Present: Dr. Richard Davidson, Chair; Drs. Rob Averbuch, Judy Bowers, Lou Ann Cooper, Marvin Dewar, Timothy Flynn, Cari Hernandez, Heather Harrell, George Heck, Caridad Hernandez, Lisa Merlo, John Meuleman, Sigurd Normann, Kyle Rarey, Louis Ritz, William Winter; Wayne Bottom; Cynthia Karle, Students: Chris Bucciarelli MS1, JR Taylor MS2 (replaced Nitesh Paryani as Academic Chair), Sarah Smith-Vaniz MS4
Members not present: Students: Bhavin Adhyaru MS4, Omayra Marrero MS3, Drs. David Caro, Mike Chen, Robert Hatch, Maureen Novak, Mohan Raizada, Peggy Wallace
Dr. Kyle Rarey said there were good presentations at the SGEA meeting in Nashville. Overall attendance was down this year, but good representation from our college. It was good to see Vanderbilt’s Medical School Complex and simulation area. Medical Education Week will be April 21-25. The content ranges from Dr. Timothy Flynn talking about “The Effect of Duty Hour Regulations on Graduate Medical Education,” on Monday, and on Friday, Dr. Charles Griffith from the University of Kentucky on “Teaching Yourself.” These presentations are at Noon in Rm. C1-4. Monday afternoon is the Honors Convocation and the AOA banquet.
Students:
Dr. Davidson announced that JR Taylor MS2, is replacing Nitesh Paryani as Academic Chair of the Class of 2010. JR reported from the second year class: The second year class is looking forward to finishing strong in the last 6 weeks of class. They are eagerly anticipating the White Coat Ceremony, yet dreading the studying for Step 1 in the summer. They have a string of tests coming up in Pharmacology, Evidence Based Medicine, and Clinical Diagnosis. All in all the class is enjoying this semester.
Chris Bucciarelli MS 1: The class had their endocrine exam which they did very well on as a whole and that they are currently enjoying learning about the ins and outs of fat metabolism, along with getting familiar with the pulmonary block.
Sarah Smith-Vaniz MS4: The students nominated Dr. Stone for the 2008 AAMC Humanism in Medicine Award. They had a large amount of contributions of quotes and stories from students, residents, and faculty members. Sarah finished the nomination essays and mailed them off this past Monday. Also, the AAMC student representatives will all be traveling to Destin Beach on Thursday for the regional meeting.
Dr. Davidson received an email from Bhavin Adhyaru MS4, “I would like to convey to the committee, my thanks on behalf of the class, to the faculty for attending Match Day and making it a success. The majority of the class was very happy with their outcome. We are looking forward to the Senior Banquet on April 25th and Graduation on May 17th.”
Course Directors:
Dr. Winter: Drs. Davidson and Rarey led the Basic Science Course Directors meeting last month when he was out of town. Dr. Winter discussed some of the challenges Dr. Kone put toward the Basic Science Course Directors when he visited in February. One challenge was, “How can we engage and lead students in leadership, policy development and in research?” Also, that we should be involving students in more interdisciplinary teaching as well as information technology. Dr. Winter told the committee that he went to the American Board of Medical Examiner’s website and obtained the most recent information on the status of the review of Steps 1 and 2. Dr. Davidson said that whenever that happens, there will be profound effects.
Jacksonville:
Dr. Judy Bowers announced that Jacksonville’s Research Day is May 15th.
Dr. Davidson said Dr. Hernandez will report next month on the Master Educator Fellows program.
1.Reports from the SGEA:
Dr. Davidson thanked Drs. Hernandez and Cooper for their efforts and for really being responsible for a great showing at the SGEA meeting.
Dr. Harrell said it was a great meeting even though the attendance was affected by spring breaks and the overlap of the SGIM and SGEA meetings. She said that UF had a great presence at the meeting. There were 4 oral presentations, 3 of those will be presented at Medical Education week. There was one workshop led by Dr. Wayne McCormack as our representative to a big national RIME initiative. There was one small group discussion, 5 posters (2 were Jacksonville faculty), and 3 demonstrations. Because the theme of this meeting was balancing learning strategies and technology, there was an entire section of presentations devoted to how people are using technology to teaching innovative things. Every single presenter except for Dr. Cooper, who helped everyone, was either a current or former Master Educator, which speaks well for the strength of the program that Dr. Rarey and Dr. Andrea Klioze developed years ago and that now Dr. Cari Hernandez oversees. Dr. Rarey is the National RIME Section Chair and reports that the national group will be focusing a big initiative on peer evaluation. We should benefit from this, as Dr. Wayne McCormack is nationally known in this area. Brownie Anderson was representing the AAMC at the meeting and said that one of the areas they really want to focus on in the future is interprofessional education. Dr. Harrell said this is wonderful for UF because we have one of the premier programs. She said quite a few people approached her at the meeting asking questions and were surprised to learn our college is doing more than small group meetings at AHEC, but are going to the patients’ homes. Dr. Harrell said there is an interest at the AAMC in the transition between medical school and residency; particularly where the support fits in. There is currently a working group that has some overlap with this and Dr. Harrell believes this is what the SGEA UME section wants to give a lot of focus to. There are already about three potential studies out there. This is a possibility for our college to get a collaborative grant that they sponsor. Dr. Harrell mentioned Vanderbilt’s phenomenal computer system being seamlessly interwoven. Regarding portfolios, they have a system that can automatically upload any notes into the student portfolio. Dr. Harrell continued her discussion on technology, principles of medical education and deliberate practice.
Dr. Davidson said that currently we have responsibilities to our students to best prepare them for Step 1 as long as it exists, however, when Step 1 doesn’t exist, we should be planning to completely rethink what we are doing and to determine what is important, especially as we are thinking abut changing the curriculum.
Dr. Harrell added that there should be no delay in moving ahead considering how hard it was to just come up with consensus about the patient logs. She said the important topics coming up at meetings are patient safety, cultural competences, leadership and professionalism, and global health. Part of the reason we’re seeing all of these topics is that we’re saying we now value these differently. At the conference there was a session on generational differences giving the message that there is a much bigger disconnect in generation X and millennials. There was further discussion on the differences.
Dr. Davidson said that he has been having discussions with Russell Bauer who is the Chair of Clinical Health and Psychology, and Dr. Bauer has agreed to talk to the Course and Clerkship Directors on June 5th about dealing with these generational differences.
Dr. Flynn said he thought they were locked into that because of its interface with not just educators but the rest of the healthcare delivery system. He believes the processes are not likely to change much. The College and Board have been discussing this for the past 4 or 5 years. There is no good solution and he said that right now, the junior group, judging by what’s going on this year has more disruption this year in our intern classes.
SGEA meeting – Dr. Averbuch said the meeting was very well organized; the sessions were very interesting and very applicable to what we did.
Dr. Hernandez said that Dr. Lou Ann Cooper’s support of the fellows and their research was key to getting as many of our physicians accepted. She said our goal is to help faculty have a greater presence at future meetings.
Dr. Cooper said we had 8 posters and 5 talks including Drs. Harrell’s and one done by a graduate student for Dr. Juan Cendan in addition to Dr. Wayne McCormack’s and Dr. John Armstrong’s presentations. UF presented 8 out of the 55 posters at the conference.
2.Dr. Marvin Dewar – Patient Safety in the Curriculum:
Dr. Dewar said that since patient safety has already been presented, this will be an update. The curricular handout is the framework of the things that we want to get presented over the four years of this curriculum. This course will have course directors in charge of its content and it will be delivered and changed over time. As in other courses the Course Directors will have the job of negotiating their time and their content from other courses that are currently in place. He said they initially found an overwhelming barrier but believe they have been able to identify places in the curriculum where the things that are going to be done will fit in with what’s already been done. He believes because they are just a modification of what’s being done, he doesn’t think this will be disruptive. Dr. Eric Rosenberg and Dr. Bob Wears have agreed to be co-course directors. Dr. Dewar said it will be challenging because something will be going on simultaneously at any given time for all four years of the curriculum. He said they will start with pre-orientation with readings, selected readings and assignments when they arrive and then they will be given assigned readings. Years 1 through 4 will have a mixture of didactics, grand rounds, panel discussions, workshops, and when the student goes into the clinical years, there will be projects. Dr. Dewar said they have been talking with the departmental quality officers and the departmental medical directors who have an assignment to do quality and safety things in their departments and in their clinics, and to look to the students who need projects and activities in this course and fill them in to what is going on in actual clinics. Dr. Dewar said this is a great opportunity where you’ve got a built in control group of people in classes who didn’t get this in courses. He said that we’ll evaluate this to see what kind of impact that we’re able to make. Dr. Dewar said there are some potential funding opportunities because safety is such a “buzz” word in the educational ranks. He said the next step is for them to put to rest the work group and hand it to the two course directors who will need a lot of help. He said they’ll get this started in part with the next academic year.
Dr. Davidson expressed that this is not going to suddenly happen in September and be a four-year curriculum fully developed with evaluation methods. He said that Dr. Dewar and the committee, which includes Drs. Flynn, Harrell and Cooper, have done a really great job elucidating and identifying those important contents. Dr. Davidson said that Dean Kone approved the funding for the two course directors and now we need to present this to the Course and Clerkship Directors so they will know what to expect. Dr. Davidson further said that they envision, for instance, that in the beginning of Essentials of Patient Care, to have a workshop. The EPC Course Directors are not responsible for putting together the content, but the Course Directors of the Patient Safety Committee will work with the Course Directors to provide the content that is needed.
There was further discussion on whether this would be set up like an elective where they get credits. Dr. Davidson said that his impression of this course is that it will be a required course with no credit; a Pass/Fail course the students must pass. Dr. Dewar said they did not want to get into the credit issue but that participation in these events would be required to finish their degree. Dr. Flynn mentioned giving certificates. Dr. Harrell said that it would be meaningful only if other programs recognize it. Dr. Rarey said it would need to be brought up to the University Committee. Dr. Davidson said if it is listed as a new course then you would need to go through Tallahassee, but the course could be listed as a requirement with no course number. He said that will be further explored with the Course Directors. Dr. Davidson said the categorization will not deter them from getting the curriculum going and it will be worked on There was continued discussion on whether it should be made into a course and if it could be done without university credit. Dr. Davidson said the details will be worked on but the content needs to be moved ahead. He said Dr. Bob Wears who is on the faculty in Jacksonville in the Emergency Medicine Dept., is a nationally known patient safety author and consultant who also has an appointment in a London university. Dr. Wears deals with patient safety issues there and it would be good to have someone in Jacksonville who can possibly implement much of this there, as well.
3.Lisa Merlo – Department of Psychiatry – Smoking Initiative
Smoking Presentation Download
Dr. Davidson introduced Lisa Merlo – She is working with the Area Health Education Center on their smoking initiative which is significant. Our AHEC received a lot of funding to look into ways of implementing education for smoking cessation. He said Lisa’s interest is particularly in second hand smoke and that she is an expert in motivational interviewing which is a way of convincing people to change their behavior over a period of time. He said she has been working with Dr. Maureen Novak to correct information regarding information we currently have in the curriculum.
Lisa Merlo thanked everyone for being helpful and covered the current status of tobacco related education in the curriculum. ADD SLIDES Lisa discussed each year of study. She said in the first year there is a good introduction to clinical skills related to tobacco, but not yet a good connection between the pathology and clinical presentation. She said the key factors are the ATTAC program (four-hour workshop plus a day of learning where the students are on an interdisciplinary team and go into local middle schools. They meet with the students and discuss smoking issues.) Lisa Merlo said that in EPC 1 & 2, students are educated on how to obtain a smoking history. In IFH, smoking comes up frequently as one of the topics for the family health project, although it can be emphasized more in some groups than others. In Human Behavior there is currently an addition lecture that is not tobacco specific. In preceptorship, AHEC provided content to the students. In the second year, there is much more information on pathology and related illness. In the third year, Lisa Merlo said that the students get direct practice. She said that she is concerned that there is not enough second-hand smoke exposure and that needs to be increased. She said the goal would be to get up to the factual information that is presented in a written format and also have quick interview blurbs videotaped from a representative of each of the departments or clerkships that discusses how tobacco and second-hand exposure are particularly relevant to the population.
There was further discussion on socio economics regarding smoking issues. Dr. Davidson said that third year medical student Dhipthi Mulligan is working on information regarding health disparities and cultural issues.
Dr. Harrell said that the students are limited in the first two years and can’t relate the information they know. She said they know the information, but on her clerkship, for example, tools are not readily available to them on the inpatient setting.
Dr. Davidson said one of the barriers for implementing the actual practice of this is that the behavioral change interviewing really requires longitudinal contact with the patient.
Lisa Merlo concluded that from her perspective, one of the main deficits is the second-hand smoke issue. She said the students are getting good exposure about smoking issues but there needs to be more done on second-hand smoke. She said she is doing the work on improving this.
Dr. Davidson summarized Lisa Merlo’s presentation by saying that in general, the curriculum is reasonable at present but we need to increase second-hand smoke training and one way to do that would be through web-based exercises and to actually interact with patients.
The meeting was adjourned.