Minutes 09.05.13

Minutes 09.05.13

University of Virginia School of Medicine
Curriculum Committee
Minutes – 09/5/13

Pediatric Conference Room, 4:00 p.m.

Present (underlined) were: Gretchen Arnold, Stephen Borowitz, Megan Bray, Donna Chen, Peter Ham, Donald Innes (Chair), Sean Jackson (alternate Matthew Dickerson),  Keith Littlewood, Nancy McDanielBart NathanSabrina NunezNeeral Shah, Amita Sudhir,  Linda Waggoner-Fountain, Casey White,  Bill Wilson,  Mary Kate Worden, Yasmin Poukazemi,  Jean-Baptiste Maitre, Derick Thiel (alternate Tom Jenkins),  Debra Reed (secretary)


  1. Bob Bloodgood Years of Curriculum Committee Service to Medical Education.   Bob, thank you for your service to the University of Virginia School of Medicine as a member of the Curriculum Committee since the inception in 1999. This entire period of nearly 15 years has been one of great curriculum change, evaluation and renewal with many new projects. Your leadership on planning and organizational subcommittees and design groups is much appreciated, e.g. your almost single-handed leadership of the yearly ADE Medical Education Research and Innovations Poster Sessions is to be commended. The Pass/Fail wellness study received much attention when published in Academic Medicine showing that “students under a pass/fail system brought just as much intensity to their studies, but without the associated stress.” Considering your many contributions to improve the education of our medical students, perhaps the most valuable has been your critical voice, one tempered by reason and focused on constructive outcomes.

    In summary, we salute your dedication and service to improve medical education at UVA. We trust that we can call upon you for advice and counsel in our continuing efforts to strengthen and advance the curriculum.

  2. Pass/Not-Pass (Pass/Fail) for Geriatric Clerkship The Committee voted to make the two-week required Geriatric clerkship a Pass/Fail (Pass/Not Pass) course in the post-core phase. A strict rubric for defining Pass and Fail will be needed and should be submitted to the Curriculum Committee for approval by October 24, 2013.

  3. Assessment Guidelines The Curriculum Committee approved the  Assessment Committee recommendation of August 26, 2013 that all courses must follow the following guidelines:

    A. If after review an assessment item is dropped, no students receive credit for the item, nor is credit given to everyone.  

    B. If after review there is more than one correct answer on an item, the correct answers will be accepted for credit. [This will start with SMD17.  With SMD16 this will be done going forward starting with cardiovascular.]

    C. Formative, summative and practice questions must be in USMLE format.

    D. The questions used for in-class formative activities, e.g. clicker questions and as study aids don't necessarily need to be in USMLE format, but they should not overtly violate our current assessment standards, i.e. no "except" questions or negatively phrased questions, etc.  All questions should be positively phrased.

  4. Gastrointestinal System Review Elizabeth Bradley briefly reviewed the 2013 GI Review for 2013 comparing them with the 2012 conclusions. The scheduling and content changes are progressing. For the full review please see the May 16, 2013 minutes of the Curriculum Committee. http://www.medicine.virginia.edu/education/medical-students/UMEd/curriculum/minutes/minutes-05-16.13.html

  5. USMLE Step 2CK Results of first time examinees from the 2012-2013 USMLE-2CK were reviewed. The percent passing was 99%. The UVa/National mean was 249/238; with all score category means well above the national mean and all within +.3 and +.8. Total scores were compared with the previous 4 years: 2008 - 239/226, 2009 - 246/229, 2010 - 245/230, 2011 - 246/233 and 20012 - 250/237. Although we believe Admissions is doing a great job of recruiting highly qualified students we believe our educational process adds demonstrated value. It was noted that 69% of the 2013 students scored 246 or higher; similar to the previous year. 

  6. PROBLEM SET Definition A DRAFT of criteria to define NxGen sessions labeled “PROBLEM SET” was presented and a vigorous discussion ensued with further discussion next week. Variations in the form and composition of the current “Problem Sets” led to a proposal to standardize them, but students find that what is most important is the quality of the exercises – preferring challenging exercises that “make it worth our [student] time” rather than easy factoid problems. The Committee values application, analysis and evaluation especially in group settings (teamwork) and thus needs to find a way to encourage and measure this type of learning.

    Format of problem set sessions
    Problem sets run in large sessions in a single room (not in a distributed set of classrooms).

    Problem sets are structured such that students are discussing the content for 70% of the time and the instructor is speaking for no more than 30% of the time.

    The problem set question must be released at the start of class, not prior to class, to ensure all students consider the problems at the same time and while in the presence of their small group members.

    Answers to problem set questions must be made available at end of the session either orally or by posting to the course website, and LOs must be explicitly cited.

    Students should work in groups to solve problems.

    Nature of problem set questions
    More than 80% of problem set questions should be open-ended, to stimulate broad discussion and to increase the degree of challenge for the learner.

    At least 50% of question must be higher level Bloom’s, so that discussion is challenging and the value of discussion with others is clear.

    At least 50% of the problem set questions should be designated as “graded” questions

    Grading of problem sets
    A RAT must precede the problem set, to ensure all students are prepared to engage in the problems.  (RAT can be online prior to class or in class).

    Students must submit their answers to problem sets.  Students may submit group answers or individual answers.

    Weight of the RAT should be 50% of the grade, weight of the submitted work should be 50% of the grade.

    Related issues
    Assessments: we suggest no more than 15% of the formative grade be determined from group grades in each summative period of the curriculum.

    Number of problem set questions: we suggest 5-6 questions per hour might be appropriate, depending on the level of complexity of questions and answers.

    Unresolved issues:
    1.  Are problem sets open-book?

    2.  Should instructors patrol during problem sets to provide feedback and answer questions?  If so, how would this influence student answers to graded questions?

    3. MKW is ambivalent about grades associated with submission of problem sets. 

    Current Definition
    : Problem Sets are a type of Large Group Discussion where the focus is the presentation of multiple short problems for the students to work through and discuss their answers, receiving feedback from the faculty and/or peers. The problems may be given prior to class or during class; students may work on them individually or in groups either prior to or in class, and the format of the problems may be anything appropriate to the content (e.g., MCQ, vignettes, equations). The key features are that feedback is given by the faculty during the block of instructional time coded as “Problem Set” and that at least 70% of this time is spent in reviewing or working the problems.


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