Minutes 01/10/07

Minutes 01/10/07

University of Virginia School of Medicine
Principles of Medicine Committee

  1. Review 2005-06 1st and 2nd year courses in light of new curriculum

    In order to comply with LCME standards, the Curriculum Committee has asked the Principles of Medicine Committee to, each year, obtain reports from each 1st and 2nd year course and to review these course, as well as to identify trends and problems in the 1st and 2nd year of the curriculum. Every third year, the Principles of Medicine Committee is asked to submit a report to the Curriculum Committee on the state of the 1st and 2nd year curriculum (Principles of Medicine and Core Systems) as well as the individual courses. The members of the Principles of Medicine Committee were provided with course reports from 2005-2006 to review.

    Bob Bloodgood led off the discussion by presenting some recent trends and issues in the 1st two years of the curriculum:

     1. Changed grading to Pass/Fail (03-04) with cumulative honors
     2. Added "Cells to Society"
     3. Added "Exploratory" (05-06) then "Social Issues in  Medicine" (06-07)
     4.  Shortened the basic sciences (05-06)
     5.  Extended length of first year  (05-06)
       a.  Started earlier in August
       b.  Ran later in June
       c.  Reduced summer break between Yr 1 & Yr 2 (12 to 9 wks) 
     d.  Increased amount of vacation by adding a 2nd week of
          vacation  in the Spring.
    Emphasis on professionalism as it relates to 1st and 2nd year courses
    Dramatic decline in attendance in semester 4 (2nd semester of 2nd yr)
    Gross Anatomy - continuing cadaver/formaldehyde issues
    Facilities issues:  not enough small group teaching spaces; needed renovations of Gross Anatomy facilities; continuing temperature control problems in the lecture halls
    Introduced Audience Response System in both lecture halls (06-07)

    A general discussion ensued on the curriculum in the first two years. It was noted that the performance of the Class of 2009 in Microbiology was improved over previous classes.  It was pointed out that PoM2 tutors have been unhappy with the new curriculum, in part because Core Systems (including PoM2) begins in May of the 1st year.  This meant that, in the first year where the new curriculum was introduced, the PoM2 tutors went straight from one class of medical students to the next without a break.  In future years, there will be a longer break.  A more serious concern seems to be that the PoM2 tutors see their students for about 6 weeks and then the summer break (between the 1st and 2nd years) intervenes before PoM2 resumes.  There were reports from PoM2 staff that starting Core Systems with endocrinology was a challenge for the students.  This was somewhat surprising because the students had just finished the endocrinology unit in Physiology/CTS before starting Core Systems.  Pharmacology noted that they found it useful for the medical students to come straight from endocrinology in Physiology/CTS into Pharmacology.  Moving NeuroPathology earlier in Core Systems caused some faculty complaints, even though it meant a shorter period of time between the Neurosciences course and the neuropathology material.

    Don Innes asked that the template used for collecting the annual course reports be revised to include a question about redundancies and gaps in the curriculum based on the USMLE Part I content specifications.

  2. Audiotaping/Videotaping Lectures (John Jackson)

    This represents a continuation of a discussion started at the November, 2006, Principles of Medicine Committee meeting.  It started with a request from certain medical students to audiotape lectures.  This morphed into a discussion of whether the Office of Medicine Education should consider audiotaping, or even videotaping, all lectures in the 1st and 2nd years of the curriculum and post them on web sites and as podcasts.

    John Jackson conducted a survey of U.S. medical schools concerning this issue. Among other things, the survey suggests that quite a number of medical schools are getting involved in audiotaping or videotaping lectures (using a wide variety of technologies).  Most medical students responding to the survey indicated that providing access to recorded lectures had no effect on lecture attendance, although it is not clear what sort of assessment was performed by these schools.

    With the assistance of medical students Greg Weaver and Doug Clarke, John Jackson conducted a survey of the 1st and 2nd year medical students on this issue.  When asked if making available a digital recording of lectures would affect lecture attendance, 48% of responding students said that it would not make a difference while 44% said that it would result in slightly less attendance, 4% said it would result in considerably less attendance and 4% said they would attend lectures very "seldom".  When asked if they would utilize audio recordings of lectures, 50% of respondents indicated "often" or "very often".  When asked if they would utilize video recordings of past lectures, 51% of respondents indicated "often" or "very often".

    A vigorous discussion ensued.  Course directors expressed a number of concerns about providing digital versions of lectures: 1) Would it affect attendance at lectures, 2) Concerns about confidentiality and violations of HIPAA in terms of discussions about or with patients, 3) Copyright issues in terms of lecture content, 4) Effect on performance of lecturers being negatively impacted by knowing that a record was being made, 5) concerns about recordings of lectures being available for P&T purposes.  On the hand, it was also suggested that digital recording might result in improved lecture performance by faculty and also would provide faculty an opportunity to edit the digital recordings to correct mistakes.

    John Jackson discussed the costs associated with audiotaping and videotaping lectures. There are both personnel and hardware/software costs to be considered.  Digital audiorecording might cost $ 2,000 to set up plus labor costs while automated digital videorecording would likely cost $ 50,000 to set up (for the two lecture halls combined) plus at least a part of an FTE.  However, there is new technology on the horizon that might significantly reduce the set-up cost for digital videorecording of lectures ($ 5,000?).  So costs may drop significantly in the near future making this more affordable.

    Since the resources for digital videorecording are not currently available, It was decided that the Office of Medical Education would conduct a pilot project utilizing one volunteer course and digital audiorecording of lectures to be posted to the course web site and as podcasts.

  3. Issues related to student SSANs: Because of recent incidents at the University, the Provost has asked that schools stop using Social Security Numbers to identify student exam and course grades. The University is proposing to replace the use of social security numbers with computing IDs until such time as students are issued student ID numbers. In terms of the School of Medicine's current use of social security numbers in course exams and grades, several things need to be changed:

     a.  Medical Education will need to change the Grade Book utility in the Faculty
     b. Toy Box to accept Computer IDs instead of SSANs.
    New Scantron sheets will need to be obtained that have boxes and bubbles for Computer IDs [these are available]
     c.  The equipment for scanning Scantron sheets will have to be re-programed to accept computer IDs instead of social security numbers.

    In the event that all of this can not be accomplished in time for the first set of Spring exams (February 12-16th), we will probably utilize an interim system of using the last 5 digits of the student social security number.  Course directors will receive updates about the progress of the switchover.

  4. Lecture Handout Costs

    Don Innes asked about whether allocations for covering the cost of lecture handouts for the various courses were adequate.  Courses that feel that the current allocation is inadequate should contact Don Innes as soon as possible.

The next meeting of the Principles of Medicine Committee will be held on Wednesday, February 14th at 2:00 PM.   Please send any suggestions for agenda items to Bob Bloodgood at rab4m@virginia.edu