THE FIRST YEAR CURRICULUM COMMITTEE MEETING MINUTES
April 14, 2009: 8 a.m. to 9:30 a.m. in 133 MacNider
 Attendance: Stephen Chaney, Alan Cross, Claudia Condrey, Joe Costello, Georgette Dent, Ken
Dudley, James Evans, Kurt Gilliland, Michael Goy, Lara Handler, Deborah Ingersoll, Eve Juliano, Ed
Kernick, David Klapper, Warren Newton, Mindy Roush, Aldo Rustioni, Karen Stone
 Q & A about Step 1 Scores
o No questions.
o Kurt Gilliland, Ed Kernick and Aldo Rustioni have agreed to participate on a joint committee
with CC1 volunteers to review ways that we can help students prepare for Step 1. Gwen
Sancar and Stephen Chaney agreed to participate but are not available to meet until the end
of the month.
 Podcasting lectures
o What’s its advantage? It’s an advantage to the students. Podcasting allows commuters to
listen to the podcasts on their iPods, etc.
o Drs. Cross and Chaney would like to send an e-mail to everyone to have a discussion about
this issue and then come up with a consensus by e-mail on how to handle this issue.
o Of the groups reporting so far, the majority of faculty are fine with it. Some faculty are
vehemently opposed.
o Legal counsel will defend you if any problems arise with podcasting.
o You can opt out of the podcasting feature.
 Integrative Clinical Cases
o The subcommittee met to investigate how cases could tie the curriculum together.
o Why have we used cases/clinical material in general?
 Promote specific competencies: teamwork, communication and critical thinking;
 Introduce general skills: population-based and evidence-based medicine;
 Enhance basic sciences, introduce clinical material and connect various aspects of
the first-year courses with each other.
o
o
o
Recommended a list of diseases that would be common threads in the curriculum. Picked top
9 diseases that were voted on by the committee.
 We could enhance current patient encounters with the Clinical Applications Course or
possibly add cases. Dr. Cross added additional encounters throughout the childhood
of Justin Williams, one of the cases in the current Clinical Applications Course.
 Cases are well-known to the course directors.
 It would illustrate a continuity of care with the family.
 Lecturers can refer back to the cases and provide a link to these ongoing
stories.
 The students can review these cases from home and we would provide
hyperlinks for them to review.
After working with it for one year we should then work with CC2 to integrate.
Dr. Cross will need assistance in developing the other two cases.

Motion: The CC1 will commit resources to the continued development of these disease case
studies in the curriculum and support CAC as necessary. Motion carried.
 LCME Internal Review Discussion:
o
LCME Review Committee: Carol Tresolini, Tom Bacon, Lisa Slatt, Cam Enarson and Daniel
Fox. This committee asked the following questions of the Curriculum Committee. The
answers appear below each question.
o
How do you use the institutional competencies in your courses and in the first-year
curriculum?
 As course directors we get these forms occasionally where we fill whether the
competencies are met.
 It helps us in terms of focusing and reminding us what the core competencies are
and where we are teaching those things. In our basic science courses we look at
these course competencies, and this doesn’t apply to us at all but it is nice to be able
to see where we have little segments of our course where we are talking about
clinical applications of knowledge.
 In the past we had worked together starting with what were considered the core
competencies to have some rational approach to structure.
 We recognize that our job in the first year is to create an understanding in the student
of the basic physiology, biochemistry and genetics that they need to understand the
core competencies that will be developed more fully in their curriculum.
 We try to incorporate communications skills in our small group exercises.
 We try to incorporate interactive approaches to medicine when we design our small
group activities.
 We try to install an understanding of the ethical approach to communicating
information and treating patients when we have patient encounters in our classes.
 We try to emphasize the appropriate way to interact with patients in a formal setting
as well as the way to interview patients one-on-one.
o
How do you use the student course evaluations in the planning and development of your
courses?
 We use them in terms of which faculty we assign to give a particular lecture.
 We sit down with faculty members and mentoring them about improving their
teaching skills.
 We also use them in terms of looking at our coverage and seeing whether we are
getting the concepts across to the students. They tell us if we are missing the boat
and whether we need to rethink how we deliver the information.
 The most useful information comes from the last five questions, which are tailored to
our course. We consider new features for the course, small group activities, new
cases, etc.
 We don’t rely solely on student feedback. Most of the course directors sit in on a
good portion of the lectures in their course, so when we see students saying that a
lecturer is a terrible we usually have a good idea that they are not doing what they
should be doing.
 We meet with student representatives in focus groups several times during the
course. We can have the students informally poll their fellow students with a

particular question.
Student feedback indicates when flow of information is not efficient or when the
students are getting overwhelmed by the structure of the course or when structurally
the course would work better one way or another.
o
What is the role and responsibility of this committee vis-à-vis Curriculum Management &
Policy Committee, and the basic science and clinical departments with respect to curriculum
planning, implementation, oversight and evaluation? When are decisions made at this level
and what do you take to the CMPC?
 The decisions that are general to the first-year curriculum are made in this
committee.
 If the decisions affect the rest of the curriculum, faculty assignments or written
policies, we take it to the Curriculum Management & Policy Committee.
o
If there was movement of material from the second semester into the first semester would it
be decided here without taking it up to the Curriculum Management & Policy Committee?
 Yes, it would be decided here unless it had an impact on the curriculum as a whole.
o
What is the relationship of this committee to the basic science and clinical departments?
 There were 17 courses, but when we went to the block system that link was not quite
broken but made more complicated. To a large extent, a course director represents
not only the department of their appointment but the other departments that
contribute to that block; he or she has responsibilities to the members of the course
committee, who then report to their respective department chairs and other interested
faculty within their department.
o
As an example, if the committee decided to increase small student group learning and
decrease lectures or topics, would that be something the committee could do or would you
have it approved it at the department level?
 If we ran into something that needed some policy decision from the department level
we might take it to Curriculum Management & Policy Committee to discuss with the
chair of that department. Or the department representative from this committee would
be a part of the discussion and would keep his chair informed.
o
How is the first-year curriculum monitored to assure it has no gaps or redundancies? What is
the process of periodic review of first-year courses and curriculum by this committee?
 We are better at finding the redundancies than the gaps.
 We have not stepped back and looked at the whole thing. We did do a review at the
retreat, but there has been relatively little follow-up in terms of overarching views.
o
Do you have a formal process that says once a year we will take a formal look at the full year
curriculum and review in a comprehensive way?
 We do not.
 Many course directors will individually try to make the assessment for their course to
review what we are and are not covering. We can go to a website to see how
material is covered in other blocks to make sure we are not redundant. It’s not formal,
but it is what we do.
o
How does this committee achieve vertical and horizontal integration?



We accomplished horizontal integration a huge amount by creating the blocks. There
is a subsequent new level to accomplish by integrating the blocks together.
We have created subcommittees to talk across blocks to try to identify areas where
we can work completely together.
We are just beginning that process of vertical integration.
o
As in any review that you have done, does this review include learning objectives, content,
methods of teaching, student evaluation? What is the process of addressing issues that arise
during any review process?
 The Structure and Development block discovered and consulted the core
competencies document and identified where we were covering the competencies
and where we were deficient. There was a sense of awareness of where we fall
within those, and we had a discussion on how to implement cases, assessments and
evaluations.
o
Does this committee routinely see the course evaluations for all courses within the CC1 year?

The evaluation goes to Curriculum Management and Policy Committee and the
individual course director. It is unlikely they would review their peers’ evaluations.
o
What is the role of the committee in terms of design and approval of evaluation methods,
exams, frequency, and who is responsible for approving the examinations that are delivered
in the first year?
 Overall the responsibilities of an exam are within each course.
 The committee sets policies so that the exams, for example, are given on an every
other week basis and always given on a Monday. The decision for pass/fail is a
committee decision.
 The content and structure of the exam is up to each course director.
o
Does the committee review the effectiveness of the examinations delivered in the CC1 year?
 No.
o
In terms of formative feedback with students, how does the CC1 committee assure that
appropriate feedback has been provided during the CC1 year?
 One of the advantages to block courses in year one is that they are long enough that
there are multiple exams, and when we set this every couple of week exam policy it
ensures that the students know where they stand.
 The Structure and Development block pioneered this year a system of student-peer
evaluation. It is a work in progress, but they are hoping that it could be the process by
which the faculty could identify potential student deficiencies and then meet those
students personally, one-on-one, and provide feedback based on personal
observations.
 As course directors, we get results of the exam, and every course director is in
contact with the students.
o
Does the committee monitor how long it takes to report grades to students?
 It is not an issue with first year.
 The multiple choice exam results are prompt.
o
How does this committee monitor student mistreatment?
 Student mistreatment information was recently provided in the course evaluation
information, but unfortunately we don’t know what to make of it. There are a few
students alleging mistreatment but we don’t get enough specificity so we don’t know
what this mistreatment consisted of or why they felt mistreated.
 Students have the option to meet with the ombudsman if they want to be more
specific.
o
Would this committee routinely see the graduation questionnaire data on student
mistreatment?
 The co-chairs have seen the data and the committee has access but may not have
reviewed it or brought it up at the committee level.
o
One of the new standards from the Liaison Committee on Medical Education is the need for
students to be introduced to the basic principles of clinical and translational research. How
are you doing currently on this?
 We have not created that as a buzz word. If we were to look at our curriculum we can
find examples because some of our faculty are connected with translational research
and use those examples. We need to address this specifically.
 We have lecturers in our course who talk about research that is translational, but we
just haven’t labeled it as such.
o
How does this committee monitor a student’s lifelong learning skills?
 From the beginning we get the students involved in reading and interpreting literature
and resources. Part is the life long earning skills but part is the ability to just interpret
information and know how to access it.
o
Does the committee take a look at the time available to students for independent study?
 When we designed the curriculum, we decreased it by 15 percent specifically to give
the students a little more independent study time. We haven’t set aside time that is
identified for that purpose.
o
Do you as a committee monitor student workflow?
 We do. We receive that information a lot of times from the students themselves and
we all look at this in terms of how we design our courses.
o
Does the course calendar come to this committee for approval? At what level of specificity is
that approved?
 It does. The allocation of time to courses, the distribution of exams, the integration of
time used by the students so that they are not overlapping or duplicating exams, etc.,
are approved by this committee. The actual content is left to each block.
o
What support is available to this committee with respect to helping with the curriculum design,
selection of appropriate teaching methods and development of student evaluation and
methods and metrics?
 We have received assistance from the Office of Educational Development in the past
and recently in terms of designing some evaluation forms and bringing in experts to
talk about innovative teaching strategies.
 Now that we have reorganized, we need to look again at how we are going to rebuild,
that but traditionally that has been a part of the Offices of Medical Education.
o
Are graduate students and/or residents involved in teaching and/or evaluation of students in
the CC1 year, and if so, how are they trained for their role?
 Anatomy uses residents, fourth-year medical students and graduate students.
 Structure and Development has not used students in evaluating or assessing the
first-year students; however, they do provide instruction. They receive mentoring both
from their clinical residency director and from basic science course directors in the
course for which they are providing instruction.
 Other courses have teaching assistants who serve as resources to the students.
o
Are residents involved in the ICM course?
 No.
o
Would you comment on the adequacy of the number, type and quality of teachers available to
teach the students during their first year?
 One of the biggest problems is that we feel from an administrative point of view as
course directors that we could get more effective teaching if we could focus on a few
teachers who were really good and committed, but this often conflicts with
departmental needs. We end up with a lot of teachers. We would actually like fewer.
 The model we are gravitating toward is to have a few core faculty lecturing and then
a number of clinical people who come in for well-orchestrated, limited appearances.
 Anatomy is the best example of this, but most of us are not gravitating in that
direction.
 We need financial support to pay a small number of good teachers to be full-time
teachers.
 Teaching is built on the back of research and other activities, and each person who
has a grant can do a little bit of teaching, but not all departments set aside funds for
dedicated teaching.
o
On a scale of one to 10, where teaching was not important is at level one and 10 is most
important, where would you rate teaching?
 It varies by department.
 In block 3, faculty ranking might be 5-6 in terms of faculty’s perception of its value; by
the institution it might be around 2.
 Teaching continues to be perceived as a hobby, which is unfortunate (by
administrators, not by faculty) in a sense of what institutional support there is in real
tangible terms. We are lucky that there are lots of faculty who see how important it is,
and lots of departments recognize its importance and make accommodations so that
people can teach. But there is still a perception that one has to make
accommodations and create opportunities because of a lack overarching institutional
commitment to teaching.
o
Is the space for teaching and the availability of computers and educational software
adequate?
 Small group teaching space is woefully inadequate and a serious barrier to teaching
certain courses.
 The audio-visual is very good in MBRB where we do large group classes.
 The layout of the rooms in Berryhill is inadequately designed.
o
What is your understanding of what will happen to Berryhill?
 That ceiling tiles will be put in and there will be Wi-Fi as well as a student lounge.
 Berryhill was never designed for small group teaching but rather as wet laboratories.
o
Could you comment on the strengths that you see of the first-year curriculum and if you could
change anything to enhance the student experience?
 A strength is the integrated block system because we have successfully integrated
the different disciplines. Each of the blocks in different ways has integrated clinically
as well.
 We have dedicated faculty.
 Need to enhance vertical integration.