University of Virginia School of
Curriculum Executive Management Group
Minutes – 10/24/13
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,
Debra Reed (secretary)
Joint Clerkship Meeting. A meeting of Clerkship Directors and Coordinators from UVA, Fairfax Inova, Richmond Bon Secours, Salem VA, and Western State took place on Wednesday 10/23/13. The Minutes are posted on the web at:
Entrustable Professional Activities. The Committee discussed the creation of a set of entrustable professional activities (EPAs) to help program directors achieve the goals of competency-based medical education. EPAs have been developed for graduate medical education (GME) programs and the group agreed that a similar set of activities should be developed for medical students (UME) to lead up to the GME policy. The EPAs would need to be signed off by at least one (if not more than one) faculty member in at least one clerkship (possibly more) depending on the procedure involved. Some EPAs might require signoff on more than one service, i.e. neurologic exam in generalist clerkship and neurologic exam in Neurology clerkship. Don Innes will contact Carol A. Aschenbrener, M.D. at the AAMC to find out the status of AAMC work on EPAs. When EPAs are developed, both the student and the patient welfare must be considered. Linda Waggoner-Fountain, Director of the Pediatric Residency Program, begins as Director of Clinical Performance Development II in November 2013, would be the perfect candidate to develop EPAs for medical students that would dovetail with the residency EPAs.
USMLE Step 1 Results for SMD 2014. The Committee reviewed the graphs of UVA Step 1 results as compared to the national average. In every case, UVA ranking above the National mean. Results based on discipline performance were also at or above the mean in every area. Results for Cardiovascular System, Musculoskeletal, Skin and Connective Tissue and Gross Anatomy and Embryology were the only disciplines where students performed at the National mean. For SMD15, changes were made to the Cardiovascular system that may improve these scores next year. The group discussed ways to enhance the importance of Anatomy and MSI throughout the systems. Exams in all the systems should be carefully reviewed each year to make sure that these threads in particular are included. Having thread leaders provide questions in the question bank that are properly coded for the threads and systems is key. The group believes that if a higher number of questions on these disciplines are included in the subsequent systems (i.e. cardiovascular, etc) students might consider this material more important. Clerkships (i.e. Surgery) should be asked to include some anatomy material in their OSCEs. The possibility of isolating “thread” question results on each system exam to make sure students are learning this material and/or creating thread exams was discussed. Creation of a “blue print” for all exams that delineates the number of questions that should address specific threads was suggested. The group was overall satisfied with the Step 1 results for SMD2014 and does not believe that anything other than minor changes to the curriculum is warranted.
Clerkship Year Defined. The Clerkship year will now include 48 credits (48 weeks) of clerkship plus two credits for the Transition course and two for the DxRx course for a total of 52 credits. It is believed the Transition and DxRx courses will serve as excellent “bookends” for the core clerkship period.
2014 Geriatrics Clerkship. In 2014, the Geriatrics Clerkship will become a required two week experience in the fourth year curriculum. Since absences during a clerkship are not acceptable, the period when the fourth year students are interviewing for residency positions (end of October 2014 – mid January 2015) will be problematic. It has been suggested by the Director of the Electives program that Geriatrics not be scheduled during this period. The consequence of this would mean 7-8 or even 9 students participating in the Geriatric clerkship at one time.
Huai Cheng, Geriatric Clerkship Director, does believe that the large number of students on each rotation that this change would precipitate will be difficult considering the small number of faculty in Geriatrics. Having no students during the November – January time frame in Geriatrics is probably not a wise option.
The group offered suggestions to alleviate this problem:
Offer students who are not participating in the residency match (i.e. MD, Ph.D., military) only the time periods between October and January.
Allow students to swap Geriatric rotations among themselves when interviews cannot be arranged outside their assigned Geriatric rotation.
Create one or more “bail out” slots during each session that students could use if they are unable to arrange an interview outside of their geriatric rotation and cannot arrange to swap dates with a classmate.
Consider a Geriatric rotation at the Salem VA.