Curriculum Committee Minutes - October 28, 2003
Present: Ragan, Davidson, , Kaunitz, Lorena, Genuardi, Allen, Duerson, Vidaurreta, Chen, Harrell, Romrell, Karle, Caro, Meuleman, Burchfield, Sumners, Douglas, Gulig, Hatch, Gold, Rathe, Rarey, Butson,
Guests; LuAnn Cooper, Rob Laurence (MEME)
Recording Minutes: Margie McGarva
Dr. Romrell reported that 1st and 2nd year students are into exam cycles. Lorena Merano stated that students in her class are doing well.
Dr. Davidson announced a Subcommittee on Public Health and Prevention was formed. Members included Janice Ho, Asal, Mark Gold, Arlen Rosenberg, Patti Ragan
Charge: survey public health and preventive medicine content, make recommendations to Curriculum Committee regarding specific changes/additions. Will present recommendations in February.
Evaluation Subcommittee
Retreat to address grading distribution (Harris report). Will present
recommendations in March.
In September 2002, the Nutrition Subcommittee presented a curriculum which was endorsed.
"The
committee recommended that a work group be established to move forward the
implementation of this plan and this would be addressed by Dr. Davidson upon
assuming the Chairmanship."
The working group of this subcommittee includes Mike Chen (replacing Dr. Davidson), Heather Harrell, Larry Rooks, Josef Neu, and MaryJo Koroly .
Capstone: the crowning achievement or final stroke; the culmination or acme.
A brief history of "underrepresented topics"
A brief history of "third-fourth year continuum" and "intersessions"
Plans for a Capstone experience to provide both content and assessment
"Special Topics: A History"
1994: subcommittee appointed to address curricular deficiencies in:
Geriatrics
Health Services
Rehabilitation
Doctor/Patient Relationship
Evidence-Based Medicine
Nutrition
Health Promotion/Disease Prevention
Continuum/Intersessions
(History)
1997: first discussions about "flexibility" in the third and fourth years
1. surgical subspecialties full in July
2. anesthesia, ER not available in the 3rd year
Two possibilities: deferment or continuum
1999: students offered the option of "deferring: a clerkship until the 4th year
Dr. Romrell gave an overview: In 1999, we gave students an opportunity to defer anything. One-third of the class deferred neurology and anesthesiology. The logistics were impossible for clerkships to handle. Surgical subspecialties were opened up to students. This year, 10-15 students are deferring. Some are missing parts of family medicine and PBE that comes with it; however, they are required to take PBE's with their class.
Around 70% of students felt offering a deferment was "essential" or "important"
Most would take a required 4th yr clerkship early
Recommendation: All students can defer one core clerkship( except medicine) to
the 4th year
"Short-term, teaching blocks integrated into the clinical years"
Purpose: to cover content relevant to the clinical years that is currently inadequately covered (i.e. "special topic)")
Would fit well with continuum concept; what to do without it?
Dr. Davidson showed the AAMC questionnaire on UF's weak areas in teaching students, i.e. nutrition, pain management, public health, drug and alcohol abuse, primary care, etc. The national questionnaire was administered by the AAMC. In 1999 it went to web-based administration and addresses over 200 items. In 2002, students gave 14,000 responses (91%).
A pilot program be instituted in the spring 2004 during Internship 101
Three topics will be selected to be presented to the 4th year students.
Each student must pick at least one topic but my pick all if they want.
Based on the success of this pilot, a month of "special topics" would be developed
for the 4th year.
Capstone Evaluation – Dr. Davidson asked for members and ex-officio members to vote on at least 3 topics listed below:
Informatics/strategies for keeping current
Palliative care and/or pain control
Advanced clinical skills training on patient simulator
Clinical nutrition
Bioterrorism
Use of the clinical lab, including cost effective use of laboratory tests
Addiction medicine/impaired physician
Alternative medicine
"As the pressures to limit postgraduate training and the need for increasing efficiency in patient care converge, residency directors will come to expect incoming first-year residents to demonstrate competence in a spectrum of skills that had previously been taught in residency. Responsibility for early competence in the practical skills necessary to practice medicine will shift from postgraduate training programs to the medical schools." Academic Med article (2003)78:39-44 (Langdale etal)
PBE 1: 8 stations with interstations; emphasis history, PE, communication
skills, basic science knowledge
PBE 2: 8 stations with interstations; emphasis history, PE, basic science
knowledge
PBE 3A: 8 stations with interstations; emphasis history, PE, clinical knowledge, EBM
PBE 3B: 8 stations with interstations; emphasis history, PE, clinical knowledge
What skills are necessary for
success as a PGY1? "Advanced" clinical skills are not
assessed independently at UF.
1.
Two cases per
clerkship
2.
Cases should be
representative of simple inpatients who would be seen in the ER with reason for
admission, or who would be hospitalized for other reasons.
3.
There should be
a fair amount of agreement among faculty in your field regarding:
a.
Whether the
case should be admitted or not
b.
What a
differential diagnosis should be
c.
What standard
admission orders and management plan could be expected
d.
Dr. Davidson
suggested asking for feedback from pre-developed cases by clerkship directors
and tested with other members of their department so we will know if we can grade it or not. Heather Harrell suggested cases be given to
residents to see if they have the skills to complete the case.
Objective
To provide the Curriculum Committee with information regarding graduate
performance on advanced clinical skills
Performance of selected procedures using simulators
Appropriately written admission or clinic note, including test ordering
Development of appropriate assessment and management plan for provided history and physical examination
Evaluation in the afternoons of the first week of "Internship 101"
Students do NOT have to pass
Students should NOT prepare
Students will be given feedback and recommendations for self-remediation
Results compared with competency-based program director form anonymously
This pilot program would start in the spring of 2004 and will not be more than one afternoon. Members and ex-officio members were asked to support this pilot. Dr. Kaunitz affirmed the motion and Dr. Rathe seconded it. A show of support was made by hand count and was passed unanimously.
Dr. Davidson announced that the December meeting will be the 2nd Tuesday (Dec 9), and the November meeting will be held on the 25th (the 4th Tues).
Meeting adjourned at 8:50 a.m.