Minutes 09.13.12

Minutes 09.13.12

University of Virginia School of Medicine
Curriculum Committee Executive Management Group
Minutes – 09/13/2012

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 Fern Hauck, Meg Keeley, Debra Reed (Secretary)

  1. Examination Review/Grade Distribution.  The committee stated that reviews of exam question with the students should not be done until exam questions and exam data analysis was completed (Jim Martindale).  Podcastng of exam reviews should also be considered carefully so as not to destroy the integrity of the exam questions.   Jim Martindale will be asked to prepare a procedure for exam validation and review to be used by all systems.

  2. Cultural Responsiveness.  Cultural competency has been renamed cultural responsiveness.  Fern Hauck, Chair of the Cultural Responsiveness Steering Committee, outlined committee progress.  This Committee was formed to specifically address two LCME standards, ED-21 and ED-22 regarding cultural competency.  The Committee was tasked with learning where cultural competency was taught in the Medical School curriculum and to seek ways to enhance and evaluate this thread.  A MSSRP student, Shelby Catlett worked with Dr. Hauck over the summer to do the following:

    Review prior reports and definitions of cultural competence (CC) that were developed by the CC Steering Committee.

    Review CC objectives as developed by the AAMC Tool for Assessing Cultural Competence Training (TACTT) and modification of this in the Curriculum for Culturally Responsive Health Care (Jeffrey Ring and colleagues). Determine which one best for UVA, modifications made. We chose the version developed by Ring et al (29 objectives).

    Analyze each CPD session/case according to the 29 curricular objectives (match to the 29 objectives. Identify cases that could be modified/enhanced to reflect more CC content and meet CC objectives.

    Search the literature for CC student assessment tools.-in progress.
    Three documents:
    Background, definition, taxonomy, individual objectives (See attached).
    Review of CPD cases/sessions for CC content, recommendations.
    Grid of CPD and SIM in relation to the CC objectives.      

    Discussion points will be developed for CPD mentors to enhance the cultural competency thread.  Faculty Development is planned for CPD mentors on cases that are infused with cultural responsiveness themes.  The clerkship global passport will be updated to include evaluation of some cultural competency skills.  A unit will be developed for orientation to define cultural competency for the medical students.

    Other activities in development:  A  Proposal to have activities for the students at various times to further enhance cultural responsiveness curriculum:

    a.  The Implicit Association Test (IAT) ( https://implicit.harvard.edu/implicit/ ) is one method that has been well researched for its use in measuring implicit or automatic attitudes. Students could use this tool to gain greater awareness of their own unconscious preferences and beliefs. As such, subcommittee members would recommend its use at an early point in CPD-1 and again potentially in CPD-2 or 3.
    b.  Watch "Rolling" (film about a man who is disabled)
    c.  Watch other films, such as “Hold Your Breath” (about an Afghan man with stomach cancer demonstrating the challenges of cross-cultural communication)
    d.  Read a common book before arriving to med school, such as, “When the Spirit Catches You, You Fall Down.).  
    e.  Look into grants/foundations, such as the Gold Foundation, and look other funds to bring outside speakers to the SOM, pay for supplies, etc.

    Student help - The MSSRP was very helpful, and brings the critical student perspective. We would also like a 4th year teaching elective student to help with our projects so we can stay on top of CPD case changes.

     Learning objectives - Provide learning objectives that would be relevant across all clerkships and perhaps participate in an inter-session with activities, like those listed in #7, if these activities are going to happen.

     OSCE's/CPX – Review current OSCE's and CPX, and recommend changes/tweaks to explicitly address cultural responsiveness objectives.

    Interpreter training – Students need to have at least one learning activity focused on working with interpreters. Probably best in transition to clerkship year (CPD-2), or at end of CPD 1c using SP in small groups.

    Care of the returning veteran and family – Develop learning activities addressing this priority area. SIM plans a panel; also case(s) for CPD.

    Dr. Hauck added that a survey is being developed for all clerkship and post clerkship directors to determine where cultural competency learning objectives could be added to those curricula.

    Mary Kate Worden noted that much cultural competency is taught in the Mind Brain and Behavior system.  She will provide learning objectives for these activities to Fern Hauck for review.  While some redundancy is essential, extensive redundancy may cause students to lose interest in the topic.

    It was suggested that the portfolio already being done in Social Issues in Medicine should be further developed to focus on cultural competency issues as well.

    The Committee thanked Dr. Hauck for her efforts with the Cultural Competency Committee and applauded their progress thus far.   Dr. Hauck asked for suggestions from the Curriculum Committee of any other activities that might further enhance this valuable thread in the curriculum.

    The next immediate step is for the Cultural Competency Committee to work with the CPD-1 and 2 programs to put these recommendations into action in CPD-1 as the Class of 2016 progresses and in the Clerkships (CPD-2) for the Class of 2015.

  3. Postclerkship Recap (Meg Keeley) Dr. Keeley outlined a proposed elective schedule for SMD14.  

    After carefully looking at calendar weeks/vacation/credits and reviewing what the curriculum committee had recommended 50 or 52 weeks of required credit for SMD14 which is in line with requirements and weeks-off in past years  This is the breakdown:

    The "4th year" for SMD14 is 63 weeks--start DX/RX March 4, 2013 and graduate May 18, 2014.  We needed to drop rotation 14B from the original schedule so all the evaluations can be recorded in time for graduation.

    63 weeks total

    7 weeks of built in time off (11/17-11-24/13) (12/15/13-1/5/14)(4/28-5/16/14)--Thanksgiving, Winter Holiday, last rotation-graduation

    8 weeks of flexible time off (previous classes have had 8-10 weeks)

    SMD14 year is 7 weeks longer than SMD13 who had a requirement of 44 weeks = 51 weeks, but 52 is a multiple of 4 weeks so that works better
                      2 weeks DX/RX
                      4 week ACE
                      4 weeks IM selectives
                      2 weeks Psych selective
                      36 weeks of electives
    48 weeks total
      4 weeks of fixed vacation (Thanksgiving and Winter Break)
    11 weeks of Interview; Free time
    63 weeks

    [plus 4 weeks Surgery Specialty (from clerkship year) = 52credits]

    The Curriculum Committee will review the SMD14 elective schedule at the 10/4/12 meeting. 

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