Minutes 05.16.13

Minutes 05.16.13

University of Virginia School of Medicine
Curriculum Committee
Minutes – 05/16/13

Pediatric Conference Room, 4:00 p.m.

Present (underlined) were:  Gretchen Arnold, Robert Bloodgood, Stephen Borowitz, Megan Bray, Donna Chen, Peter Ham, Donald Innes (Chair), John Jackson, Keith Littlewood, Nancy McDaniel, Bart Nathan, Selina Noramly, Theresa Schlager,  Amita Sudhir, Linda Waggoner-Fountain, Casey White, Bill WilsonMary Kate Worden,  Jean-Baptiste MaitreDerrick ThielElizabeth Bradley, Debra Reed (secretary),

  1. Announcement
    A document entitled “Teaching Medical Students in Clerkships” was provided to all clerkship directors for distribution to all teaching faculty and residents in all clerkships. 

  2. GI System Review.  Elizabeth Bradley updated the Committee on the 2013 GI System Review.  The leadership, clinical relevance and organization was found to be excellent.  Students and system leaders did note that the system seemed rushed.  The System Leaders prepared the following proposal.

    Proposal for GI System Changes 2014

    After reviewing all feedback received for this year's iteration of the GI System it was felt  necessary to make some changes in 2014, to address some key concerns from SMD16 students.

    Dr. Brian Behm decided to step down as a GI system leader and Dr. Anne Tuskey was proposed as his successor. The discussion points below are the product of the collective assessment of Drs. Tuskey, Nunez, and Shah.

    Lack of break between MSI and GI
    For the last two years students have complained about the start of the GI system immediately following MSI, which requires them to take a summative and practical assessment during the weekend leading to the GI system.  This lack of a break results in students falling behind on preparation (pre-class) material early on in the GI system, hindering their ability to grasp foundational knowledge and engage in active learning.

    Dedicated anatomy lab time
    GI has an unusually high number of lab hours compared to other organ systems - students must complete 7 hours of anatomy lab time during the 4-week system. Given that anatomy lab can only accommodate half the class at a time, there are 14 hours of morning activities that need to be done as half-class.  Since anatomy has to be scheduled early on in the system (rather than spread out over the 4 weeks), it is difficult to organize the first week, such that it maintains a flow of content and contains a high level of engagement.

    Limited available time for GI content
    Feedback from all three NxGen classes suggests students would like to have more time devoted to the GI system, to allow for better integration and application of material. Luminal content in the first two weeks would benefit the most from some extra time, as the last 2 weeks are consistently reviewed as better paced and containing activities that integrate and reinforce materials from earlier sessions.

    Proposed solutions:

    provide one full free day following MSI
    Our discussion with the MSI system leader suggests it would not be possible to reschedule any portion of the assessments happening in the weekend leading to GI – both the second summative assessment and the practical assessments for MSI will continue to be scheduled for that weekend. We propose removing all scheduled activities on the first Monday of the GI system, to allow the students some time to rest and prepare for the first day of class in the GI system.

    Cancel CPD in the 1st week of the GI System
    Freeing up the first Monday would necessitate canceling CPD for the entire week. We propose scheduling a single, 4-hour anatomy lab session in the afternoon during this week (repeated, as each session will only accommodate half the class) – see point below and attached draft 2014 schedule. This would address both issues 2 and 3.

    Condense anatomy labs and one afternoon session
    In place of CPD, we would schedule anatomy lab one afternoon. Thus the total number of hours of scheduled activities would not increase and the added time would allow for the addition of activities to reinforce the Pathology and physiology content. This would functionally increase the hours devoted to the system and improve the flow of the first week by eliminating half-class activities.

    Reassign one SIM session to another system
    In the current GI system class runs on a daily basis from 8-12 and we are still limited on time. We believe all activities have been trimmed down as much as the content allows in 2013 and the students still feel they need more time devoted to GI. The proposed 2014 schedule improves on the organization and use of class time, but we have been unable to clear time on a Monday morning for one of the two SIM sessions. We propose that one SIM session is assigned to either MSI or MBB (perhaps taking the time freed up by the behavior content moved to Foundations?).

    The Curriculum Committee discussed this proposal.  Mary Kate Worden, who had been asked at the 5/9/13 Curriculum Executive Committee Meeting to look into some of these changes prepared the following report.

    Update on Scheduling in 2013-2014

     

    Projected for 2013-2014

    Reason

    Foundations of Medicine
    (6 weeks)

    Include human behavior, cultural issues, family, communication

    OSCE  in CPD-1A

    Cells Tissues and Mechanisms of Disease
    (4 weeks)

     

     

    MIS
    (6 weeks)

     

     

    MSI
    (6 weeks)

     

     

    GI
    (4 weeks)

    Start on a Tuesday to allow a break after MSI

    Students coming off MSI final exam

    MBB
    (10 weeks)

    9 weeks

    moving human behavior to FoM,

    moving human factors in medical care, SBIRT, physician wellness, Information science to CPD.

    Eliminating some material not important for good performance on the clerkship or generalist practice of medicine

    End academic year earlier or provide more break time in the spring semester.

     

    Note: this may or may not cancel a week of CPD

    CPD
    No CPD weeks of:
    Labor Day
    April school vacations
    Memorial Day
    (Because mentors are not available)


    CPD will run 1 afternoon (4 hours) of large group sessions in weeks of Labor Day and April school vacations

    (no CPD mentors)

    SIM Lectures might also be scheduled during CPD large group sessions

     
    Recapture 2 weeks time in CPD, use time to do large group activities relevant to CPD



    The Committee discussed the ramifications in this plan for Anatomy and CPD.  The leaders of these areas as well as system leaders for MSI, GI and MBB will meet to continue the discussion and offer a concrete plan to the Curriculum Committee.  GI System learning objectives and schedule should be reviewed carefully to make sure all content as well as the method of delivery is appropriate.  The possibility of including breaks for the students, even if only long weekends during the MSI/GI/MBB block was discussed and will be encouraged.  Schedules beginning or ending mid week with an exam were discussed.  Students on the Committee noted that students would probably not mind this as long as the schedule were published in advance and due notice was given.

  3. UVA Mental/Physical Examination.   The Committee discussed and unanimously approved the “UVA Mental/Physical Examination” document with minor changes (i.e. removal of highlighting). Donna Chen, with the assistance of Peter Ham and Nancy McDaniel were thanked for their efforts in bringing this defining document.

  4. Policy on Technical Standards.  The Curriculum Committee discussed the proposed changes to the Policy on Technical Standards.  This policy applies for matriculation, progression and graduation.  Students will be asked to read and sign a copy of the policy on admission to the UVA SOM.  The Committee made suggestions to improve clarity.  The changes will be incorporated and a revised version submitted to the Committee for review and comment by e-mail.  The Committee will then be asked to vote to approve the final document via e-mail.  This policy will be effective July 2013 for SMD17.
  5. Cultural Competency Objectives for Clerkships.  Learning objectives for Cultural Competency in the clerkships are to be covered and assessed across all clerkships.  It was suggested that the title as well as the Learning Objectives for Professionalism and Ethics be amended for consistency. 

Donald Innes
Debra Reed