Minutes from the Curriculum Committee Meeting
9/3/10
Topic
Attending:
Annual Review of
Outcomes
Discussion
Bacon, Byerley, Chuang, Cross, Dent, Dreesen,
Enarson, , Farrell, Fields, Gilliland, Perry, Rao,
Slatt, Steiner, Stone Viera, Guest: Wurzelmann
(Dan – MSIII); Not There: Bankaitis, Bynum,
Clarke-Pearson, Felix, Heck, Johnson, Shaheen,
White
 Powerpoint is attached, we welcome
additional comments.
Action Items
Comments:
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Where are we and what are the big
lessons?
Diversity remains a major
commitment, as underscored by the
replacement of Larry Keith. In
particular, we may need to focus on
Hispanic and possibly rural/low SES
students.
We need to pay attention to
struggling students. This is both a
mechanism – how to track people
with comments below the Dean’s
lines - but also making sure that
people who can be doctors are
doctors.
Balance of workforce – we need to
have an appropriate balance. Of
note, Erin Fraher will be focusing on
that as we move forward in the
future.
What we are missing is an evaluation
at the end that our doctors are ready
to go on to residency pulling it all
together. This is akin to what
residency directors do at the end of
residency but it’s got to be one
person who knows the patient being
able to say that.
Do we really know how well people
practice at the end? We’ve got OSCEs
but not an integrated whole.
Furthermore, most of the faculty in
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How can the UNC
mission guide our
assessment of
outcomes?
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the third year don’t know them well
enough to be able to say – here is
one of the places where the Asheville
project can guide the way for us.
o How well are we doing in terms of
keeping people in the state? Do we
prefer people coming in? Do they
attract and stay here – analogous to
the residencies?
What other data do we need to look at?
o Both residency director and former
medical student self assessment at a
year out, and possibly later than that.
o Long-term outcomes of the MD-MPH
program and the MD-PhD program.
They are both prominent and
important. How can we know
whether or not they’ve made a
difference?
o What schools are we bringing people
from? This is important to our
discussion of keeping people within
the state.
o Better knowledge of specialty by
specialty outcomes. We need better
graphs but also information across
that board. We are above average in
Ob/Gyn and Pediatrics. Where are
we below average - ? Surgery, ?
Medicine.
o We need to have a sense of how
many are solid clinicians at the end.
o National practitioner database – can
we get that information as a sign of
professionalism?
o Can we track balance of specialty,
not just particular specialties?
Alan Cross participated in the process.
Comments included:
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Should there be a fourth category of
service?
Should education come before
patient care?
A lot of emphasis on education and
research and not as much on other
aspects of education.
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o
Competency
Milestones
We need to think about metrics and
the current mission.
o To create a community of educators
would be attractive.
o Emphasize our diverse students and
products.
General issues that were addressed:
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Ongoing Program
and Curriculum
Management
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All send specific comments to Warren,
Lisa and Cam.
How well do we know that fourth years are
competent?
We need to make sure that some of our
competencies are not actually too elevated
for medical students- more appropriate for
residents or fellows.
Syncing competencies so that they are all at
the same time in the first year is important –
this is particularly important since we’ve
made a decision to push more clinical care
into the first year.
We need to come to agreement about
elements that can be in more than one place
– there’s some knowledge that can be both
in medical knowledge as well as others,
although we have to be very careful about
the message that we transmit or items that
could be population health or other
elements.
Reviewed above and overall process affirmed
with additional data and time for discussion.
Overall management of the curriculum –
Newton presented the framework in the
memo and there was commentary. Major
comments included:
o In the clinical years, evaluations can
be tracked to the competencies and
then rolled up. This should be a
major way of tracking how well we’re
doing, both for individual patients as
well as for the curriculum. We
discussed the need for formal
assessment at the end of the third
and fourth year with people who
know the students. Should we do this
earlier in the curriculum also?
o Clinical evaluations need to be
integrated across the four years so
that they are coherent and
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sequential. GQ feedback can go into
course reviews as well as reviews of
student programs.
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Clinical Log – Newton presented the
principles from the subcommittees.
Please note that the Appendix sent
out with the minutes was not the
right Appendices. What we have in
mind, was a sample of what the
competency committee developed as
an Appendix.
Additional comments:
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We need to be careful about complexity
of the list which is important. It needs to
be user-friendly. We have experience
with this in Asheville.
 The balance will be challenging. On the
one hand, clearly the conditions should
be ones in which we should be
embarrassed if the students did not see,
but on the other hand, we can be
aspirational.
 We need to be thoughtful about the
procedures. The epidemiology of
experience of procedures has changed
dramatically as Interventional
Radiologists have begun to get involved.
Many residents don’t get enough
exposure at this stage much less
students. We need to have a focused
attention as to what we want them to
have and then seek that out.
Should we begin to think about following up
with students systematically after 12-24
weeks into 3rd? This might require calendar
changes. The assumption is that this will be
used also in the mid-clerkship assessment
and remediation taken care of.
The next draft of the tracking document will
emphasize changes in evaluations and clinical
log, as discussed, as well as filling out specific
sources of data.
Key decisions regarding the log:
o Technically user friendly
o Both diseases/conditions
and symptoms
o Over all four years
o The list of core diseases
will be dealt with
repetitively over that
period of time but it’s
expected that other noncore diseases will be
brought up as necessary.
o Rule for diseases and NC
prevalence, morbidity &
mortality, cost of care for
both conditions as well as
preventive conditions
o Consensus that
students must drive
the process and
advisors work with
the students on that.
We need to build that
in.
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The next step will be to come up
with a list of core diseases for
input by the Curriculum
Committee. Newton will follow-up
and get input from the
subcommittee.
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