THE SECOND-YEAR CURRICULUM COMMITTEE MEETING MINUTES
March 31, 2009: 4 p.m. to 5:30 p.m. in 133 MacNider
 LCME Internal Review Discussion:
LCME Review Committee: Carol Tresolini, Tom Bacon, Cam Enarson, Lisa Slatt, Daniel Fox. This committee asked
the following questions of the Curriculum Committee; answers appear below questions.

Institutional Competencies/Outcome Objectives: How do you use them to plan second-year curriculum and for the
individual courses in regard to content and assessment methodology? (Whether we use them or how we use
them)
 Harder to apply to medical students; easier with residents
 System-based practice isn’t feasible for medical students.
 Practice-based learning is hard to judge.
 Communication skills, Professionalism, Medical Knowledge – can get at to some extent
 Clinical practice – can assess very well – as addressed in ICM
 In general, the content is highly referable to the core competencies but it’s difficult to structure the course
around them.

When it comes to thinking about the second year’s contribution to the curriculum as a whole, how do you know
whether the overall competencies have been achieved at the end of the entire curriculum and what role the
second year had in that?
 The goal is medical knowledge and giving them a springboard to clinical skills.
 We look at Step 1.
 We look at their performance on the examinations that we give them, which give us a good feel for their
medical knowledge.
 There is a good deal of communication back-and-forth skills and how well they relate to situations that are
presented, they think on their feet, they think about it, get a consult from one of their colleagues. We bring
patients in and talk about how to approach the patients.
 The other core competencies we barely touch on.

Student Course Evaluations: How do you use them for development and evaluation for your individual courses as
well as your second-year curriculum?
 We read them all, but it is difficult when there are no narrative comments; the narrative comments are more
valuable
 We have a large set of narrative comments, some of which are more valuable then others. If it gives
constructive criticism and we see that it is justified, then we can make an appropriate change.
 The MSK course is going to provide a pre-test this year in an effort this year to determine what is
accomplished during their course. They will administer two almost identical tests at the beginning and end of
the course to get some measure of what they brought to the course from the first year as well as what they
learned during the course.

What is the role of this committee? In respect to CMPC? In respect to planning and evaluation?
 Each course is evaluated by the student.

Most courses have some piece of student peer evaluation in them.
 At the end of the course, the course evaluations and other criteria are reviewed by the curriculum committee
co-chairs with the block committee, and then the strengths and weaknesses are identified so we can plan for
remediation is developed.
 This committee is charged with the curriculum of the second year, but does not do this work in isolation.
 Curriculum Policy and Management Committee (CMPC) is responsible for the vertical integration among the
years, and the co-chairs of this committee sit on the CMPC.

Is there a formal process of periodic review of second-year courses and second-year curriculum as a whole?
 Individual courses are evaluated.
 We have not evaluated an entire year around the table.
 This has largely been left to CMPC.

This committee feeds information forward to the CMPC about what is working and not working and in turn,
receives information from the CMPC regarding information coming from LCME as well as other items the
course directors need to be made aware of.

How do you as a committee assure that there is horizontal integration within CC2 as well as vertical integration
with CC1 and CC34?
 We have organ-based courses in the morning and then longitudinal courses in the afternoon. The longitudinal
courses, such as ICM, have been successful at integrating with what is going on in the morning.
 At the end of every course we have an open discussion on the performance of the course -- the plusses and
minuses, the curriculum, etc. At that point we can identify any overlap and gaps and create better integration.
 We have also assessed through the entire second year how a particular topic is being dealt with. For
example, oncology was reviewed for duplications and omissions.

Do you know, for example with Heart Disease, what the students have learned from their first year and what they
are expected to know during their third year?
 It is the responsibility of each organ-based course director to know what is being taught in the first year.

What is the role of this committee in design and approval of student evaluation methods and frequency of exams,
etc.?
 We have worked on this hard in the committee. How we test, how often we test, grading policies have been
endorsed by this committee.
 The evaluation itself is not reviewed by this committee but within their own blocks.
 During the annual course evaluation each year we discuss what worked, what didn’t work and any changes
for the next year.

What is the process for the management of the student workflow, and how do you assure that students have time
for independent study?
 Each course director meets with student focus many times during the course to get feedback from students.
 The structure of the courses is consistent from week to week and year to year -- not a lot of variation.
 Students have free access to the course directors and laboratory instructors, and if they are getting behind
they will send emails to sort things out.

What is the average amount of time from the end of the block to the time when students will receive their grades?
 A week to 10 days is the average amount of time unless there are multiple exams and/or written material to
review. Then we get the course team to get together to review and discuss why some students failed.
 This has not been an issue with second-year students.

What has the committee done to monitor student mistreatment and harassment and to ensure that students are
learning in the appropriate learning environment?
 There are questions on the student evaluations and those would be looked at.
 Dr. Dent addressed this issue with the committee but nothing since then at any great length.

What support is available to faculty to assist in curriculum design or innovation, improving teaching methods and
designing student evaluations and tests?
 We have a Clinical Scholars program.
 We have invited speakers to this committee such as how to write appropriate test questions.
 The AIMS person is always very helpful and generous with her time.
 Receive support from OED whenever needed.

Are there any graduate students or residents involved in the teaching or evaluating of students during the second
year? How are they trained?
 Students/residents are used on a course-by-course basis. The course director assures that they are trained
before they teach.

Is the support for faculty in medical teaching appropriate as far as number, type, space, computer systems, etc?
 Meeting space is not always appropriate for what is needed for a specific course. Course may have to be
modified to adjust for the spaces.
 The support from OED has been variable throughout the years. There have been times when it was very well
staffed and could help with each block and other times there was no help. It appears that some things are
getting better.


Many folks don’t have educational degrees.
Course directors do not have administrative support within their division. Many course directors choose to do
things themselves because they always seem to be training a new person.

Is there a person coordinating each block?
 No. We don’t have a person who coordinates each year.
 Departmental support for teaching is variable, and we are losing good teachers.
 There used to be salary support for teaching. The clinical parts of the departments used to provide
administrative support but now some don’t see that they should be supporting teaching from clinical dollars.

There is a new LCME requirement for students to be introduced to the basic principles of translational clinical
research. What does the second year do to enhance this?
 Nothing formal.

What do consider the key strengths of the second-year curriculum? If you could have carte blanche to make
changes, what changes would you feel necessary to optimize student experience and learning outcomes?
 Within some blocks, the course directors have done an outstanding job of integrating basic science and
clinical medicine. That is a definite strength.
 We have done a fairly good job of cutting out redundancies being taught during the year. The students
provide excellent feedback, and we make appropriate changes.
 Financial support. There is 50 percent support while your block is running.

What changes has the committee made to improve Step 1 scores?
 We don’t teach to the test. We felt that this test wasn’t very predictive in what kind of doctor you will be.
 We don’t entirely understand the problem: the material we teach has not changed very much during the year,
but Step 1 scores dropped.
 Announcement : Survey about communication skills (Erin Malloy)
 A subcommittee from what was formerly LCSF is developing a way to assess the acquisition of competencies of
clinical communication skills.
 Survey all course directors in years one through four.
 Where are we teaching communication skills and where are we assessing them?
 Are there holes/redundancies?
 Are there communication skills not being addressed?
 Should we add podcasting to lecture capture?
 What is podcasting?
 Downloadable file that can be used on someone’s iPhone, Blackberry, etc., where they can listen to what they
would normally get from lecture capture. This is more flexible because it can be downloaded and taken with
them.
 We would need to make modifications to the curriculum system if we would include podcasting. Need to know
by May 1 so that programmers can begin the process.
 Pros:
 No additional cost to the school;
 Provides flexibility to students;
 Should not affect class attendance since they are already getting lecture capture.
 Cons:
 They are downloadable, but Word and PowerPoint presentations are already downloadable;
 Podcasting does not allow chaptering, which forwards to a particular topic.
 The CC1 and CC2 committees need to come to an agreement on whether or not to allow it.
 Faculty can elect in or out of podcasting, and this decision can be different than their decision to opt in or out
of lecture capture.
 The committee voted to make podcasting an option that you must opt in at the same as you do lecture
capture. This decision will be brought up to the CMPC.

Review of Step 1 results
 Compared to national data, we have a fewer students scoring high and even fewer students scoring low for
this year’s Step 1 scores.
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Should we be pulling our poor performers aside and remediate with them prior to Step 1?
If we concentrate on our bottom 5 percent it could dramatically change our results. Should we do a case study
on our poor performers?
The cause:
 Change to organ-based systems curriculum?
 Change to pass/fail?
 Other contributing factors?
Should we teach them how to take the board? Practice questions? Tricks?
We would like to form a subcommittee of volunteers to come up with some suggestions for CMPC to look at
to address some of theses issues and to work with a combined committee with CC1.
 Volunteers: Gerald Hladik, Ryan Madanick, Susan Hadler
NEXT MEETING
April 28, 2009 from 4:00 – 5:30 in MacNider 133