University of Virginia School of Medicine
Curriculum Committee
Minutes – 05/19/11

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, Bart Nathan, Linda Waggoner-Fountain, Bill Wilson,  Mary Kate Worden, Thomas Jenkins, Long Vinh,  Sam Zhao,  Debra Reed (secretary)

1. Role of Medical Students in EPIC.  Donald Innes presented a follow-up from Jonathan Truwit. 
   
   Colleagues,
   
   We have discussed co-signing of student notes with your chairs and other members of the clinical staff executive committee over two meetings. As a result the automatic cosign check on student notes has been removed.  However, please note while you are not required to co-sign you remain, as pre EPIC, responsible for student notes as they remain in the electronic medical record.  You and the post graduate trainees are also expected to provide feedback to the learner regarding his/her notes.  
   
   It has been noted that should you sign a student note, you become the author.  To help clarify that the note is a student note the following smart phrases have been created.   You may also use them for notes that had been automatically checked for co-sign at the time of go-Live.   Lastly, if you desire to co-sign student notes going forward, the student should check the co-sign button.
   
   Jonathon (Truwit)
   
   Smart phrases:
   
   .Stusign
   I am signing this note generated by the medical student.
   .Stuatt
   I have read and corrected, where indicated, this note generated by the medical student.
    
   The Committee is concerned about Epic access for students and insuring that  timely feedback from faculty and residents is provided.  The recommendations from the student group presented at the 5/12/11 Curriculum Committee will be discussed at the upcoming Clinical Medicine Committee on 5/23/11, possibly refined and presented to the Dean and Medical Center administration.  One proposed solution is for the student  to write their notes in Epic, print these notes, have the printed notes reviewed by faculty/residents and then delete the note in Epic.  This solution does seem to increase the work load for faculty and residents but provides the valuable experience and feedback to the students while avoiding the legal issues.  The student “shadow” chart which is deleted after the patient leaves the hospital is available at other institutions but is not available at the present time here at UVA.   The Committee agreed that this option should be explored as well.
   
   
2. Biomedical Ethics Program "Witnessing Suffering"  This program has been presented during one of the Clinical Connections in the past to both medical and nursing students.  It has been well received by both students and faculty.  In previous years, this was a day-long program.  It has now been shortened to a half-day module.  Marsha Childress, leader of the program, is seeking grant funding for this program in the coming year.  Input regarding the value of this program will be solicited from the Geriatrics clerkship director.   The Curriculum Committee agreed to endorse inclusion of this valuable program in the Cells to Society weeks just prior to the fourth year elective period. 
   
   
3. Grading Discussion Continued.  The Committee continued the grading discussion from their 5/12/11 meeting.   Don Innes has spoken to Jeff Wong at the Medical University of South Carolina regarding the grading scheme used in their similar curriculum.    At the end of the first year, students achieving a 70% or better average on all systems receive a grade of  “Pass.” Those receiving between 60-69% have a change to remediate by studying and taking  a make-up exam in the summer prior to the beginning of their second year.  Those students with an average below 60% are asked to leave the school unless special circumstances such as illness are noted.
   
   The Committee discussed what emphasis should be placed on formative and summative grades.  Whether the amounts should be 60% summative and 40% formative or 70% summative and 30% formative was discussed as well as whether students should be required to achieve at least 50% in each system even if their total average for the year was above 70%.  The Committee felt that this requirement might insure that all students would participate in formative activities and take all exams. The Committee agreed that grading formative assessments is difficult with 150 plus students in the Learning Studio – that maybe attendance alone might provide a grade.  MCM does require students to write one paper as part of their formative grade.    Linda Waggoner-Fountain noted that there should be no “nebulousness” in grading policy – the rules should be clear and carefully delineated to both faculty and students prior to the beginning of the system/course.
   
   

Donald Innes
dmr