CURRICULUM COMMITTEE MEETING
June 10, 2008
Present: Dr. Richard Davidson, Chair; Drs. David Caro, Lou Ann Cooper, Heather Harrell, Marvin Dewar, Frank Genuardi, John Meuleman, Richard Rathe; Louis Ritz, Eric Rosenberg, George Heck, Cynthia Karle; Students: Chris Bucciarelli, MS1, Omayra Marrero, MS3
Members not present: Drs. Rob Averbuch, Judy Bowers, Mike Chen, Robert Hatch, Sigurd Normann, Maureen Novak, Mohan Raizada, Margaret Wallace; Student: JR Taylor, MS2
REPORTS:
Chris Bucciarelli MS1: The first year class has finished for the year. Some students will be returning from vacation for research aspects.
Omayra Marrero MS3: The third year class is working very hard towards the Step exam and expects to do well. Omayra said the class just had CSE’s – Dr. Davidson said for the first time, everyone in the class passed. Either Dr. Duerson or Dr. Cendan will email the class.
Dr. Frank Genuardi: Psychiatry
is coming back and now the new Chair of Anesthesia has come on board. The
Cynthia Karle: Medical Education is posting grades for students and getting ready for next year.
Dr. Richard Rathe: Dr. Rathe said that for the entire campus, there is a move for all student emails to be GMail. It will be a paid system. The main campus is very serious about it. Jan Vander aa is trying to get the HSC people together.
Dr. Harrell said that in the patient care realm, we have been reassured that there is some extra security for ufl.edu. and she was assuming that was for students. Dr. Rathe said that the ufl.edu rule is that you are only supposed to email information about scheduling, medications, etc. Actually talking about a real patient is breaking a HIPAA violation. He said if you read what that policy says, it is very circumscribed. Dr. Rathe does not know how this will change at this time.
1.
Presentation
and Approval of the Patient Safety Curriculum:
Drs. Rosenberg and Dewar:
SLIDES
Dr. Rosenberg presented slides of “Quality and Patient Safety 2008-09” covering the following: UF COM Patient Safety Task Force; Themes-institutional imperatives; Why a Patient Safety/QI Course for Students…now?; (some) Preliminary efforts; Students “get it”; Table – Perceived Importance of Proposed Causes for Adverse Events by Student Discipline and Occasion; How did we go about drafting a curriculum?; Medical School Curricular Descriptions; University of Michigan Patient Safety Curriculum Road-Map; What do we expect physicians to do in patient safety?; Curriculum Goals – MS I-IV; Objectives: MS-III; Patient Safety Curriculum to be incorporated longitudinally into existing curriculum; Quality and Patient Safety: 1-IV; Clerkship Directors’ Proposals: June 6, 2008; Methods of Evaluation; Who will teach it?; How will we know if this is effective?
Dr. Davidson said
the only thing he would add is that there is a Faculty Learning Community group
that Drs. Lou Ann Cooper, Marvin Dewar and Bob Wears are involved in that is
interdisciplinary and has representatives from five other colleges. They are working toward presenting each of
the safety curriculum for each of the colleges, finding the areas in which
there may be opportunities for interdisciplinary education that would go on top
of this. For example, in the IFH
course. There are several examples of where
patients “fell through the cracks” in the families that they are visiting
themselves. Dr. Davidson said the next
meeting will be Friday, June 13th.
Dr. Rosenberg will be presenting the
Dr. Harrell said this was an excellent presentation. She remains very concerned about students entering the clerkship years and to try to report concerns to faculty or residents and then being shot down. She said that she is not aware of any group that has developed some guidelines for the proper way to approach hierarchy. She said it might be clerkship specific. She said because the medical students are the most vulnerable population, that goal could be started, but she would like to see input from all levels so that program directors could reinforce what they’re being taught.
Dr. Davidson said that will largely be up to clerkship directors. The clerkship directors are the contact with faculty.
Dr. Caro said that the work that has been done to put this curriculum together is phenomenal. He believes the #1 thing that might sabotage this is that some of the faculty and resident body might shoot this down. Dr. Dewar said that has been discussed at length. He said he does believe the faculty at large hears the message and conceivably they could be asked at departmental meetings to have a departmental physician director of quality, and the clerkship director and one of the members of the group to let them know how they can help. He said we need to know what safe language is. He said there is an anonymous way to report safety issues online that is getting more use – there are now 500 submissions per month. His comment was that people don’t use it because they don’t believe anything is going to happen because of no response. This process will change so that all who are not submitting anonymously will get a response.
Dr. Rathe brought up a discussion on the availability of safety officers and that students shouldn’t be shot down when they go to a safety officer. Omayra Marrero MS3 said she likes the idea but knows it won’t happen overnight. She said the clerkship directors are the ones she would start with.
Dr. Caro said the safety officer is different than the GME director and the Chair. He said he thinks the difference is going to be that the Chair is not going to set the tone for the department and the faculty to buy into this safety culture. It’s not being put out there frequently. He said he is afraid the message might get lost.
Dr. Davidson said that Dr. Good is very committed to patient safety and that was the first thing Dr. Good asked him regarding this curriculum. He said that being in the position Dr. Good’s been in, he’s been involved with safety issues and has had as much experience as anyone else.
Dr. Rosenberg said it is important to get the students to be aware of what is going on around them…not only what other people are doing but what they themselves are doing. He said the curriculum will help them improve the quality of the care they’re going to provide and in emergent situations, they should be comfortable speaking up.
Dr. Meuleman said we need to give real examples to students. Then they can see for themselves who is modeling the right behavior. He said he would show as many real case examples as possible. Dr. Rosenberg said that’s what the clerkship directors will be doing…using cases that the students bring up or that they have in their files.
Dr. Harrell said that sometimes students are shot down for things that they are exactly right for mentioning. She said this curriculum is an opportunity for a very focused message. This curriculum is amazing and is extensive and that all the departments will need to be informed about this wonderful, innovative, longitudinal curriculum. Dr. Harrell said that one result of this is that our students are now going to be much more focused on patient safety issues and that we’re trying to develop a culture where they’re free to discuss these issues. She said this is an opportunity to make a very focused safe language driven at all three levels…faculty, residents and students. She said that because we are the student people with this wonderful curriculum, that we can drive that conversation and have very focused faculty development. Also that others from different constituency groups may want to give advice or have input. She said that this is an opportunity not altering this curriculum but to add some focused way that we can start communicating.
Dr. Davidson said the dean needs to be involved and the educational leadership and the departments need to be made aware.
Dr. Rathe – the obvious way to do that is to have a specific forum in every clerkship, essentially every ward scenario and outpatient clinic where it’s just part of the routine. Quality safety rounds are done. At the bedside it is a chain of command process.
Dr. Davidson said it is going to be a required course beginning with next year’s first year class. It is not required for students that are here. It will be Pass/Fail because the evaluation scheme is still being worked on.
Dr. Genuardi
said the one thing that is interesting to him is the multidisciplinary
aspect. Dr. Davidson said the Faculty
Learning Community will have that task.
For example, the
Dr. Caro said that he questions what will we be losing in the curriculum in this process? Dr. Rosenberg said they tried not to take anything out, particularly for the first couple of years. Dr. Davidson said this is a major concern and they’re working on it. He said there will be additional changes in the curriculum.
Dr. Harrell said we’ve tried to be very judicious, we’ve tried to use things that allow self pace learning but that means time away from study. The reality is that at this stage things have been added without taking away. She said that this is the right decision for this subject matter; now the next thing is to figure out what things need to come out of the curriculum. Dr. Harrell said that this is just the first of many things we’re going to see that are coming to the forefront in the changing times that need to go in the curriculum.
Dr. Davidson said he’s been on the Curriculum Committee for 15 years and has chaired it for 6 and he has never seen a group that has so effectively put together an extensive curriculum, albeit it not totally complete and being worked out at this point in time. He said that the first meeting with this group was in late January and they have really done a huge amount of work He said he knows it will not be without detractors and will not be without challenges to implement but he believes there are really good people working on it and we should be proud of what we have.
There was a vote to approve the Patient Safety Curriculum, understanding that whenever something is approved if it undergoes changes it does not have to go before the Curriculum Committee.
Dr. Meuleman proposed that it be accepted.
Dr. Caro seconded the motion.
It was unanimously passed.
Dr. Genuardi asked if there is some sort of executive summary of what this is all about because he does a lot of presentations where a summary would be helpful. Dr. Harrell suggested a course description.
Omayra suggested that something needs to be in the first year orientation. She said that this also needs to be addressed to the 2, 3 & 4th year students. Dr. Davidson said it will be part of their curriculum but not be graded Pass/Fail.
Dr. Davidson said that at this point in time, he is still debating whether there will be a July meeting. July 8th would be bad because that will be the clerkships will be beginning. Dr. Davidson will get in touch with everyone. He said the committee has done a great job this year. Next year the committee needs to be prepared for a significant amount of work over the next year in working and thinking about revising the curriculum. It’s time that we approach that and Dr .Harrell will be involved in a significant way.
Dr. Davidson thanked everyone for coming and said that he looks forward to more work together.