Minutes from the Curriculum Committee Meeting
4/11/11
Topic
Attending:
Minutes
Information Items
Consent Agenda
Discussion
Bacon, Byerley, Bynum, Cairns, Chuang, Cross, Darrow,
Dent, Dreesen, Enarson, Farrell, Gilliland, Heck, Hobbs,
Marks, Newton, Perry, Quinto, Rao, Serra, Shaheen, Slatt,
Steiner, Stone, Viera, White, Woods
 No questions
Comments included:
 The SOM strategic planning will be quite relevant to
the work of the Curriculum Committee in terms of the
development of mission, core policies such as bylaws
(for faculty inclusion in ongoing activities), diversity
and APT and then finally Admissions, including the
possibility of rethinking our admissions process.
 Thanks to the Academy of Educators for Drs. Nivet and
the Cruesses. Both were excellent. The
professionalism workshops were foundational, coming
just at the right time to inform our curriculum.
 Regarding comparability of grade, across clerkships,
most give between 35-40% honors. Across campuses,
there is also one clerkship that’s an outlier in terms of
grade comparability. We are still off in inpatient
medicine. There appears to be some differences in
students across sites in that clerkship and will require
a further look.
 The Assistant Dean/Directors of the Office of Special
Programs has been offered. More later.

 LCME next steps: 1) Foundational is the reframing of
all blocks/clerkships and sessions in terms of
competencies and in light of our strategy for
curriculum reform. 2) The core task forces will take
place in late April and their input will come here and
to CCs.
 One45 as necessary will be critical in support of and to
manage new curricula including reports, clinical logs,
the new clerkship evaluation form, mid-course
evaluations, Advisory College and milestone report.
 Year-end retreats of each of the year curriculum
committees will be reviewing a) the implementation of
competencies in each course, b) calendar/duty hours,
c) success of the year and priorities for improvement
next year.
 School of Medicine CC retreat in late June is being
scheduled. NB: We’ll also need a retreat in the fall.
 Approved except for the CTSA. Further discussion

Action Items
Coordination and
timeliness is
important.
Committee endorsed
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about this. The report describes all of the courses that
might do a component of the curriculum. Do we have
endorsement of the general direction?
Following Up the
Retreat
approach. Kurt will
map precisely and
report back.
Other comments included:
 Do the clinical clerkships have a formal curriculum
with respect to asking questions, reviewing articles
and getting answers?
 How do we accomplish teaching patients about
research?
 Clin. Epi. does both the formal questions and answers
as well as teaching students to inform patients about
research. There may be other opportunities as well.
Strategies at the retreat decided upon are:
 Active learning in all courses
 As we create more active learning opportunities, an
internal goals becomes decreasing lectures to less
than 50% and requiring more accountability for
students having read materials in advance in the third
year.
 Systematic broadening of assessment process.
The committee endorsed these. Proposed additions were:
 Reduce the numbers of core faculty teaching both
in individual courses and ultimately across the
curriculum.
 Push small groups and assigned
readings/accountability in the first two years
 Have systematic programmatic measures and
follow up these principles.
Comments included:
 We need to be careful about the work inherent in
“active learning.” If we add prep work and tests, it
will add to student effort. Lots of tests will make
courses complicated. We need to track student
work time and probably decrease lectures to give
time for studying.
 The School of Pharmacy was able to pull back
(reduce by 2/3) and use class time only for face to
face experiences.
 Perhaps we can create a system whereby students
have options of lecture/iPods or last year’s lecture
capture vs. problem based learning and groups.
The idea is to accommodate individual learning
styles.
 In the clinical years, students need to prepare for
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the clinical experience, not just the didactic
experience. Again, we need to be careful about
pushing them too far.
Cameo lectures have a role, but the issue is they
are much more likely not to fit in with the overall
course/competencies and other things we are
trying to do. Perhaps a way of framing it is the
cameo lecture should be good only if it furthers
the objectives of the course and if teaching is
excellent.
Student representatives were very supportive of
reduced numbers of faculty within courses. Having
some faculty who teach in more than one session
and more than one course improves continuity
and responsiveness of faculty.
Consensus:
 We need to promote reduced numbers of
teachers within individual blocks initially, and over
the long term throughout the curriculum while
preserving occasional good cameos and
appropriate variation in the clinical years. Courses
and years will need to come to their best solutions
for their particular materials and to share best
practices. The core principle is active learning
throughout the curriculum.
 The group was divided about how much to push
advanced preparation and accountability. Clearly,
some of this is important, but the group was
worried about going too far in terms of advanced
preparation particularly if there wasn’t any
lessening of student work in other areas and to
respect student learning styles.
C. Next steps on major priorities
The next issue was strategies going forward. A proposal
was:
 To have a plan for population health; will come
back with a series of proposals for the May
Curriculum Committee meeting.
 To develop plan for calendar changes, to begin
that discussion at the next Curriculum Committee,
do planning over the course of the next year and
start in the following year (i.e., post LCME).
 Embedding regular ongoing assessment around
these core strategies will be critical.

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
Newton/Gilliland will
come back with a
proposal to CC
regarding
management of these
strategies and
improvement over
time.
CC1 and CC2 leaders
will follow up with
their CCs regarding
incorporating
strategies into play for
next year.
We will need to
develop a policy on
continuity of groups
and other structures
and peer feedback as
a key part of these
learning strategies.
Newton, OME and
Assessment Task
Force will follow up on
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this.
The Course Formerly
Called ICM

The proposed new name for ICM is Clinical Skills
Development and Clinical Skills Integration (replacing
ICM I and II). These are substantial changes from the
prior ICM in smaller groups, emphasis on symptomsbased curriculum, increased emphasis on differential
diagnosis and clinical integration, and rethinking of
community experiences and use of simulations.
Feedback questions included:

 General support for the strategy
 How will Pediatrics be developed? Ideally, one week
block in for Pediatrics in years 1 and 2 then Pediatrics
in the third year. The logistics are challenging. While
we are developing this, we will try to integrate more
clinical skills development with respect to Pediatrics .
 Core 24 symptoms are an important part of the new
courses. This a major contribution to coverage of the
UNC96 and the clinical integration around that.
 What about volume of ambulatory experience?
Ideally, we would have each one of these in a half day
of clinic/week over the first two years, but resources
don’t permit that. We believe that there will be more
clinical exposure to real patients in the current
curriculum as we move forward. Will specific skills be
taught? They could alter the transition to clinical
clerkships.
 How should we integrate ICM material with other
courses? Currently, we try to co-schedule and
integrate a certain number of symptom-based
problems into courses that are held at the same time.
On discussion, we raised the question of whether or
not we could include days in which we integrated
symptoms, basic science and clinical management on a
regular basis. Some medical schools do this with a

weekly quiz .
 Students were very supportive of combining all of
that. This is very consistent with their goals for this
year.

Student Self Study

CC affirmed direction
of development and
new course names.
OME will continue to
work with ICM faculty
to develop.
OME will work with
faculty in order to put
these in place.
OME will bring to the
Curriculum
Committee for
discussion next time.
People had a chance to review the synopsis. The full
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Education Certificate

document will be coming out in 1-2 weeks. Any
surprises? 1) The passion about laptops was strong. 2)
The love for MBRB; the students explained that this
should be seen in the context of the room itself but
not the distance between the two parts of campus and
in contrast to the other areas. 3) A surprise was what
the students described as a “culture of disrespect” for
students – more than single clerkship. It was a very
concerning issue. Combined with some of our
discussions around professionalism, this makes a need
for more systematic treatment such as an emphasis on
positive aspirational goals. It will be important to
coordinate with the institution and develop
procedures for both the positive and negative sides of
it, along with a strategy for changing the professional
culture.
The focus for discussion is: Should we have
certificates? These represent programs short of dual
degrees with some significant investment of
time/activities and which could be recognized in the
Dean’s letter and transcript.



OME and the task
force on
professionalism will
be following up.
We will review
student self-study
soon.
OME will develop
specific proposals for
further discussion.
Comments included:
 Students are quite interested in this. For some of
them, medical education and health disparities
research are passions.
 Some medical schools have developed tracks, as have
residencies, that are attractive (and more substantial).
 It’s unclear whether residencies currently look at or
would reward these things.
 Would this be a distraction given fundamental issues
we have around quality of education and teaching of
basic procedures, e.g., venipuncture?
 Do dual degree programs have more substance?
Perhaps a priority should be expanding those
programs further.
 Also, the clinical calendar redesign would support this
substantially.
 Students can get some of this coursework in the first
and second years. It doesn’t necessarily need to be in
clinical years.
Conclusion: Needs further discussion. If we do one,
make sure that it’s robust enough and pilot one.
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Curriculum Committee Meetings (monthly) in 238 MacNider:
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5/2 – 5-6:30pm
6/6 – 5:30-7pm
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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