Minutes from the Curriculum Committee Meeting
1/25/10
Topic
Attending:
Minutes
Information
Discussion
Cairns, Fields, Perry, Chhotani, Verma
Action Items
(Cross, Bynum, Dreesen, Felix, Dent, Byerley, Stone,
Gilliland, Rao, Shaheen, Steiner, Johnson, Viera, ClarkePearson, Bacon, Farrell)
 No additions.
 The fall retreat was very successful with over 100
people and very good evaluations. Networking across
years and disciplines is critical. The group did good
work on both the objectives and the next level of
evaluation of some of our innovations. We will plan
this annually.
 Budget – Currently a 5% cut envisioned.
 OME Reorganization - Current organizational chart
included with input for your reference.
 Academy of Educators – The major goal this year is to
develop a faculty development program with a major
focus being faculty teaching faculty – core skills. We
envision a variety of modalities including seminars,
workshops, visiting professorships in addition to
funding for educational research. New elections are in
process as the teaching awards. This year will mark the
transition of one of the founding leaders – Alan Cross.
 CC3/4 has created a robust process for course review
which includes peer review and assessments of
comparability, mistreatment and timeliness of grades.
 CC1 and CC2 are working on a protocol for test review
with students. They will come to a policy that both
approve and then it will likely be a consent agenda
item for this committee.
 Renovations – New small group rooms were put online
in January so all ICM classes have suitable rooms for
teaching which the students have appreciated. It is
likely that the Osler area will be converted into a
lounge space, but unsure when: we are caught
between two bureaucracies at this stage. Roper has
given us permission to revise the plan for a new
education building. The architects are coming on
March 5th and we’ll get other faculty involved.
 Asheville – The LCME consultation was very successful.
The students are thriving. Mission Memorial has
contributed significant funding for six students next
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Consent Agenda
LCME Planning
Process
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year. We’ve finalized the fourth year curriculum along
the lines that we’ve previously discussed – two AI’s,
two rural requirements with the APS or IS selective
being built into the international experience. Several
clerkship directors went on the site visit--Chuang,
Lindsey and Klipstein—and will be meeting to talk
about where this should go in the rest of the
curriculum and will report back to this committee.
The Charlotte site visit is now scheduled for May
12th/13th.
We will move to identify campus Deans. The exact title
depends on our discussions with the campus vis-à-vis
the Bain report. We are also moving to complete
memoranda of agreement and will attempt to get the
AHEC housing fee increased.
The Curriculum Director Search is in process. We have
a number of candidates; Cam Enarson will also be
joining the university with a significant track to help
with the LCME process. He’ll also be working in
Anesthesiology and other settings.
WebCIS, CPOE & Beepers – We are defining a list of
exactly what we need to do with Liz Dreesen and
Christopher Klipstein and will push this as part of the
LCME preparation.
All approved.
Note that there were two documents attached. The
first is the overall LCME plan which has been approved
by Bill and Etta and will be introduced to UNC SOM
and UNCHCS leadership on 2/8. The second is a
tracking document to follow-up which Lisa Slatt will
use for remediation of all 44 issues.
Comments and questions included:
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How will student self study be organized? There are a
number of different models nationally. Cam,
Georgette and I will work with Whitehead this spring
to develop a process. I’ve announced it at town
meetings.
How will residents as teachers be organized?
Preliminary work in included. Meetings with the
Chairs and identification of some best practices for
training residents as well as some sharing of resources.
We need, however, an institutional strategy. I’ve
begun the process of working with Phil Boysen and
Brian Goldstein. The requirement is not only to offer
but to assure that residents as teachers are trained as
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School Objectives
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teachers.
Our activities such as service and research are built
into the school. These are a key part of the vibrancy of
our school and will be built into the self study.
What are the responsibilities to campuses? What
about IT support? The Asheville pilot has taught us
the need to revamp our student services and other
activities. IT is one of this but access to advisors,
financial counseling and the like are also important.
We’ll need to come up with solutions on a campus by
campus basis. Historically, we got involved in the
satellite campus business (e.g., AHEC) 30 years before
the current fashionability. These are resources we
need to bring to bear for the students who are
spending time there. This is particularly true if they
spend all of their time there such as at Asheville and
Charlotte.
How will we do faculty appointments? We need to
identify a list of faculty in both ICM and the clinical
clerkships who are teaching. The LCME standard is
clear that we need everybody who’s teaching medical
students to have a faculty appointment. We need to
develop a simplified process and we will act on that.
The current draft was distributed with the minutes. Of
note, we’ve had extensive input from this committee
initially, the faculty as a whole at the retreat and then
this committee again. The document has gone from
approximately 25 pages single spaced to a 6 page core
including appendices. The latest revision we were
boiling down. We combined some of the specifics and
reframed the objectives in sharper language that
includes competencies. As a result of feedback, we
have moved the ACGME communications element into
the patient care component and a little bit into
professionalism. We established a new competency
around managing the health of populations.
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Newton/Stone will
follow-up to push a
simplified process for
adjunct professors.
Since this is within the
School of Medicine,
we will work with
Harvey Lineberry and
appropriate
committees to
develop this process.
In the meantime,
courses should
develop lists of people
who are teaching so
we can target our
efforts.
There was consensus
that it is much
improved over initial
document and retains
its usefulness with
shortening.
Committee members
will send limited
conceptual edits to
Newton.
In a parallel process,
Newton will send to
the CC Directors who
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Suggestions for additions/changes included:
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CPX Follow-up
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Include social and behavioral in the medical
knowledge piece;
Include the knowledge necessary for diagnosis and
treatment in the medical knowledge piece.
The acute care of the common conditions need to be
framed as time dependent conditions and not have
cardiac seizures.
The Appendices A, B, C and D will need to be reframed
and prioritized, probably converted into some sort of
tracking mechanism that we will use to follow-up. It
will be valuable to explore via AAMC whether there is
any standard list of conditions or cases that other
schools have worked on. NB: While it’s good to
include, we’ve put a lot of effort into building up this
current list of conditions from the bottom up.
Professionalism – There are a number of elements
that are not in there such as reliability, showing up on
time, doing work and so on.
Also, how these things will be assured.
More broadly, in terms of process, how will this kind
of document be used? We envision a longitudinal
process in which students are told at the beginning
what the objectives are and then every course they
will be told which core competencies this course deals
with. The core competencies has also become how
faculty are oriented to education and how residents as
teachers are told what they are teaching. We will
develop a grid and review it regularly.
We also discussed process of next steps. Newton and
Slatt will make some minor revisions and then will
send to CC committees for final input but the
emphasis of that is beginning the process of tracking
where things are in the curriculum.
Please note that these are draft minutes and that
there is a typo. It’s not the NC Clinical Skills program
but the USMLE Clinical Skills program.
There was a brief description of the background of the
CPX and broad consensus that we needed to move
forward with implementing the recommendations of
the task force. We will need to develop a longitudinal
curriculum and make sure the CPX plays a role in this.
We will begin to do this.
Comments included:
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will distribute to all
course directors.
Our goal now is to
begin to map in the
curriculum what is
being taught where
and with some
additional edits and
finalization in our
March meeting.
The committee
endorsed the
recommendations of
the task force,
underscoring the
importance of the
longitudinal
curriculum in
developing clinical
skills and underscoring
the role.
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ICM
Recommendations
Report
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Format similar to the USMLE test is important.
Integrating what is asked in the OSCE with what
the clerkships are asking is important.
 This will need to be integrated development of
CPX and OSCEs in clerkships.
 Students taking it seriously and believing that it’s
relevant is a key element. The performance
results this year are important. We also believe
that if they are given a list of cases that they need
to know that it is considered practice for the
clinical skills test but harder.
Please note that the document is a draft document
and there is still discussion with the committee about
various aspects of it. We had a preliminary discussion
of ICM and its associated courses. The general sense
was that the comments were well taken. There should
be an overall longitudinal curriculum in clinical skills.
ICM needs to feed into that. We need to have some
discussion as to what things are being done too early.
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Where do the community weeks go? Do we eliminate
or begin to repurpose to other pieces?
The discussion was focused on two issues. First of all,
was the committee supportive of major changes in
ICM? The consensus was, “yes”.
Appeals Policy
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What should be the core curriculum of ICM? Clinical
skills +/- professionalism +/- clinical medicine. There
was consensus that clinical skills needs to be at the
heart of it and some variation as to whether there
should be some element of that. There was support
for significant changes in pedagogy including driving
down experience to a smaller level.
Committee members reviewed the specific issue of
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the appeals policy. The proposed goal is to simplify
the process and take the committee of faculty out. The
simplified process involves three levels of appeal
unless there is an adverse decision that could result in
expulsion. In which case, there would be an additional
level of appeal to the Dean.
With respect to process for amendment of policies,
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the committee got copies of the current process.
Newton proposed we reform to allow this committee
to advise on issues that relate to educational policy
and not operationalization. Thus, the Curriculum
Newton will follow-up
with the task force
and has made an
appointment to meet
with the students. He
will move forward
with the planning of a
“major change” in
ICM. This will depend
on clinical skills, CPX
and others. Given the
size of the course, it
will be a major change
in the curriculum. The
committee will review
plans at the next
session.
The committee
approved change of
the appeal plan as
noted.
The committee
endorsed the change
in agenda and the
committee will focus
on obtaining faculty
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Committee would deal with changes in policy with
respect to admissions, promotions, curriculum and
assessment of outcomes but not such as issues as the
operationalization of appeals.
input on core issues
related to the
educational program
but allow the Dean’s
Office to resolve
administrative issues
directly.
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