Minutes from the Curriculum Committee Meeting
5/4/11
Topic
Attending:
Minutes
Information Items
Discussion
Bacon, Byerley, Chuang, Darrow, Dent, Dreesen, Enarson,
Farrell, Felix, Heck, Hines, Hobbs, Jordan, Perry, Rao, Serra,
Shaheen, Slatt, Steiner, Stone, Woods
 Approved unanimously.
 New Whitehead Co-Presidents were introduced
(Rachel Hines and Meg Jordan)
 Cedric Bright, MD will start as Director of the Office of
Special Programs and Assistant Dean of Admissions
7/1/11. He came to the SNMA graduation celebration
and the students are excited to have him. He is the
incoming president of the National Medical
Association.
 Strategic planning at the School of Medicine is
underway. Some of you may have received the survey.
This is important because it will determine the broad
scope of our education mission over the next number
of years. Importantly, the research done for the
review has identified that benchmark institutions have
done competencies a while ago and are proceeding
towards team based learning and often longitudinal
curriculum.
 Budget & tuition increase news – in process. The
House budget has 17.5% cut, which is an improvement
over the first budget. The House budget will be
finalized in the next week or so and then it moves to
the Senate and the Governor.
 Liz Dreesen has agreed to become co-director of CC1.
Jonathan Oberlander has agreed to become course
director of the Humanities and Social Sciences
seminars. Anthony Charles will be the director of the
Surgery clerkship. Tim Farrell will serve as co-director
of that clerkship and retain his leadership role in
CC3/4. Jim Barrick has agreed to be the course director
for Introduction to Acute Care.
 Campus visits will focus on LCME issues – what the
campus leadership and faculty need to know.
 We have started a significant intervention with
Pharmacology and then perhaps also Cardiovascular.
 Timeliness of Grades – We’ve had significant
improvement in the timeliness of grades but inpatient
medicine and electives are still a problem.
 ? Berryhill vs. Taylor Hall – We are now in the process
of negotiating with campus for which one we should
Action Items
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Consent Agenda
support. The possibility has risen of renovating Taylor
Hall in the way that we did Burnett-Womack. We
decided that the new medical education building will
not have another lecture hall and that we will likely
not use Brinkhous-Bullitt for Anatomy. We will embed
Anatomy facilities in the new facility.
Comments on Course Reviews:
 Please note that integration selective will be changing
its name to “The Science of Medicine” starting with
the new year.
 Gastroenterology has demonstrated a best practice.
Their exam quality has improved substantially as a
result of efforts of the course director, Ryan Madanick,
to implement what he learned from AOE workshops,
faculty presentations, and support from Mari-Wells
Hedgpeth.
 Host Defense and Microbial Pathogens (MS1) has
piloted mid-course feedback across competencies.
Comments Regarding Midcourse Review:
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Professionalism
How should clerkships include in clinical settingsformative vs. summative? Discussion included
importance of being explicit about what would
happen. Clinical settings are often formative with
the exception of exams if previously labeled such.
 What’s innovative about what Kurt described is
feedback across the competencies. There needs to
be some faculty development in giving feedback
across competencies regarding pilot of midcourse
review.
The rest of the consent agenda items were accepted.
 The Professionalism Task Force included
representatives from ICM, students, advisors and
Social Medicine. Draft minutes are available in the
agenda. The group reviewed the Cruess visits and
the learnings from their visit and then put
together the components of what we might want
to do with respect to teaching professionalism –
the chart is a draft .
The focus of the discussion was on priorities for next year.
The recommendations were:
1. Orientation should include an explicit mention of
social contract as well as introduce the
language/concepts by Advisor.
Priorities for 2011-2012:
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Orientation to include
social contract and
introduction to core
concepts in Advisory
Colleges.
Track where taught
explicitly.
Pilot peer evaluation.
Capstone
Faculty development
OME will work with
faculty leaders to develop
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2. A next step should be defining where topics are
taught, specifically what’s done within Medicine
& Society vs. other settings.
3. Pilot and spread peer evaluations in the next year.
4. Embed professionalism in the student clerkship
evaluations.
5. Include professionalism in Capstone.
6. Faculty development around professionalism.
explicit plan and bring it
back to SOM Curriculum
Committee.
Comments:
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We need to include guidance on appropriate use
of Facebook and other social media.
Dr. Pamela Rowland of Surgery has done a lot of
work on communication and professionalism; it
might be appropriate to incorporate her in the
group.
How to do faculty development is critical – the
next phase of the discussion should include that.
One approach would be to work with the
institutional leadership to establish definitions of
professionalism and other common terms.
Perhaps the Academy of Educators can invite
another guest speaker on professionalism.
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Population Health
The Curriculum Committee endorsed these principles
for next steps. A task force with slightly different
composition will meet to flesh out where
professionalism is addressed in the curriculum - a
definition and strategy for faculty development in the
next year.
Please see draft minutes from the Population Health Task
Force. The major focus of the group was to explore what
we’re currently doing and to see whether we should add
focused material in the first year. Members of the task
force included course directors from Medicine & Society
and Clinical Epidemiology with previous input from
CSD/CSI and the MD-MPH leaders. The task force began by
describing what is currently taught. Medicine & Society
includes a lot of theoretical framework for looking at
populations as well as some of the organization of care.
Clin. Epi. takes the tools of population science and focuses
on those things relevant to the care of individual patients
– diagnostic assessments as well as critically appraising the
literature. Indeed, explicitly, clinical epidemiology took out
some of the population management issues several years
ago. Also of note, for the last three years the students
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OME will work with
faculty leaders to
track what and where
population health is
delivered through the
curriculum and define
options for how it
might be integrated in
the first year.
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have said that they want to put Clin Epi into the first year.
The consensus of the task force was that there was indeed
new material and that it should probably go in the first
year whether it be part of Medicine & Society or a new
course itself, provided that the details could be worked
out. In addition, the committee considered the question of
whether there should be a block or a distributed
longitudinal base. The sense of the group was that there
should be both going forward.
Finally, they commented that there was much less
population health involvement in clerkships than there
might be. The students commented that it was hit and
miss. The task force will address.
Comments:
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The overall goal of improving the population health
curriculum is to give a perspective not just of patients
one by one but of managing a population.
This will need a gradual approach to place through the
curriculum. It includes, but is not limited to, burden of
suffering in the second year. It needs some actual
exercises.
Basic metrics such as quality and costs need to be
presented in the first two years so they can be
followed up in the third and fourth years.
Putting more critical appraisal in the first year may be
helpful for summer research projects.
A key issue is where Host Defense goes. There are also
many things in Host Defense that could help with the
content of population management.
The task force envisioned what the key elements are
in learning how to manage a population. They believe
that it naturally occurs as an extension from managing
individual patients. So, they start with individual
patients, take collections of patients (from a group
practice), then extend to those who don’t come in,
with explicit attention to both subspecialty and
primary care examples.
The community weeks play an important role, and
exercises can be added to them to underscore
management of populations.
As with professionalism, we are evolving a framework
in which each of the competencies is tracked and
managed through the curriculum.
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Integrated Fridays
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Simulations might be possible, but we need to think
more deeply about assessment.
Context – The Curriculum Committee decided that
ultimately they want to combine normal and abnormal
science throughout the curriculum. Several have had
the idea of trying to integrate them in a particular day
– for example, starting with a case presentation and a
symptom, then the normal anatomy and physiology
and then pathophysiology and diagnosis all grounded
in the clinical assessment. GI, Musculoskeletal and ICM
are interested in doing this.
The discussion here was whether and when we should
pilot.
Discussion:
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The Framework for
the Next Two Months
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There was concern that we needed a more
developed vision of where the curriculum is going,
particularly in view of the calendaring. We need
the overall vision and need to fit this into it.
Otherwise, it’s just piecemeal.
 The counterpoint is that we have milestones and
established strategies, and we need to learn how
to implement them, since it is not trivial. We need
to proceed to start to do that – such integrated
days would allow us the opportunity to begin to
learn .
 SHAC and foreign experiences can be helpful –
they reveal a lot about management of
populations in addition to systems based practice.
Can students be given a Chinese menu style
approach?
 Role modeling is critical, so we need to have a way
of explicitly identifying faculty who are managing
populations.
 We need to have a strategy for dealing with
variation of knowledge among faculty about
management of populations. Again, this is
something that the Academy of Educators might
address.
We’ve reached the stage where work along a number
of different lines is going to be integrated. 15 months
ago we started to define competencies then
milestones and now integrate them into each of the
courses. This is the major task of the next 2-3 months.
At the same time, we’ve got a number of cross cutting
initiatives that we as the leadership group have
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defined – curricula on professionalism, population
health, high salience LCME issues that will need to be
acknowledged and built into the curriculum.
Our review has also determined that we need a
broader set of assessment tools. We need to identify
what we are doing already, and we need to have a
strategy for moving forward with assessment. Alice
Chuang and her task force are leading this process.
In June, the end of year reviews in each of the year
curriculum committees will give us a chance for each
the years as a group to decide where they are and
where they need to go. I don’t anticipate that all of the
work with integrating the new components of
assessment will be done by that time but we should
have the objectives mostly in place by then.
The SOM Curriculum Committee retreat will take place
at the end of June and will again address how the
whole Curriculum Committee will begin to ensure that
the various threads are woven together.
As I think we all recognize, pulling everything together
is a challenging task. As Nick Shaheen noted, it is
important to give our course directors and clerkships
prioritization – things that they need to be working on
and help them as much as we can. The first task is to
evaluate the competencies and milestones in the
courses/clerkships.
Curriculum Committee Meetings (monthly) in 238 MacNider:
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6/6 – 5:30-7pm (NOTE: CHANGED TO 5-6:30PM)
7/11 – 5-6:30pm
8/18 – 5-6:30pm
9/19 – 5-6:30pm
10/17 – 5-6:30pm
11/14 – 5-6:30pm
12/15 – 5-6:30pm
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