Curriculum Committee Minutes 2/5/18

University of Virginia School of Medicine

Curriculum Committee

Minutes – 2.5.18

MCBR, #2700 -4:00 p.m.

Present (underlined) were:

Chair (votes only to break a tie): Megan Bray

Voting: Juliana Bueno, Donna Chen, Aaron Freilich, Barry Hinton, Rachel Kon, Robin LeGallo, Keith Littlewood, Vishal Madaan, Juan Olazagasti, Margaret Plews-Ogan, Steven Powell, Theresa Schlager, Neeral Shah, Ryan Smith, Carlos Tache-Leon, Stephen Wolf

Students: John Hickman, Elizabeth Hoang, Ory Streeter, Rick Vavolizza

Non-voting: Gretchen Arnold, Elizabeth Bradley, Maryellen Gusic, Mark Moody, Selina Noramly, Bill Wilson

Staff: Bobbi May

Guests: Mohan Nadkarni, MD, Jeremy Middleton, MD

Minutes Reviewed/Accepted. The Committee unanimously approved the minutes from the January 29, 2018 meeting.

Clerkship Reviews.

Pediatrics.

Reviewers: Drs. Rachel Kon and Elizabeth Bradley

Clerkship Director: William G Wilson, MD

Assistant Director: Jeremy Middleton, MD

Strengths of the Clerkship:

Per the Self-Study, the strengths of the Pediatric Clerkship include a “strong tradition of teaching at all levels. Faculty have won numerous teaching awards; clerkship coordinator has won a national award from her peers.”

The strengths noted in prior years remain:

Faculty and housestaff educators. The students comment upon the supportive educational environment that is especially important in learning to care for children. The department has received several teaching awards and has several faculty members involved in the SOM educational efforts.
Department priorities: The department articulates and appears to practice a high priority for education of medical students
The use of CLIPP scenarios help to standardize student experience to help balance differences of seasonal illnesses and patient populations of different rotations.
Efforts to improve offsite rotations, particularly Bons Secour, may be gaining traction as judged by comparison to the prior year’s data. The only concerns are those noted above regarding Fairfax.

Unique Challenges: There is a lack of community sites in which to place students for outpatient rotations.

Update on Previous Recommendations from Prior Year (2016) & Remedies:

The clerkship website requires continued updating of links following the university revision in 2015. Dead links noted above should be corrected or deleted Reference materials are being updated.

The reviewers endorse consideration of educational workshops or seminars for offsite faculty, particularly in the case of Bon Secours. Bon Secours- problems were discussed with the local clerkship director, and the attending about which most of the negative comments were made is no longer there. We have not done specific educational workshops with the Bon Secours faculty- but the leadership has attended Joint Clerkship Meetings.
The requirement of observing relevant history taking and examination should be reinforced to faculty both in terms of actual practice and in clarifying to students that said observation is occurring. We have reinforced the importance of direct observation by faculty to our faculty. The EPA pilot will be helpful in this regard.
The newborn nursery experience is an ongoing project.

Recommendations for the Upcoming Year:

The website still needs to have the links fixed.
The Cultural Competency learning objectives should be edited to be Pediatric specific.
Clekrship needs to solidify a uniformway to given midclekrship feedback. Suggestions have been reviewed at CD meetings.
Continue to work on smoothing out variations in teaching and experience across sites and on inpatient and outpatient settings. This includes considering adjustments to when and how the CLIPP cases are completed.

Plan for Leadership Transition:

Jeremy Middleton will become the Clerkship Director starting with the 2018-19 clerkship year. Dr. Wilson will remain on the leadership team as the Associate Director, and Marlo Meyer will continue as the Coordinator.

Geriatrics.

Reviewers: Drs. Selina Noramly and Stephen Wolf

Clerkship Director: Huai Cheng, MD

Assistant Director: Justin Mutter, MD

Strengths of the Clerkship:

Longitudinal learning experience with faculty mentor
Varied and unique rotation sites
Interprofessional team-based care environment
LOs and curriculum based on national geriatric education standards
Responsive leadership that focuses on curriculum innovation and evolution

Unique Challenges:

Perceived relevance of geriatrics to student’s chosen future specialty
Position within the 4^th year
Timely feedback in a compressed 2 week schedule
National shortage of geriatricians

Update on Previous Recommendations from Prior Year (2016) & Remedies:

Last year there was discussion of removing the 2-week clerkship and turning the content into a “thread” of sorts through the four years of medical school. The final decision arrived upon was that there was not enough time to successfully convert to a geriatrics thread prior to the upcoming clerkship year beginning in March 2017 and DOM as well as SOM leadership still see value in this 2 week clerkship, so it will continue as it stands. The following (in quotes) were provided by Dr. Mo Nadkarni, Division of Geriatrics, as commitments to improve the geriatric clerkship in 2017-2018.

- Work to improve the student to patient ratios in clinics. There has been an increase in patient volume at JABA and additional teaching sites will be added this year [Memory & Aging Care Clinic – (Mutter), Charlottesville Health & Rehabilitation – (Cheng), Albemarle Health & Rehabilitation-( Cheng). PACE site will be reactivated (Ombres)].

Commitment to work hard to recruit and hire more geriatric faculty to decrease the burden of teaching on current faculty. 3 new faculty (Drs. Mutter, Tieu, Ombres) have been hired and recruitment efforts continue to secure 2 additional physicians.

Faculty have committed to avoiding last minute cancelations of their clinics, which leave students scrambling for assignments. The division is implementing a central scheduling tool (Qgenda) to better track and plan for faculty absences. There is also a new rule limiting the number of faculty who can be on vacation/conference at the same time. Qgenda is currently being used.

Improve Orientation to help students understand the structure and reasoning behind placements at various sites. Orientation has been condensed to one hour with emphasis on educational value of each site.

Limit, as well as improve on line materials for students on the rotation. Continue to improve the website. There is continued effort in this arena. The additionof an Assistant Director will help accomplish this task.

Improve commitment to faculty- student continuity in preceptor assignments. This will happen with expansion/reactivation of clinical sites & increased number of faculty described above.

Continue ongoing monitoring and feedback regarding success of the clerkship utilizing student evaluations and programmatic evaluation. Ongoing efforts in this area.

With new hires, will work to identify an assistant or co-clerkship director. In process of nominating Justin Mutter, MD.- a former UVA student and resident who is extremely enthusiastic about this educational role.

Work to actively encourage note writing in EPIC and offer feedback on notes. Each student writes and presents a case including submission of EPIC note to clerkship director for review & comment.

Recommendations for the Upcoming Year:

Continue faculty recruitment & retention efforts with the intent of having a more stable faculty with a longitudinal interest in teaching.
Define role of Assistant Director and assess contributions.
Improve orientation re clarity of clerkship requirements & expectations (due to a few complaints in the student evaluations).
Incorporation of EPAs over the next year (as for all clerkships). It seems that some headway has already been made with EPA4 & 7.
Final assessment validity – the MCQ assessment should be reviewed and discussed as per the standards of the pre-clerkship MCQ assessments.
LO Reduction/Review – perhaps there needs to be a distinction between LOs that may be covered/needed during the clerkship and those that will definitely be mastered e.g. more specific LOs need to be grouped under general LO subheadings?Dr. Mo Nadkarni was present to hear the review and offered his support and commitment as Division Director to the overall stabilization and improvement of this 2 week Clerkship.

Nomination: Assistant Clerkship Director, Psychiatry – Dr. Meredith Lee. Dr. Anita Clayton, Chair of the Department of Psychiatry and Neurobehavioral Sciences, submitted her nomination for Dr. Meredith Lee as Assistant Clerkship Director. Dr. Lee is invested in the training and education of residents and students alike and is well qualified for this position.

Vote: The Committee voted unanimously to approve Dr. Meredith Lee as the Assistant Clerkship Director for Psychiatry.

Note: The next Curriculum Committee meeting will be held on Monday, February 12, 2018 in MCBR, #2700.