Minutes 12.04.07

Minutes 12.04.07

Working Group on Clinical
Skills Education

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

In this 4th meeting of the Working Group on Clinical Skills Education, spirited discussion continued on defining the set of clinical skills which all students at UVA should be expected to learn during their 4 year curricular experience, and a strategy for accomplishing this task. The group studied the AAMC national consensus recommendations in detail. Agreement was reached regarding the following:

  1. Utilize the AAMC consensus recommendations on clinical skills education appendices as a template for defining the skill set for UVA.
  2. Adopt the communication and physical examination skills lists per se being it unlikely that our faculty would disagree with any of those skills as being expected to be performed and assessed at some level of competency by our students upon graduation.
  3. For the clinical testing and procedure skills (approximately 190 in number), each was reviewed and commented upon. Except for a few, these skills were unanimously accepted as appropriate for UVA student learning. This list will be revised accordingly and distributed to the Working Group before our next meeting.
  4. In order to establish levels of learning and assessment for each of these skills, a survey will be conducted of selected faculty teachers. These are to include course and clerkship directors, residency program directors, and members of the Academy of Distinguished Educators.
  5. The faculty survey will also provide for obtaining faculty suggestions for any additions to the clinical skills list.
  6. Regarding a scheme for determining competency levels, here is an idea for the Working Group's consideration:

Levels of skill learning and assessment will utilize an adaptation of Miller's Learning Pyramid. The faculty will be asked, "for each of the following skills, what competency level is appropriate for a graduating UVA medical student?":

  • knows how the skill is performed (minimal "exposure")
  • shows how the skill is performed in any simulated scenario
  • can and has performed the skill in an actual clinical setting

Examples of corresponding assessment methods might be:

  • written examination
  • simulation exercise, real or standardized patient osce, web-based scenario
  • direct clinical observation

The group also opened discussion on the idea of "ensured [clinical skill] exposure" and the importance of creating the mechanism for guaranteeing the achievement of designated levels of competency.

Once a UVA skill learning and assessment template has been defined, next steps include:

  1. identification of where and when in the current curriculum each skill is being taught
  2. identification of skill practice opportunity and frequency
  3. identify how each skill is being taught (educational methods)
  4. determine whether and how skill learning is being assessed
  5. creation of curricular recommendations for improving skill teaching, learning and assessment

Next meeting tentative agenda: finalize survey design, survey participant list, & survey deadlines

Next meeting: Monday, January 7, 2008, (time tba) HS Library Classroom 1330-31