Working Group on Clinical
Skills Education
Minutes
03.04.08

Present: Darci Lieb, Evan Heald, Meg Keeley, Nancy Payne, Anne Chapin, Elizabeth Bradley, Melanie McCollum, Keith Littlewood, Veronica Michaelsen,, Eugene Corbett. Absent: Seki Balogun, Walter Davis, Brian Wispelway, Mark Kirk, Mary Bryant, Marcus Martin, Student Rep

At today's meeting, action ideas for enhancing clinical skills education were discussed. They are organized into 5 categories. Additional ideas obtained from a subsequent meeting with the Student Medical Education Committee are written in italics.

1. Implementation of specific skills curriculum experiences
   
   Procedures skills courses in years 1 through 4 (continuing thread)
   
   Simulation enhancements (Harvey, other mannequins, skill practice scenarios, etc)
   
   Physical exam enhancements in POM I & II
   
   Advanced surface anatomy
   
   Clinical skills workshops in all clerkships
   
   Expanded transition course between preclerkship-clerkships
   
   Skill-based intersessions
   
   Yr 1: focused exam videos with note writing
   
   Clinical Skills Educator program in all clerkships including other UVA affiliated sites
   
   
2. Creation of early student clinical exposure
   
   Longitudinal / continual
   
   More robust
   
   Utilize (patient) complaint-based exam / teaching / integration techniques in POM I & II
   
   
3. Enhance and systematize clinical skills assessment
   
   Throughout 4 years
   
   Set the performance expectation higher
   
   Utilize readiness assurance testing (RAT)
   
   Emphasize competency-based assessment (12 UVA clinical competencies)/
   
   Consider peer review as one mechanism for assessing professionalism
   Incorporate assessment/ performance feedback into web-based experiences
   
   
4. Expand and emphasize faculty (and resident)  development and support
   
   Raise and standardize expectations of faculty for teaching & mentoring skill development (same for resident teaching)
   
   Pay for teaching (mission-based budgeting, bottom line valuing)
   
   Emphasize student's feeling of ownership of / responsibility for patient's care to enhance their participation / skill practice opportunities (currently estimated to be 20% during clerkship year)
   
   Emphasize daily theme of "clinical-mindedness" throughout curriculum
   
   (residents are not doing much teaching/mentoring)
   
   
5. Educational design
   
   Emphasize the importance of learner making the transition from passive (knowledge-based) learning to professional (patient-oriented) performance
   
   Create learning communities of faculty and students ("college system")
   
   Ensure repetitive opportunities for skills practice
   
   Formal clinical skills remediation program
   
   Ensure a developmental design in all clinical skills education activities (linkage)
   
   Utilize 4^th year students in year 1 & 2 teaching
   
   Basic-clinical science partnering
   
   One physical diagnosis course for years 1 & 2
   
   Combine Human Behavior (1) and Psychiatry (2) into one course (making more time in curriculum for other things)
   
   Reduce biochem to half semester (")
   
   Make POM I a one semester course, and POM II  1.5 semester
   
   Integrate more skill practice through simulation into the curriculum
   
   MD input into all courses, especially microbiology, biochemistry
   
   On clerkships, require that students perform a minimum number of initial patient evaluations independent of those done with housestaff (EC)
   
   Maximally integrate knowledge and skill learning throughout the curriculum (EC)

Administratively, make "clinical performance education" a top priority

Next meeting: tba, 10:30 HS Library Classroom 1330-31