Curriculum Committee Minutes

[Betsy]

You can access minutes to any of the curriculum committee meetings here:

www.mcg.edu/mcg/som/minutes/

[Betsy]

Minutes of October 11, 2005 Meeting
Phase 3 Curriculum Committee


The Phase 3 Curriculum Committee met in the Dogwood Room from 7:05 to 8:30 a.m. on October 11, 2005.

Members present: A. Albritton, J. Albritton, B. Hughes, I. Khan, L. Leggio, M. Manting-Brewer, E. Mendell, G. Nixon, R. Nesbit, R. Fincher, and C. White. Guest: Dr. Peggy Wagner. Dr. Nesbit chaired the meeting.

Members absent: H. Gross, S. Khan., M. Rader, H. Szerlip, A. Thomas, S. Wragg.

Minutes of the September 13, 2005 meeting were approved as circulated.

Each month one department is presenting a review of its department’s clerkship. This month the report was given by Dr Iqbal Khan from Ob-Gyn. His presentation was primarily a discussion of the very successful development of new off-campus clerkship sites – a change necessitated by our withdrawal from University Hospital. Currently there are nine sites (in addition to Atlanta Medical Center and Savannah) all of which, based on student feedback and exam scores, seem to be meeting the needs of the students very well.

Dr. Khan will be leaving the Clerkship Director position to become Assistant Dean at the new MCG Albany campus. He was thanked for his long and excellent service to the committee and to student education and given best wishes in his new endeavor. He introduced the new Ob-Gyn Clerkship Director, Dr Michele Manting-Brewer who was welcomed to the committee.

Dr. Peggy Wagner presented a brief video put out by the USMLE describing the Clinical Skills Exam. She also gave an update on the OSCE which she has developed and which is now required to be taken by our current senior students prior to their taking the Clinical Skills Exam. (Promotions Committee policy requires that the CSE must be taken by December 15th.) The overall response to the OSCE appears to be good. Some of our students’ deficiencies on the exam were discussed. Currently all but 12 seniors have signed up to take the OSCE. Dr. Wagner and others have made repeated efforts to contact those 12 students and have had no reply. It was agreed that one more attempt to contact those students will be made and if no reply is received or if they do not sign up to take the OSCE, their names and notification of this deficiency will be sent to the Promotions Committee.

Junior students Betsy Hughes and Elizabeth Mendell asked several questions raised by their classmates. Betsy has already addressed those questions and their answers in a Word document which she has already sent out to her classmates and I will include her document as an addendum to these minutes.

Dr. Andy Albritton reviewed the performance of the current senior class (and other recent classes) on Part II of the USMLE exam. The pass rate on Step 2 CK for the Class of 2005 was 95% with a national pass rate of 94%. The mean for MCG students was 222 with a national mean of 220. The classes have a higher pass rate on step 2 than on step 1.



The next Phase 3 Curriculum Committee meeting will be held @ 7:05 on Tuesday, November 8, 2005 – either in the Magnolia or Dogwood Room. The departmental clerkship review will be of Pediatrics and will be given by Dr. Leggio.

Following the Curriculum Committee meeting there was a brief Clerkship Directors meeting. Dr. Pruitt was not in attendance at this meeting, but he had asked that the group hold a special meeting to consider how to deal with students requesting absences from clinical rotations for observance of religious holidays. Dr. Andy Albritton presented a proposal regarding how such religious obligations should be handled. It was agreed to discuss this further at a special meeting of the clerkship directors with Dr Pruitt in attendance. Dr. Nesbit will schedule this in the near future.

Other specific student problems were also discussed.




ADDENDUM: Responses to student questions / written by Betsy Hughes

Results from the curriculum meeting 10/11/05

• Problems with clerkship grades not being reported within 6 weeks
o OBGYN grades from rotation #1 will be reported this week
o The reason why some rotations are having delays  attendings in the military being enlisted in active duty and being deployed to Iraq (therefore delay in acquiring grades)
o If you ever encounter problems in your clerkship with grades not being reported within 6 wks, please contact Dr. Albritton and let him know.
• SPEL and Procedures log
o These logs are required at the discretion of each clerkship. You will find out the requirements for the specific clerkship during orientation of that clerkship. There have been rumors floating around that you are required to complete the procedures logs to pass the third year. There is no blanketing requirement across the year to complete certain procedures. You must follow the requirements of the individual clerkships. However, you are encouraged to enter procedures that you perform, as this data is being monitored by the committee when the requirement is implemented for next year’s class.
o Here is the policy on the SPEL from “Standard Policies and Procedures for all Core Clerkships”
 7. For each of the clerkships, students must complete the Student Patient Encounter Log (SPEL) using One45 to fulfill the requirements for the clerkship. On the Family Medicine Clerkship, you are to complete the Department’s log.
o If you see a patient multiple times (ex: inpatient service), enter the patient only once in the SPEL
o If you find that there is a diagnosis that does not exist in the SPEL, please email Dr. Albritton with additional diagnoses that should be included in one45. The lists of diagnoses were created by the clerkship directors by what they felt students commonly see. However, this does not mean that they all exist in one45. Therefore, if you have some diagnoses that you feel should be added, please email Dr. Albritton and let him know. Thanks for your help in aiding in the development in this new software.
• Grading inconsistencies
o Several students have approached the class officers with complaints of subjective grading inconsistencies. If you feel like you have been graded unfairly, the curriculum committee advised the students to follow the guidelines set up in the “Standard Policies and Procedures for all Core Clerkships”. See www.mcg.edu/SOM/coffice/Ph3Electives/juniorpolicies.htm
 4. If a student has a concern regarding a clinical grade, s/he must discuss it with the clerkship director first, and not the attending physician or residents. A violation of this policy will result in a student forfeiting the right to officially appeal the grade.
 5. If a student formally appeals a clerkship grade, the student’s narrative will reflect the fact the student appealed her/his grade with the result of the appeal.
o Dr. Albritton stressed the importance of addressing your concerns to the clerkship director first and NOT the attending who graded you. Please keep this in mind.



If you have any other concerns that were not addressed at the meeting, please feel free to contact Liz or myself.

[Betsy]

Curriculum Oversight Committee Meeting Minutes
September 8, 2005
3:00-5:00 PM
CB-1101

DRAFT 9/16/05

Members Present: Andy Albritton, Rashid Akhtar, Bala Ambati, Scott Barman, Rhee Fincher, Iqbal Khan, Ralph Kolbeck, Lisa Leggio, Walt Moore, Bob Nesbit, Carol Nichols, Pam Rosema, Stewart Shevitz, Harold Szerlip, Andria Thomas, Diane Turnbull, Peggy Wagner, and Liz Mandell (Class of 2007),

Members Absent: John Barrett, Hartmut Gross, George Nixon, Jonathan Pellet, Ned Pruitt, John Vender, Stephanie Wragg, Melissa Rader and Sohail Khan (Class of 2006), Betsy Hughes (Class of 2007), Daniel Ketterer (Class of 2008), and Nadeem Fatteh (Class of 2008).

The meeting was called to order at 3:00 PM by Rhee Fincher. The minutes from the July 14, 2005 meeting were approved.

Announcements
Rhee updated the group on the school’s response to Hurricane Katrina, including willingness to help address the needs of LSU and Tulane students and residents and our students desire to help.

Dr. Rahn has told Rhee Fincher to matriculate 190, rather than 180, first-year students in August 2006. Students who deferred entry from August 2005 will be included in this number.

Old Business
Laptop computer requirement/audience response system: Chris White demonstrated the audience response system and the group discussed the ease with which it could be incorporated into the classroom. All module directors felt some of their faculty would use the technology if enough response units were available to accommodate the entire class. Bill Dolen and Chris White have used it in very successfully. Chris gathered information about possible purchase from Bob Gahagan. Students would purchase RF pads ($15 one-time fee) and pay $15/semester registration ($150/student during their medical school career). Relevant information is attached (CHRIS: PLEASE SEND relevant info if you have any)
ACTION: Unanimous approval to look into purchase of an ARS for the entire class.

The members again discussed whether or not to require laptop computers for the incoming class in August 2006.
ACTION: After discussion, the group voted unanimously not to require laptops for in class entering in August 2006.
The members recommend trying to develop a computer lab on campus that can be used for computer-based testing. They felt there is not sufficient required use at this time for the students to be required to purchase laptops with standardized software.

Committee Reports

Phase l/2: Diane Turnbull, chair, reported that the year has begun much more smoothly than last year.
Phase 1: The first Structures exam was given 9/2/05 and there have been no problems with the module so far. ECM 1 has nearly completed communication labs. Faculty development sessions are held weekly for one hour before each session to increase consistency of evaluation and to review content and teaching strategies. The core clinical educator program is working well and all seem actively engaged.

Phase 2: ECM 2 began the year with a 2-week clinical skills program which seemed to be well received. Students were encouraged to begin studying immunology for the Fundamentals module that followed. The students seemed much more “engaged” and proactive in their study than at the beginning of last year.

Phase 3: Bob Nesbit, chair, reported that the clerkship directors have developed a schedule to review and provide recommendations regarding one clerkship each month. The chair will report the committee’s recommendations to the COC.

One45 is being used to track students’ experiences as well as for evaluations. Most of the directors are not yet using the data for program evaluation or to guide students’ subsequent experiences.

Bob presented an analysis (attached) of NBME Subject Test performance by discipline, with explanations regarding standard setting. He led a discussion regarding the varying recommendations for national standards by clerkship. The surgery clerkship will decrease its pass-fail standard in 2005-06 to be more commensurate with the other clerkships.

Evaluation Team: The evaluation team has completed the next phase of curriculum and professionalism focus groups thanks to the work of 2 summer students. The team will begin theming the data and comparing it to that from last year. The diagnostic reasoning task was completed by the class of 2007 (n= 27) and data from this project will be analyzed soon. A survey of students who just took Step 1 of the USMLE boards regarding their study methods. Dr. Stephanie Wragg compiled a summary of the results. See attached report.

Evaluation Services: A pilot study of web-based testing begins with the Class of 2008 Friday. Three students will complete their module exam in web-format. The Class of 2009 will begin at the first ECM exam.

The next meeting of the COC will be November 10, 2005.

The meeting adjourned at 4:45 PM

Respectfully submitted,


Ruth-Marie E. Fincher, MD
Chair

Attachment
Phase 3 NBME Subject Test performance

[Betsy]

Curriculum Oversight Committee Meeting Minutes
November 10, 2005
3:00-5:00 PM
CB-1101

Draft11/15/05

Members Present: Scott Barman, Rhee Fincher, Iqbal Khan, Ralph Kolbeck, Lisa Leggio, Walt Moore, Bob Nesbit, Carol Nichols, Ned Pruitt, Pam Rosema, Stewart Shevitz, Harold Szerlip, Andria Thomas, Diane Turnbull, Peggy Wagner, and Liz Mandell (Class of 2007), Daniel Ketterer (Class of 2008), and Nadeem Fatteh (Class of 2008)

Members Absent: Andy Albritton, Rashid Akhtar, Bala Ambati, John Barrett, Hartmut Gross, George Nixon, Jonathan Pellet, John Vender, Stephanie Wragg, Melissa Rader (Class of 2006), and Sohail Khan (Class of 2006), Betsy Hughes (Class of 2007),.

The meeting was called to order at 3:00 PM by Rhee Fincher. The minutes from the September 8, 2005 meeting were approved.

Announcements
CLW-1101 and 1103 will be renovated May-July 2006. The renovation will include improving the audio-visual systems, probably replacing the small televisions with two larger screens juxtaposed to the side walls in addition to the front screen. An architect has been hires and plans are underway.

Step 1 data comparing performance from 1996-2005 was shown, illustrating Class of 2006 pass rate commensurate with national data.

Old Business

Audience response system update: Proposal developed by Chris White (attached). The total cost to MCG for 190 students/class would be approximately $19,760. (190 x $52). This includes the cost of $12./ receiver and $40. lifetime registration (activation) fee. The group proposed that students should be responsible for their keypad; replacement cost would be $12 and would be the responsibility of the student. Students would turn in their keypad at the end of the academic year for redistribution the following year. A request for acquiring the system for the first- and second-year classrooms will be submitted during the FY07 budget process.

Tegrity: Chris White reported that John Meyer (School of Dentistry) demonstrated the Tegrity system the recent Phase l/2 committee meeting. Information about the impact of the audio-visual recording system on class attendance and learning outcomes has been requested.


Committee Reports

Phase l/2: Diane Turnbull, chair, reported that the Structures module is going well as reported by the module tri-directors. The Processes module is fully planned and the final schedule completed (attached). ECM 1 facilitator training sessions are well received by the faculty and felt to be helpful. They are designed to help ensure consistency of the sessions and consistency in evaluation/feedback.

Phase 2 Disease States Fundamentals module has been completed and went much more smoothly than last year. While integration is not feasible because of the topics, the coordination was much better than last year. Dr. Turnbull reported that the presentations have been up-to-date and generally the slides and handouts have been good. The faculty who have had too many slides and too much material for the allotted time have received feedback. The Hematology/Oncology module began October 31. Participation of two family members in class has been well received.

The women’s health intersession has been completed successfully. The standardized patient experience during which students obtained a sexual history was well received. In general, it was felt that the content was too dense and that too much material was covered for the allotted time. Some exam questions were submitted late, precluding the usual review, editing, and selection process that has been used quite successfully in other Phase 2 modules.

Phase 3: Bob Nesbit, chair, reported that the monthly review of core clerkships began last month with OBG. Dr. Iqbal Khan reported that 9 (is that right) community-based sites have been developed. The spectrum of patients the students see, numbers of deliveries, and performance on examinations equals or exceeds performance of the students assigned to MCG (Get copy of presentation from Iqbal). Dr. Michele Manting was introduced as the new clerkship director, replacing Iqbal who assumed his role as assistant dean of the MCG Southwest Georgia Clinical Campus on November 1. It was suggested that the CDs complete the LCME form for clerkships for these presentations, including recommendations for changes for the next academic year.

The Phase 3 Committee is working on a process students and faculty should follow to ensure all students have opportunity to fulfill their religious obligations. Chaplain Jeff Flowers attended a recent meeting to discuss important features and unique characteristics (including obligations) of various religions.

Bob requested approval of a new pediatric sub-specialty elective that would be offered monthly and consist of two 2-week sub-specialty experiences (e.g., GI and ID). The appropriate paperwork has been submitted and the proposal was approved by the Phase 3 committee.

Action: Unanimous approval

Evaluation Team: Dr. Peggy Wagner reported the initial results of themes that emerged from the focus groups conducted by students during the summer of 2005. The focus groups included students who had just completed Phase 1 and Phase 2. The data obtained during the initial focus groups conducted during the summer of 2004 were compared to that obtained during the summer of 2005.

A summary of the focus group results follows:

End of Phase 2 focus group results:
New theme emerged: The integration in Phase 2 was good.
Theme present in 2004 disappeared in 2005: Insufficient preparation for Phase 3 (i.e., the students who completed Phase 2 in 2005 felt they were well prepared for Phase 3).

End of Phase 1 focus group results:
New themes: Need more enthusiastic teachers and need more interaction with the class during lectures
Themes present in 2004 that diminished in 2005: Too much information presented and mass memorization vs. problem solving (i.e., the students in 2005 felt the information overload was less prominent and that there exams emphasized more application and less memorization than in 2004).

Cognitive Behavior Survey results showed that members of the Class of 2007 were more likely to think about how they learn at the end of Phase 2 than they were at the end of Phase 1.

Step 2 Practice OSCE: For the first time, all members of the Class of 2007 are required to participate in an internal 8-station (4 standardized patients) OSCE before they take Step 2 CS. The only exceptions are the students who took Step 2 CS before the internal OSCE was begun. The most common problem identified is incongruence between the information obtained from the patient (history and physical examination) and the content of the note (including all parts of the SOAP note). All students receive detailed feedback regarding their clinical performance and their note. To date, the Step 2 CS scores for 43 students have been reported and 42 have passed.

Simulation Center: MCG is creating a Simulation Center (Jennings Building), co-directed by Drs. Lori Schumacher (School of Nursing) and Richard Schwartz (School of Medicine). Dr. Peggy Wagner will direct the Clinical Skills Program whether it continues to be located in the CJ building or moves to the Jennings Building.


Evaluation Services: Dr. Andria Thomas reported that the program director assessment of MCG graduates’ performance during their PGY-1 year continues to be strong (see attached graph). Andria recommended reviewing the questions in the survey and updating it to be based on the core clinical competencies. The COC endorsed her proposal.


New Business:

Dr. Walt Moore, Associate Dean for Graduate Medical Education, discussed the important role of residents as teachers. He reported that there are 3 required noon conference series topics on this subject annually and that some departments have implemented teaching skills workshops for their residents. He discussed both LCME Standard ED-24 and the RRC requirements in the context of what we do now and what we want to do in the future. The COC recommended further discussion and recommendations regarding this topic. The emphasis on residents’ teaching skills has increased considerably compared to two years ago, but is not yet consistent across departments.

Peggy Wagner proposed creation of a Cultural Competence Theme Team to assess what is currently taught about cultural competence, analyze national “best practices”, and recommend a comprehensive 4-year curriculum that integrates topics in cultural competence. Interested Committee members were encouraged to volunteer and to suggest other faculty who may be interested.

The School of Medicine will begin its self-study for the next LCME site visit in mid-2006. The next visit is expected in early 2008.

The next meeting of the COC will be January 12, 2006.

The meeting adjourned at 4:50 PM

Respectfully submitted,


Ruth-Marie E. Fincher, MD
Chair

Attachments

Audience response system proposal
Phase 1 Processes module schedule
OBG presentation to Phase 3 committee
Residency performance graphic data

[Betsy]

Curriculum Oversight Committee Meeting Minutes
January 26, 2006
3:00-5:00 PM
CB-1101

DRAFT 2/8/06

Members Present: Andy Albritton, Scott Barman, Rhee Fincher, Ralph Kolbeck, Michele Manting-Brewer, Walt Moore, Bob Nesbit, Carol Nichols, Ned Pruitt, Jo Albritton (Stewart Shevitz), Harold Szerlip, Andria Thomas, Diane Turnbull, Peggy Wagner, and Liz Mandell (Class of 2007), Devon Patel (Class of 2009), and Katherine Mohney (Class of 2009).

Members Absent: Rashid Akhtar, Bala Ambati, John Barrett, Hartmut Gross, Lisa Leggio, George Nixon, Jonathan Pellet, Pam Rosema, John Vender, Stephanie Wragg, Melissa Rader (Class of 2006), and Sohail Khan (Class of 2006), Betsy Hughes (Class of 2007), Daniel Ketterer (Class of 2008), and Nadeem Fatteh (Class of 2008)

The meeting was called to order at 3:01 PM by Rhee Fincher. The minutes from the November 10, 2005 meeting were approved by mail ballot after the meeting because Rhee forgot to request approval after Interim Dean Schwab left.

Interim Dean Steve Schwab attended the meeting from 3:00-3:50 and discussed the following:

• He believes the SOM should continue to develop its integrated curriculum and remain accountable for the outcomes. He told the group he expects defined outcome measures to assess success (e.g., exam, evaluation, and focus group results). Outcomes should be used to make decisions. Rhee commented the Evaluation Team has developed a series of studies (including focus groups and surveys) to assess outcomes, and that test results (USMLE and NBME Subject Tests), Graduation Questionnaire results, and internal student and faculty evaluations are being tracked and used to assess outcomes.
• There was discussion of ways to increase the physician workforce in Georgia, including tracking graduates more carefully and encouraging them to return to the state to practice
• Dr. Schwab said the state is looking at various ways to increase the number of medical student graduates. A variety of opportunities are being explored including expansion of existing campuses and development of regional campuses.

Announcements
Renovation of CLW-1101 and 1103 has been approved and will occur May-July 2006. The renovation will include replacing the tables and seating, increasing the seating capacity to about 220 in each room; replacing the podium and updating the audio-visual components, replacing carpet, replacing chalk boards with white boards, improving lighting and sound system, painting, and installing electrical and internet connections at each seat. Harold Szerlip asked if acoustical outlets could be added to the proposal.

Rhee introduced Jo Albritton, MD as the new module director of ECM 2 and Mike Kilbride as module co-director of ECM 1 and medical director of the clinical skills program.

Rhee encouraged members to submit to RIME – submission deadline is 2/20/06.

The request for an updated audience response system with sets for 380 students (Phase 1 and 2 classes), prepared by Chris White, has been submitted to Joel Covar for consideration in the FY07 budget.

Faculty were encouraged to consider applying for the 2006 Governor’s Teaching Scholars Program.

Committee Reports

Phase l/2: Diane Turnbull, chair, reported the committee is continuing systemic review of modules. She intended to present the analysis and recommendations from the Fundamentals module (fall 2005), but Rhee asked to defer the presentation to March because of the length of time the dean met with the group. She reported exams are improving (more like USMLE) and that most modules are using the group review system to develop exams. In Phase 1, the Processes module has started and seems to be going more smoothly than last year and in Phase 2, the Renal/Pulmonary module is ending.

Phase 3: Bob Nesbit, chair, reported the Department of Medicine requests a policy change regarding students from other medical schools doing electives at MCG. Harold Szerlip presented a request that he brought previously to the Phase l/2 Curriculum Committee and that the Phase l/2 Committee referred for consideration by the COC. The School of Medicine accepts students from LCME- and American Osteopathic Association-accredited medical schools for electives. It does not accept students from other medical schools. Harold requested change in the policy to allow students in international medical schools to do electives at MCG if:

• School is recognized by the Department of Education for eligibility for student loans
• Students speak English as a native language or school curriculum is taught in English
• School’s first-time taker pass rate is at least 80%.

The rationale for the request is to try to improve the quality of residents in the internal medicine residency program. Andy Abritton raised several issues that must be addressed before a decision could be made:
• Consult the legal office
• Attain MCGHI approval (it has been very difficult to get access to Powerchart for visiting students from LCME-accredited medical schools
• Develop a mechanism for background security checks
After discussion, Rhee asked Harold to develop and submit a written proposal with rationale for the recommendation, and submit it for consideration by the COC.

Recent LCME site visits: Rhee has just returned from an LCME site visit and Andy will soon go on one as a Faculty Fellow. They volunteered to present “lessons learned” at the March meeting as we get ready to begin our self-study.


Evaluation Team: Peggy Wagner reported the Professionalism Theme Team is currently theming the results of the focus groups from summer 2005.

She reported on the Class of 2006 performance on USMLE Step 2 CS since implementation of the pre-Step 2 CS practice OSCE. To date 136 scores have been reported and two students have failed (0.75%). One of these students did not take the practice OSCE because of taking Step 2 CS before the OSCE sessions began.

Evaluation Services: ITSD is working to create an interface between One45 and Banner. Andria continues to work with clerkship directors and students to make the system more user friendly. MCGHI has agreed to pay half the cost of the system for use by each residency.

New Business

Curriculum to Go: Carol Nichols and Mike Kilbride represent the SOM on a VID project designed to create “learning objects”/videos – 7 seconds to 7 minutes in duration that can be loaded on an IPod and accessed. Carol asked members to contact her if they have an idea they might like to develop.

The Cultural Competence Theme Team, led by Peggy Wagner, has been established and met once.

The student members each commented about their classes, and reported no significant problems.

Andy Albritton recommended addition of a Clinical Skills Program representative to the COC because clinical skills plays such a central role in all aspects of the curriculum.
ACTION: Unanimously approved.

Peggy Wagner suggested creation of a Clinical Skills Theme Team and requested volunteers to define the goals and desired products.
ACTION: Unanimously approved.

Peggy Wagner presented a list of possible OSCE scenarios. After brief discussion, the members endorsed the list as the list from which OSCE scenarios will be developed.

The Policy for Medical Students’ Observance of Religious Holidays (attached) was presented again today for further discussion if needed and approval. There was no discussion.
ACTION: Unanimously approved.

The next meeting of the COC will be March 9, 2006.

The meeting adjourned at 5:00 PM

Respectfully submitted,


Ruth-Marie E. Fincher, MD
Chair

Attachments
COC Minutes 11/1/0/05
Possible OSCE scenarios
Policy for Medical Students’ Observance of Religious Holidays

[Betsy]

Policy for Medical Students’ Observance of Religious Holidays


Approved by the School of Medicine Curriculum Oversight Committee 1/26/06

The Medical College of Georgia School of Medicine’s diverse student body represents many religions. Students should have the opportunity to fulfill their religious obligations.

The process for requesting time off to fulfill religious obligations follows.

Phase 3

Students should meet with the clerkship director (or designee if the clerkship director is not available) prior to the beginning of the rotation to make him/her aware of their religious obligations. The clerkship director will notify the attending physician that the student has permission to be away from their clinical responsibilities for the time the religious observance(s) take(s) place. In addition, students should meet with their attending physician and resident to make arrangements for the care of their patients. If possible, students should arrange for a colleague on the rotation to cover their patients. The time away from the rotation will not impact on students’ evaluations.

Students should meet with the Associate Dean for Curriculum prior to beginning Phase 3 if: (1) they need to be away from their clinical responsibilities on any required rotation for more than three days (or three 26-hour periods) or if (2) if they are required to be away for more than seven days (or seven 26-hour periods) during an academic year. In such instances, the Associate Dean for Curriculum will work with the student to modify the curriculum to ensure the student meets the educational requirements for graduation. Modifications might require a delayed graduation date and should be approved by the student’s promotion committee.

Phases 1 and 2

Students should meet with the module director at the beginning of the module to make him/her aware of any religious obligations that would require the student to miss required module activities. Arrangements will be made on a case-by-case basis.

[Betsy]

Minutes of March 14, 2006 Meeting
Phase 3 Curriculum Committee


The Phase 3 Curriculum Committee met in the Dogwood Room from 7:05 to 8:35 a.m. on March 14, 2006

Members present: A. Albritton, J. Albritton, L. Leggio, B. Hughes, M. Manting-Brewer, G. Nixon, J.N. Pruitt, R. Nesbit, A. Thomas, and C. White. Dr. Nesbit chaired the meeting.

Members absent: H. Gross, S. Khan., E. Mendell, M. Rader, S. Wragg. H. Szerlip and R. Fincher

Minutes of the February 14, 2006 meeting were distributed and approved.

The monthly departmental clerkship report was given by Dr Pruitt. The Power Point version of his report is attached. Dr. Pruitt has been clerkship director since 1997. Since that time the NBME subject exam has been used as the final exam on the clerkship and it now constitutes 25% of the final grade. Lectures are now all on web CT and are required - and failure to listen to all of them results in a 5% grade reduction. Neurosurgery has been dropped from the neurology rotation. There is broader exposure of students to different types of patients. A “Word of the Day” exercise has been instituted for all students at MCG and the VA. A significant number of students each year are choosing neurology as a career. Goals for the future are to increase the NBME exam pass rate, to add high quality off campus sites and to continue to interest students in neurology.

Patient logs and One-45 were discussed at length. Each clerkship director will have a list of clerkship specific diagnoses prepared for Dr. Thomas by the next committee meeting (April 11) so that they may be put in One-45 for the July rotations. Using pocket sized log books as an initial method for students to record their patient contacts – as is currently done in Pediatrics – appears to be the preferred and most effective way of getting good data. (Dr. White will email copies of the pediatric log book to committee members.) Clerkship directors will also have to set and enforce rules regarding when students must input their data into One-45.

Although there is still strong support for the concept and importance of using a “passport” to document competency in specified procedures, because of the time and effort involved in trying to institute the log books and comply with ED-2, it was agreed to put the passport aside for now with a plan of reconsidering it next year.

Dr. Manting-Brewer briefly mentioned her ideas about instituting cross specialty education on certain topics such as breast disease or uro-gynecology. She will elaborate more on this in a written proposal to be circulated to the members of the committee prior to our next meeting.

Because of time constraints, other topics including mid-clerkship evaluations and teaching residents to teach were deferred to the next meeting.


The next Phase 3 Curriculum Committee meeting will be held @ 7:05 on Tuesday, April 11, 2006 – either in the Magnolia or Dogwood Room. The departmental clerkship review will be from Medicine and will be given by Dr. Szerlip.

[Betsy]

Curriculum Oversight Committee Meeting Minutes
March 9, 2006
3:00-5:00 PM
CB-1101

DRAFT 3/20/06

Members Present: Rashid Akhtar, Andy Albritton, Bala Ambati, Scott Barman, Rhee Fincher, Hartmut Gross, Michele Manting, Lisa Leggio, Walt Moore, Bob Nesbit, Carol Nichols, George Nixon, Jo Albritton (Stewart Shevitz), Pam Rosema, Harold Szerlip, Andria Thomas, Diane Turnbull, Peggy Wagner, and Liz Mandell (Class of 2007), Betsy Hughes (Class of 2007), Devon Patel (Class of 2009), and Katherine Mohney (Class of 2009).

Members Absent: John Barrett, Ralph Kolbeck, Jonathan Pellet, Ned Pruitt, John Vender, Stephanie Wragg, Melissa Rader (Class of 2006), and Sohail Khan (Class of 2006), Daniel Ketterer (Class of 2008), and Nadeem Fatteh (Class of 2008)

The meeting was called to order at 3:01 PM by Rhee Fincher. The minutes from the January 26, 2006 meeting were approved.

Announcements
Renovation of CLW-1101 and 1103 has been approved and will occur May-July 2006.

The “Scramble” will occur 3/14 and Match Day is 3/16.

Peggy Wagner will be the clinical skills program representative to the COC.

Carol Nichols will be the Evaluation Team representative to the COC.

Committee Reports

Phase l/2: Diane Turnbull, chair, reported on the Phase 1 Structures module and Phase 2 Modules 1 (Fundamentals) and 2 (Hematology/Cardiovascular).

Module: Phase 1 Cellular and Systems Structures: (MED1 5115)

The module directors were David Lause, PhD (Gross anatomy component), Dale Sickles, PhD (histology component), and Mark Hamrick, PhD (Development component). The following strengths and recommended areas for improvement were identified based on student, faculty, and module director feedback and evaluations:

Strengths:

Integration among the components
How much was taught in one semester
Knowledgeable, approachable, dedicated faculty; time spent out of the classroom
Clinical correlations
Laboratory experience; balance of didactic and practical information
Quality of lectures, handouts, videos, resource room
Histology review sessions, anatomy practice practicals

Recommended Areas for Improvement:

Too little time devoted to development
Need more 3D models for embryology
Meiosis overly redundant
Need for more faculty in anatomy lab
Too many students/cadaver
Imaging demonstrations: insufficient introductory information for students on how to interpret CTs and MRIs
Need more histology clinical correlations
DVDs of lab exercises should be available for purchase
Cell biology moved too fast
More histology resources needed – update resource room
Integration of course earlier
First exam too much material
Friday exams – not Monday
Supply each student with microscope slide box

After discussion, the COC unanimously approved the following recommendations for improvement in the module for the 2006-07 academic year:

Issue to Be Addressed Action Approved
Increase amount of Development and clinical correlations in Histology ECM will develop clinical correlation scenarios (beginning with physical diagnosis correlations) to complement material presented in Structures; module faculty will continue to work to optimize pace, integration, and content
Need for more cadavers The Department of CBA expects to have 4 more cadavers in 06-07 than 05-06. The repository of available cadavers is larger this year and the department expects to return to the previous ratio of students/cadaver despite the increase in class size
Need for more resources such as laser discs, DVD Dale Sickles will be asked to address the accessibility and adequacy of resources and propose upgrades/new equipment if needed
Integration of cell biology and histology sub-optimal Reduce quantity of “pure” cell biology to 2 weeks, introduce additional topics at points of need; explore the possibility of requiring cell biology as a prerequisite for entering MCG
More emphasis on imaging and correlation with Structures Icons directing students to specific imaging interpretation sites that are relevant for Structures material will be added to WebCT; Dr. Fincher is negotiating for a core clinical lecturer in radiology
First exam too much material Module faculty is aware and will take the amount of material and days (Friday vs. Monday) of exams into consideration in making the 2006-07 schedule)


Module: Phase 2 Cellular & Systems Disease States: Fundamentals Module (MEDI 5215)

The module director was Diane Turnbull, EdD. The following strengths and recommended areas for improvement were identified based on student, faculty, and module director feedback and evaluations:

Strengths:

Fundamentals module provides foundation for integrated second year by providing background in immunology, pathology, microbiology, and pharmacology
Format and integration were well received by students
Immunology was well planned and taught (Note: cited as a weakness in 2004-05); the module “flowed” much better than in 2004-05
Information was obviously relevant and clinically important
Small group, student led pathology case presentations reinforced clinical relevance and application
Provided sound foundation for subsequent modules
“Free” day for study before exam on Friday
Fair exams; multiple choice items were better than in 2004-05 and continue to improve as a result of more faculty taking item writing workshops and group NBME-style exam development meetings; compared with 2004-05, a greater percentage of items were clinical vignettes and assessed application of knowledge.
Use of One45 for grades; prompt posting of grades

Recommended Areas for Improvement:

The organization of and presentations during the last 2 weeks of the module were not as good as during the first 6 weeks.
Continue to improve communication between lecturers to improve the overall organization, eliminate unplanned redundancy, and enhance planned reinforcement (Note: This was significantly better than 2004-05)
Fewer lecturers in the module would enhance cohesiveness
Pharmacology: Needs better integration and placement of lectures; more input from clinicians recommended
Many lecturers were excellent, but module directors need to continue to work with those who are not.
Students suggested more clinical vignettes on the immunology portion of exam
Improve quality and standardize length of handouts
Encourage faculty to emphasize key points and provide objectives for each lecture
Ensure small group sessions reinforce important concepts and provide effective reinforcement

After discussion, the COC unanimously approved the following recommendations for improvement in the module for the 2006-07 academic year:

Issue to Be Addressed Action Approved
Increase cohesiveness, eliminate unplanned redundancy • Continue group review and planning sessions and evolution of themes within the module that were begun in 1/05 to eliminate unplanned redundancy & improve sequencing
• Continue assigned readings for pathology and immunology from same text
• Enhance whole year planning for 06-07 as well as single module planning (Diane Turnbull, John Fisher, Scott Barman, and Andy Albritton will be involved in all module planning teams to ensure cohesiveness across modules)
• Some lectures from the last 2 weeks of Fundamentals will be incorporated into organ systems modules
• Ensure students understand the overall structure of the year and rationale for it
Continue to reduce number of lectures and increase small groups as possible • Core clinical lecturers have helped consolidate clinical topics
• In 2005-06, Fundamentals lectures decreased from 32 to 26; strive to maximize use of lecture time & introduce more small groups if possible (faculty availability is key issue)
Quality of presentations & exam questions • Module leaders will communicate even more with lecturers about context of each presentation, suggested format, deadlines for submission of handouts & exam questions, participating in item writing workshop, expectations for handouts
• Continue group exam development meetings
o Goal: Every lecturer will attend an item writing workshop if he/she has not attended previously


Module: Phase 2 Cellular and Systems Disease States: Hematology/Cardiovascular (MED1 5225)

The module director was Diane Turnbull, EdD. The following strengths and recommended areas for improvement were identified based on student, faculty, and module director feedback and evaluations:

Strengths:

Information was relevant and timely
Pathology small group presentations and pharmacology small group case discussions reinforced clinical relevance, application, and integration of material
Review sessions by Drs. Fincher and Albritton helped reinforce application and integration
Hematology was well organized, lecturers were excellent, and handouts were helpful
Students felt module was valuable for enhancing their preparedness for Step 1 and third year
Students liked organization and planned reinforcement; they felt there was no unplanned redundancy

Recommended Areas for Improvement:

Try to have a few fewer lectures and a few more interactive sessions next year
Small group case discussions (e.g., like pharmacology CV/hypertension case)
More use of audience response session
Interactive, case-based review session before each exam
Continue to work with lecturers to help them become better teachers/improve flow of modules
Work with core clinical lecturers have helped with this; CV core lecturer responded promptly to feedback and improved dramatically during the module)
Identify a hematology core clinical lecturer for 2006-07 (Done: Paul Dainer, MD)
Ensure quality and consistency of length of handouts
Be sure lecturers understand the context of their presentation (module directors will be responsible for this)
Core clinical lecturers will work more with pharmacology component director next year to ensure drugs discussed are used clinically and up-to-date
Continue to improve organization and relevance of module
Planning teams will continue to use USMLE Step 1 content outline and input from clinicians
Ensure exams reflect important knowledge and application from module
Try to incorporate all pulmonary lecturers into pulmonary module (this year DVT/PE and pulmonary hypertension were at end of CV module because of timing of exam)

After discussion, the COC unanimously approved the following recommendations for improvement in the module for the 2006-07 academic year:

Issue to Be Addressed Action Approved
Fewer lectures/more interactive sessions All module directors will be asked to address this issue and report to the COC in May 2006 about feasible plans for 2006-07. Encourage:
• Use of ARS
• More case-based small group discussions
• More interactive style in large lecture hall
• Interactive review before each exam to integrate segment
Continue to improve exams • Module directors will continue exam development meetings, encourage all faculty to attend item writing workshop, provide feedback on students’ performance on questions
• Balance on Fridays with logical breaks in content
Continue to improve classroom presentations • Module directors will work with faculty on handout and slide expectations, including length
• Ensure all lecturers understand where their presentations fit in the context of the whole
Cohesiveness of module • Module directors, pharmacology component director, and associate dean for curriculum will work consistently as a team to develop all modules



Phase 3: Bob Nesbit, chair, requested approval of emergency medicine ultrasound elective (proposal attached).
ACTION: Unanimously approved.

Dr. Nesbit presented the annual assessment and recommendation for the Family Medicine, Pediatrics, and Psychiatry clerkships.

Pediatrics 5000 is a 6-week required clerkship; students are assigned to one of 16 sites. The clerkship goals and objectives, site characteristics, rotation patterns, strategies to ensure core experiences (e.g., CLIPP cases), evaluation system, and student performance were reviewed.

The following challenges and recommendations were discussed and approved:

Issue to Be Addressed Action Approved
Need to maintain and expand sites • Keep working on housing– more difficult with AHEC fund cuts
• Ensure computer access at all sites for tracking, access to cases, communication with Augusta campus
• Continue to work with community-based faculty to recognize them for their valuable contributions (e.g., promotion, plaque, on-site faculty development); consider schoolwide annual recognition meeting
• Continue at least annual visits to sites
• Strive for “perks” for ancillary staff
Seasonality of diseases is challenge for consistency • Continue to use CLIPP cases
• Track students’ experiences (One45)
Ensure mid-rotation feedback • Develop form for written feedback evaluation (consider modifying Medicine’s)
• Students will be responsible
Continue to work on accurate logging of patient encounters • SPEL/One45
• Finalize requirements


Psychiatry 5000 is a 6-week required clerkship. The clerkship goals and objectives, site characteristics, strategies to ensure core experiences, evaluation system, and student performance were reviewed. In June 2004, there were 6 sites (MCG inpatient, MCG consult/liaison, MCG child/adolescent, VAMC, GA Regional, Focus by the Sea). The following sites have been added: MCG continuity of care (in and out-patient), GA Regional Hospital (Rome), Southwestern State Hospital (Thomasville), and Laurelwood Hospital (Gainesville).

The following challenges and recommendations were discussed and approved:

Issue to Be Addressed Action Approved
Acquisition and maintaining sites • Consider adding sites in Brunswick, St. Simon’s, Americus, Milldegeville
• Continue to monitor students’ performance at all sites, identify weaknesses, and address them
• Continue annual visits to sites for faculty development
Consistency of experiences and evaluation • Continue to work on implementing One45 for tracking experiences
• Assess consistency of evaluation across sites and address inconsistencies if identified
Student perceptions of rotation • Student evaluations improving; continue to follow and respond to areas for improvement
• Continue to track students’ interest in psychiatry as career (one student declared interest in psychiatry in 2004-05; 7 students in 2005-06)



Family Medicine 5000 is a 6-week required clerkship and students are assigned to one of 16 sites. The clerkship goals and objectives, site characteristics, orientation, strategies to ensure core experiences, evaluation system, and student performance were reviewed. Student ratings of the clerkship are very positive, as indicated by the majority of the ratings in the above average to excellent range.

The primary challenges for the clerkship director are ensuring consistent experiences across sites and logistically being able to make annual site visits. The Department of Family Medicine continues to hold an annual faculty development meeting at Jekyll Island, attended by at least one member from each site.


Evaluation Team: Carol Nichols reported the theming of data from the student perception of professionalism focus groups continues, but is proving less helpful than the data from the data from the medical education/curriculum focus groups. The team had 3 peer-reviewed presentations accepted for the 2006 SGEA meeting.

Evaluation Services: Andria Thomas presented the current system for SPEL and discussed the Phase 3 committee’s plans to make clerkship-specific longs and to require student completion of logs effective July 1, 2006.


The next meeting of the COC will be May 18, 2006.

The meeting adjourned at 5:02 PM

Respectfully submitted,


Ruth-Marie E. Fincher, MD
Chair

Attachments
COC Minutes 1/26/06
Emergency Medicine ultrasound elective proposal

[Betsy]

Minutes of June 13, 2006 Meeting
Phase 3 Curriculum Committee


The Phase 3 Curriculum Committee met in the Dogwood Room from 7:05 to 8:35 a.m. on June 13, 2006

Members present: A. Albritton, J. Albritton, L. Leggio, G. Nixon, R. Nesbit, A. Thomas, and M. Manting-Brewer. Dr. Nesbit chaired the meeting.

Members absent: E. Mendell, B. Hughes, H Gross, J.N. Pruitt, H. Szerlip, R. Fincher and C. White

Minutes of the June 9, 2006 meeting were approved as circulated (with circulated revision.)

The monthly departmental clerkship report was given by Dr Nesbit. The Power Point version of his report is attached. Dr. Nesbit reviewed the changes over the years in the length and organization of the clerkship and other changes which have occurred since he became clerkship director in May 2001. Currently the clerkship is eight weeks long with most students having their four weeks of core General Surgery on the GI, Vascular or Surgical Oncology services at MCG or on General Surgery at the VAMC. In addition, a few students take core out of town at Memorial Hospital in Savannah, at Atlanta Medical Center or at Archbold Medical Center in Thomasville. Subspecialty (SSS) rotations are all on MCG services. Dr. Thomas has run statistical comparisons of the grades obtained this year and last at the various core and SSS sites and there are minimal significant differences apparent from site to site. (see attached for data - on slides.)

Current problems include lack of documentation of what students see, limited exposure to a variety of surgical problems, lack of documented mid-rotation evaluations and lack of availability of lectures to students not in Augusta. Proposed solutions include required use of a new improved specialty specific One45 for patient contact documentation, required mid-rotation evaluations which will be obtained and turned in by the students, documented required off-service experiences which will include exposure of every student to patients with vascular disease, breast disease and hernias, and change in the length of SSS rotations to two weeks so that each student will rotate on two SSS. Grading will be changed to place more emphasis on the NBME subject exam and points will be given for “professionalism” for timely submission of documentation of evaluations, patient contact and off-service clinical experiences.

Dr. Thomas discussed One45. Service/rotation specific diagnosis lists should be in place for use by students in July. Dr. Thomas also noted that she is happy to provide statistical analysis of grades versus sites for other services as she did for surgery.

Dr. Manting-Brewer discussed the Mammacare System which uses realistic silicone breast models with various size masses and tissue-like consistency and teaches a specific technique of breast exam. She envisions using this as part of a teaching program across the clinical curriculum with the ultimate possibility of having our graduates all certified in breast exam by this program. Dr. Nesbit has also become familiar with the program and he will review it with Dr Lind in Surgical Oncology. There will be further investigation of how we can introduce and use this program across the clinical curriculum.

There was brief discussion by Dr Albritton of the proposed end of the second year “shadowing” program to introduce upcoming third year students to their responsibilities as clinical clerks. This will begin next year and will involve students shadowing students, probably for two half days in June. This has already been approved through the Curriculum Oversight Committee.

Dr. Nesbit reported that he has verified through Dr. Walter Moore that MCG Hospital residents received instruction on teaching students as part of their required noon lecture series. This academic year they received three lectures on teaching and evaluating students. These were given in October by Drs. Fincher, Albritton and White. Dr White will also give a 45 minute presentation on teaching to the new housestaff during orientation later this month.

Drs Sohail Khan and Melissa Rader have graduated and will no longer be on the committee. We appreciate their contributions to the work of the committee. They will be replaced by third year medical students Dan Ketterer and Nadeem Fatteh.

The next Phase 3 Curriculum Committee meeting will be held @ 7:05 on Tuesday, August 8, 2006 – either in the Magnolia or Dogwood Room.

[Betsy]

Curriculum Oversight Committee Meeting Minutes
May 18, 2006
3:00-5:00 PM
CB-1101

DRAFT 06.15.06

Members Present: Rashid Akhtar, Andy Albritton, Scott Barman, Rhee Fincher, Hartmut Gross, Ralph Kolbeck, Michele Manting, Lisa Leggio, Walt Moore, Bob Nesbit, Carol Nichols, George Nixon, Pam Rosema, Harold Szerlip, Andria Thomas, Chris White

Members Absent: Bala Ambati, John Barrett, Jonathan Pellet, Ned Pruitt, Jo Albritton (Stewart Shevitz), Diane Turnbull, John Vender, Peggy Wagner, Melissa Rader (Class of 2006), and Sohail Khan (Class of 2006), Daniel Ketterer (Class of 2008), and Nadeem Fatteh (Class of 2008), Liz Mandell (Class of 2007), Betsy Hughes (Class of 2007), Devon Patel (Class of 2009), and Katherine Mohney (Class of 2009).

The meeting was called to order at 3:03 PM by Rhee Fincher. The minutes from the March 9, 2006 meeting were approved.

Announcements
Academic Affairs is currently recruiting an Assistant Dean for Student Affairs and a Director of Academic Support Services.

Diane Turnbull has been appointed Director of Phase 2 Curriculum Development.

Committee Reports

Phase l/2: Andy Albritton reported in Diane Turnbull’s absence on the Phase 1 Cellular and Systems Processes module and Phase 2 Module 3 (Pulmonary/Renal).

Module: Phase 1 Cellular and Systems Processes (MEDI 5135)

The module co-directors were Rashid Akhtar, PhD, biochemistry component and Ralph Kolbeck, PhD, physiology component. The following strengths and recommended areas for improvement were identified based on student, faculty, and module director feedback and evaluations:

Strengths:

Many professors were excellent teachers and easily accessible
Students felt the biochemistry component was well organized and prepared students well for the NBME Subject Test
Students appreciated using USMLE format for many exam questions
Course directors were perceived as instrumental in successes of the module
Biochemistry optional 5:00 PM review sessions were appreciated
Handouts (not all faculty provided)
Clinical lectures

Problems and Recommended Areas for Improvement:

Little integration between the components (Note: Integration may not be feasible. Coordination between the components, and effective sequencing and basic science/clinical interdigitation within each component may be the goal for this module).

Lectures relevant to an exam were given in the hour after the exam and lectures were scheduled during exam week even though no lecture time was scheduled in the master schedule.

Students did not like exam(s) scheduled on the Monday after a holiday weekend.

Powerpoint slides were a strength and a weakness, depending on the use. Slides that were prepared for a particular lecture and complemented the presentation were well received, but commercial, generic slides that were not especially relevant to the topic were not. Such slides were often complicated and “busy”.

Students would like handouts in addition to copies of Powerpoint slides.

Many lectures included objectives, but some did not. Objectives should be given for each lecture, and they should be congruent with the objectives of the module and the Phase.

Students felt the weekly biochemistry review sessions facilitated their learning and requested similar sessions for physiology.

The Processes module directors did not follow the agreed-upon policy for adjusting students’ grades when an exam item was eliminated or more than one response counted as correct.

Students noted that some of the clinical lectures were taught at a level inappropriate for the level of the learners or appeared “out of sync” with the course content.

Some topics were felt to be unnecessarily redundant and faculty did not seem to know the topic had been covered before; therefore, coverage was not planned reinforcement.

Exam questions varied in quality and congruence with USMLE style.


After discussion, the COC unanimously approved the following recommendations for improvement in the module for the 2006-07 academic year:

Issue to Be Addressed Action Approved
Integration/Coordination • Module directors will coordinate the biochemistry and physiology components as much as feasible.
• Physiology module director will work with faculty to ensure appropriate content, sequencing, and planned reinforcement with unplanned redundancy or gaps.
• Coordinate topics with ECM if feasible.
Exam preparation • Module directors asked to strongly encourage their faculty to participate in an item writing workshop if they have not already
• Module directors will send new questions or those that need revision to Rhee Fincher or Andy Albritton for stylistic suggestions.
Review Sessions • Biochemistry and physiology will hold review sessions at 5:00 PM on a scheduled basis (must not interfere with scheduled afternoon activities)
Exam scheduling • Lectures will not be scheduled after an exam on day of exam.
• Lectures will not be scheduled during exam week, congruent with the policy.
• Exams will be scheduled when appropriate; module directors will take holidays into consideration when developing schedule.
Exam grade adjustment • Module directors will follow SOM Phase l/2 policy
Problems with clinical lectures • Module directors will work more closely and earlier with clinical faculty to ensure they cover the appropriate topic at the desired level.



Module: Phase 2 Cellular and Systems Disease States: Pulmonary/Renal (MEDI 5235)

The module director was John Fisher, MD. The following strengths and recommended areas for improvement were identified based on student, faculty, and module director feedback and evaluations:

Strengths:

Core clinical lecturers
Content seemed appropriate to students
Organization
Clinical lectures effective in supplementing pharmacology, pathology, and microbiology lectures


Recommended Areas for Improvement:

Ensure handouts are uniformly available on WebCT before lecture and that all handouts are clear and concise
Student suggest recommended or required text on fluid/electrolytes
Students felt grades were not always promptly posted after item adjustments
Students suggest reorganizing renal component so the complicated material that was presented toward the end of the module is presented earlier (giving more time to learn it before exam).
Pulmonary began before holiday break – try to avoid separation
Increase time allocated to renal
Place exams at logical breaks, not necessarily every two weeks.


After discussion, the COC unanimously approved the following recommendations for improvement in the module for the 2006-07 academic year:

Issue to Be Addressed Action Approved
Module sequencing • Modules have been better sequenced for 06/07 (attachment). Cardiopulmonary will be a 7-week module following the holiday break followed by a 7-week Renal/Endocrine/Genito-urinary module
Fewer lectures/more interactive sessions All module directors will be asked to address this issue and report to the COC in May 2006 about feasible plans for 2006-07. Encourage:
• Use of ARS
• More case-based small group discussions
• More interactive style in large lecture hall
• Interactive review before each exam to integrate segment
Continue to improve exams • Module directors will continue exam development meetings, encourage all faculty to attend item writing workshop, provide feedback on students’ performance on questions
• Exams will be given at logical intervals, about every 2 weeks, to avoid excessive amounts of material
Continue to improve classroom presentations • Module directors will work with faculty on handout and slide expectations, including length
• Ensure all lecturers understand where their presentations fit in the context of the whole
Cohesiveness of module • Module directors, pharmacology component director, and associate dean for curriculum will work consistently as a team to develop all modules
• Module directors will work with faculty more extensively to ensure they meet deadlines for submitting exam items, handouts, and slides



Phase l/2 organizational schematic for 2006/07 was presented and approved (attached).

Phase 3: Bob Nesbit, chair, requested approval of two new acting internships, OBG 5009 (Uro-gynecology) and PED 5009A (General pediatrics) and authority for the Phase 3 Curriculum Committee to approve new acting internships, and to inform the COC of new acting internships.
ACTION: Unanimously approved.

Feedback to students: COC discussed and reiterated the importance of ensuring mid-rotation, documented feedback to all students during all clerkships. Medicine requires students to seek written feedback from attending(s) and to submit the completed form to complete the clerkship requirements. Pediatrics uses a 3x5 card for feedback at the end of every half-day in clinic. The clerkship directors will share their models with each other and ensure that each student receives formalized feedback. They will also encourage attendings and residents to label feedback as feedback so students realize when they are receiving suggestions.

Dr. Nesbit presented the annual assessment and recommendation for the Neurology and Medicine clerkships.

Neurology 5000 is a 4-week required clerkship that concentrates on neurologic examination, principles of localizing lesions, common symptom complexes, and logical approach to diagnosis and management of common neurologic disorders. The clerkship is primarily an in-patient experience and students attend clinic with their attending. Students are assigned to one of the following: MCG wards, VA wards, child neurology, or the epilepsy service. The clerkship goals and objectives, site characteristics, rotation patterns, strategies to ensure core experiences (e.g., CLIPP cases), evaluation system, and student performance were reviewed.

Changes implemented in 2005/06 included:

Neurosurgery, previously a clerkship site, became a sub-specialty venue for SUR 5000.

All students assigned to MCG spent two weeks on an in-patient service and two weeks in adult out-patient clinics.

A student-led “Word of the Day” teaching session was introduced, first at the VAMC.

All lectures were placed on WebCT.

The following challenges and recommendations were discussed and approved:

Issue to Be Addressed Action Approved
Clerkship sites
Need to maintain and expand sites • Add 3 community-based teaching sites in 2006/07. Negotiations are ongoing with a site in Gainesville, GA.
Ensure mid-rotation feedback • Develop form for written feedback evaluation (consider modifying Medicine’s)
Continue to work on accurate logging of patient encounters • SPEL/One45
• Finalize requirements


Additional goals for 2006/07 are to lower failure rate on NBME Subject Test and increase the mean score, continue the high proportion of students who choose residency training in neurology (give numbers for last 3 years), and community-based sites.

Medicine 5000 is an 8-week required clerkship, divided into two four-week, in-patient segments. All students must complete at least one segment at MCG or the VAMC, and one segment on a service that is defined as general medicine. The clerkship goals and objectives, site characteristics, strategies to ensure core experiences, evaluation system, and student performance were reviewed.

Students may be assigned to the following:

MCG: 3 general medicine teams, nephrology, cardiology, or hematology/oncology.
VAMC: 3 general medicine teams
Eisenhower Army Medical Center (decreased number of students because of deployments)
Atlanta Medical Center
Memorial Medical Center, Savannah

The clerkship was 12 weeks long until 2004/05 when the third-year clerkship was decreased to 8 weeks of inpatient and the ambulatory 4-week segment was moved to the fourth year.

The following changes were implemented in 2005/06:

All lectures, based on the CDIM curriculum, have been placed on WebCT; each lecture is followed by 2 web-based questions the students are required to complete.

A teaching attending was added in July 2005. These faculty are renowned teachers and spend 2-3 hours/week with Medicine 5000 students helping them with physical examination and presentation skills, and reading and giving feedback on their write-ups.

An online quiz consisting of 50 multiple choice questions was developed to encourage students to view the WebCT presentations.

The following sites were added in 2005/06:

Dr. Steve Goggans was appointed director of fourth-year ambulatory rotation

The following challenges and recommendations were discussed and approved:

Issue to Be Addressed Action Approved
Acquire and maintain sites: there are too few patients on the in-patient services at MCG and VAMC; decreased number of positions at MMC • The following sites are under development:
• Ft. Benning, GA
• Floyd Medical Center, Rome, GA.
• Albany, GA
• Continue to monitor students’ performance at all sites, identify weaknesses, and address them
• Continue annual visits to sites for faculty development
Consistency of experiences and evaluation • Continue to work on implementing One45 for tracking experiences
• Assess consistency of evaluation across sites and address inconsistencies if identified
The DOM at MCG has decided to convert all services to sub-specialty care • Monitor students’ experiences to determine if they are seeing an adequately broad spectrum of patients.
• Monitor students’ performance on NBME ST to be sure the mean performance does not decline
• Monitor students’ evaluations of the rotation.

Evaluation Team: Carol Nichols reported there are now sufficient results from several of our ongoing curriculum assessment studies for meaningful analysis. As a result, the team had 3 peer-reviewed presentations at the 2006 SGEA meeting. The key conclusions to date relevant to the curriculum changes we began in 2004/05 are:

• 65% of Phase 1 and 56% of Phase 2 students find lecturing to be an effective teaching method for the basic sciences at MCG. Students would like to see more discussion of case studies and independent learning to complement lectures. Students appreciate the use of interactive learning strategies during lecture. By the end of Phase 2, students like a lecturer with teaching expertise.

• Student definitions of professionalism are varied. All students feel respect is essential to professionalism. Professionalism is learned by experience, faculty modeling, and the technical aspects of professionalism can be taught. Unprofessional behavior by peers reflects on all.

• From the attitudes toward social issues in medicine, freshmen display attitudes similar to upper class medical students who have been enrolled in the curriculum 2-3 years. Communication skills appear stable pre and post integration.


The next meeting of the COC will be July 13, 2006.

The meeting adjourned at 4:55 PM

Respectfully submitted,


Ruth-Marie E. Fincher, MD
Chair


Please put the following COC meeting dates on your calendar and let me know if you identify a conflict of sufficient magnitude that we should change the date.

2006: July 13, Sept. 14, Nov. 9
2007: Jan. 11, Mar. 8, May 17, July 12, Sept. 19, Nov. 8

Please also put the LCME site visit dates on your calendar AND plan to be on campus these days: January 14-16, 2008.

[Betsy]

Phase 3 Curriculum Committee
Minutes of August 8, 2006 Meeting


The Phase 3 Curriculum Committee met in the Dogwood Room from 7:05 to 8:35 a.m. on August 8, 2006

Members present: A. Albritton, L. Leggio, G. Nixon, R. Nesbit, A. Thomas, R. Fincher, H. Gross, I. Khan, H. Szerlip, C. White and M. Manting-Brewer. Dr. Nesbit chaired the meeting.

Members absent: E. Mendell, B. Hughes, J.N. Pruitt, J. Albritton, N. Fatteh, and D. Ketterer.

Minutes of the June 9, 2006 meeting were approved as circulated.

Dr. Khan discussed the progress that has been made towards establishing a clinical campus in Albany, Georgia. A copy of his handout is attached. The bottom line is that he has made significant progress over the last year in establishing the groundwork for third year clerkships in all specialties. It is expected that housing in new dorms built at Albany State will be available to MCG students and that third year students will be able to be fully in place in Albany in the 2008 – 2009 academic year. Dr. Nesbit has already visited the site and other clerkship directors will be doing so in the near future.

Dr. Thomas presented information about changes in One45. It is now possible to look at sets of diagnostic categories by specialty. The possibility of listing more than one diagnosis per patient was suggested and Dr. Thomas will pursue the with the One45 developers.

Dr. Fincher discussed the new osteopathic school in Marietta and the proposed new private medical school in Savannah and the potential impact those schools will have on MCG. With the growth of those schools it will be particularly important for all specialties to work on developing new clerkship sites for our students. Dr. Albritton also noted the importance of working with AHEC as early as possible in the development of new sites.

We will have our LCME site visit in January 2008. The steering committee for the LCME report has already been named. The report will be submitted in October 2007. Dr. Albritton will be working with each department to get the data required for the report.

There was brief discussion of faculty development. That will be a major topic for discussion at our next meeting.

The next Phase 3 Curriculum Committee meeting will be held @ 7:05 on Tuesday, Sept. 12, 2006 in the Dogwood Room.
Clerkship Directors Meeting

After the Curriculum Committee meeting a brief Clerkship Directors meeting was held.

[Betsy]

Curriculum Oversight Committee Meeting Minutes
September 14, 2006
3:00-5:00 PM
CB-1847

DRAFT 1 – 9/15/06

Members Present: Andy Albritton, Scott Barman, Rhee Fincher, Hartmut Gross, Michele Manting, Lisa Leggio, Walt Moore, Carol Nichols, Harold Szerlip, Andria Thomas, Diane Turnbull, Chris White, Peggy Wagner, Phillip Murray (Class of 2010), and Jordan Weitzner (Class of 2010)

Members Absent: Rashid Akhtar, Bala Ambati, John Barrett, Ralph Kolbeck, Bob Nesbit, George Nixon, Jonathan Pellet, Ned Pruitt, Jo Albritton (Stewart Shevitz), Pam Rosema, John Vender, Daniel Ketterer (Class of 2008), and Nadeem Fatteh (Class of 2008), Liz Mandell (Class of 2007), Betsy Hughes (Class of 2007), Devon Patel (Class of 2009), and Katherine Mohney (Class of 2009).

The meeting was called to order at 3:04 PM by Rhee Fincher. The minutes from the July 13, 2006 meeting were approved.

Announcements: None

Committee Reports

Phase l/2: Diane Turnbull reported on ECM 1 and 2 from the 2005-06 academic year.

Module: ECM 1 (ECM 5100)

The module director was Peggy Wagner, PhD and the co-director was Mike Kilbride, DO. For 2006-07, Dr. Kilbride will be director and Dr. Wagner, co-director. The following strengths and recommended areas for improvement were identified based on student, faculty, and module director feedback and evaluations.

Strengths

• Clinical experience
o Communication lab (standardized patients)
o Behavior change sessions (standardized patients)
o Interviewing real patients (especially when followed by discussion with preceptor)
• OSCE (for feedback and summative evaluation)
• Small group discussions
• Introduction of concepts of evidence-based medicine

Problems and Suggestions for Improvement

• Statistics
o Instructor felt to be ineffective
• Grading
o Students felt there was too much variability in evaluation, feedback, and grading among facilitators and preceptors
• Students perceive ECM as less important than more “scientific” modules
o Some recommended changing ECM to pass-fail and requiring attendance at lectures
• Students recommended elimination of county project and community resource visits
• Students recommended more emphasis on religion/culture and impact on health care

Plans for 2006-07

• Dr. Mike Kilbride was appointed module director and Dr. Peggy Wagner co-director
• Statistics: Dr. Jim Dias will present statistics segment. He is working with directors and Dr. Bruce LeClair to coordinate well with epidemiology and teach basics medical students need to know to understand the medical literature and do well on Step 1. Rhee Fincher negotiated this change with Dr. Varghese George, chair, Dept. of Biostatistics, who is eager for the department to earn a strong reputation in teaching.
• Faculty development
o Mike Kilbride, working with Peggy Wagner and Andy Albritton, will conduct frequent faculty development sessions to:
 Increase consistency of expectations among small group facilitators and clinical skills preceptors
 Increase consistency of feedback and evaluation
• Correlation with other Phase 1 modules
o Mike Kilbride is working with Structures directors to incorporate clinical examples to illustrate basic science topics (e.g., back pain)
• Dr. Kilbride is considering whether or not to continue county project; if eliminated, need to be sure to cover the population-based medicine and epidemiology principles it illustrates
• Add more emphasis on spirituality and medicine

After discussion, the COC unanimously approved the following recommendations for improvement in the module for the 2006-07 academic year:

Issue to Be Addressed Action Approved
Integration/Coordination • Module directors will coordinate the basic science and clinical components as much as feasible.
• Module directors will work with faculty to ensure appropriate content, sequencing, and planned reinforcement without unplanned redundancy or gaps.
• Coordinate topics with other modules as feasible.
Handout materials • Ensure all lectures have objectives
• Ensure lecture objectives flow from module and School objectives
Exam preparation • Encourage all faculty to participate in item-writing workshop
Biostatistics • Dr. Jim Dias – new instructor; he and Bruce LeClair work with Mike Kilbride and Peggy Wagner on content
• Ensure content is congruent with Step 1 Content Outline
Faculty Development • Increase frequency and effectiveness of FD sessions, including:
o Expectations of students and faculty
o Case examples to enhance reliability of evaluations
o Discussion of strategies for each small group topic
o Consistency of clinical expectations
Ensuring coverage of topics such as cultural, spiritual, and population-based medicine topics • Careful planning as ECM evolves to ensure important LCME standard topics are not diminished (e.g., cultural diversity)


Module: ECM 2 (ECM 5200)

The module director was Andy Albritton, MD. Dr. Jo Albritton was appointed module director beginning with the 2006-07 academic year. The following strengths and recommended areas for improvement were identified based on student, faculty, and module director feedback and evaluations:

Strengths

• Implementation of intersessions in physical diagnosis, women’s health, pediatrics, medico-legal issues

• Physical diagnosis intersession
o Core clinical faculty concept and their dedication to helping students
o Interactions with standardized and real patients; feedback from standardized patients

• Women’s health intersession
o Opportunity to work with standardized patients
o Learning to take sexual history and do pelvic exam
o Emphasis on interacting with women from various cultural backgrounds
o Many lectures were high quality
o Content supplemented important topics covered elsewhere (e.g., menstrual cycle and menopause, anatomy, contraception, sexual history)

• Pediatric intersession
o Well organized, efficiently run, effective
o High quality lectures and handouts, informative and appropriate length
o Use of audience response system
o Content supplemented important topics covered elsewhere (e.g., immunizations, developmental milestones, endocrine physiology, nutrition)
o Valuable preparation for Phase 3

• Medico-legal intersession
o Expectations stated clearly
o Extremely well organized
o Small group discussions, jeopardy, and panel discussions effective
o Appropriate amount and density of content
o Content supplemented important topics covered elsewhere (e.g., legal issues in medicine, health insurance, management of risk)


Weaknesses and Recommendations for Improvement

• Physical diagnosis
o Shorten to one week
o Ensure consistency of expectations and feedback among faculty preceptors

• Women’s health
o Improve organization and limit amount of content/unit time
o Ensure exam assesses knowledge of important topics taught
o Ensure amount of reading appropriate
o Make expectations of students clearer
o Improve coordination with other modules

• Pediatrics
o Ensure exam assesses knowledge of important topics taught
o Eliminate unplanned redundancy; enhance coordination with other modules
o Decrease number of lecturers
o Increase emphasis on adolescents

• Medico-legal
o Change exam so the exam questions are not the same as the practice questions
o Intermix lectures with jeopardy

Plans for 2006-2007

• Women’s Health
o Dr. Shilpa Brown will direct
o Will follow Module 5 (Renal/GU/Endocrine) for better sequencing

• Physical Diagnosis
o One-week intersession at beginning of Phase 2 (clinical skills)
o One-week intersession at end of Phase 2 (clinical skills, getting ready for Phase 3 clinical expectations)

• Medico-legal
o Will become intersession #2 so topics can be reinforced during year
o Andrew Newton, JD will direct since Carol Schwab left MCG faculty

• All
o Review content of each intersession and improve coordination with other modules and ensure preparation for Step 1
o Eliminate unplanned redundancy
o Improve exams

After discussion, the COC unanimously approved the following recommendations for improvement in the module for the 2006-07 academic year:

Issue to Be Addressed Action Approved
Integration/coordination • Module director and intersession directors will work to ensure optimal content, coordination, and sequencing
Exams • Ensure item quality (faculty attend item-writing workshops as indicated)
• Ensure exams assess most important topics

After discussion, the COC recommended the module directors and core clinical lecturers review the USMLE Step 1 content outline, Clinical Diagnosis and Management 2006 and Pathophysiology for the Boards and Wards (Phase 2 required texts), lecture titles, and relevant handouts from previous year (available on One 45) as they plan for succeeding years. Despite gains in 2005-06, the overall Phase 2 curriculum is not yet as well sequenced as it could be and there are still unplanned redundancies and unplanned gaps. The module directors will take the lead in meeting with core clinical lecturers and other faculty teaching in modules to accomplish these aims.

Phase 3: No report.

Evaluation Team: Carol Nichols reported that the Evaluation team met on Sept 13 to discuss the status of evaluation projects. The projects that are ongoing are:
1. Examining student grades and scores on Step 1 and subject exams.
2. Step 1 follow up survey
3. Student led curriculum focus groups
4. Interest, Attitudes, and Approach to Learning (IALLS) Survey for students
5. Clinical readiness

In preparation for LCME site visit, the Team analyzing all current data with focus on comparing the objective measurements with survey, focus group, and clinical readiness data.

Evaluation Services: No report.

LCME Self-study: Andy Albritton led discussion about reviewing, revising, and updating the MCG SOM Educational Principles, Objectives, and Phase 3 Objectives and Outcomes.

The educational principles (approved 1/13/05) were discussed and several suggestions made. The revised version is attached and members agreed to review and discuss by email so a revised version can be approved at the November COC meeting.

Andy described the MSOP-based objectives (approved 2/22/00) and ACGME competency-based objectives (approved 2003). A sub-committee will review and draft improvements of the competency-based objectives for presentation at the November COC meeting. The committee will be chaired by Andy Albritton and members include Peggy Wagner, Andria Thomas, Walt Moore, Diane Turnbull, and Scott Barman. They will use the ACGME competency framework and expand the objectives to be applicable to all four years. Andy also presented “ED Standards of Particular Importance” and a curriculum matrix for objectives for review by the COC. The matrix describes when an objective is introduced, when students practice, and when competence is expected (and assessed).

At the July COC meeting, Rhee asked the group to recommend ways to recognize excellent teaching and educational innovation/interdisciplinary collaboration in addition to the current awards. She suggested the COC consider sending recommendations to the Faculty Senate Executive Committee. The following ideas were suggested at the end of the meeting:
• Consider a Faculty Senate award for excellence in educational innovation or interdisciplinary curriculum development
• Consider moving the Faculty Senate Awards ceremony to the fall to enable faculty who teach in spring modules to be considered for excellence in teaching awards
• The SOM Class of 2001 has given a $1000 donation to be used to recognize excellence in teaching/education. The COC members were asked to make suggestions about what the award should recognize, and to recommend criteria for selection.

The following was discussed:

• The COC members decided to create an award (a plaque) funded by the gift of the Class of 2002 to recognize teaching/education. Recognizing innovation, especially interdisciplinary innovation, in teaching was suggested as a possibility. An ad hoc teaching award committee will develop a proposal and send it to Rhee by the end of October for presentation at the November COC meeting. The committee will be chaired by Chris White and the members are Walt Moore, Peggy Wagner, and Phillip Murray.


The next meeting of the COC will be November 9, 2006.

The meeting adjourned at 5:01 PM.

Respectfully submitted,


Ruth-Marie E. Fincher, MD
Chair


Please put the following COC meeting dates on your calendar and let me know if you identify a conflict of sufficient magnitude that we should change the date.

2006: Nov. 9
2007: Jan. 11, Mar. 8, May 17, July 12, Sept. 19, Nov. 8
2008: LCME Site Visit January 13-16

Attachments

SOM Educational Principles
SOM Objectives – 2001
SOM Competency-based objectives
All Phase Recommendations for 2006-07

[Betsy]

Phase 3 Curriculum Committee
Minutes of October 17, 2006 Meeting


The Phase 3 Curriculum Committee met in the Dogwood Room from 7:05 to 8:35 a.m. on October 17, 2006

Members present: A. Albritton, J. Albritton, H. Gross, L. Leggio, G. Nixon, J.N. Pruitt, R. Nesbit, A. Thomas, R. Fincher, H. Szerlip, C. White and M. Manting-Brewer. Dr. Nesbit chaired the meeting.

Members absent: E. Mendell, B. Hughes, N. Fatteh, D. Ketterer, and I. Khan.

Minutes of the September 12, 2006 meeting were approved as circulated.

Dr. Thomas asked if there are any problems with the One45 system and no major problems were noted. Dr. Nesbit did mention a problem (which he has discussed with Dr. Thomas previously) with printing out some of the reports for the surgery clerkship. The format is very wide and we have not been able to print out the data. This will be addressed with the programmers. There was extensive discussion of using One45 to have students report their work hours. Some Clerkship Directors (CDs) see no need for the added time and effort for them or their students to do this since they know that their students do not exceed 80 hours a week. There is concern, however, that hours may be a problem on some clerkships and Dr. Fincher noted that it would be useful to have data showing actual hours on all clerkships. Dr. Thomas demonstrated the system used in One45 to document work hours for medical residents. She will modify this for use with students and we will give it a trial for a three week sample of student hours when it is ready. It was agreed that students should report hours that they are actually in the hospital and required to be there, not hours spent studying in the hospital (or elsewhere) by choice.

Dr. Leggio had queried CD’s by email regarding whether they had specified minimum or maximum numbers of patients which students should follow on the wards. Dr. Szerlip noted that on Medicine the students are expected to follow 3 to 5 active patients, but not more than 5. No other clerkship specifies patient numbers.

Dr. Nesbit and Dr. Thomas showed the statistical review that Dr. Thomas performed for the surgery clerkship on all performance and test grades for all teaching sites and services. The only statistically significant difference shown was that students had lower performance grades on the rotation on the Trauma service, but this did not affect their final surgery grade. This information will be shared with the Trauma service faculty and it was noted that the effect of such a difference should be even less this year since the trauma rotation has been shortened from 4 to 2 weeks. Dr. Thomas noted that she was able to perform this analysis because Ms. Halstead, the Surgery Clerkship Coordinator, provided her with a very complete Excel report of all grades, locations etc. This still entails a fair amount of effort on Dr. Thomas’ part, but she will perform the analysis for any service which provides her with the required data. It was noted that this is an excellent way to document whether there are significant differences among teaching sites.

The LCME site visit will be from January 13 to 16, 2008. All CDs must be present and available during that time. Data is currently being gathered for the self-study. Various expectations of the LCME were discussed. Among these was the requirement that all physicians who play a significant role in teaching students – including those at off-campus sites - must have faculty appointments. Also, it is important that residents (and faculty) be aware of school and course objectives and to accomplish this we will put the objectives on One45 so that residents and faculty can review them and document their familiarity with them.

The role of residents as teachers and their training for this role was discussed. Dr. White noted the IRCC lectures and sessions during new housestaff orientation (see attached). It is not known exactly how much added training for teaching is being given by individual departments, but this information should be included in the LCME self-study information currently being gathered.

Dr. Szerlip brought up the subject of performance grade inflation. (We will report the actual clinical grade distribution at the next meeting.) He questioned whether the current letter grade system (used Georgia Regents system wide) is suited to clinical performance grading. He cited an internal medicine clerkship directors study of 77 schools which showed that slightly more half report grades using a Fail, Marginal Pass, Pass, High Pass, Honors (or similar) system and that only 14% use our letter grade system.. Several committee members stated their feeling that having a numerical grade (GPA) is important to some residency selection processes. The possibility of having a numerical GPA with an Honors/Pass/etc. system or of having a GPA only for the first two years was discussed. Dr. Fincher said that if this committee wanted to change to a different system and the Curriculum Oversight Committee approved, she would be happy to request permission from the Regents for us to change. This will be further discussed at our next meeting. The possibility of revising our current grading form will also be further addressed.

The meeting was adjourned at 8:35.

The next Phase 3 Curriculum Committee meeting will be held @ 7:05 on Tuesday, November 14, 2006 in the Dogwood Room.

Clerkship Directors Meeting
After the Curriculum Committee meeting a brief Clerkship Directors meeting was held.

rrn – 10/19/06

[Betsy]

Phase 3 Curriculum Committee
Minutes of November 14, 2006 Meeting


The Phase 3 Curriculum Committee met in the Dogwood Room from 7:05 to 8:35 a.m. on November 14, 2006.

Members present: A. Albritton, J. Albritton, E. Mendell, L. Leggio, G. Nixon, J.N. Pruitt, R. Nesbit, A. Thomas, H. Szerlip, C. White and M. Manting-Brewer. Dr. Nesbit chaired the meeting.

Members absent: R. Fincher, B. Hughes, H. Gross N. Fatteh, D. Ketterer, and I. Khan.

Minutes of the October 17, 2006 meeting were approved as circulated.

Dr. Albritton discussed multiple concerns raised by his committee which has been reviewing our readiness for the January 2008 LCME visit. Several items of concern were discussed.

The SOM general competencies for students include- under “Systems Based Practice” -five items, most of which are really more applicable to residents than students. It was agreed to modify # 1 to understand how their patient care and other professional practices affect health care professionals and delete all but #4 – “advocate for quality patient care and assist patients in dealing with system complexities.” In keeping with this change it was agreed to drop the third line of items under Systems-Based Learning on the Medical Student Clinical Evaluation Form.

Dr. Pruitt noted that Ed Hamilton in Neurology has prepared an on line course/exercise, intended for Neurology residents, which goes into detail describing medical systems, organizations, government policies, practice, etc. Dr. Pruitt will talk with Mr. Hamilton about making this course or a modification of it available to our students and the committee will look further into making completion of the course on line a requirement for all sophomores prior to their beginning clinical rotations.

The MCG SOM objectives include one which lists procedures which students are expected to be able to perform. We currently do not document such performance. Last year this committee prepared a list of procedures and examinations which we expect students to do or to see and we were about to implement a system to document compliance, but then because of the ED2 requirement to specify numbers and types of patients to be seen on each clerkship, we dropped the procedure policy to attempt to document patient diagnoses in order to comply with ED2. Now that our mechanism for dealing with ED2 is in place, it was agreed that we need to readdress the procedure requirement and Dr. Thomas will circulate the previously agreed upon procedure list for reconsideration at our next meeting. Because we will be evaluating procedures in this way, it was agreed to delete the line regarding Procedural Skills from the Medical Student Clinical Evaluation form.
Dr. Nesbit noted that excellent videos of multiple procedural techniques are now available from the NEJM on line. He will look into whether we can make these more easily accessible to our students.

The SOM objectives also currently include 1) The ability to recognize patients with immediately life threatening cardiac, pulmonary, or neurological conditions, and to instate appropriate initial therapy and 2) The ability to recognize and outline an appropriate initial course of management for patients with serious conditions requiring critical care. The concerns with these two objectives are that – although all seniors are required to pass a critical care selective – that the objectives may not really be attainable by all students during medical school and also that we are not able to assess them. It was agreed to look into the finances and feasibility of requiring all students to pass an ACLS course (probably about 65% take ACLS now), but also, in order to make our objectives more attainable and measurable, to combine the two objectives and change the wording to: “The ability to recognize patients with life threatening conditions and to participate in the initial course of management.” This will be recommended to the Curriculum Oversight Committee.

Dr. Albritton also noted concerns about the formal teaching about pain management and ameliorating suffering, and about diagnostic imaging and radiology in the third and fourth years. These will be readdressed at our next meeting. We will also address the students’ curricular exposure to translational research at a future meeting.

The meeting was adjourned at 8:35.

The next Phase 3 Curriculum Committee meeting will be held @ 7:05 on Tuesday, December 12, 2006 in the Dogwood Room.


Clerkship Directors Meeting

There were no items for the Clerkship Directors to discuss and thus there was no formal clerkship directors meeting..





rrn – 11/15/06

[Betsy]

Phase 3 Curriculum Committee
Minutes of December 12, 2006 Meeting


The Phase 3 Curriculum Committee met in the Dogwood Room from 7:05 to 8:25 a.m. on December 12, 2006.

Members present: A. Albritton, J. Albritton, L. Leggio, G. Nixon, J.N. Pruitt, R. Nesbit, H. Szerlip, C. White, M. Manting-Brewer, B. Hughes and E. Mandell. Dr. Nesbit chaired the meeting.

Members absent: R. Fincher, H. Gross, N. Fatteh, D. Ketterer, A. Thomas and I. Khan.

Minutes of the November 14, 2006 meeting were approved with previously circulated revisions.

Dr Pruitt noted that Ed Hamilton will happily make his “medical systems course” available for us to use with students. Dr. Pruitt will look into how it can be put on Web CT. It will be required that all third year students complete the course and the Curriculum Office will keep track of compliance. When the course must be completed will be decided at our next meeting.

Dr. Szerlip inquired about the status of discussions of the clerkship evaluation form. This was not on today’s agenda but will be a priority at our next meeting.

Dr. White reviewed the history of the procedures log. This was ready to be put in place when the LCME introduced the ED-2 requirement and we deferred the procedure log to address the numbers and types of patients problems. Questions were raised about how best to document procedure experiences and about the necessity of many items on the list. Some clerkships/rotations already have lists of their own which overlap with this list and there is no point in duplicating efforts. Even sections without such lists do require some of these exposures, so each member will review the procedure list (attached) and we will readdress the subject in January. (Procedure lists from Family Medicine and Emergency Medicine are also attached. Are there others?)

The survey of clerkship duty hours will be done on One45 during the first three weeks of January. A memo will be sent out to students and clerkship directors regarding the details of the survey. It is important that during January 2nd orientation clerkship directors emphasize the students’ responsibility for timely completion of the logs.

Dr. Nesbit noted that he had looked into making the NEJM procedure videos available on WEB CT, but that so far he has not been able to contact the correct person at NEJM who can tell him if that will be allowed without a license fee.

Dr. Albritton reported that he contacted Pam Rosema in Anesthesiology about making the ACLS course available to and required of all students prior to graduation. Doing so would require the hiring of additional help and would entail an additional new student fee of $150. Requiring a fee would have to be approved by the MCG Provost and Dr. Albritton will look into whether it would be allowed. There was also discussion (but no agreement) on when the students would be required to complete the training. There was general agreement that it would not make sense to put it off until late in the senior year since most residency programs will offer the course for free to students who have not already completed it. If we do require it, it will probably be in the third year. The possibility of some on-line substitute for the course or some common exam at the end of the required critical care selective be used instead of ACLS was also raised. This too will be discussed in January.

The topic of the teaching of radiology/imaging and pain management in the clerkships was again discussed. Dr. Nesbit suggested that a course in radiology could replace the current elective month during the third year. He will discuss this further with Dr. Rawson. Another option would be for each clerkship to take responsibility for the teaching of some aspect of radiology and pain management. This too will be a continuing agenda item.

There was brief discussion of the future LCME requirement that Translational Research be addressed in the curriculum. This is a topic to be addressed in the future.

The meeting was adjourned at 8:20.

The next Phase 3 Curriculum Committee meeting will be held @ 7:05 on Tuesday, January 9, 2007 in the Dogwood Room.


Clerkship Directors Meeting

A brief Clerkship Directors meeting was held. Dr Albritton noted some problems with delinquent grades and reminded the CDs that the LCME considers a problem in one clerkship to be a problem with all.





rrn – 12/15/06