Curriculum Committee Minutes- May 24, 2005

Present: Watson, Davidson, Romrell, Kaunitz, Paulson, Rathe, Burchfield, Butson, Meuleman, Normann, Chen, Harrell, Hatch, Averbuch (for Dr.Gold ) Margie McGarva recording

The AMA has recommended to the LCME that they monitor closely student duty hours. With that in mind, a statement concerning student duty hours was developed using the current resident duty hour statement as a template. The statment is as noted below (click to open):

Medical Student Duty Hours

Dr. Davidson asked the committee to vote on the medical student duty hours, as outlined above. Dr. Hatch stated that he thought it was a little controversial, as some clerkships will have to change how they are structured. Dr. Chen noted that the conferences are a controversial issue and that students will miss some lectures. It was pointed out that it is the responsibility of the clerkships to arrange their educational conferences so that the students will be able to attend. This paper is almost identical to the ACGME rules and we feel it will suit the needs of our students and educational program.

A vote was taken to approve the above proposal as presented by Dr. Davidson. All approved.

Presentation – by Dr. Watson

Dr. Watson stated that we can develop more than simply a list of numbers of patient encounters and procedures. Dr. Davidson noted that collecting this kind of data would provide excellent feedback to the Curriculum Committee regarding the breadth of patient interactions, including breakdowns of ambulatory versus inpatinet exposure, primary versus tertiary care exposure, and the possible utility of our clinical presentation list. Dr. Watson observed the following:

LCME: ED-2

• “The objectives for clinical education must include quantified criteria for the types of patients (real or simulated), the level of student responsibility, and the appropriate settings needed for the objectives to be met.”
• The school should “specify the major disease states/conditions that all students are expected to encounter.”
• The school should “specify the extent of student interaction with patients and the venue(s) in which the interactions will occur. Courses and clerkships will monitor and verify, by appropriate means, the number and variety of patient encounters in which students participate, so that adjustments can be made to ensure that all students have the desired clinical experiences”.
• We expect our students to be competent, to have achieved the objectives of the educational program, and to have received a general professional education.
• Achieving competence requires a variety of learning and assessment methods.
• Knowledge is attained through lectures, small group discussions, and self-learning.
• Experience is achieved through patient and family interactions, procedures, simulations, and standardized patients.

We intend to utilize ED-2 to help our students become competent over the course of their four years in medical school. We know that individual numbers mean little, that one student can learn more quickly than another.

On-line data will be monitored by course and clerkship directors, the Director of the Fourth Year Program, the Office of Program Evaluation and Faculty Development, and the Office of Medical Education.

• Our Clinical Presentations include specific clinical presentations that guide learning objectives, fulfill the goal of a general professional education, and in which we believe all students should be competent.
• Clerkship Directors should select from the clinical presentations those that are germane to his/her clerkship, and will be responsible for monitoring students’ achievement of competency in these presentations. This monitoring may include numbers of patients and procedures, but can be attendance, reading assignments, shelf exams, or PBE’s.
• The Clinical Presentations will be the guide, which places clerkship directors in a pivotal position. They must work with course directors to define and monitor the needed competencies, and be aware of each student’s progress when they begin and end his/her clerkship.
• The fourth year takes on new significance. The fourth year will now be a time when any student who has not achieved the competencies will receive help in designing their fourth year in order to achieve the competencies.
  

For the UFCOM:

• We don’t want a priori lists of numbers of patient encounters and procedures.
• We don’t want to create more of a “silo” effect.
• We want to foster more basic and clinical interaction.
• We want to assess competency.
• We want to monitor students’ development.
• We want to utilize ED-2 to help monitor the overall education program.
  

Dr. Romrell
Dr. Romrell did a short presentation on the new Comtrack database which tracks the patients and cases students are exposed to, from their entering class until graduation. Pull down lists specific to the course or clerkship and view screens to view data online are being developed to assess student progress, address clerkship needs, and also to provide feedback to the Curriculum Committee as to whether the clinical education of our students is appropriate.

Dr. Burchfield stated that in addition to the diagnosis the tracking system should collect information regarding the clinical presentations that are seen by our students. The presentation model we addressed six years ago can serve as a template with which to assess the overall curriculum. Each tracking page is specific to each clerkship, and will include specific items that are being tracked in each clerkship. The tracking system is monitored daily and input into the tracking system should be done daily.

Meeting adjourned at 9:00 a.m. Next scheduled meeting will be June 28, the last meeting until September.