University of Virginia School of Medicine

Principles of Medicine Committee

Minutes 11.16.99

November 16, 1999, 3:00 p.m., Jordan 3-31.

Present were: Robert Bloodgood, Amy Bouton, Bruce Cohen, Alfred Connors, Claudette Dalton, Carl Creutz, Barry Hinton, William Hobbs, Peter Holloway, Donald Innes (Chair), Joanna Goldberg, Howard Kutchai, Kevin Lee, Andrew Lockman, Jennifer McClune, Jonathan Moreno, Christine Peterson, Marjorie Rein, David Waters, Brian Wispelwey, Wendy Golden, Allison Innes, Richard Pearson, Jerry Short, Marcia Childress, Eugene Corbett, Tony Tamburello, Mariecken Verspoor, Robb Williams, Andy Darby , Guests: Virginia Taylor and Elaine Lowe

1. Dr. Kevin Lee reported to the committee on the revamping of the medical neuroscience course.
   
   Goals and Process:
   • Balance the distribution of contact hours among lectures, clinical correlations and small groups
   • Increase health-related context for lectures
   • Evaluate total contact hours
   • Five month period of reassessment, including meetings every 2-3 weeks with primary faculty
   • Nine text books evaluated
   • Content of all lectures examined
   • Overlap in lecture content with all 1 st and 2nd year courses identified
     

   Modifications:

   • Total number of contact hours reduced by 13%
   • Lecture hours reduced from 71% to 59% of the contact hours
   • Two clinical problem sets were added (now a total of 5), in which small groups meet with faculty and residents to discuss case studies (from 8% to 12%)
   • Additional clinical correlations integrated into the course (from 13% to 21%)
   • Disease subthemes established for most lectures (many were already incorporated into the lectures)
   • Texts: one primary text, two supplementary texts, and one atlas were selected (total cost:= $149)
     
     

   Theme based packages of information were developed. The computer program, "Digital Anatomist" was made available for student self-study. This program is not perfect for their needs and other programs are being evaluated for use next year. All notes for the Neuroscience course were placed on the WEB as well as distributed to the students as hard copies. Dr. Lee suggested that all the courses provide searchable PDF format files of their handouts so that course content can be monitored and improved. Copyright issues and time constraints will need to be overcome. Sample questions from the lectures of the preceding week are posted on the WEB page weekly. A parallel enhancement course ‘Fundamentals of Neuroscience" examining original literature pertaining to key concepts in the course has been developed to enhance investigative techniques of the students. Attendance is optional but tended to be more in the beginning with decreasing frequency after a couple of months. Courses of this nature would be ideal during the time set aside in the new curriculum for exploratory sessions. Some areas of study have been incorporated more effectively into the Clinical Correlatives. Since these changes have yet to be implemented, nofeedback as to board scores, etc. has been obtained as yet but will be looked at carefully when it becomes available.
   
    

2. Don Innes briefed the committee on activities of the Curriculum Committee.
   
   Proposals ranked & grouped by Y1&2vs. Y3&4vs. general beginning Year 2000.

   Restructuring High

   LuncheonActivities High

   Prac of Med Course High

   Exploratory Medium

   Cases/problem solv Medium

   BasicSciClinReview Low

   Electives Y3/4 Low

   AssocDirectorsTeam High

   Management process High

   DataBaseObjectives Medium

   Grading Uniformity Medium

   Coordinators Low

   Faculty Development Low

   Considering the mission, values and purpose of the institution and the goals and objectives laid out in previous weeks, as well as feasibility issues, the Curriculum Committee discussed the proposals. Based on a consensus regarding the above rankings, the committee agreed to consider the following changes for the year 2000.
   
   

   1.  Restructuring. Scheduled course activities are limited to mornings until noon and two afternoons per week. A common lunch hour and activities period for years one and two, is incorporated for the purpose of creating an environment conducive to the development of appropriate professional attitudes and social skills.
      
      

      All courses are strongly encouraged to engage students in problem solving case-based approaches to learning as appropriate. Courses are encouraged to employ faculty from multiple disciplines as appropriate.
      
      

   2. All courses and clerkships must have both a basic science and clinical director.
      
      
   3. A "Practice of Medicine" course will be implemented merging elements of the Doctor-Patient-Illness (DPI), Physical Diagnosis, Human Behavior, Ethics and Introduction to Clinical Medicine (ICM) courses into a single course (Parts 1 & 2) across two years. Primary to the course are weekly [biweekly] patient encounters. The program should be sequential, developing and building on an expanding base of skills and knowledge and experience. Students should work primarily in small groups with physicians and social scientists as faculty members.
      
      
   4. Implement a Clinical-Basic Science Review Program for the third and fourth years as an important start to lifelong learning in the practice of medicine.
      
      
   5. Implement a management process by which the Curriculum Committee through the actions of the "Principles" and "Clinical" committees is responsible for ensuring an integrated curriculum throughout the 4 years of medical school. The content, coordination, integration and pedagogy of courses, clerkships and electives will be reviewed on a regular basis.
      
      
3.  Jerry Short provided a summary of the results of the "Looking Back." Copies of which were distributed to all course directors at the previous meeting. Brief discussion followed.
   
    
4. Jerry Short reported on the activities of the task force looking at space needs for the medical school. This group consisting of Munsey Wheby, Donald Innes, Linda Watson, Jay Levine, Robb Williams and Jerry Short, has met three times in October and November to consider space needs and options with a target date of 2003-2005. The task force has met once with the Dean. Education space is now scattered throughout the Health Sciences Center. There is no focused space devoted to undergraduate medical education. In fact, the School of Medicine does not appear as a physical entity on any of the University maps.
   
   

   Three general options have been identified: 1) increase and improve the educational space spread throughout the Health System; 2) Build a new comprehensive medical education building; and 3) build a smaller new building (as an addition to the Library toward Lane Road) and continue to use the existing classrooms and labs in Jordan. Option 1 is seen as the least desirable since it provides a fragmented environment for education and higher costs for remodeling. Option 2, is seen as optimum, but it has the disadvantage of higher cost and greater distance from the hospital, clinics, faculty offices, and library. Option 3, would provide a central location for medical education, but would require the use of the current classrooms and labs in Jordan Hall.

   Please e-mail comments or suggestions regarding teaching space to Jerry Short jgs0x@virginia.edu or Donald Innes dji@virginia.edu.
    

The next Principles of Medicine Committee meeting will be December 7, 1999 at 3:00 p.m. in the Cell Biology Library (Jordan 3-31). Steve Meixel will discuss progress on the Practice of Medicine Course with the group prior to submission to the Curriculum Committee.

The Curriculum Committee will host an open house for faculty and students to discuss curriculum issues on January 12, 2000, from 3:00 until 5:00 in PCC Classroom A.

 Minutes submitted by: Donald J. Innes, Jr., M.D. Date: 11/17/99