Present: Dr. Richard Davidson, Chair; Drs. Bruce Kone Rob Averbuch, Judy Bowers, David Caro, Lou Ann Cooper, Marvin Dewar, Frank Genuardi, Heather Harrell, Robert Hatch, George Heck, Caridad Hernandez ,John Meuleman, Maureen Novak, Kyle Rarey, Richard Rathe, Louis Ritz, Beverly Vidauretta, Margaret Wallace, Wayne Bottom; Cynthia Karle, Robyn Sheppard; Students: Bhavin Adhyaru MS4, Chris Bucciarelli MS1, Nitesh Paryani, MS2
Members not present: Students: Omayra Marrero MS3, Sarah Smith-Vaniz MS4; Drs. Mike Chen, Sigurd Normann, Mohan Raizada
1.Excluding sub-internships from grade distribution criteria – Dr. Davidson
Dr. Davidson presented the issue of grading on Sub-Is that was discussed at the last meeting. He said the issue goes back to evaluation guidelines which were passed several years ago. The Course Directors Committee and Dr. Winter, working in a special subcommittee, developed outlines for student grading. One of the issues that the committee passed at that time was that any course or clerkship that gives more than 50% A’s for two consecutive years will be deemed as not being discriminatory and will be asked to become Pass/Fail. The issue that was raised at the last meeting had to do with the Sub-Is in the 4th year because it’s a highly select group of students, especially those in Pediatrics and Family Medicine who want to get a very good grade because they’re going to be applying for their residencies. All three Sub-I’s have given more than 50% A’s. Dr. Davidson said that this was discussed and it seemed reasonable to exclude the Sub-Is from that particular requirement.
A proposal was made that the sub-internships should be excluded from the requirement to limit the number of A’s to less than 50% of the students. The proposal was unanimously passed.
2.Patient Safety Committee Update – Drs. Dewar/Davidson
Dr. Dewar gave an update and provided an overview. He said that last summer conversation began about trying to put together an organized curriculum in quality and safety for the students. There was a need to organize information that was already being taught and making sure the content was delivered. The Patient Safety subcommittee was formed and continues to work on what would be the best content and delivery. He said that unlike some other courses, it starts on day one of classes and doesn’t end until the student leaves so it stands for all of the years and grows in complexity as the student goes through those years. Dr. Dewar said that Dr. Davidson can send an electronic copy to anyone interested to see it of what the group determined the content should be. Right now it deals with a couple of broad areas. One is the whole content area of quality improvement, safety improvement, what are the nuts and bolts of that area that surrounds more effective communication and teamwork, a content area that is around what is called a culture of safety. Dr. Dewar said that what the subcommittee is doing now is running through the content year by year and seeing how the first year objectives that they have might be actually delivered. An example of the first year is that there will be a selected set of pre-readings on quality and safety issues the students will do before they come to orientation. Things will be emphasized like what does it mean to have a culture of safety and why this is a topic that you’re going to be hearing about. Very early in the curriculum there will be safety and quality grand rounds, and safety grand rounds continued through the four years. Dr. Dewar said there will need to be a lot of flexibility in terms of course and clerkship directors. There was a discussion on the interdisciplinary aspects and they will be worked on but the idea of the interdisciplinary part is it will fit on top what is currently in each college, but not necessarily replace what is already there. The question was asked, how are we going to know if it is successful? Dr. Dewar said that right from the beginning, they will be developing outcomes and evaluations.
Dr. Harrell mentioned that more residents and faculty need to be on board. Dr. Davidson said that Dr. Tim Flynn serving on the subcommittee is a big help. Dr. Kone had initially stated that we need to start with the medical students and build collaboratively through GME and faculty development so that we have a fully trained efficient patient safety group of faculty and students. Dr. Kone said that he believes there are two aspects from the faculty side and residency side as well as the whole continuum that needs to be communicated well. He also said that emphasis should be on research opportunities for some of the quality improvement programs. Dr. Friedman’s department is doing some initiatives. He said a key component is going to be communication from the Curriculum Committee.
There was further discussion on potential gaps, making a threaded course, including it in the preceptorship in the first year, and concern about a disconnect. It was brought up that if a student on a ward service sees a faculty member or resident do something they don’t understand, and it is questionable from a safety perspective, it is very difficult to say something because of evaluations. Dr. Davidson said that this will be brought up again.
3.Faculty Learning Communities – Dr. Davidson
Dr. Davidson said that faculty learning communities are essentially a method of faculty development. There are two kinds. One is an interprofessional or interdisciplinary group of faculty who engage in a program about enhancing teaching and learning with various types of activities using consults, etc. It was decided that patient safety would be an appropriate topic for this and representatives of each of the HSC colleges with the exception of Vet Med have been recruited. Dr. Davidson said he is facilitating with Diane Beck of Pharmacy who is particularly involved with faculty development and is very creative. There are two faculty members who are actually teaching courses in patient safety in the COP. In the COM, there are Marvin Dewar and Bob Wears from Jax, who is an internationally known expert in safety. There are two faculty members from the CON, Bryan Weber and Karen Reed. Boyd Robinson, Associate Dean for Clinical Affairs in Dentistry is particularly interested in safety and the clinical aspects of dentistry. Russ Bauer is the Chair of Clinical and Health Psychology in Public Health and Health Professions and is interested in human factors issues. Scott Blades from Pharmacy is an expert in instructional design and the use of the lab in a variety of different types of creative learning activities. Other faculty involvement: Drs. Lou Ann Cooper, Sven Normann and Almut Winterstein from Pharmacy. As a group they are collaborating on both education and research regarding the topic of patient safety and quality, and developing a framework that essentially will go to the Curriculum Committees of each of the colleges. Dr. Davidson said the group would like to create some web-based resources where all the colleges will store what they are using in terms of patient safety. The group is hoping the implementation will occur in the first year; long term goals include establishment of research funding, increasing educational scholarship, publications, etc., by faculty to increase submission of abstracts and presentations and improve educational outcomes in patient safety and students. Each of the deans have agreed to support this endeavor whether or not funding is provided from the Provost’s office. There is a minimal amount of funding, $10,000, but each of the involved deans have agreed to support their faculty for release time. The group will have a monthly meeting.
4.Discussion of MD/MPH and MD/MSSCI – Dr. Davidson
Dr. Davidson said that the MD/MPH program which was approved by the Curriculum Committee and the Dean and was supposed to be approved by the graduate school in January hasn’t happened. However, there have already been meetings with interested students, and had several students interested in international health. One of the other things that Dr. Davidson said he is working on is a Masters in Science and Clinical Investigation, a degree program with Dr. Betsy Shenkman, Chair of the Department of Epidemiology and Health Policy Research. That is within the COM as opposed to the MD/MPH which is outside of the COM. Dr. Davidson said they are trying to integrate the program that Dr. Marian Limacher that has run for years that fellows train in clinical investigation. This is pending for the future and will probably come for this community. The emphasis of this will be more quantitative and will be geared towards students who are particularly interested in clinical and translational research as opposed to public health.
5.Update on student evaluation – Dr. Lou Ann Cooper
Dr. Davidson asked Dr. Cooper to give an update on what she had found after the first semester of evaluations. Dr. Cooper said that for the purposes of this discussion, she is talking about faculty evaluations in the first year for the first semester. Some of the issues that we’ve always had are that we are forced to do a series of questions that do not lend themselves to multi-instructor courses in medical school. That is one reason why we see these huge proportions of what she calls straight-line or monotonic responding in which the student gives the same response to all questions. She said that the premise of faculty evaluations, is that each of the questions actually mean something, requires a skill or characteristic of faculty teaching that if we are providing valid evaluations, and should be evaluated accordingly with each student attending to each question of each faculty member. Dr. Cooper said one of the things they did this year is to train our incoming medical students on what they wanted them to do. They were given information on how to write appropriate comments. Dr. Cooper said that they’re in the preliminary stages of looking to see how these changes were implemented.
The meeting was adjourned at 9 AM.