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Curriculum Committee Minutes 4/9/18

June 27, 2018 by zrb8mf@virginia.edu

University of Virginia School of Medicine

Curriculum Committee

Minutes – 4.9.18

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

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

Staff: Bobbi May

Minutes Reviewed/Accepted. The Committee unanimously approved the minutes from the March 19, 2018 meeting.

Suggested Edit to the Research Status Policy. Dr. John Densmore, Associate Dean for Student Affairs contacted Dr. Bray regarding some VISA concerns that have arisen with students requesting this Research Status, a policy the Committee approved in the fall of 2017. Depending upon the specific Visa, there are “work” constraints.  The policy as it exists now has a requirement “Students must work 35 hours per week.” He is recommending that we change the language in the policy to “Students are expected to engage in research, as part of the research course, for at least 35 hours per week.” The Committee discussed this proposed change and had no concerns regarding it.

Vote: The Committee voted unanimously to approve the revisions to the Research Policy verbiage as outlined above.

Nomination of Peter Schofield, MD to Psychiatry Clerkship Site Director at Western State. Dr. Ann Walling has recently stepped down from the Psychiatry clerkship site director position at Western State. Dr. Jonathon Anderson, Medical Director at Western State Hospital nominated Dr. Peter Schofield who is a senior faculty member there and has held this position in the past. His letter of nomination and CV were circulated electronically to members of the Committee prior to the meeting. No concerns were raised.

Vote: The Committee voted unanimously to approve Dr. Peter Schofield as the Clerkship Director of Psychiatry, Western State Hospital.

Announcement of New SOM Faculty Leadership Positions: Dr. Bray announced to the Committee the recent selection of faculty to open leadership positions. Each of these positions involved an interview process by Medical Education faculty within the SOM.

Dr. Andrew Parsons, Assistant Professor of Medicine, will become the new Foundations of Clinical Medicine Clinical Skills Course Director (formerly CPD).  Andrew has served multiple roles in medical education including as a CPD mentor and assisting with both our intern readiness program as well as the Medicine Residency Program.  In this new position, he will work with Dr. Peggy Plews-Ogan on the design, implementation, and evaluation of the 18-month pre-clerkship Clinical Skills Course to help prepare our medical students for their clerkships.  He will continue as a CPD Coach.

Dr. Kathryn Mutter, Assistant Professor of Emergency Medicine, will become our “Transitions” Director.  She currently manages the 4th-year Internship Readiness Course, coordinating eight separate courses.  She has also served as a CPD mentor.  In her new leadership position, she will use her proven capacity to juggle the required trainings, skills updates, clerkship tours, and other myriad pieces that have become a part of the two-week Transition Course—all designed to help prepare students as they move from the classroom to their clerkships.

Drs. Leigh-Ann Jones Webb, Assistant Professor of Emergency Medicine, and Linda Waggoner-Fountain, Professor of Pediatrics, will work together on our leadership curriculum.  Deans Wilkes and Canterbury have made providing leadership training to all our medical students a priority.  Leigh brings a fresh perspective, experience at other institutions, and soon, an MBA from Darden.  Linda brings long-term experience with our undergraduate medical education curriculum from her many roles including System Leader, Master Assessor, and Residency Director along with a Master’s in Education.  This combination will help move our leadership curriculum to its next phase.

 

Clerkship Reviews- continued.

Otolaryngology.

Reviewer: Carlos Tache-Leon, MD,

Subspecialty Clerkship Director: Katherine Fedder, MD

Subspecialty Clerkship Contact person: Tina Cross

A formal report on the Otolaryngology Component of the Surgical Subspecialty Clerkship was submitted to the Curriculum Committee. The highlights are listed below.

Strengths of the Clerkship.

  • Engaged and energetic clerkship director that is actively evaluating and improving the structure and design of the course, along with its performance and results.
  • Variety of available rotations with flexibility to choose areas of focus and tailor the clerkship to individual interests and needs.
  • Clear interest and commitment to education from faculty and residents that provides a consistently positive experience for students.
  • Good exposure to various procedures in the Operating Room and in the office.

Unique Challenges.

  • Short clerkship, part of the surgical subspecialties that has several generic goals that are tangential to the specific context of the routine practice in this highly specialized field. The students come with insufficient knowledge about the anatomy, physiology and pathology that they will encounter during the clerkship.

Update on Actions Required from Prior Year (2016).

  • The transition to the new clerkship director happened smoothly and without difficulties.
  • The shelf exam is no longer a requirement. Instead the clerkship director has instituted a case report presentation in a small group format, with content review and a feedback session directly with each student.
  • Students are receiving more responsibility and opportunities for direct interaction with patients in clinic and other environments.
  • In response to comments from students and previous clerkship reviews there have been deliberate efforts to expose students prior to their clerkship to the pertinent subjects including:
    • Presence of faculty and residents during first year neck anatomy dissections.
    • Dr. Early is involved in the medical student ENT interest group.
    • Dr. Kesser provides lectures during years 1, 2 and 4.
    • Dr. Fedder, Dr. Daniero and Dr. Shonka participate in surgical boot camp.
    • Dr. Moyer and Dr. Fedder have revamped 4th year head and neck anatomy elective to include faculty from clinical departments   This elective is much more clinically oriented now.

Actions Required for the Upcoming Year.

  • Incorporate Entrustable Professional Activities in the clerkship, including specific requirements for all students, and a way to monitor that they have the opportunity to participate actively in the care of patients under the supervision of a faculty member, and receive useful feedback following the encounter.
  • Standardize a core set of requirements across the five different rotations, in order to ensure a consistently positive and fruitful experience for all students, while meeting the educational goals.
  • Carry to fruition the initiative of a series of sessions focused on faculty and residents as teachers.
  • Continue to expand the participation of the Department in activities prior to the 3rd year clerkship.
  • Provide students coming to the clerkship with study guides, required and optional reading suggestions and other tools to optimize their educational experience, and maximize the utility of their exposure in the clinical setting to ENT pathology and the various surgical procedures.

Plastic Surgery.

Reviewer: Gretchen Arnold

Subspecialty Clerkship Director: Jonathon Black, MD

Subspecialty Clerkship Contact person: Freda McClung

A formal report on the Plastic Surgery Component of the Surgical Subspecialty Clerkship was submitted to the Curriculum Committee. The highlights are listed below.

Strengths of the Clerkship.

  • Experience and volume of OR time.
  • Diversity of the field demonstrated in 2 weeks
  • Inpatient rounding experience.
  • Administrative Leadership

Unique Challenges.

Is one of five Subspecialty Surgical services offered to third year students without required prior general surgery experience.

Update on Actions Required from Prior Year (2017).

  • Improved OR student experience
  • SOM has improved the preparation for student OR work
  • Added more clerkship specific skill training
  • EMR documentation – this improvement will be achieved now that legal limitations have been removed recently. As mentioned earlier, Dr. Black has worked closely with students to develop appropriate patient notes.

Actions Required for the Upcoming Year.

  • Integrating the EPAs into the entire clerkship experience
  • Develop a curriculum for wound care

Obstetrics/Gynecology.

Reviewer: Neeral Shah, MD

Clerkship Director: Megan Bray, MD

Assistant Clerkship Director: Yvonne Newberry, FNP

Clerkship Coordinator: Jessica Tawney

A formal report on the Obstetrics and Gynecology Clerkship was submitted to the Curriculum Committee. The highlights are listed below.

Strengths of the Clerkship.

  • Overall organization of Clerkship.
  • Comprehensive all-day clerkship specific Orientation to set the tone for clerkship.
  • Wahoo Wisdom booklet.
  • 30 minute sit-down Mid-Clerkship Feedback sessions at Ch’ville campus with each student.
  • Daily lecture/discussions address objectives of the clerkship
  • 2-week preceptor exposure at Bon Secours

Unique Challenges.

  • Lack of volume inpatient OB and numbers of learners
  • Lack of hands on experience
  • 1-2 malignant residents currently- being addressed
  • Richmond – less teaching, more observational, more private practice based (good and bad)

Update on Actions Required from Prior Year (2016).

  • Decrease learner: teacher ratio at Charlottesville.   Leadership sending a few students to Culpeper for new Ob/Gyn experience to help this ratio. Not consistent every week given the schedules of three practitioners there.
  • EPIC or comparable EMR for student notes not available in Richmond. Administrative Leadership at Bon Secours is not amenable to this despite continued discussion.
  • Create more enduring materials that can be accessed by Richmond students.

Actions Required for the Upcoming Year.

  • LO’s for this clerkship are complete/extensive. Reviewer requesting re-assessment. After discussion at CC meeting and discussion- less concerned about this given 6 week clerkship is only time to deliver this content.
  • Continue to search for additional sites for students to provide equal clinical experiences to those in Ch’ville.

 

Note: The next Curriculum Committee meeting will be held on Monday, April 16, 2018 in MCBR, #2700.