Minutes 03.04.08

Minutes 03.04.08

Working Group on Clinical
Skills Education

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 4th 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