Agenda and Meeting Materials - UConn School of Medicine
Agenda and Meeting Materials - UConn School of Medicine
Agenda and Meeting Materials - UConn School of Medicine
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Education Council<br />
Wednesday, August 8 at 4:30pm<br />
Walker Conference Room, AG070<br />
<strong>Agenda</strong><br />
1. Approval <strong>of</strong> the minutes <strong>of</strong> June 2012<br />
Approval <strong>of</strong> the minutes <strong>of</strong> the special meeting <strong>of</strong> July 31, 2012<br />
2. Business Items<br />
Creation <strong>of</strong> an ad hoc subcommittee on visiting students (foreign, <strong>of</strong>f-‐<br />
shore US citizens <strong>and</strong> US/Canadian <strong>School</strong>s)<br />
3. Informational Items<br />
CCESC reports on Inpatient <strong>Medicine</strong>, Clinical <strong>Medicine</strong>, Human<br />
Development <strong>and</strong> Health<br />
Grading issues<br />
Open discussion the role <strong>of</strong> the Education Council<br />
4. St<strong>and</strong>ing Monthly Reports<br />
CUME<br />
GPC<br />
GME<br />
CME<br />
Next <strong>Meeting</strong>:<br />
Thursday, September 20, 2012<br />
4:30pm – Walker Conference Room<br />
Note the change to the third Thursday
Education Council<br />
June 13, 2012<br />
Minutes <strong>of</strong> the <strong>Meeting</strong><br />
Present: Adler, A.; Dieckhaus, K.; Guerrera, M.; Huey, L.; Kosowicz, L.; Kream, B; Mains, D.; Mayer, B.; Nissen, K.; Puddington, L.; Rajan,<br />
TV; Taxel, P.; Tulikangas, P.; Zalneraitis, E.;<br />
Guest: Dr. Dan Henry<br />
Topics Discussion Outcome<br />
Minutes <strong>of</strong> May 2012 Reviewed. Approved unanimously.<br />
MD/PhD Grading Policy Dr. Barbara Kream outlined the reasons behind the proposed changes to the<br />
MD/PhD Grading Policy.<br />
Approved unanimously.<br />
• This will effect only how the grades are transmitted to the Graduate<br />
<strong>School</strong> for credit<br />
• Other systems were investigated<br />
• A subcommittee was gathered: MD/PhD Director, Course Directors,<br />
students<br />
• Questions were asked <strong>of</strong> the MD/PhD listserv – received 35<br />
responses<br />
• GPA will reflect the graduate work<br />
• Performance <strong>of</strong> the students will continued to be monitored<br />
• Will need to go to the Graduate <strong>School</strong> for approval<br />
Information Only: Revised<br />
rules <strong>and</strong> regulations <strong>of</strong> the<br />
Academic Advancement<br />
Committee (AAC)<br />
Dr. TV Rajan explained the proposed revised rules <strong>and</strong> regulations:<br />
• Overview <strong>of</strong> the Committee <strong>and</strong> the range <strong>of</strong> actions that the AAC<br />
can take<br />
• Pr<strong>of</strong>essionalism is not yet delineated in the document due to the<br />
discussions underway currently in the Pr<strong>of</strong>essionalism Task Force<br />
• Suggestions can be sent to Dr. Rajan<br />
None.<br />
CCESC Report on MAX-‐2 Dr. Rajan explained the MAX-‐2 report compiled by the CCESC: None.<br />
1
• CCESC found that courses are well-‐run <strong>and</strong> well-‐liked<br />
• Concern that our students will no longer have access to a number <strong>of</strong><br />
good surgeons due to changes in the structure<br />
GME Report Dr. Zalneraitis provided the st<strong>and</strong>ing monthly report <strong>of</strong> the GME:<br />
None.<br />
• First dates for the self-‐studies – 2014<br />
• Pediatrics – 2020<br />
• DIO will have visits every 18 months<br />
• Orientation June 18<br />
• New exit interview<br />
• Policy committee is discussing how residents are allowed to go to<br />
conferences<br />
• Cost <strong>of</strong> residency<br />
• Update in the policy manual<br />
• Site visit on October 9, 2012 – key visit in terms <strong>of</strong> st<strong>and</strong>ing<br />
• <strong>Meeting</strong>s between GME <strong>of</strong>fice members <strong>and</strong> the affiliated hospitals<br />
CME Report No report. None.<br />
GPC st<strong>and</strong>ing monthly Dr. Kream noted that graduate school research day was well received. In None.<br />
report<br />
the future, notice <strong>of</strong> the event will be sent out in an email blast.<br />
CUME st<strong>and</strong>ing monthly None. None.<br />
report<br />
Next Accreditation System<br />
(NAS) presentation<br />
Dr. Nissen provided an overview <strong>of</strong> the Next Accreditation System:<br />
• Timeline <strong>of</strong> Accreditation<br />
• Resident duty hour st<strong>and</strong>ards – 16 member task force – creating a<br />
culture <strong>of</strong> safety that went beyond the debate on duty hours<br />
• Focus <strong>of</strong> the NAS – provide accountability to the public,<br />
communication <strong>and</strong> collaboration<br />
• Current impact <strong>of</strong> the NAS – details on data that is submitted<br />
• Scheduled site visits replaced by a 10-‐year visit with a self study<br />
• New common program requirements<br />
• Explanation <strong>of</strong> outcome requirements<br />
• Implementation <strong>of</strong> NAS begins in 2013 with certain programs, all<br />
remaining in 2014<br />
• Milestones will be implemented <strong>and</strong> milestone data compiled at<br />
certain points throughout the year<br />
None.<br />
2
• Clinical Competency Committee will become crucial – tracking,<br />
ensuring meaningful <strong>and</strong> manageable experiences<br />
• Program Directors must stay current<br />
• Overview <strong>of</strong> Entrustable Pr<strong>of</strong>essional Activities (EPAs) <strong>and</strong><br />
differences between EPAs <strong>and</strong> Milestones<br />
• Clinical Learning Environment Review (CLER) – generate national<br />
data on program <strong>and</strong> institutional attributes – Goal: move to a broad<br />
focus that can deliver a high level <strong>of</strong> patient care – results <strong>of</strong> the<br />
visits<br />
• Focus <strong>of</strong> CLER<br />
• Importance <strong>of</strong> change<br />
Discussion:<br />
• Parallels with other programs (UME, CME)<br />
• Reasoning behind the change<br />
•<br />
Timeliness <strong>of</strong> evaluation Dr. Dan Henry updated the EC on the timeliness <strong>of</strong> evaluation data:<br />
data<br />
• Doing very well, all within 15 days<br />
Update on the Third Year Dr. Henry noted that certain changes had been made to the third-‐year<br />
Curriculum<br />
curriculum:<br />
• Curriculum mapping will show the major changes that need to be<br />
made<br />
• Some duplication was taken out this past year<br />
• July 9 is the first day <strong>of</strong> the 2012/2013 academic year<br />
• Lottery went well<br />
• Student Clinician’s Ceremony on July 6<br />
• Orientation has been changed <strong>and</strong> improved<br />
For the next meeting Dr. Zalneraitis will be the acting chair for the next meeting.<br />
Many thanks to the EC members whose membership period has completed – Drs. Mayer, Kosowicz, <strong>and</strong><br />
With no further business, the meeting adjourned at 5:41pm.<br />
None.<br />
None.<br />
3
Education Council<br />
July 31, 2012<br />
Special <strong>Meeting</strong> – Minutes<br />
Present: Aguila, H.; Alerte, A.; Angus, S.; Adler, A.; Dodge-‐Kafka, K.; Huey, L.;<br />
Mains, D.; Nissen, K.; Puddington, L.; Rajan, T.; Rose, S. (chair); Taxel, P.;<br />
Wetstone, S.; Zalneraitis, E.<br />
Guest: Henderson, D.<br />
<strong>Meeting</strong> was called to order at 4:32pm.<br />
• Dr. Rose provided an overview <strong>of</strong> the changes in the strucuture <strong>of</strong> the MSPE<br />
Letter <strong>and</strong> the LCME st<strong>and</strong>ards surrounding the MSPE.<br />
• Explanation <strong>of</strong> student evaluations for the MSPE <strong>and</strong> the requirement (from the<br />
AAMC) to put students in quartiles or categories<br />
• Overview <strong>of</strong> nonacademic honors as they were determined previously at the<br />
SOM:<br />
o Admissions Committee<br />
o Inducted into Gold Humanism Honor Society<br />
o National member <strong>of</strong> a leadership organization<br />
o Combined degree<br />
• Students objected to the previous pattern for determining honors<br />
• Time issues surrounding MSPE letters – quick resolution needed as new deadline<br />
<strong>of</strong> October 1<br />
• Students unanimously endorsed the proposal<br />
• Committee on Undergraduate Medical Education (CUME) did not believe this<br />
proposal to need a vote as it was not a policy change, only a change in process<br />
Dr. David Henderson presented the proposal to the Committee<br />
• This proposal change in the criteria, not in the policy on nonacademic honors<br />
itself<br />
o After discussions with students, it seemed reasonable to make changes in<br />
the criteria<br />
o 3 categories were created (leadership, scholarship <strong>and</strong> service) <strong>and</strong><br />
students could apply in two <strong>of</strong> the three categories<br />
o Details on the three categories were given<br />
o The process has been moving forward after the CUME endorsement<br />
pending presentation to EC <strong>and</strong> there were 40 submissions in each <strong>of</strong> the<br />
three categories<br />
o Committee was setup to review data in de-‐identified manner – eliminate<br />
bias on the part <strong>of</strong> the reviewing faculty<br />
Education Council<br />
August 2012, page 4
o Committee has criteria, which is not released, by which to evaluate the<br />
submissions for each <strong>of</strong> the three categories<br />
o Maximum amount <strong>of</strong> honors = 8<br />
o Reasoning behind the changes<br />
o Previously, you could theoretically receive 4 nonacademic honors<br />
(however, it was very unlikely <strong>and</strong> the number <strong>of</strong> students who received<br />
nonacademic honors was relatively small) but with the changes you can<br />
now receive only 2 – this lowered so as not to overpower the weight <strong>of</strong><br />
academic honors<br />
o The graduate school was brought into the discussion on the changes,<br />
specifically there was a discussion that a combined degree <strong>of</strong>fers the<br />
benefit <strong>of</strong> the degree; only the scholarship resulting from the degree can<br />
be considered in this process (e.g. a PhD with no publications would not<br />
qualify for non academic honors in the medical school)<br />
o This proposal/process is thought not be a policy <strong>and</strong> is not located in a<br />
h<strong>and</strong>book<br />
Committee discussion<br />
• Discussion on whether or not this is a policy <strong>and</strong> not a procedure<br />
• Concern with grading policy<br />
• EC should be raising issues for the future<br />
o CUME has a better h<strong>and</strong>le on the day-‐to-‐day operations <strong>of</strong><br />
undergraduate medical education<br />
• Comments on the collegial environment <strong>and</strong> competition, as well as rankings<br />
• Discussion on the grading structure – along with positives <strong>and</strong> disadvantages<br />
• Impact <strong>of</strong> board scores, number <strong>of</strong> honors <strong>and</strong> AOA on residency placement<br />
• Continuous revaluating <strong>of</strong> what is being done for the students<br />
• Discussion on how the students can be best assisted<br />
• Students will be given specific instructions <strong>and</strong> examples <strong>of</strong> appropriate things to<br />
submit<br />
Motion was made to change this document to a process. The motion was seconded <strong>and</strong><br />
approved unanimously. It therefore did not require a vote but there was general<br />
consensus to support this.<br />
LCME Update<br />
• 15 original citations <strong>and</strong> 4 areas <strong>of</strong> transition<br />
• Currently: completely in compliance, with some areas compliance with a need<br />
for monitoring<br />
• Updated information is due to the LCME in December <strong>of</strong> 2013<br />
• Each <strong>of</strong> the areas in need <strong>of</strong> additional monitoring were outlined<br />
• Class expansion is paused due to the inability to increase class space<br />
• Additional educational space will be created under Bioscience CT<br />
Education Council<br />
August 2012, page 5
• Curriculum reform – retreats in September <strong>and</strong> November<br />
• Requests to involve more faculty at the ground level<br />
• Curriculum reform planned for January 2013<br />
• Question as to whether the Education Council is, <strong>and</strong> should remain, the keeper<br />
<strong>of</strong> the curriculum according to the bylaws<br />
Future meetings: Grading issues. Visiting students (foreign, <strong>of</strong>f-‐shore US citizens, <strong>and</strong><br />
US/Canadian schools). Interactions between departments having to do with financial aid<br />
<strong>and</strong> student debt. Discussing what we are doing with Dean’s Council. Bring operating<br />
guidelines back to the EC.<br />
Education Council<br />
August 2012, page 6
Inpatient <strong>Medicine</strong>: review <strong>and</strong> recommendations from CCESC<br />
May 2012<br />
Course description (adapted from the Blackboard site):<br />
Inpatient medicine encompasses 4 weeks <strong>of</strong> the Inpatient Course. At any given time, 12 -15<br />
students are rotating through the experience. The overall course director for the Inpatient<br />
experiences is Dr. Catherine Lewis. The Section Leader for Inpatient Internal <strong>Medicine</strong> is Dr.<br />
Dan Henry. The two major components are the educational sessions <strong>and</strong> patient care.<br />
Clinical Experiences<br />
The inpatient medicine section <strong>of</strong> the 'Inpatient Course' is currently a 4 week block. Students are<br />
placed at THOCC, Hartford Hospital, St. Francis Hospital, or John Dempsey Hospital. Shortly<br />
before each block begins, students receive information about their sites <strong>and</strong> all scheduled<br />
activities. Students are an integral member <strong>of</strong> a team <strong>of</strong> one or two R1's <strong>and</strong> one or two R2/R3's.<br />
Noon conferences <strong>and</strong> morning report are optional. Some students have preceptor rounds. Work<br />
up <strong>and</strong> write-up <strong>of</strong> at least two patients per week is required. Required clinical encounters (ED-2)<br />
include CHF, renal failure (acute or chronic), pneumonia, asthma/COPD <strong>and</strong> inpatient<br />
management <strong>of</strong> diabetes.<br />
Didactics<br />
Case based conferences occur weekly for a total <strong>of</strong> 14 hours. Students have rounds with a<br />
preceptor for 4-8 hours/rotation. There may also be additional didactics (gr<strong>and</strong> rounds, etc) for<br />
students at a particular site.<br />
Case conferences during inpatient medicine cover a range <strong>of</strong> common topics including acid-base<br />
disorders, fluid/electrolytes, ECGs, CXR, <strong>and</strong> interpretation <strong>of</strong> ABGs.<br />
Exam<br />
The Inpatient <strong>Medicine</strong> exam is a home grown exam. It is administered on the last Friday <strong>of</strong> the<br />
rotation. The questions pertain to the eight general learning topics: ID, acid base, renal failure,<br />
cardiology, pulmonary, GI, fluid <strong>and</strong> electrolytes, <strong>and</strong> ECGs.<br />
Grades<br />
A passing grade is awarded for receiving satisfactory evaluations on the rotation. An honors<br />
grade is earned in the discipline <strong>of</strong> Internal <strong>Medicine</strong> based on the student's performance in<br />
MAX (ambulatory) medicine <strong>and</strong> inpatient medicine. Honors are awarded at the end <strong>of</strong> the<br />
academic year based on an algorithm (see Appendix)<br />
Education Council<br />
August 2012, page 7
Evaluation <strong>of</strong> Inpatient <strong>Medicine</strong> by CCESC:<br />
In order to evaluate Inpatient Internal <strong>Medicine</strong>, we followed the course evaluation template<br />
developed by CCESC (please see appendix A). We collected <strong>and</strong> reviewed the following<br />
documents:<br />
• Lecture schedule (please see appendix A )<br />
• Inpatient <strong>Medicine</strong> Course Director Survey (Appendix B)<br />
• Clerkship goals, objectives <strong>and</strong> competencies (please see appendix C)<br />
• Composite evaluation form (please see appendix D)<br />
• Structured clinical observation (SCO) form (please see appendix E)<br />
• Inpatient <strong>Medicine</strong> 2011-12 student survey (please see appendix F)<br />
• Algorithm for Honors' designation (appendix G )<br />
As mentioned in the course evaluation template, we also interviewed Dr. Dan Henry at a<br />
regularly scheduled meeting <strong>of</strong> CCESC.<br />
CCESC findings <strong>and</strong> recommendations<br />
The most recent (AY2011-12) Inpatient student survey reports (appendix F) indicate that the<br />
students rate the overall experience positively. Thus,<br />
• 98.5% <strong>of</strong> students rated their rotation sites as good or excellent<br />
• 68% <strong>of</strong> students said that the goals <strong>and</strong> objectives were discussed thoroughly during<br />
orientation session (1st day)<br />
• 83% said that most or all aspects <strong>of</strong> the experience were well-integrated<br />
• 97% said that decision-making/responsibility was consistently or mostly appropriate<br />
<strong>and</strong> kept pace with increasing skills<br />
• 98.5% reported having a mid-point evaluation <strong>and</strong> ~88% said that they had had an<br />
end-<strong>of</strong>-rotation evaluation<br />
• 92% had an overall very good or excellent experience<br />
• The vast majority <strong>of</strong> students felt that the patient volume <strong>and</strong> diversity were excellent<br />
or good.<br />
• 94% felt that the level <strong>of</strong> precepting was appropriate.<br />
• 91% felt that the didactic sessions were good or excellent.<br />
Overall, CCESC finds that Inpatient <strong>Medicine</strong> is well designed <strong>and</strong> delivered. The<br />
students’ evaluations <strong>of</strong> the experience were positive overall. There are minor issues that CCESC<br />
found:<br />
Item # Finding Recommendations Action by course<br />
leaders<br />
1 Is the number <strong>of</strong> patients worked New policy to ensure a<br />
up adequate?<br />
minimum <strong>of</strong> 8 patients (2<br />
per week) is being<br />
Education Council<br />
August 2012, page 8
2 It appears that the ED-2<br />
requirements were not revised<br />
recently.<br />
3. Hospitalists have varying<br />
interactions with students at<br />
different sites<br />
4. Alcohol withdrawal was taught but<br />
appears to be shifting to the<br />
inpatient psychiatry curriculum<br />
5 Some faculty/site directors were<br />
not including adequate objective<br />
comments in written evaluations<br />
6 Case conferences are evaluated on<br />
the end <strong>of</strong> rotation survey<br />
implemented along with<br />
required rounds on 8 to 10<br />
patients. Is 2<br />
patients/week adequate?<br />
Since the LCME is<br />
particularly interested in<br />
ED-2 requirements, it<br />
might be a good idea to<br />
review the required<br />
combined clinical<br />
encounters periodically.<br />
Continue to monitor<br />
effect <strong>of</strong> hospitalists on<br />
student learning<br />
Monitor to ensure that this<br />
area is formally covered<br />
Bring faculty<br />
development sessions to<br />
sites so more affiliated<br />
faculty (site directors) can<br />
participate<br />
Consider evaluations at<br />
the end <strong>of</strong> each<br />
conference for more<br />
accurate <strong>and</strong> complete<br />
feedback to facilitators.<br />
Education Council<br />
August 2012, page 9
CMC : review <strong>and</strong> recommendations from CCESC.<br />
Course description: (from the CMC Blackboard site): The Clinical <strong>Medicine</strong> Course introduces<br />
students to their clinical role as physicians <strong>and</strong> allows them to develop the knowledge, skills,<br />
values <strong>and</strong> attitudes required to successfully interact with patients. The course focuses on the<br />
patient, the developing physician, other members <strong>of</strong> the health care team <strong>and</strong> the special <strong>and</strong><br />
complex relationships between them. It examines the roles <strong>of</strong> community <strong>and</strong> family in health<br />
<strong>and</strong> illness. It has two major sections: the Student Continuity Practice (SCP) <strong>and</strong> Principles <strong>of</strong><br />
Clinical <strong>Medicine</strong> (PCM). The course draws heavily on two major components <strong>of</strong> the <strong>School</strong> <strong>of</strong><br />
<strong>Medicine</strong>: The Clinical Skills Assessment <strong>and</strong> Community Based Education programs.<br />
Course organization:<br />
1. PCM:<br />
PCM takes place on Tuesday <strong>and</strong> Thursday afternoons from 1:00-5:00 p.m. Students<br />
meet in Core Groups <strong>of</strong> 8-10 students with two preceptors, a physician <strong>and</strong> a behavioral scientist<br />
or allied health pr<strong>of</strong>essional. Physicians are from a variety <strong>of</strong> specialties including Family<br />
<strong>Medicine</strong>, Geriatrics, Internal <strong>Medicine</strong>, <strong>and</strong> Pediatrics. Behavioral scientists <strong>and</strong> allied health<br />
pr<strong>of</strong>essionals include nurses, nurse practitioners, physician assistants, social workers,<br />
psychologists, sociologists <strong>and</strong> public health pr<strong>of</strong>essionals. Preceptors are paired in this way to<br />
give students exposure to the multidisciplinary aspects <strong>of</strong> health care <strong>and</strong> to the biopsychosocial<br />
model. Typically a 4 th year medical student will also be serving as a co-preceptor.<br />
Students learn <strong>and</strong> practice clinical skills in these groups <strong>and</strong> share experiences from their<br />
practice sites on a regular basis. Each Core Group has an assigned meeting room. The Core<br />
Group mixes students with SCP sites in suburban <strong>and</strong> urban practices <strong>and</strong> in the disciplines <strong>of</strong><br />
Family <strong>Medicine</strong>, Internal <strong>Medicine</strong>, <strong>and</strong> Pediatrics. Within that Core Group, students pair up as<br />
partners to learn physical diagnosis with each other.<br />
Basic principles <strong>and</strong> introductory sessions developing new topics are presented either in a Class<br />
<strong>Meeting</strong> in a lecture hall early in the year (before SCP assignments begin) or in a Team <strong>Meeting</strong><br />
in a large conference room or lecture hall. A Team <strong>Meeting</strong> is composed <strong>of</strong> PCM Core Groups<br />
that meet on Tuesday or Thursday afternoons.<br />
2. SCP:<br />
The Student Continuity Practice (SCP) is an important <strong>and</strong> unique component <strong>of</strong> the<br />
medical school curriculum. Students are assigned to work one half day a week for three years in<br />
a community physician’s <strong>of</strong>fice. The fundamental goals <strong>of</strong> SCP are to expose students to patients<br />
in a continuity setting <strong>and</strong> to allow them to become increasingly involved with patient care as<br />
their knowledge <strong>and</strong> skills develop <strong>and</strong> to practice newly taught history taking, physical exam or<br />
counseling skills. Students interact with large numbers <strong>of</strong> ambulatory patients with diverse<br />
medical conditions who receive ongoing comprehensive care at the SCP site. SCP provides the<br />
opportunity for students to form a mentoring relationship with a physician <strong>and</strong> to underst<strong>and</strong> the<br />
practice <strong>of</strong> medicine in the 21 st century. Students become integral members <strong>of</strong> the <strong>of</strong>fice <strong>and</strong> are<br />
Education Council<br />
August 2012, page 10
expected to work collegially with <strong>of</strong>fice personnel. Students also become knowledgeable about<br />
the communities served by the practice.<br />
SCP fosters the direct integration <strong>of</strong> basic medical <strong>and</strong> social science principles into the care <strong>of</strong><br />
individual patients. During the first two years <strong>of</strong> medical school, expectations for students at<br />
their SCP will be linked to those <strong>of</strong> PCM as well as the basic medical science [BMS] curriculum.<br />
As a result, by the time students enter the clinical rotations in their third year, they are<br />
experienced in interacting with patients, they are active learners, <strong>and</strong> adept problem solvers.<br />
Students have a better appreciation <strong>of</strong> the relevance to clinical practice from what they have<br />
learned in BMS <strong>and</strong> PCM.<br />
The Student Continuity Practice continues throughout the third year. However, the PCM Core<br />
Groups are now replaced by a pr<strong>of</strong>essional development (SCPIII) seminar that provides an<br />
informal opportunity to discuss with their peers <strong>and</strong> faculty the complexities <strong>of</strong> medicine as<br />
experienced in their clinical rotations in the third year. At the end <strong>of</strong> three years, students have a<br />
comprehensive view <strong>of</strong> their SCP patients as well as their practice site, providing them with a<br />
strong foundation upon which to choose an area for postgraduate training or research.<br />
Student evaluations.<br />
1. PCM<br />
• Student evaluations will reflect the student’s level <strong>of</strong> preparation, participation in Core<br />
Group discussions, quality <strong>of</strong> written work, mastery <strong>of</strong> clinical skills <strong>and</strong> pr<strong>of</strong>essional<br />
attributes.<br />
• PCM faculty will provide a major portion <strong>of</strong> the evaluation, giving ongoing feedback <strong>and</strong><br />
periodic formal evaluation. PCM preceptors will provide oral feedback during PCM<br />
sessions, written feedback <strong>of</strong> pr<strong>of</strong>essional journals <strong>and</strong> other assignments, <strong>and</strong> will meet<br />
individually with students at least twice a year. PCM faculty will contact the course<br />
director <strong>of</strong> PCM 1 or 2 if a student is not meeting expectations.<br />
• PCM preceptors complete a written evaluation that is submitted to the Dean’s <strong>of</strong>fice <strong>and</strong><br />
becomes part <strong>of</strong> the student’s permanent file. A copy <strong>of</strong> this form can be found on<br />
Blackboard in the Evaluation section.<br />
• There is a Clinical Skills assessment in the late spring which provides part <strong>of</strong> the<br />
information used for final evaluation at the end <strong>of</strong> each year <strong>of</strong> the course. Multiple other<br />
Clinical Skills assessment sessions throughout the year are to provide experience <strong>and</strong><br />
formative feedback for students <strong>and</strong> preceptors.<br />
• At the end <strong>of</strong> the course, students receive a grade <strong>of</strong> Satisfactory, Unsatisfactory, or<br />
Incomplete for CMC I or II. This grade reflects the summation <strong>of</strong> the evaluation across<br />
PCM, SCP, <strong>and</strong> Clinical Skills.<br />
• Students must pass CMC I <strong>and</strong> CMC II to pass CMC as a unit course <strong>and</strong> progress into<br />
the next phase <strong>of</strong> medical education.<br />
• The “Learning Assessment <strong>and</strong> Enhancement Program” is available for students needing<br />
individualized, intensive help in skill development <strong>and</strong> is described separately at the end<br />
<strong>of</strong> this section.<br />
Education Council<br />
August 2012, page 11
2. SCP<br />
• SCP preceptors complete a formative student evaluation at the midpoint each year <strong>and</strong> a<br />
final, summative evaluation at the end <strong>of</strong> years 1, 2 <strong>and</strong> 3. Preceptors are asked to assess<br />
their student's motivation, attendance, interpersonal skills, effort <strong>and</strong> commitment to<br />
SCP. The evaluation process is an opportunity for students <strong>and</strong> preceptors to: discuss<br />
whether or not goals <strong>and</strong> objectives have been met; to note the evolving role <strong>and</strong> skill<br />
level <strong>of</strong> the student; <strong>and</strong> to establish new goals <strong>and</strong> objectives to accommodate increased<br />
clinical competency within the SCP experience.<br />
Evaluation <strong>of</strong> CMC by CCESC.<br />
In order to evaluate CMC, we followed the course evaluation template developed by CCESC<br />
(please see appendix A). We collected <strong>and</strong> reviewed the following documents:<br />
• Course overview for CMC (please see appendix B).<br />
• PCM snapshot (please see appendix C)<br />
• SCP snapshot (please see appendix D)<br />
• Course direction survey (please see appendix E)<br />
• Student survey results for PCM 1 (please see appendix F)<br />
• Student survey results for PCM 2 (please see appendix G)<br />
• Student survey results for SCP (please see appendix H)<br />
• Faculty development that is provided (please see appendix I)<br />
As mentioned in the course evaluation template (appendix A), we also interviewed Dr. Lynn<br />
Kosowicz at a regularly scheduled meeting <strong>of</strong> CCESC.<br />
CCESC findings <strong>and</strong> recommendations<br />
The last review <strong>of</strong> CMC by the course <strong>and</strong> curriculum evaluation committee (in 2003-2004)<br />
begins with the following paragraph:<br />
"SCP is a highly successful, rewarding, <strong>and</strong> cutting-edge experience for medical students. This<br />
was cited as one <strong>of</strong> the 5 strengths <strong>of</strong> the University in the recent LCME visit. <strong>UConn</strong> is only one <strong>of</strong> 2<br />
schools in the country with the required 3-year continuity clinic. The clinical assessment portion <strong>of</strong> CMC<br />
course is excellent <strong>and</strong> extensive. This is also listed as a strength in the recent LCME visit."<br />
The current iteration <strong>of</strong> CCESC agrees entirely with the previous review. Committee members<br />
unanimously felt that under the leadership <strong>of</strong> Dr. Kosowicz, the CMC course has remained one <strong>of</strong> the<br />
signature courses in our school <strong>of</strong> medicine, one that is <strong>of</strong>ten mentioned by prospective medical students<br />
as a uniquely attractive feature <strong>of</strong> our curriculum. The course is singled out again in the most recent<br />
LCME visit (2010):<br />
“The Student Independent Analysis reflects general satisfaction with the course with 69%<br />
agreeing that the course was successful <strong>and</strong> valuable, <strong>and</strong> 94% <strong>of</strong> respondents rated it good-to-excellent<br />
on the 2009 AAMC Graduation Questionnaire. Students are overwhelmingly positive about the Student<br />
Continuity Practice.”<br />
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August 2012, page 12
The ratings in the 2010 AAMC graduation questionnaire were equally laudatory, with 99% <strong>of</strong><br />
students rating the course good or excellent. 84% <strong>of</strong> our students rated the CMC course as excellent,<br />
compared to 57% <strong>of</strong> students from all schools surveyed by AAMC (please see table below).<br />
Poor Fair Good Excellent Mean Count<br />
Uconn<br />
SOM<br />
0.0 0.0 15.8 84.2 3.8 57<br />
All schools 2.2 8.6 31.8 57.4 3.4 13,449<br />
Members <strong>of</strong> CCESC felt that there are features <strong>of</strong> CMC that make it a model course <strong>and</strong> that it<br />
would behoove other course leaders to attempt to emulate Dr. Kosowicz in at least two aspects:<br />
a. Dr. Kosowicz appears to have her pulse on national trends in clinical education. As a<br />
consequence, the CMC course has stayed current <strong>and</strong> cutting-edge. The admirable innovations<br />
introduced within CMC over the past few years points to the need, on the part <strong>of</strong> other course<br />
<strong>and</strong> section leaders, to participate more extensively in national discourse.<br />
b. At the last iteration <strong>of</strong> CCESC, the committee felt that faculty development was insufficient. To<br />
quote from the review,<br />
i. "Faculty development is insufficient, primarily due to lack <strong>of</strong> University<br />
resources <strong>and</strong> not to fault <strong>of</strong> CMC. New faculty need an extensive preparation to<br />
teach the curriculum in this innovative course – prior teaching experience <strong>and</strong><br />
expertise will not prepare them adequately."<br />
Perhaps in response to this critique, Dr. Kosowicz has developed a faculty development<br />
curriculum (please see appendix I).<br />
The student evaluations <strong>of</strong> SCP, PCM 1 <strong>and</strong> 2 by CCESC reveal a fairly consistent pattern <strong>of</strong><br />
positive, laudatory remarks. On Likert scales ranging from 1 to 5, with the latter representing the most<br />
positive rating, most survey questions received ratings in excess <strong>of</strong> 4, indicating very positive responses<br />
(please see appendices F, G, & H). Narrative comments are similarly strongly positive. It is clear that the<br />
students appreciate the quality education <strong>of</strong>fered by the CMC course. There are, however, some minor<br />
issues that may merit attention.<br />
Item # Finding Recommendations Action by course<br />
1 Blackboard organization is confusing<br />
to some students <strong>and</strong> does not seem<br />
to meet the needs <strong>of</strong> the course<br />
2 "Personal Wellness" learning<br />
objective does not seem to be covered<br />
adequately<br />
Request assistance from FITS to<br />
organize the Bb site for the course<br />
<strong>and</strong>/or look at alternative platforms<br />
to suit this course. In addition<br />
resources/s<strong>of</strong>tware should be made<br />
available such that the course leaders<br />
have the ability to adjust the schedule<br />
or other logistics with short notice<br />
<strong>and</strong> communicate this clearly to<br />
students <strong>and</strong> faculty in a timely<br />
manner.<br />
Some students felt that this objective<br />
is not met by the course. It is<br />
addressed, but some feel that it is not<br />
covered well. This should be<br />
reviewed <strong>and</strong> adjusted as able within<br />
the course. Discuss other places<br />
within the curriculum to address in<br />
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August 2012, page 13
3 Difficult for students to c<strong>and</strong>idly<br />
evaluate their SCP preceptors<br />
Conclusion:<br />
more detail, i.e. student advising<br />
groups.<br />
This is difficult to accomplish.<br />
Continue to monitor <strong>and</strong> consider<br />
alternative ways to provide feedback<br />
to preceptors (group oral reviews) .<br />
In summary, CCESC feels that the CMC course remains the signature achievement <strong>of</strong> our curriculum.<br />
That is much to be admired in the way that the curriculum is organized <strong>and</strong> presented.<br />
Education Council<br />
August 2012, page 14
HDH: review <strong>and</strong> recommendations from CCESC<br />
Spring 2012<br />
Course description: The course surveys the following subjects which are necessary to practice medicine<br />
in the context in which patients live <strong>and</strong> society functions: Health <strong>and</strong> the Health Care System, Health <strong>and</strong><br />
Behavior across the Lifespan, Health Law <strong>and</strong> Ethics, Clinical Epidemiology <strong>and</strong> the Biopsychosocial<br />
Perspective. Threads which are woven vertically into these 5 topic areas are population health,<br />
pr<strong>of</strong>essional health care <strong>and</strong> personal health themes.<br />
Course organization: HDH currently occupies 8 weeks <strong>of</strong> the 2nd year curriculum. Dr. Zita Lazzarini is<br />
the course director.<br />
With regard to modes <strong>of</strong> instruction, the following table lists the distribution <strong>of</strong> hours among lectures,<br />
exams/evaluation, <strong>and</strong> small group discussions:<br />
Instructional Method Scheduled Hours<br />
Lecture 91<br />
Small group discussion (case-based, etc) 33<br />
Examinations/student evaluation 8<br />
Total 132<br />
The curricular content is detailed in the attached appendices (please see appendix ).<br />
Students are evaluated by 2 exams: one covering the first four weeks <strong>of</strong> material <strong>and</strong> the other at the end<br />
<strong>of</strong> the course covering the last four weeks. Each examination contains multiple choice <strong>and</strong> short- <strong>and</strong><br />
long-answer essay questions which stress application <strong>of</strong> concepts <strong>and</strong> principles. Exam questions relate<br />
directly to learning objectives. Additionally the second exam tests clinical epidemiology by asking the<br />
student to respond to short answer questions based on a journal article provided in advance. In order to<br />
pass the course students must receive 75% <strong>of</strong> available points on the 2 exams combined, a 60% on each<br />
individual exam, satisfactory grade in conferences, satisfactory grade for required presentation in "Topics<br />
in Human Development <strong>and</strong> Health Conference" <strong>and</strong> must complete online training for performing<br />
research with human subjects.<br />
The format <strong>of</strong> the exams is indicated in the following table:<br />
Evaluation Format Percent <strong>of</strong> Grade<br />
Internal written exams: multiple choice,<br />
true/false, matching questions<br />
Internal written exams: fill-in, short answer<br />
questions<br />
Internal written exams: essay questions<br />
76%<br />
15%<br />
7%<br />
Education Council<br />
August 2012, page 15
Evaluation <strong>of</strong> HDH by CCESC<br />
In order to evaluate HDH, we followed the course evaluation template developed by CCESC<br />
(please see appendix A). We also sent Dr. Lazzarini the course director survey instrument developed by<br />
CCESC (please see appendix B). We collected <strong>and</strong> reviewed the following documents:<br />
• Introduction <strong>and</strong> overview 2011 <strong>of</strong> HDH (please see appendix C).<br />
• HDH learning objectives 2011-12 (please see appendix D)<br />
• Academic year 2011 HLE <strong>and</strong> CE formative <strong>and</strong> summative evaluations (please see appendices E<br />
<strong>and</strong> F.)<br />
• Topics in HDH evaluation form 2011 (please see appendix G)<br />
• Student survey results for HDH Fall 2011 (please see appendix H)<br />
• Shorter Academic year proposed changes for 2012-13 (please see appendix I)<br />
We also interviewed Dr. Lazzarini at a regularly scheduled meeting <strong>of</strong> CCESC.<br />
CCESC findings <strong>and</strong> recommendations<br />
Overall, CCESC finds that HDH is very well designed <strong>and</strong> delivered.<br />
The primary objective <strong>of</strong> HDH fits in well with many LCME st<strong>and</strong>ards including the following:<br />
ED-10: The curriculum must include behavioral <strong>and</strong> socioeconomic subjects, in addition to<br />
basic science <strong>and</strong> clinical disciplines.<br />
ED-20: The curriculum must prepare students for their role in addressing the medical<br />
consequences <strong>of</strong> common societal problems, for example, providing instruction in the diagnosis,<br />
prevention, appropriate reporting, <strong>and</strong> treatment <strong>of</strong> violence <strong>and</strong> abuse.<br />
ED-21: The faculty <strong>and</strong> students must demonstrate an underst<strong>and</strong>ing <strong>of</strong> the manner in which<br />
people <strong>of</strong> diverse cultures <strong>and</strong> belief systems perceive health <strong>and</strong> illness <strong>and</strong> respond to various<br />
symptoms, diseases, <strong>and</strong> treatments.<br />
ED-22: Medical students must learn to recognize <strong>and</strong> appropriately address gender <strong>and</strong> cultural<br />
biases in themselves <strong>and</strong> others, <strong>and</strong> in the process <strong>of</strong> health care delivery.<br />
ED-23: A medical school must teach medical ethics <strong>and</strong> human values, <strong>and</strong> require its students to<br />
exhibit scrupulous ethical principles in caring for patients, <strong>and</strong> in relating to patients' families<br />
<strong>and</strong> to others involved in patient care.<br />
ED-6 : The curriculum must incorporate the fundamental principles <strong>of</strong> medicine <strong>and</strong> its underlying<br />
scientific concepts; allow students to acquire skills <strong>of</strong> critical judgment based on evidence <strong>and</strong> experience;<br />
<strong>and</strong> develop students’ ability to use principles <strong>and</strong> skills wisely in solving problems <strong>of</strong> health <strong>and</strong> disease.<br />
ED-7: It must include current concepts in the basic <strong>and</strong> clinical sciences, including therapy <strong>and</strong><br />
technology, changes in the underst<strong>and</strong>ing <strong>of</strong> disease, <strong>and</strong> the effect <strong>of</strong> social needs <strong>and</strong> dem<strong>and</strong>s<br />
on care.<br />
Feedback from students in the form <strong>of</strong> the survey (Fall 2011) filled out by virtually 100% <strong>of</strong> the students<br />
(130 students) (see appendix H) is laudatory about the organization <strong>of</strong> the course, conferences, delivery,<br />
<strong>and</strong> evaluation process.<br />
CCESC did, however, find issues that were discussed with Dr. Lazzarini. These items <strong>and</strong> the<br />
recommendations are listed in the table below.<br />
Education Council<br />
August 2012, page 16
Item # Finding Recommendations Action by course<br />
leaders<br />
1 PCM <strong>and</strong> HDH overlap in certain Examine redundancies with .<br />
areas, but with different focuses. PCM <strong>and</strong> better refine <strong>and</strong><br />
Planned redundancies with PCM are eliminate as indicated.<br />
not well communicated to students Communicate planned overlap<br />
<strong>and</strong> should be examined to assess<br />
whether they are beneficial or if time<br />
can be used in other ways<br />
with PCM to all students.<br />
2 Many feel that the 8 weeks devoted to Course will be 7 weeks in Should be<br />
HDH are too long.<br />
2012-13 which corresponds to<br />
a 10% cut in hours. See<br />
Appendix I for planned<br />
changes. Additional hours will<br />
be gained in the afternoon<br />
from CMPS.<br />
confirmed that<br />
dental students will<br />
be available during<br />
the CMPS<br />
afternoon hours<br />
which are unused<br />
during the first<br />
weeks <strong>of</strong> class<br />
3 "Special topics" was an area <strong>of</strong> Consider having deadlines for<br />
concern since presentations occur at students to confirm their<br />
the end <strong>of</strong> the course near the topics, provide resource list<br />
examination.<br />
etc. <strong>and</strong> encourage early<br />
completion <strong>of</strong> presentation.<br />
4 Course survey data should be split so Speak to FITS about setting up<br />
the medical school <strong>and</strong> dental school the survey to allow<br />
can assess their students.<br />
discrimination between the<br />
students in each school.<br />
5 Film about aging was felt to be Discuss with conference<br />
redundant with a lecture <strong>and</strong><br />
instructors better ways to<br />
conference <strong>and</strong> students did not feel<br />
engaged.<br />
engage students in the session.<br />
6 HDH might fit better in the first year The placement <strong>of</strong> HDH in the<br />
curriculum. Biostats fits naturally curriculum should be reviewed<br />
with HDH.<br />
by CUME.<br />
7 HDH is a complicated,<br />
Administrative support for<br />
multidisciplinary course with many HDH should continue at the<br />
faculty required. Administrative<br />
support is critical<br />
existing level.<br />
8 Faculty training <strong>and</strong> development is Increase faculty development<br />
provided prior to conferences, but in the area <strong>of</strong> evaluation <strong>and</strong><br />
more is needed for faculty in<br />
assessing <strong>and</strong> writing narratives.<br />
writing narratives.<br />
9 Narratives provided in conference Correspond with faculty about<br />
evaluations could be more complete. increasing the quantity <strong>of</strong><br />
narrative provided in<br />
conference evaluations (also<br />
see #8)<br />
Education Council<br />
August 2012, page 17
Conclusion:<br />
The committee feels that HDH is full <strong>of</strong> valuable content some <strong>of</strong> which is being reduced, along with that<br />
in other courses in the second year. The course has been seen as too long by students for many years.<br />
This impression may or not change with the new changes.<br />
Education Council<br />
August 2012, page 18
Committee on Undergraduate Medical Education<br />
Minutes <strong>of</strong> the <strong>Meeting</strong><br />
July 29, 2012<br />
4:30pm – Medical Dean’s Extension, L5095<br />
Present: Thatcher, C. (acting chair); Guerrera, M.; H<strong>and</strong>, A.; Henry, D.; Makoul, G.; Oliver, D.; Palma-‐Sisto, P.; Summerer, M.; Rajan,<br />
T.; Regan, T.; Siegel, G.; Watras, J.; White, S.;<br />
<strong>Meeting</strong> called to order at 4:30pm.<br />
Topic Discussion Results<br />
Minutes <strong>of</strong> the previous<br />
meeting<br />
Tabled. N/A<br />
Policy from the CCESC Dr. Rajan provided information on the proposed policy:<br />
Focus Groups: Motion was<br />
concerning data gathering • The forming <strong>of</strong> the CCESC<br />
made to allow time for<br />
strategies (T. Rajan)<br />
• History <strong>of</strong> the committee<br />
exploration <strong>of</strong> feasibility <strong>of</strong><br />
• Details on the surveys currently provided to students on focus groups by reviewing<br />
individual courses<br />
multiple areas including<br />
• Proposal for the different methods for attaining information on expertise to run the focus<br />
courses<br />
groups <strong>and</strong> a pilot program.<br />
• Focus groups <strong>of</strong> students – r<strong>and</strong>om sampling <strong>of</strong> students Unanimous.<br />
• Medical Education Gr<strong>and</strong> Rounds with Dr. Polifroni on focus<br />
groups in October<br />
• Faculty (peer) evaluations – two individuals will review a section<br />
<strong>of</strong> the first <strong>and</strong> second year curriculum<br />
Faculty Evaluations: Motion<br />
was made to forward this<br />
proposal to the Academy <strong>of</strong><br />
CUME discussion:<br />
• Students chosen as part <strong>of</strong> the r<strong>and</strong>om sampling should be<br />
required to participate as a requirement <strong>of</strong> pr<strong>of</strong>essionalism<br />
• Students should participate in one sampling per year<br />
• Suggestion for longer intervals between focus groups<br />
• Discussion regarding how to make this feasible in the third <strong>and</strong><br />
fourth year-‐ need a large enough on for each site. Suggested that<br />
focus groups for clinical rotations only occur twice per year.<br />
Distinguished Educators,<br />
with a request for a specific<br />
format <strong>and</strong> action plan for a<br />
faculty peer evaluations for<br />
approval, which will then go<br />
to the Sr. Assoc. Dean <strong>and</strong><br />
then the SAPC. Unanimous.<br />
1<br />
Education Council<br />
August 2012, page 19
CCESC report on Inpatient<br />
<strong>Medicine</strong> (T. Rajan)<br />
CCESC report on the<br />
Clinical <strong>Medicine</strong> Course<br />
(T. Rajan)<br />
• Proposal would be in addition to what the CCESC is working to<br />
accomplish<br />
• Proposal would provide a balanced view <strong>of</strong> faculty <strong>and</strong> student<br />
opinions on the course<br />
• Discussion on the delivery <strong>of</strong> material versus the material itself<br />
(content)<br />
• Suggestion for CUME to support<br />
• Suggestion to send it to the SAPC <strong>and</strong> tie the proposal to<br />
promotions-‐ dual purpose<br />
• Purpose is to both improve the curriculum <strong>and</strong> provide feedback<br />
to the individual faculty members which may be used in<br />
promotion <strong>and</strong> merit review. This would also allow a trigger for<br />
faculty mentorship.<br />
• Overview <strong>of</strong> the course<br />
• Number <strong>of</strong> weeks <strong>and</strong> the locations for placement<br />
• Overview <strong>of</strong> the examination <strong>and</strong> process<br />
• Well-‐received by the students<br />
• Suggestions: Further outline the goals <strong>and</strong> objectives to students<br />
• ED-‐2 requirements should be examined<br />
• Improvements enacted this year<br />
• Overview <strong>of</strong> the components <strong>of</strong> the course<br />
• Course is functioning well<br />
• Course is continuingly innovational<br />
• Use <strong>of</strong> blackboard is a problem<br />
• Students felt that personal wellness was not addressed<br />
• Student evaluation <strong>of</strong> faculty preceptors in the SCP course has<br />
problems without a solution currently due to the lack <strong>of</strong><br />
anonymity<br />
• Overall, course is very well-‐received<br />
• Students have many thoughts on CSAP but they are not reflected<br />
on the surveys<br />
None.<br />
None.<br />
2<br />
Education Council<br />
August 2012, page 20
CCESC report on Human<br />
Development <strong>and</strong> Health<br />
(T. Rajan)<br />
Proposed changes to<br />
Mechanisms <strong>of</strong> Disease<br />
(D. Henry)<br />
Discussion by CUME:<br />
• Discussion on CSAP <strong>and</strong> suggestion to use the SIM center<br />
• Recommendation to change the CSAP evaluation – suggestions<br />
for where the evaluation should focus<br />
• Usefulness <strong>of</strong> feedback<br />
• Overview <strong>of</strong> the course <strong>and</strong> the components<br />
• Issues outlined, some have been addressed<br />
• Overlap <strong>of</strong> information between PCM <strong>and</strong> HDH <strong>and</strong> suggestion<br />
made to discuss what can be changed<br />
None.<br />
Dr. Henry outlined the changes to the MOD. Motion was made to<br />
approve the changes.<br />
Seconded. Approved<br />
unanimously.<br />
COSC Dr. Henry provided an overview <strong>of</strong> the COSC actions <strong>and</strong> decisions. None.<br />
CCESC Previously covered. None.<br />
Alpha Omega Alpha (AOA) will be brought before the CUME in the future. Suggestion for a town hall <strong>and</strong> a transparent discussion<br />
with the students. Ongoing discussion.<br />
Dr. Rajan will circulate his paper for the AAMC convention on shortening the number <strong>of</strong> years <strong>of</strong> medical school.<br />
<strong>Meeting</strong> adjourned at 5:33pm.<br />
3<br />
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August 2012, page 21