Minutes 06.11.14

Minutes 06.11.14

University of Virginia School of Medicine
Pre-Clerkship Meeting
Minutes – 6/11/14

Claude Moore Medical Education Building, Room G165, 4:00 p.m.

Present: John Dent, Mary Kate Worden, Randy Canterbury, Laurie Archbald-Pannone, Neeral Shah, Bart Nathan, Eva Casola, Sabrina Nunez, Robin LeGallo, Elizabeth Graham, Melanie McCollum, Bart Nathan, Kambiz Kalantari, Don Innes, Melanie Tomlin, Barb Rogers, Francis Nelson, Michelle Yoon, Dela Alexander, Laurie Shaffer

General Announcements – There will be no Pre-Clerkship meeting in July and August; meetings will restart in early September.

Introduction of Francis Nelson – Francis introduced himself to the group; he has replaced Paula Roy as Instructional & Research Support Manager.

Farewell to Sabrina Nunez  - Sabrina is leaving at the end of July to take a position as Assistant Dean of Curriculum at Washington University in St Louis.

Laurie Shaffer discussed Deaf Services – Kate O’Varanese and Christopher Read have left the Deaf Services department, but Robert McGee has taken over for Christopher as a temporary (and hopefully permanent) replacement.  She reported that the deaf student has stated he is “able to just be a student” without worrying about access to resources.  He has sign language interpreters with him in the classroom, and most activities are being captioned in real time and uploaded to his iPad via Skype.  In order to coordinate interpreters/transcriptionists, Deaf Services needs to be made aware of any changes to the course schedule. Also, it was decided that we will be using the captioned videos/PRLs for SMD18, but newly recorded videos/PRLs will NOT be captioned.  The students in SMD18 need to be aware of this to avoid confusion on their part.  Our emphasis on being a paperless curriculum is good but means that all videos, pre-recorded lectures, etc. need to be closed captioned and should be sent to Deaf Services for captioning at least 2 weeks in advance.  Sabrina pointed out that, in the Cardiovascular System, the students listen to heart sounds on a website and also visit the Harvey Lab where they listen to heart sounds of a simulated patient.  Laurie stressed to the group that she needs to communicate with system leaders regarding these and similar activities that require auditorily accessed components so that a solution can be reached to ensure all students have a comparable experience.

Best Practices in the GI System – Neeral Shah reported on the GI system which ran for 4 ½ weeks in February and March of 2014.   The system leaders were Neeral Shah, Anne Tuskey, and Sabrina Nunez.

Week 1: The system gained 3 days this year (with the Curriculum Committee’s blessing) and consisted of Anatomy Labs, Luminal Pathology Part 1 and GI Physiology Part 1 – this avoided overwhelming the students with that subject matter later on in the system.  There were also some overview sessions and some afternoon labs as CPD was not in session that week. 

Week 2:  Sessions on Luminal Physiology and Histology, Histopathology (lower GI), lots of case discussions and problem sets which were modeled after the MIS “You Are The Doc” sessions to synthesize what was learned that week. 


Week 3: Some Infectious Disease followed by lower GI sessions.  The TBL on Luminal Disease and Malignancy had a pathology focus which worked well, the Pediatric Disease session was too high level and will be modified for next year.  The Pharmacology unit was good but students were not prepared.  The small groups on Friday used 12 faculty and senior fellows – Neeral and Anne are already in contact with the Division Chair to get faculty excused from clinic duties so they can participate next year. 


Week 4:  Pathology session on Monday will be moved to end of the week next year to reinforce this material before the summative at the end of the following week.  This week introduces Liver pathology, GI surgery, and Susanna Keller’s Problem Sets which cover Liver and Pancreatic Histology and Physiology.  There is also a Problem Set on liver disease which included a quiz in the online testing system – Neeral monitors it in real time and adjusts his presentation to address areas in which the students are having trouble.  The week ends with small groups on Abdominal Surgery using Surgery Dept. faculty and chief residents, and GI Radiology Cases team taught by Neeral, a Radiology resident, and the instructor who introduced normal radiology at the beginning of the system.


Week 5: This week covers the Pancreas and Biliary systems.  The GI POT cases were very popular – Robin LeGallo and residents observe and instruct the students as they look at gross organs in the Anatomy Lab.  The Case Review TBL incorporates Luminal and Hepatology.  There is also a Review Panel Discussion that went well as culminating activities for the system.


Areas of Improvement – 1) Physiology first year with new instructor, 2) Will need to develop balance of basic science with clinical application, 3) Front loaded system seems overwhelming, 4) There were 3 snow days during the 4.5 weeks – it may be necessary to have a back up plan to avoid last minute scrambling for next year.


LCME Mock Site Visit – Dr. Canterbury reported many positive outcomes from the site visit, including 1) high quality of both faculty and students who participated in the event, 2) Members of junior faculty, basic science faculty, clinical chairs and research faculty were overwhelmingly positive about UVA and the NxGen curriculum, 3) Curriculum, Health Science Library, pay for teaching model, promotion and tenure, emphasis on teaching and faculty development also received positive reviews.

Concerns include 1) Database did not explain where Anatomy is taught in a clear manner, 2) Clerkship curriculum not integrated with pre-clerkship NxGen curriculum, 3) Lack of transparency in grading during clerkships, 4) Lack of narrative evaluations of small group activities, 5) How we assure ourselves that our students have met the graduation competencies – what are the elements of competencies and how do we measure them?  Sean Jackson will address this issue. 


Secret ballot for new Co-Pre-Clerkship Meeting Leader – The meeting ended with a ballot to elect Sabrina’s replacement.  Results will be communicated via email.