Minutes 05.10.12

Minutes 05.10.12

University of Virginia School of Medicine
Curriculum Committee Executive Management Group
Minutes – 05/10/12

Pediatric Conference Room, 4:00 p.m.

Present (underlined) were: Peter Ham, Donald Innes (Chair), Keith Littlewood, Nancy McDaniel, Bart Nathan, Casey White, Mary Kate Worden, Guests:  Megan Bray, Sabrina Nunez, Debra Reed (secretary)

  1. Endocrine-Reproductive System.  Megan Bray presented an overview of the UVA NxGen Curriculum System Evaluation Report for the Endocrine & Reproductive System, Curricular Weeks 64-67. She spoke to the plans for improvements in 2012.

    Endocrine & Reproductive System Specific

    1.  System Leadership: The students felt strongly that the system leadership in Endocrine was responsive, approachable, and genuinely caring of the students. They appreciated that the System Leaders were present and available during the sessions. The students recognized the great effort put forth by Drs. Dalkin and Bray.

    2.  Materials: Students were less vocal in Endocrine about the quality and volume of learning materials when compared to other Systems. They were appreciative of the handouts, and of instant feedback on assessments.

    3.  Learning Objectives: The students are very sensitive to variations in the quality of the learning objectives. Student comments reflect that the quality of the learning objectives in Endocrine & Reproductive can improve further in terms of providing links across learning sessions and weeks within the System.

    4.  Clinical Relevance: The students broadly praised Endocrine & Reproductive for its clinical relevance and focus. The students are sensitive to and supportive of the effort made to maximize the clinical relevance of the material presented to them. It serves a continual reminder of why they are medical school, and helps support their professional development. This effort should be continued in both the Systems, and in CPD.

    5.  System Organization: The students felt the sequencing of material in Endocrine & Reproductive could be changed to improve the overall flow of the System. 

    CommentsMegan Bray and Alan Dalkin learned much and look forward to making changes to improve the educational product for students in next year’s class. Selina
     Noramly worked closely with Megan and Alan bringing her great experience and organizational skills as course director and System Leader to the Endocrine and Reproductive System. They will:

    1.  Reorder the Sequence of System.  As identified by students in OASIS evaluations, we are interested in changing the sequence of topics through the system.  In the first iteration, we approached OB/GYN followed by endocrinology.  Urology was interspersed throughout the 4 weeks, in part related to limitations in their schedules due to national meetings.  In contrast, the flow would be improved by starting and completing the non-reproductive portion of endocrinology, followed by female reproductive medicine and ending with urology.  Continuity should be better achieved in this manner.

    2.  Increase active learning.  We had an observed active learning percentage rate of 29.1 in the first iteration of our system.  Although we realize that there is a subjective component to this scoring, we do recognize the need to help our faculty increase active learning sessions next year.  We have identified areas where problem sets, TBL’s and other more participatory methods can be substituted for current didactic approaches.  Several of our faculty themselves identified better ways to present their material immediately after having given their learning sessions this year.  We hope that with providing them some additional tools from Faculty Development sessions provided through the SOM and the Medical Education Support Department that we improve in this arena.  Certainly- even challenging faculty to utilize more and different technologies than they have in the past is a goal.  As System leaders- we additionally want to ensure that our system syllabus accurately identifies the method of education as well as the topics to be covered.

    3.  Improve Learning Objectives.  We now have better understanding of the critical nature of the learning objectives.  This year, every test question that was utilized was clearly attached to a learning objective.  Moving forward, we need to make sure that not only are the LO’s written in a clear and concise fashion, but that they internally are either covered by the learning sessions/PRL’s themselves or addressed by the sessions’ reading assignment/study material (handouts).   We also will integrate prior topics into our formative and summative exams to the 15% metric, in order to match NexGen guidelines.

    4.  Improve Quality of Learning Resources.   We will be more rigorous in evaluating the resources put forth by faculty for students.  We will look to make sure that the source is at an appropriate level of understanding as well as appropriate length so that overnight pre-class preparation remains manageable.  We will encourage the development of quality handouts that might focus student’s studying efforts and more clearly outline the information that is most pertinent for them to grasp.

    5.  Give Pertinent Feedback to Faculty.  The plan is for the system leaders to review with each faculty their evaluation obtained on their prior sessions either from OASIS, Final Assessment Report and or personal observation.  This will include a dedicated effort to improve the amount of active learning in all sessions as well as to improve LO’s, resources, test questions and use of technology.  We anticipate having to adjust the faculty roster in light of the students’ feedback regarding the quality of some of the education.

    6. Encourage more Inter-Departmental Faculty Collaboration:  The sessions most enjoyed and appreciated by students seems to be those where several faculty members collaborated to give a topical session from many different angles, e.g. Breast Health with radiology, pathology, surgeon, medical oncology present reviewing normal alongside of abnormal.   We will seek to encourage with type of activity for more topics- especially within the non-reproductive endocrinology portion of the course.

    The Committee is satisfied with the 4 week length of the System, but encouraged the further development of inter-departmental collaboration that appears to have been most successful in demonstrating normal-abnormal and the importance of communication and collaboration between an array of care-givers. When done well it can be a demonstration of teamwork in action.

    There can be no afternoon system classes or laboratories. The Committee asked that some resource sessions be converted to Pre-Recorded Lectures, e.g. the Sexual Function and the Histology lectures. Remember that if more than four hours of Pre-Recorded Lectures are assigned then equivalent self-study time must be provided in the morning hours.

    The Committee questioned the use of open book three question quizzes for a grade the day after the 10-minute cases are presented with review of those same questions.  This appears to straddle the border between attendance reward and assessment. More emphasis on assessment should be placed on graded materials.

    There will be 12-three question cases presented throughout the System that will be open book in nature.  The cases will be presented at the end of class and the questions reviewed.  Students will have from 12 noon until 7:50am the following day to answer the questions.  They will be a review of the learning material presented that day or in preparation for material to be covered the following day.  The total of 36 questions will account for 12% of the grade.

    The Committee thanked the System Leaders Megan Bray, Alan Dalkin and Selina Noramly for their work in this evolving and well-received system.  The Committee endorsed the proposed recommendations for improvement.

  2. The Dean’s Town Meeting (May 10th) for the Class of 2015, held earlier in the day with 44 students in attendance was reviewed. Much was made about assessment  - frequent low stakes (<1% if daily) assessment was okay for most; have some break days; exams need to test process, clinical reasoning; “dipping back into lecture mode” is not good for higher learning; two formatives in one weekend is not good; no one does readings for CPD, therefore needs assessment focused on the resources; CPD cases are best when they are a catalyst for clinical reasoning; Monday mornings better if less dense; liked hands-on activities, liked problem sets  (introductory or consolidation); small groups with multiple residents or faculty provide a) validation and b) time management; synthesis in TBLs better if pull together a week or more of material.  

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