University of Virginia School of Medicine

Principles of Medicine Committee

Minutes 04.11.01

April 11, 2001, 1:30 p.m., Jordan 1-17.

Present were: Eve Bargmann, Robert Bloodgood, Bruce Cohen, Alfred Connors, Claudette Dalton, Carl Creutz, John Gazewood, Wendy Golden, Barry Hinton, William Hobbs, Joel Hockensmith, Donald Innes (Chair), Robert Kadner, Howard Kutchai, Heidi Scrable, Jennifer McClune, Darci Lieb, David Moyer, Lucia Smerage, Virginia Taylor, Brian Wispelwey, Marcia Childress, Karen Grandage, William Petri, Allison Innes, Richard Pearson, Jerry Short, Eugene Corbett, William Wilson, Gary Owens, Susan Squillace, Mariecken Verspoor, Vinay Chandrasekhara, Atul Gupta, Joey Dubose, Guests: Elizabeth Bradley, Aliya Carmichael, Alicia Tobin-Williams, Maurice Apprey

1. Creating a Culturally Competent Physician at the University of Virginia - Aliya Carmichael, Alicia Tobin-Williams and Rhoneise Barnett. Ms. Tobin-Williams and Ms. Carmichael spoke to the Committee regarding cultural diversity education at the University of Virginia School of Medicine.
   
   Mission:
   • To cultivate an environment that is informed and sensitive to cultural differences of patients served by UVA Health Sciences Center
   • To cultivate an awareness of how cultural differences impact the delivery of health care
   • To enhance the ability of UVA medical students to form relationships with patients that are culturally different from themselves
   • To develop a standardized format to teach and evaluate cultural competency that may be used as a model for the LCME
     

   True cultural competence is an ideal...an umbrella term that encompasses many areas including: ethnicity, religion, sexuality, socioeconomic status, education, protocol, mores and more.
   
   Racial and ethnic minority groups make up 28% of the U.S. population in 1998, by the year 2030, that number is projected to rise to 40%. Improving cultural competence among physicians may enhance the quality of health care for minority populations.
   
   Suggestions on how to teach cultural competence:

   1. A.Select applicants who value the ideal of cultural competency in the practice of medicine and can contribute to the diversity of the student body. Design the interview process to determine an applicants qualifications and readiness for medical training. Incorporate a probing question during the interview is a perfect opportunity to explore the applicants cultural sensitivity.
      
      B. Pre-medicine course recommendations should reflect our interest in cultural studies or experiences.
      
      C. Faculty/Professors/Attendings should be reflective of our societys rich diversity. Faculty development regarding cultural sensitivity should be enhanced because students often focus on and emulate the values expressed by those who teach them, learning is by example.
      

   First year -

   • Provide a copy of Culture and the Clinical Encounter to every incoming 1st year student.
   • Continue to discuss cultural issues in the Practice of Medicine course.
   • Have 4th year students give clinical correlations on culturally relevant issues providing examples from their own experiences.
   • A summer reading assignment after first year The Spirit Catches You and -You Fall Down with discussion in the Practice of Medicine 2 course.
   • Medical Spanish Summer Institute (optional)
     
     

   Second year -

   • Address cultural traditions through clinical vignettes in PoM-2 small group sessions monthly (approximately 10 minutes of discussion)
   • 4th year clinical correlations as in 1st year
     

   Third year -

   • Cultural Education Day - this day long workshop would serve as part of the third year clerkship orientation. Guest speakers from the University Health System would discuss traditions of the five largest patient populations serviced by the University Hospital in order to prepare students for their ward responsibilities. Students will be provided with a list of University resources that may be helpful in handling common issues that arise when managing diverse patients (i.e. AT &T translation service).
     

   Fourth year -

   • 4th Year elective course/taskforce to review texts and videos that address cultural issues in medicine; perform cultural sensitivity curricular review; present a biannual recommendation to the Curriculum Committee; Organize a clinical correlation for either the 1st or 2nd year class; submit one new case for PoM; investigate one dominant culture (AA, Hispanic etc) with a focus on the cultural issues that the student will most likely encounter in their residency.
     
     
2. 2001-02 Course Schedule.The latest version of the Fall 2001-02 first year schedule was distributed. First year course directors were asked to review the random free hours on this schedule for additions, elimination or consolidation. Student Affairs (Allison Innes and Moses Woode) should be contacted to arrange informational or study help meetings during some of the free time. The course directors were also asked to have the Spring 2002 first year schedule completed by the end of April, 2001. John Gazewood asked that Saturday examinations, be rotated [avoided] in the future. This occurs rarely, but should Saturday examinations be necessary, the sequence of exams should rotate.
   
   The second year 2001-02 schedule is complete with a few minor modifications expected.
   
   
3. WEB Based Evaluations. The evaluations are now available for use by all first and second year courses for the May, 2001 examination period. The Committee agreed that the evaluations should be opened to the students after the last day of class prior to the exam and remain open one week after the examination.
   
   
4. Committee members were invited to attend the seminar, Understanding Personality for Effective Teaching and Learning - Janet Levine, Director, National Educators Institute, Milton Academy in the Rotunda, Lower West Oval Room on April 16, 2001, 1:30-4:30 p.m.

Minutes submitted by: Donald J. Innes, Jr., M.D. Date: 04/23/01