pediatric exposure in the pre-clerkship years should be remedied if possible but at the least,

    Attending and resident physicians in Pediatrics should be aware that students has have little experience with the pediatric population prior to the beginning of the clerkship

    Surgical specialties were reported as variable experiences.  Plastic surgery was praised for their learning objectives and expectations but other subspecialties provided a richer hands-on experience and still others, i.e. neurosurgery, provided no surgical hands-on experience.  The Committee will ask the specialty supervisors to meet regularly and address the issues pointed out in the Mulholland report.  The Committee also recommends that the subspecialties develop a course catalogue with definitions of the clerkship so that students can make an informed decision when selecting their subspecialty.  All areas should add more time in clinic and post-operative venues and student participation encouraged by faculty and residents.

    Neurology was poorly reviewed by this class, but the editors believe many if not all of the negative aspects noted in this review have been fixed in the last year.

  4. Psychiatric Medicine Learning Objectives in the Mind Brain and Behavior System (MBB)
    The Committee reviewed the Psychiatric Medicine Learning Objectives (sent out in advance) as well as the suggestions made by the review task force who reviewed them.  The review task force was comprised of Laurie Archbald-Pannone, Randy Canterbury, Pam Herrington, Nassima Ait-Dao Tiouririne, Bart Nathan and Mary Kate Worden. The Curriculum Committee agrees with the recommendations of the review task force in regard to the learning objectives and suggested that the few exam questions regarding the learning objectives that were removed by the reviewers be eliminated.  Due to the impending system start date, any changes in educational activities (lectures, etc.) need not be made this year based on the learning objective changes but should be looked at for 2015. Bruce Cohen has indicated that he does not agree with the suggestions; however, considers the matter closed for this year.

  5. Learning Objectives.  The Curriculum Committee subcommittees who recently reviewed the Clerkships have been asked for summary reviews of the learning objectives for the clerkship(s) they reviewed.  Their reviews will be shared with the group when submitted.  The pre-clerkship systems are reviewed by selected subcommittees in a similar fashion as the review for MBB.

  6. Transition Course.  The mandatory attendance requirement in the transition course was discussed.  It was emphasized that the Curriculum Committee approves the essential elements of any course through the learning objectives and the assessment methods for courses as a whole. The course directors assess individual students based on the stated learning objectives and make a judgment as to whether the student has met the learning objectives or competencies required for the course. If a student is absent for valid reasons as stated in the Attendance and Absences policy the course director decides whether the student has met the level of required learning objectives or competencies for knowledge, skills and behaviors) to pass.

    Students may miss required academic activities for health related reasons (see Absences due to Illness - All students who miss required activities due to illness must obtain medical evaluation from the Department of Student Health or other licensed healthcare provider.), compelling personal or family issues (e.g., death in immediate family, participant in wedding), professional meetings, or public service.  For the complete Attendance and Absences policy see
    http://www.med-ed.virginia.edu/handbook/policy/attendance.cfm#attendance


    This discussion raised the question of a need for a transition course – required or optional review. If the in-person, hands-on elements are found not to be essential then Transitions could be on-line review and the clerkship start time moved from ~March 1 to February 1. This discussion will be continued.

  7. The final USMLE-1 results for the 2013 were reviewed and found to be unchanged from earlier reports.   http://www.med-ed.virginia.edu/handbook/academics/licensure.cfm#results


    All students from the Class of 2015 passed on either the first (151) or second attempt (4). The school mean was 233; the national 228. The bar graphs show our students at or above the mean in all areas but gross anatomy & embryology and gastrointestinal system. It is possible that in an integrated basic science/clinical curriculum certain basic elements are less hammered home (memorized) or that we are teaching above the pre-clerkship level (clinically too complex). The distribution graph shows pronounced right shift.


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