University of Virginia School of Medicine
Principles of Medicine Committee
Minutes
03.12.08

1. 4^th Year Medical Student Teaching Awards: Wendy Golden reported on this year's medical student teaching awards. Her subcommittee chose two "winners" consisting of three 4^th year medical students: (A) Anne Mills for a Clinical Medical Science Teaching Elective in Pathology and (B) Bryan Juen and Ramin Javan for a Clinical Medical Science Teaching Elective in Radiology. There was a discussion about possible venues in which to present the teaching awards and it was decided to use Match Day. Bob Bloodgood volunteered to provide a "prize" to accompany each award.
   
   
2. Discussion of Course Reports continued: There was a discussion of Fall 2007 1^st year course reports and presentation of data from those reports at the February 2008 Principles of Medicine Committee meeting. Since Melanie McCollum was not able to attend that meeting, the discussion of the Gross Anatomy course report was carried over to this meeting. There were many changes made to the Gross Anatomy course this year. These included efforts to increase lab dissection time, reduce lecture time, transfer content acquisition to self study and to utilize previous lecture time for whole group discussion, review and quizzing. Course evaluation scores were down from previous years, as were final grades. However, it was noted that significant changes to the grading criteria and exam structure prevents direct comparison of 2007 student performance data with those of previous years.   Dr. McCollum indicated that, using student feedback, there will adjustments made for Fall 2008. A discussion ensued about how many hours of self study a typical medical student performs for each hour of scheduled activities in the curriculum. It was estimated that there was approximately a 2:1 ratio of study hours to scheduled hours. The Gross Anatomy course report, along with all of the other Fall 2007 1^st year course reports, are available at:
   
   http://www.healthsystem.virginia.edupom/crsreports/crsreports-page
   
   
3. Attendance Data and Results of Attendance Survey:
   
   Bob Bloodgood presented an update on the data on self-reported lecture attendance that are collected from the medical students every semester.  There has been a recent trend of declining lecture attendance during the 2^nd year of the curriculum.  The updated data on self-reported attendance for the 2^nd year (semesters 3 and 4) of the curriculum are shown below:
   
   Self-Reported Medical Student Lecture Attendance Data for Sem 1 & 2:
   
   

   Class	Semester	100-90%	89-75%	74-50%	49-25%	<25%	Aggregate Score
   2006	3	53	19	19	3	5	4.13
   2007	3	53	24	14	5	4	4.18
   2009	3	39	20	15	6	19	3.55
   2010	3	33	22	12	14	19	3.36
   2006	4	31	20	16	13	20	3.28
   2007	4	34	23	17	9	17	3.48
   2009	4	20	20	19	12	29	2.92
   2010	4	27	16	27	5	25	3.14

   
   The latest data from the Class of 2010 suggest that the decline in lecture attendance may be leveling off.  In order to collect data addressing the reasons for the decline in lecture attendance during the 2^nd year of the curriculum, the Principles of Medicine Committee designed a survey about 2^nd year and administered this survey to the current 3^rd year class (Class 2009).  The results of this survey (representing feedback from 68 3^rd year students) were presented. Selections from these results are shown below.
   
   
   
   
   
   Factors Affecting Decision Not to Attend Lectures in Fall of 2^nd Year (all respondants):
   
   

   	Not Important	Somewhat Important	Very Important
   Pressure to study for exams	20.6%	39.7%	39.7%
   Need to prepare for USMLE Step 1	76.5%	17.7%	5.9%
   Many scheduled afternoon activities	52.2%	32.8%	14.9%
   Quality of the lectures	13.2%	42.7%	44.1%
   Increasing Confidence I could identify which lectures I needed to attend and which I did not	38.8%	32.8%	28.4%
   Belief that I learn better through self-study than through lectures	28.4%	37.3%	34.3%
   Availability of extensive web resources	26.6%	46.9%	26.6%

   
   
   Factors Affecting Decision Not to Attend Lectures in Fall of 2^nd Year (student subset with lowest lecture attendance):
   
   

   	Very Important
   Pressure to study for exams	52%
   Need to prepare for USMLE Step 1	5%
   Many scheduled afternoon activities	24%
   Quality of the lectures	24%
   Increasing Confidence I could identify which lectures I needed to attend and which I did not	43%
   Belief that I learn better through self-study than through lectures	57%
   Availability of extensive web resources	19%

   
   
   Factors Affecting Decision Not to Attend Lectures in Spring (Jan-Mar) of 2^nd Year (all respondants):
   
   

   	Not Important	Somewhat Important	Very Important
   Pressure to study for exams	8.8%	22.1%	69.1%
   Need to prepare for USMLE Step 1	22.1%	20.6%	57.4%
   Many scheduled afternoon activities	52.2%	31.3%	16.4%
   Quality of the lectures	10.5%	44.8%	44.8%
   Increasing Confidence I could identify which lectures I needed to attend and which I did not	24.6%	40.0%	35.4%
   Belief that I learn better through self-study than through lectures	25.4%	32.8%	41.8%
   Availability of extensive web resources	25%	48.4%	26.6%

   
   
   Factors Affecting Decision Not to Attend Lectures in Spring (Jan-Mar) of 2^nd Year (student subset with lowest lecture attendance):
   
   
   

   	Very Important
   Pressure to study for exams	76%
   Need to prepare for USMLE Step 1	67%
   Many scheduled afternoon activities	14%
   Quality of the lectures	43%
   Increasing Confidence I could identify which lectures I needed to attend and which I did not	48%
   Belief that I learn better through self-study than through lectures	62%
   Availability of extensive web resources	10%

   
   
   One thing that seems clear from the survey is that the availability of extensive web resources is not a significant factor in reducing lecture attendance.  This is supported by the literature (Billings-Gagliardi and Mazor, 2007, Student decisions about lecture attendance: do electronic course materials matter? Acad. Med. 82:S73-S76)
   
   Relative Importance of Lecture Characteristics Affecting Lecture Attendance:
   
   
   

   	Not Important	Somewhat Important	Very Important
   Too many lecturers and too little continuity	30.8%	35.4%	33.9%
   Poor faculty teaching skills	16.7%	45.5%	37.9%
   Failure to use resources to stimulate learning (Powerpoint, ARS)	51.6%	34.4%	14.1%
   Lectures are mere recitations of handouts	12.3%	35.4%	52.3%
   Lectures are not clinically relevant	33.9%	36.9%	29.2%

   
   
   The entire survey of the Class of 2009 on the 2^nd year attendance issues will be posted to the Principles of Medicine web site.
   
   The next meeting of the Principles of Medicine Committee will be held on Wednesday, April 9^th at 2:00 PM.