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Agenda and Meeting Materials - UConn School of Medicine

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Approval <strong>of</strong> the minutes<br />

• April 28, 2013<br />

Consent Items<br />

• None<br />

Business Items<br />

• None<br />

Education Council<br />

<strong>Agenda</strong><br />

May 23, 2013<br />

Informational Items<br />

• Update on the ad hoc subcommittee on EC’s charge (K. Nissen)<br />

• Update on the ad hoc subcommittee on visiting students (K. Dieckhaus)<br />

• Update on the AMA Grant (S. Rose)<br />

• Proposed procedural requirement (E. Nestler)<br />

• Proposed policy on anatomical donation to the <strong>UConn</strong> <strong>School</strong> <strong>of</strong> <strong>Medicine</strong> (C.<br />

Thatcher)<br />

• Update on the anatomical donation program audit (C. Thatcher)<br />

• Discussion <strong>of</strong> the nomination <strong>of</strong> representatives for the Dean’s Council<br />

St<strong>and</strong>ing Monthly Reports<br />

• GME<br />

• GPC<br />

• CME<br />

• CUME<br />

The next meeting will be held on<br />

June 20 at 4:30pm<br />

Walker, AG070


Education Council<br />

April 18, 2013<br />

Minutes <strong>of</strong> the <strong>Meeting</strong><br />

Present (voting): Rose, S. (chair); Adler, A.; Dieckhaus, K.; Dimario, F.; Dodge-­‐Kafka, K.; Guerrera, M.; Guha, A.; Kream, B.;<br />

Puddington, L.; Wetstone, S.;<br />

(non-­‐voting): Mains, D.; Nissen, K.;<br />

Excused (voting): Alerte, A.; Angus, S.; Aguila, H.; Taxel, P.; Zalneraitis, E.<br />

(non-­‐voting): Huey, L.;<br />

Guests:<br />

Topics Discussion Outcome/Action<br />

Items<br />

Minutes <strong>of</strong> March<br />

2013<br />

Reviewed. Approved.<br />

Nominations for Replacement members for the representatives to the Dean’s Council should be None.<br />

the Education nominated.<br />

Council<br />

• Members will need to vote on this matter in May/June<br />

• 3 year term renewable<br />

• Information on the regulations provided<br />

Two vacancies for basic scientists on Education Council:<br />

• Faculty names proposed<br />

GME Report Dr. Nissen provided an overview <strong>of</strong> the GME Program:<br />

• Accreditation<br />

• Match<br />

None.<br />

EC - May 23, 2013<br />

Page 1


• SOAP<br />

• Upcoming orientation<br />

• Visit in otolarynghitis<br />

• Process to capture radiation data from all <strong>of</strong> the other hospitals<br />

GPC Report Dr. Kream provided an overview <strong>of</strong> the Graduate Program.<br />

• Appointment <strong>of</strong> a new Dean <strong>of</strong> the Graduate <strong>School</strong><br />

• Overview <strong>of</strong> incoming students – highest caliber ever<br />

Integrative Member proposed speaking on integrative medicine in a 10-­‐minute overview in May<br />

medicine<br />

or a future meeting.<br />

AMA Grant Dr. Rose provided an update on the AMA Grant:<br />

• Letters <strong>of</strong> support from the administration<br />

• Declaration <strong>of</strong> support<br />

Dr. Rajan noted the present status <strong>of</strong> the grant:<br />

• Basic structure <strong>of</strong> the proposed curriculum<br />

• Function <strong>of</strong> the classroom<br />

• Interpr<strong>of</strong>essional teams<br />

• VITAL teams<br />

• EMR case-­‐based work<br />

• Logic behind the curriculum revisions<br />

• Based entirely on concept <strong>of</strong> milestones<br />

• Changes to the clerkship model – fashioned after patient-­‐centered home<br />

medical model<br />

• Use <strong>of</strong> technology in the new model<br />

• Family case models<br />

• Names for the levels <strong>of</strong> learners<br />

None.<br />

None.<br />

Motion was made<br />

to endorse the AMA<br />

grant proposal.<br />

Seconded.<br />

Approved<br />

unanimously.<br />

EC - May 23, 2013<br />

Page 2


Suggestions from the EC:<br />

• Links to the Kahn Academy information<br />

• Send back out along with information on how it relates to the grant<br />

• Presently working to underst<strong>and</strong> the costs <strong>of</strong> the curriculum<br />

• How many FTEs are used<br />

• Cost <strong>of</strong> teaching hours in UME <strong>and</strong> the Graduate <strong>School</strong><br />

• Comments about engaging clinical faculty<br />

• Compensating faculty for time spent teaching<br />

• SCP issues with regard to specialists – some specialties may be broad enough<br />

• Suggestions to stick with the generalist approach in the first year<br />

• Details on what the specialist would be used for <strong>and</strong> how it would work<br />

logistically<br />

• There are financial challenges <strong>and</strong> much work is being done on keeping the<br />

curriculum cost-­‐effective<br />

• Comments from the faculty that there are concerns about the grant<br />

• Suggestion for outside individual to speak about the relevance <strong>of</strong> medical<br />

education<br />

• Individuals have been invited to Med Ed GR<br />

• Suggestion that the support <strong>of</strong> the Education Council will assist with changing<br />

the culture<br />

• An additional forum will be held<br />

• The faculty need meaningful involvement in this process<br />

• The AMA’s process is very short, which has forced the grant process to move<br />

along quickly<br />

• Comments that change is needed in the curriculum<br />

• Member noted that the concern is that students will be unprepared for their<br />

courses in Neurology <strong>and</strong> Psychiatry<br />

EC - May 23, 2013<br />

Page 3


• Individuals are concerned about their positions <strong>and</strong> appointments<br />

• Response that in the new curriculum students will have more meaningful <strong>and</strong><br />

active learning<br />

• Comments that the learners in this generation are different <strong>and</strong> more<br />

involved in technology<br />

• The grant is just a guidepost <strong>and</strong> not necessarily exactly how it is going to be<br />

implemented<br />

• Next steps for the grant outlined<br />

All comments on the grant are welcome. The grant will be posted on 4/22/13 the<br />

committee will be emailed when it is available.<br />

<strong>Meeting</strong> adjourned at 5:47pm<br />

EC - May 23, 2013<br />

Page 4


Proposed Revisions to the Education Council<br />

Charge & Membership<br />

Compiled by the Ad Hoc Committee on EC’s Charge<br />

May 23, 2013<br />

PROPOSED DUTIES, AUTHORITY AND MEMBERSHIP<br />

Duties & Authority<br />

Education Council’s role is one <strong>of</strong> oversight <strong>and</strong> the Council is the central authority for all sponsored<br />

educational programs in the <strong>School</strong> <strong>of</strong> <strong>Medicine</strong> (SOM). EC plays a visionary role in that it considers future<br />

innovations, future needs <strong>and</strong> direction for the institution. The role <strong>of</strong> EC is not merely evaluative or<br />

reactionary; the Council is charged with inspiring <strong>and</strong> in some cases requiring the educational domains to<br />

consider new directions, discard old paradigms, <strong>and</strong>/or engage in collaborative work. The EC is also an<br />

advocate for the educational mission <strong>of</strong> school <strong>and</strong> will promote an appropriate balance between this <strong>and</strong><br />

the other missions <strong>of</strong> the school (i.e. research, clinical care, job development, etc.)<br />

Education Council, as a rule, delegates domain-­‐specific functions such as policy, curriculum <strong>and</strong> evaluation<br />

to the appropriate <strong>and</strong> responsible academic governance committees: CUME for undergraduate medicine,<br />

GMEC for the graduate medical education program, GPC for the graduate program, <strong>and</strong> CCMEC for<br />

continuing medical education. Any actions that change the culture <strong>of</strong> the school or any actions that affect<br />

two or more <strong>of</strong> these academic domains (e.g. GPC <strong>and</strong> GMEC) will require the review <strong>and</strong> direct approval<br />

<strong>of</strong> the EC. In addition, the EC is responsible for ensuring that the academic domain committees are<br />

functioning effectively <strong>and</strong> that the school is in compliance with all accreditation st<strong>and</strong>ards.<br />

The EC reviews the Annual Reports from all Education Domains, including the Annual report from the<br />

Senior Associate Dean for Education. Additionally, the EC annually reviews the resources provided to<br />

each educational domain <strong>and</strong> determines if these resources are appropriate.<br />

Membership<br />

In order to ensure an appropriate faculty voice in the decisions made in the educational domains, 1<br />

membership in the EC is comprised <strong>of</strong> a number <strong>of</strong> voting elected faculty, voting appointed faculty, <strong>and</strong><br />

ex-­‐<strong>of</strong>ficio non-­‐voting faculty.<br />

Membership<br />

Ex-­‐<strong>of</strong>ficio, Non-­‐voting members (5) 2<br />

a) Sr. Assoc. Dean for Education, Chair<br />

b) Assoc. Dean for GME<br />

c) Assoc. Dean for the Graduate <strong>School</strong><br />

d) Assoc. Dean for CME <strong>and</strong>/or similar<br />

e) Director <strong>of</strong> Undergraduate Medical Education<br />

Voting Members (14) – quorum is 8 voting members<br />

f) 4 elected members <strong>of</strong> the basic sciences<br />

g) 4 elected members <strong>of</strong> the clinical sciences<br />

h) 3 appointed members <strong>of</strong> the basic sciences<br />

i) 3 appointed members <strong>of</strong> the clinical sciences<br />

Clinical faculty must be supported ≥10% financial support for education in “E” or “A1” (educational<br />

administration) on their CREATE pr<strong>of</strong>ile or its equivalent as determined by the Senior Associate Dean for<br />

Education. Basic Science faculty must be able to demonstrate a significant contribution to education.<br />

Elected members are staggered 3-­‐year terms with a chance to be re-­‐elected. Appointed members have<br />

EC - May 23, 2013<br />

Page 5


their appointments examined yearly with turnover as needed up to a three-­‐year term. The Assoc. Dean<br />

for GME appoints one clinical faculty member. The Assoc. Dean for the Graduate <strong>School</strong> appoints one<br />

basic science faculty. All other appointments are made by the Senior Associate Dean for Education.<br />

Ongoing discussion<br />

1. In a similar vein, we have discussed the need to change the membership <strong>of</strong> CUME to have voting,<br />

elected faculty. More controversial was the idea <strong>of</strong> elected faculty on GMEC <strong>and</strong> that was an<br />

issue we said we’d put in front <strong>of</strong> EC.<br />

2. Should the majority <strong>of</strong> voting members be elected faculty?<br />

EC - May 23, 2013<br />

Page 6


Procedures requiring documented competency for graduation<br />

All others procedures are optional <strong>and</strong> require direct supervision<br />

Basic procedures: (General supervision appropriate when competent)<br />

Less rigorous supervision is required for procedures which carry minimal risk. Medical students<br />

should be observed by a qualified supervisor to assure that they are competent while<br />

performing any <strong>of</strong> these procedures until they meet the requirement for general supervision. A<br />

qualified supervisor must be readily available while these procedures are being performed.<br />

Students will be competent after successfully completing the specific procedure 3 times.<br />

Documentation (i.e. 3) must be finalized at completion <strong>of</strong> the ACE clerkships. Unless indicated<br />

by ⁺⁺, procedures can be observed <strong>and</strong> logged in any clerkship.<br />

*=skills are assessed by exam <strong>and</strong>/or direct observation <strong>and</strong> documentation(ED-­‐2)<br />

⁺⁺=required in this Clerkship<br />

Procedure Clerkship<br />

Breast Exam PCM1/obgyn/surgery SCO⁺⁺<br />

EKG interpretation Bootcamp/EM/Inpatient med⁺⁺<br />

Finger stick PCM 1(Intro to Ambulatory<br />

procedures)/SCP/FM/other<br />

Immunization administration SCP/PCM 1/outpatient pediatrics or FM<br />

Intradermal skin testing PCM 1(Intro to Ambulatory<br />

procedures)/FM/pediatrics/other<br />

IV placement Bootcamp/ACE/EM⁺⁺<br />

Peak flow measurement (obtain) SCP/FM/outpatient IM/other<br />

Pelvic exam <strong>and</strong> PAP PCM2/ObGyn⁺⁺<br />

Phlebotomy/venipuncture SCP/Bootcamp/surgery/ACE<br />

Throat culture/rapid strep PCM1/Outpatient pediatrics⁺⁺<br />

Urethral catheterization <strong>of</strong> female ObGyn/Surgery<br />

Urethral catheterization <strong>of</strong> male(under anesthesia) Surgery<br />

Urinalysis technique (dipstick) PCM 1 (Intro to Ambulatory<br />

procedures)/FM/outpatient medicine<br />

ObGyn/other<br />

Wet prep <strong>and</strong> KOH ObGyn⁺⁺<br />

Competencies always requiring direct supervision:<br />

Those procedures carrying significant risk include any procedure requiring written consent from the<br />

patient as well as central venous line placement, external or internal jugular vein puncture, joint<br />

aspiration, <strong>and</strong> arterial line placement. Any student performing one <strong>of</strong> these procedures must be<br />

directly observed by a competent supervisor. The supervisor must be present <strong>and</strong> must be prepared to<br />

take over in the event <strong>of</strong> any difficulty.<br />

Procedure Clerkship<br />

Arterial puncture Surgery, AIE, EM or Critical Care*<br />

Knot tying Bootcamp/Surgery<br />

NG Tube Insertion ?Simulation/Surgery/Critical Care<br />

Ultrasound (neck veins) EM/CC<br />

Draft #5 eon<br />

EC - May 23, 2013<br />

Page 7


Anatomical Donation to the <strong>UConn</strong> <strong>School</strong> <strong>of</strong> <strong>Medicine</strong> Policy Proposal:<br />

The procurement, use <strong>and</strong> disposition <strong>of</strong> anatomical donations to the <strong>UConn</strong> <strong>School</strong> <strong>of</strong> <strong>Medicine</strong>, at the<br />

<strong>UConn</strong> Health Center (UCHC) <strong>and</strong> John Dempsey Hospital.<br />

I. Policy Statement:<br />

The University <strong>of</strong> Connecticut <strong>School</strong> <strong>of</strong> <strong>Medicine</strong> accepts the donation <strong>of</strong> bodies for the<br />

purposes <strong>of</strong> education <strong>and</strong> research. Individuals may donate their bodies pursuant to<br />

Chapter 368i <strong>of</strong> the Connecticut General Statutes. The <strong>School</strong> <strong>of</strong> <strong>Medicine</strong> recognizes the<br />

immensity <strong>of</strong> these donations, <strong>and</strong> makes every effort to respect the donor <strong>and</strong> their<br />

families. The University in its efforts to be compliant with health, safety <strong>and</strong> ethical<br />

st<strong>and</strong>ards is providing these procedures, which assigns appropriate oversight <strong>and</strong><br />

management in regard to the use <strong>of</strong> all cadavers/parts used by the <strong>School</strong> <strong>of</strong> <strong>Medicine</strong> <strong>and</strong><br />

any associated entity granted permission by the <strong>School</strong> <strong>of</strong> <strong>Medicine</strong>.<br />

II. Definitions:<br />

• Anatomy Donation Coordinator -­‐ A position at <strong>UConn</strong> whose responsibility includes<br />

obtaining suitable bodies for the anatomy program, the embalming <strong>of</strong> the bodies,<br />

storage, transportation <strong>and</strong> cremation. This person has general oversight <strong>of</strong> all<br />

portions <strong>of</strong> the donation program, including correspondences, materials <strong>and</strong><br />

supplies, <strong>and</strong> documentation.<br />

• Cadaver <strong>and</strong> Human Body Parts: Human remains donated to the <strong>School</strong> <strong>of</strong> <strong>Medicine</strong><br />

for the purpose <strong>of</strong> dissection related to education <strong>and</strong> research.<br />

• Cost-­‐Recovery Fee: Fees determined by the Anatomical Donation Advisory<br />

Committee (ADAC) for outside use <strong>of</strong> the anatomy lab facilities, equipment,<br />

curricular materials, faculty <strong>and</strong>/or the cadavers/body parts.<br />

• Cremation: The use <strong>of</strong> high temperature to reduce the remains <strong>of</strong> the deceased <strong>and</strong><br />

then processed to form the ashes associated with cremation. The cost <strong>of</strong> cremation<br />

for bodies used in the anatomy program is assumed by the University.<br />

• Final Disposition: Families are notified after cremation occurs that the final<br />

cremains are available. A memorial service is held for the families. If the cremains<br />

are picked-­‐up or mailed to the donor’s designated agent, then any burial costs are<br />

assumed by the family <strong>of</strong> the deceased or agent. If, after notification, the cremains<br />

are not collected, the <strong>School</strong> <strong>of</strong> <strong>Medicine</strong> may bury the cremains in a common<br />

cemetery site.<br />

• Outside Use: Anyone who is not part <strong>of</strong> the Gross Anatomy program for medical<br />

<strong>and</strong> dental students at <strong>UConn</strong>. Internally – other schools within <strong>UConn</strong> <strong>and</strong> affiliates<br />

<strong>of</strong> <strong>UConn</strong>; Externally -­‐ no formal relationship to the University, <strong>and</strong> at the discretion<br />

<strong>of</strong> ADAC.<br />

• Post-­‐Mortem Donation: A body donation authorized after death.<br />

• Transfer: Any transportation between campuses <strong>of</strong> <strong>UConn</strong>.<br />

• Transportation: The Anatomy Donation Coordinator controls the transportation to<br />

<strong>and</strong> from UCHC <strong>and</strong> obtains any <strong>and</strong> all necessary permits.<br />

EC - May 23, 2013<br />

Page 8


III. Administrative Responsibility:<br />

UME Leadership<br />

It is the responsibility <strong>of</strong> the Senior Associate Dean <strong>and</strong> the Director <strong>of</strong> Medical Education to<br />

oversee all aspects <strong>of</strong> the anatomy donation program <strong>and</strong> the educational uses <strong>of</strong> these<br />

cadavers at <strong>UConn</strong>.<br />

Anatomy Donation Coordinator<br />

It is the responsibility <strong>of</strong> the Anatomy Donation Coordinator to determine acceptance <strong>of</strong> any<br />

cadaver, applying guidelines determined by this committee, to manage the social face <strong>of</strong> the<br />

University with the respective families, <strong>and</strong> to safely transport to the University facility. It is<br />

also the Coordinator’s responsibility to follow any <strong>and</strong> all State <strong>and</strong> Federal regulations in<br />

regard to preserving these bodies <strong>and</strong> storing them, as well as the final disposition <strong>of</strong> each<br />

body.<br />

The Coordinator is also charged with the following tasks:<br />

• Assigning a unique ID number: Each cadaver will be identified in an electronic<br />

database by a unique identifier. For each uniquely identified cadaver, a short<br />

description should be documented that includes gender, occupation, age at death,<br />

cause <strong>of</strong> death <strong>and</strong> any pertinent comments.<br />

• Recording any designation <strong>of</strong> the donation <strong>and</strong> actual use (research, education).<br />

• Documentation <strong>and</strong> receipt <strong>of</strong> transfer: Any UCHC cadaver that is transported to<br />

<strong>and</strong> used at another campus <strong>of</strong> the <strong>UConn</strong> must be tracked.<br />

• Final disposition: Record date <strong>of</strong> cremation <strong>and</strong> the final location <strong>of</strong> cremains.<br />

Faculty<br />

Faculty <strong>and</strong> preceptors are responsible for the curriculum <strong>and</strong> teaching in the classroom,<br />

which includes, but is not limited to, the respectful use <strong>of</strong> these cadavers in training medical<br />

<strong>and</strong> dental students, proper care <strong>of</strong> the cadavers <strong>and</strong> adhering to safety procedures.<br />

Anatomical Donation Advisory Committee (ADAC)<br />

This committee consists <strong>of</strong> faculty <strong>and</strong> administrative staff from the <strong>School</strong> <strong>of</strong> <strong>Medicine</strong>.<br />

The role <strong>of</strong> the ADAC will include:<br />

• Review any requests or changes to procedure in regard to the anatomical gift<br />

program.<br />

• Review any requests presented to the institution for use <strong>of</strong> anatomy labs <strong>and</strong><br />

materials.<br />

• All activities involved with procurement, use, storage, transport <strong>and</strong> final disposition<br />

<strong>of</strong> the cadavers/parts.<br />

• May also recommend any necessary sanctions for noncompliance.<br />

• Annual review <strong>of</strong> all donations.<br />

• Any ad hoc issues that may arise related to the cadaver program either internally or<br />

externally.<br />

• Annual Evaluation.<br />

EC - May 23, 2013<br />

Page 9


IV. Financial Records:<br />

• All donations to the Anatomical Gift Program will be documented.<br />

• Donations are deposited in the W. Wilmont Memorial Research Fund.<br />

• A fee structure will be considered to cover cost <strong>of</strong> educational resources. Fees to be<br />

determined by ADAC.<br />

• Fees should be deposited in an account to cover the actual expenses. A separate<br />

account will be created.<br />

V. General Rules <strong>and</strong> Procedures:<br />

• The Anatomy Donation Coordinator at the <strong>UConn</strong> <strong>School</strong> <strong>of</strong> <strong>Medicine</strong> must hold a<br />

current Funeral Director’s <strong>and</strong> Embalmer’s license. The license must be current <strong>and</strong><br />

updated <strong>and</strong> filed in the HOME <strong>of</strong>fice.<br />

• Cadavers <strong>and</strong> body parts donated to the <strong>UConn</strong> must be approved as usable by the<br />

Coordinator. In cases where the Coordinator deems a body as unsuitable for<br />

anatomy lab, but suitable for research purposes, this distinction will be clearly<br />

communicated to the respective family <strong>and</strong> documented.<br />

• All bodies transported to UCHC <strong>and</strong> embalmed will be documented. Any<br />

components delivered to/accepted by the <strong>School</strong> <strong>of</strong> <strong>Medicine</strong> will be documented.<br />

• Cadavers/ body parts may only be used for Gross Anatomy Laboratory sessions<br />

associated with the Medical <strong>School</strong> unless expressly approved by ADAC.<br />

• Any project or activity outside <strong>of</strong> the Medical <strong>School</strong> must seek approval through an<br />

application process to the ADAC.<br />

• The request must allow four full weeks for turn around. Any costs associated with<br />

use <strong>of</strong> the anatomy laboratories or materials including facilities expenses,<br />

equipment, curricular materials, faculty, <strong>and</strong>/or storing or preparation <strong>of</strong> the<br />

cadavers/ body components will be the responsibility <strong>of</strong> the requesting party. These<br />

costs will be defined by the Committee <strong>and</strong> agreed upon between the requesting<br />

party <strong>and</strong> ADAC prior to final approval. The Committee will also determine any<br />

required supervision during laboratory time, <strong>and</strong> the appropriate fee for this<br />

service.<br />

• Transportation <strong>of</strong> cadavers must occur under the supervision <strong>of</strong> the University<br />

Coordinator. This transportation includes both to <strong>and</strong> from the UCHC facility. The<br />

Connecticut General Statutes (sections 7-­‐69 <strong>and</strong> 19a-­‐270 et seq.) authorizes a<br />

licensed embalmer or funeral director to remove the body <strong>of</strong> a deceased person.<br />

There are no state regulations that bind UCHC to different st<strong>and</strong>ards than a funeral<br />

home.<br />

• Cadavers are cremated <strong>of</strong>f-­‐site, <strong>and</strong> cremains are <strong>of</strong>fered to the family <strong>of</strong> the<br />

deceased. The details, fees paid to the crematorium <strong>and</strong> documentation is under<br />

the responsibility <strong>of</strong> the HOME Office <strong>of</strong> Medical Education at the <strong>School</strong> <strong>of</strong><br />

<strong>Medicine</strong>.<br />

• Cadavers/Body parts are not to be sold or provided to any outside entity.<br />

• Employees unrelated to the donor are prohibited from signing donor authorization<br />

cards.<br />

EC - May 23, 2013<br />

Page 10


VI. The Donation Process:<br />

• The following forms are available <strong>and</strong> required for those who wish to donate their<br />

bodies to education <strong>and</strong> research:<br />

o Document <strong>of</strong> Anatomical Gift<br />

o Document <strong>of</strong> Anatomical Gift: Post-­‐Mortem<br />

o Supplementary Information About Donor<br />

o Donation <strong>of</strong> Body Identification <strong>and</strong> Authorization Card<br />

• Bodies donated according to State Statute are transported from locations within the<br />

State <strong>of</strong> Connecticut at no cost to the estate <strong>of</strong> the deceased.<br />

• Acceptability <strong>of</strong> the donated body is determined after death. Conditions which<br />

would prevent donation include obesity, edema, autopsy, infectious disease <strong>and</strong> the<br />

removal <strong>of</strong> organs for transplantation (other than eyes). Bodies cannot be accepted<br />

outside <strong>of</strong> Connecticut.<br />

• Post-­‐mortem donations require appropriate authorization <strong>and</strong> documentation<br />

through use <strong>of</strong> the Post-­‐Mortem Gift Form. Please see Appendix A.<br />

• A Death Certificate must be signed by the attending physician within 24 hours <strong>of</strong><br />

death, <strong>and</strong> it must be filed in the town <strong>of</strong> death within 5 days. A burial permit is<br />

obtained by the Coordinator.<br />

• The Coordinator must review all death certificates for completeness without<br />

exception.<br />

• Families are notified that the body will be kept by the <strong>School</strong> <strong>of</strong> <strong>Medicine</strong> for<br />

approximately 12-­‐ 18 months.<br />

• If a body donation is accepted that is not acceptable for use in the medical <strong>and</strong><br />

dental school curriculum, families are asked for a donation to cover the expense <strong>of</strong><br />

the cremation.<br />

• A memorial service is organized by the first year students through the HOME Office<br />

<strong>of</strong> Medical Education.<br />

VII. The Embalming process <strong>and</strong> OSHA compliance:<br />

• The Coordinator <strong>and</strong> any staff who directly prepare <strong>and</strong> maintain cadavers will be<br />

provided with appropriate protective garments.<br />

• Ventilation in the laboratory <strong>and</strong> embalming location is maintained <strong>and</strong> monitored<br />

as required.<br />

• The Coordinator as well as any student or faculty member who works with the<br />

preparation <strong>of</strong> the cadavers will have Blood Borne Pathogen training.<br />

VIII. Costs associated with lab use:<br />

• Overhead fee (includes storage <strong>and</strong> preparation <strong>of</strong> cadaver/components)<br />

• Facilities fee<br />

• Curricular materials<br />

• Faculty or staff supervisory fees<br />

• Equipment/supply fee<br />

EC - May 23, 2013<br />

Page 11


IX. Rules for use <strong>of</strong> lab:<br />

• No photography is allowed unless permission is granted by ADAC.<br />

• No visitors are allowed in the lab, including family members <strong>and</strong> prospective<br />

students.<br />

• All learners in the lab are informed <strong>of</strong> basic health <strong>and</strong> safety rules, as well as care <strong>of</strong><br />

the cadavers during an orientation presentation prior to the start <strong>of</strong> laboratory<br />

sessions. All must comply with the rules as outlined.<br />

• All students, employees <strong>and</strong> approved volunteers or outside users who have access<br />

to the anatomy labs at UCHC receive the regulations for access, use <strong>and</strong> disposal <strong>of</strong><br />

cadavers/ partial cadavers <strong>and</strong> acknowledge comprehension through signature (to<br />

be implemented).<br />

X. Cremation <strong>and</strong> disposition <strong>of</strong> the bodies after use:<br />

• Cremation is performed by an outside agency.<br />

• A cremation permit must be obtained from Farmington, CT Town Hall before the<br />

body is transported.<br />

• An agreement is drawn between the cremation facility <strong>and</strong> UCHC.<br />

• The crematorium is paid a stipend for each body through UCHC.<br />

• Families are notified when the cremains are available to be picked up or mailed.<br />

• Cremains which are not picked up are stored at UCHC or appropriate outside<br />

location until which time a burial is arranged. Families or agents <strong>of</strong> the deceased<br />

will be informed <strong>of</strong> their time frame for claiming the cremains.<br />

• Unclaimed cremains are buried in a morally responsible fashion.<br />

XI. Communication with families:<br />

• The Coordinator is the main contact with families.<br />

• Families may also communicate with the program through the HOME <strong>of</strong>fice.<br />

• Families are treated with the utmost respect.<br />

• Students/learners are not informed about the identity <strong>of</strong> the cadaver.<br />

• All conversations with the families <strong>and</strong> with potential donors are recorded by either<br />

the Coordinator or an appropriate staff person.<br />

EC - May 23, 2013<br />

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Appendix A: Post-Mortem Procedure<br />

An electronic record is to be signed on an iPad with signature <strong>and</strong> photographic capability. The electronic<br />

record allows both signature <strong>of</strong> the donor or other authorized person <strong>and</strong> witnesses, <strong>and</strong> a means to<br />

capture oral communication evidencing intent to make an anatomical gift. Where there may be a written<br />

record, the iPad will be used to photograph the record. The device uses a fillable PDF format, <strong>and</strong> the<br />

record then is transferred daily to a confidential file on the UCHC server for long term storage <strong>of</strong><br />

electronic records. The records will be reviewed for completeness quarterly by a designee <strong>of</strong> the ADAC<br />

committee.<br />

A checklist <strong>of</strong> signatures acknowledging the donation includes:<br />

a. During the life <strong>of</strong> the donor, a signature from (1) The donor (must be an adult over the age <strong>of</strong> 45);<br />

(2) an agent <strong>of</strong> the donor, including, but not limited to, a health care representative appointed<br />

under CT section 19a-576, unless the power <strong>of</strong> attorney for health care or other record prohibits<br />

the agent from making an anatomical gift; or (3) the donor's guardian.<br />

b. During the life <strong>of</strong> the donor, if the donor or agent <strong>of</strong> the donor is unable to sign, another<br />

individual at the request <strong>of</strong> the donor or donor’s agent may sign the acknowledgement <strong>and</strong> shall<br />

be witnessed by at least two adults, one <strong>of</strong> which must be a disinterested party ("Disinterested<br />

witness" means a witness other than the spouse, child, parent, sibling, gr<strong>and</strong>child, gr<strong>and</strong>parent or<br />

guardian <strong>of</strong> the individual who makes, amends, revokes or refuses to make an anatomical gift, or<br />

another adult who exhibited special care <strong>and</strong> concern for the individual).<br />

c. Post-Mortem Donations require a signature <strong>of</strong> acknowledgement from one <strong>of</strong> the following<br />

individuals with the following order <strong>of</strong> priority provided by Connecticut regulations:<br />

(1)An agent <strong>of</strong> the decedent as described above who could have made an anatomical gift<br />

immediately before the decedent's death; (2) The spouse <strong>of</strong> the decedent; (3) A person<br />

designated by the decedent pursuant to section 1-56r; (4) Adult children <strong>of</strong> the decedent; (5)<br />

Parents <strong>of</strong> the decedent; (6) Adult siblings <strong>of</strong> the decedent; (7) Adult gr<strong>and</strong>children <strong>of</strong> the<br />

decedent; (8) Gr<strong>and</strong>parents <strong>of</strong> the decedent; (9) An adult who exhibited special care <strong>and</strong><br />

concern for the decedent; (10) The persons who were acting as the guardians or conservator<br />

<strong>of</strong> the person <strong>of</strong> the decedent at the time <strong>of</strong> death; <strong>and</strong> (11) Any other person having the<br />

authority to dispose <strong>of</strong> the decedent's body.<br />

d. According to Connecticut regulations, a donor may make an anatomical gift: (1) By authorizing<br />

donor designation in a donor registry; (2) by means <strong>of</strong> a will; (3) during a terminal illness or<br />

injury <strong>of</strong> the donor, by any form <strong>of</strong> communication addressed to at least two adults, at least one <strong>of</strong><br />

whom is a disinterested witness; or (4) through execution <strong>of</strong> a record such as a Document <strong>of</strong><br />

Anatomical Gift as provided by the University <strong>of</strong> Connecticut.<br />

e. Acceptability <strong>of</strong> the donated body is determined by the Coordinator after death. Conditions which<br />

would prevent donation include obesity, edema, autopsy, infectious disease <strong>and</strong> the removal <strong>of</strong><br />

organs for transplantation (other than eyes). Bodies cannot be accepted outside <strong>of</strong> Connecticut.<br />

The Coordinator’s decision will be recorded in the permanent record by his/her signature.<br />

EC - May 23, 2013<br />

Page 13


Timeline<br />

× October 22, 2102 – meeting with the Office <strong>of</strong> Audit,<br />

Compliance <strong>and</strong> Ethics<br />

× January 14, 2013 – Office <strong>of</strong> Audit, Compliance <strong>and</strong> Ethics<br />

submits the Report on the <strong>School</strong> <strong>of</strong> <strong>Medicine</strong> Anatomical<br />

Donation Program<br />

× January 27, 2013 – SOM response issued to concerns<br />

× February 13, 2013 – Review by Joint Audit <strong>and</strong> Compliance<br />

Committee, Storrs<br />

× April 1, 2013- Follow-up report on implementation<br />

EC - May 23, 2013<br />

Page 14<br />

5/20/13<br />

1


Major Recommendations by the<br />

Office <strong>of</strong> Compliance<br />

× Cadaver Supply <strong>and</strong> Utilization<br />

× Database <strong>of</strong> living donors, forecast, alternative source, policy <strong>and</strong><br />

procedures for use by educational programs not affiliated with<br />

UCONN.<br />

× Donor Authorization<br />

× Post-Mortem donations<br />

× Update <strong>of</strong> Gift forms<br />

× Cadaver Transportation<br />

× Financial Contributions <strong>and</strong> Fund Use<br />

× Cadaver Storage <strong>and</strong> Security<br />

× OSHA compliance<br />

× Cremated Remains storage <strong>and</strong> disposal<br />

ACTION TIMELINE FOR COMPLETION/<br />

IMPLEMENTATION<br />

Database <strong>of</strong> Living Donors will be Created May 31, 2013<br />

Shared Document with Total Donations <strong>and</strong><br />

Targets will be Created<br />

May 31, 2013<br />

Alternative Source has been Identified COMPLETED<br />

Request Form <strong>and</strong> Authorized List is being Created May 31, 2013<br />

Anatomical Donation Policy has been created May 31, 2013<br />

Discussion on Post-mortem Donations <strong>and</strong> Post- ADAC meeting <strong>of</strong> February 15, 2013<br />

discussion Plans Established<br />

Documentation for AY 2011-2012 <strong>and</strong> AY 2012 –<br />

May 31, 2013<br />

2013 will be Reviewed <strong>and</strong> a Plan for Monitoring<br />

Future Documentation Established<br />

Plan for Documentation <strong>of</strong> Conversations<br />

May 31, 2013<br />

Established<br />

Prohibition <strong>of</strong> Auxiliary Signatories Completed, ADAC meeting <strong>of</strong> January 25, 2013<br />

EC - May 23, 2013<br />

Page 15<br />

5/20/13<br />

2


ACTION TIMELINE FOR COMPLETION/<br />

IMPLEMENTATION<br />

Donor Authorization Updated May 31, 2013<br />

All Certificates will be Completed Ongoing<br />

Research outsourcing transportation Ongoing- Implement decision by<br />

August 15, 2013 with documentation <strong>of</strong> alternative<br />

plans in the absence <strong>of</strong> the coordinator.<br />

Contract negotiation with local embalmers August 15, 2013<br />

ADAC decision on appropriate procedure May 15, 2013<br />

ADAC specifies appropriate donation <strong>and</strong> defines<br />

acceptable use <strong>of</strong> Fund<br />

May 15, 2013<br />

Key pad code change August 15, 2013 <strong>and</strong> yearly<br />

Regulations for access, use <strong>and</strong> disposal August 15, 2013<br />

Testing <strong>of</strong> Embalming Facility May 15, 2013<br />

Address any test result issues Upon report<br />

Contract negotiation with local cemetery <strong>and</strong> stone<br />

purchased for plot<br />

August 1, 2013<br />

Revise Donor Authorization form May 15, 2013<br />

Current St<strong>and</strong>ing<br />

× All planned revisions to the program accepted at JACC<br />

× Progress on track for full implementation<br />

× Anatomy program presently in compliance<br />

× A fully functional ADAC (Anatomical Donation Advisory<br />

Committee) has been meeting bi-weekly <strong>and</strong> making great<br />

progress<br />

× A new Embalmer Coordinator has been hired as <strong>of</strong> April 19,<br />

2013- Mr. Joseph Shine<br />

EC - May 23, 2013<br />

Page 16<br />

5/20/13<br />

3


Committee on Undergraduate Medical Education (CUME)<br />

Minutes <strong>of</strong> the <strong>Meeting</strong><br />

May 9, 2013<br />

Chair: Rose, S.<br />

Present (voting): Brenner, B.; Dodge, J.; Guerrera, M.; H<strong>and</strong>, A.; Henry, D.; Regan, T.; Siegel, G.; Watras, J.; White, S.<br />

Excused (voting): Gray, M.; Jacobs, L.; Makoul, G.; Palma-­‐Sisto, P.; Rajan, T.; Steele, C.;<br />

Present (nonvoting): Henderson, D.; Nestler, E.; Thatcher, C.;<br />

Guest: Barbara Rickets<br />

<strong>Meeting</strong> called to order at 4:36pm<br />

COSC Update Dr. Henry provided an overview <strong>of</strong> the last meeting <strong>of</strong> the COSC None.<br />

AMA Grant Dr. Rose provided an update on the grant proposal to the AMA:<br />

• Submission scheduled for this evening<br />

• Grant should not be confused with curriculum reform<br />

• Process has been invigorating<br />

• Education Council has put forth a unanimous endorsement <strong>of</strong> the<br />

grant<br />

• Majority <strong>of</strong> the grant budget is in IT infrastructure<br />

Update on the transcripts (B.<br />

Rickets/C. Thatcher)<br />

Ms. Barbara Rickets provided an overview <strong>of</strong> the present transcript:<br />

• Changes have been proposed for a future transcript related to<br />

curricular changes<br />

• IT will be implementing changes<br />

• Transcripts are presently in templates<br />

• Presently grades are either Satisfactory or Unsatisfactory – a new<br />

grading system will be implemented as already passed by this<br />

committee starting with the incoming class in August 2017<br />

• Typically, sites are not listed in the third year but they are for the<br />

fourth year rotations– suggestion for sites not to be listed at all<br />

• Suggestion to spell out AIE<br />

None.<br />

Discussion on listing clerkships<br />

individually on the transcripts<br />

tabled to the next meeting.<br />

Dr. Thatcher will create a<br />

presentation <strong>and</strong> document that<br />

will go out to CUME <strong>and</strong> a<br />

meeting may be held earlier.<br />

EC - May 23, 2013<br />

Page 17


• Suggestion for a word document to be created from the detailed<br />

transcript back page so that it could be sent around for editing<br />

Dr. Thatcher discussed changes to the transcript:<br />

• Request for the CUME to make a statement charging Dr. Thatcher with<br />

making changes to the transcript aligned with curricular changes<br />

• Dr. Thatcher will provide updates to the CUME<br />

• Presently the change to the number <strong>of</strong> elective weeks is not apparent<br />

on the transcripts<br />

• Transcripts have already been sent out for the current year, template<br />

changes cannot be made but certain items can be added on to reflect<br />

accuracy<br />

Additional discussion:<br />

• Issues with the course numbers for electives<br />

• The transcript should be more streamlined <strong>and</strong> there may be options<br />

for streamlining the process<br />

• Presently, home weeks are listed that students are not taking part in-­‐<br />

this must be rectified<br />

• IT constraints impact the ability to change the transcript for accuracy<br />

• Proposal to list each clerkship as a separate course next year<br />

• Proposal to add Barbara Ricketts to the membership <strong>of</strong> the CUME<br />

Minutes <strong>of</strong> March 2013 Reviewed. Approved.<br />

Anatomical Donation Policy (C.<br />

Thatcher)<br />

Dr. Thatcher provided an overview <strong>of</strong> the Anatomical Donation Program:<br />

• Compliance process<br />

• Committee <strong>and</strong> membership<br />

• Changes to forms <strong>and</strong> definitions<br />

• New embalmer hired<br />

• Transportation issues <strong>and</strong> changes<br />

• Correction to the last page <strong>of</strong> the policy – prospective vs. perspective<br />

• Correction to document so that it allows for options for disposal <strong>of</strong><br />

ashes by burial or scattering –in a morally responsible fashion<br />

Motion made to approve Dr.<br />

Thatcher making changes to the<br />

transcript to align it with the<br />

curriculum. Seconded. Approved<br />

unanimously.<br />

Motion made to add the Registrar<br />

as a non-­‐voting member <strong>of</strong> the<br />

CUME. Seconded <strong>and</strong> approved<br />

unanimously. Membership will be<br />

added to the CUME information in<br />

the Academic Policies &<br />

Procedures document.<br />

Motion made to approve the<br />

policy. Seconded. Approved<br />

unanimously.<br />

Proposed procedural requirement Dr. Nestler discussed documentation for procedural requirements in programs: Motion made to approve the<br />

EC - May 23, 2013<br />

Page 18


(D. Henry/E. Nestler) • Tracking system<br />

• Log <strong>of</strong> procedures that will get put into an electronic list that allows<br />

for monitoring progress<br />

• Different rotations will have different procedural requirements<br />

• Request for approval – these will eventually become formal<br />

graduation requirements<br />

• Discipline-­‐specific procedures may go into MyEvaluations.com<br />

concept <strong>of</strong> procedural<br />

requirements <strong>and</strong> the specific<br />

procedures as outlined by Dr.<br />

Nestler. Seconded <strong>and</strong> approved<br />

unanimously.<br />

Discussion:<br />

• States may have requirements for documentation <strong>of</strong> competency in<br />

procedures (e.g. NY). We should consider a certificate for these<br />

competencies<br />

• Procedures can be done through simulation<br />

• The purpose is to set goals that ultimately impact patient safety<br />

• Criteria has been discussed at the CCC<br />

Thanks to Stacy White who will be leaving the CUME after this meeting. Congratulations to Stacy on his graduation. The committee wished him continued<br />

success.<br />

<strong>Meeting</strong> adjourned at 5:33pm<br />

EC - May 23, 2013<br />

Page 19

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