University of Virginia School of Medicine
Pediatric Conference Room, 4:00 p.m.
Present (underlined) were: Gretchen Arnold, Dan Becker, Robert Bloodgood, Megan Bray, Eugene Corbett, Thomas Gampper, Wendy Golden, Donald Innes (Chair), Keith Littlewood, Mohan Nadkarni, Chris Peterson, Jerry Short, Linda Waggoner-Fountain, Bill Wilson, Mary Kate Worden, Jason Franasiak, Kira Mayo, Guest: Darci Lieb, Debra Reed (secretary)
- Action ideas for enhancing clinical skills education: a) Implementation of specific skills curriculum experiences, b) Creation of early student clinical exposure, c) Enhance and systematize clinical skills assessment, d) Expand and emphasize faculty (and resident) development and support, and e) Educational design.
Recommendations to enhance clinical performance education were presented by the Working Group on Clinical Skills Education (Gene Corbett). The recommendations are intended to reaffirm and focus upon the educational mission in the UVA School of Medicine and Health Science Center at a time when, comparatively speaking, our clinical and research missions are expanding and well supported financially. The mechanisms described below, which reflect the concerns of faculty and students alike, are intended to preserve the integrity of essential medical education activities. Implementing these recommendations will enable us to adhere to the highest medical education outcome standard: that each graduate of the UVA School of Medicine achieves clinical performance excellence. Please see attachment.
A. Clinical Performance Teaching Culture: implement specific changes designed to advance clinical performance teaching in the School of Medicine.
This recommendation addresses the challenge of securing faculty availability and accountability for student teaching. It is intended to minimize the influence of an institutional silo effect in the conduct of UME curricular responsibilities.
Create a formal, integrated system for the development, implementation and evaluation of all clinical performance education programs.
Establish a clinician leadership position in the School of Medicine to oversee clinical performance education.
c. Designate and support faculty committed to clinical performance education. Evaluate and support these faculty based upon explicit criteria. d. Phase in an integrated basic science / clinical science teaching paradigm. This includes comprehensive coordination between basic science and clinical faculty for all courses and clerkships, and implementation of a clinically-oriented organ-system curriculum design throughout the preclerkship years. e.
Develop an implementation plan for migration to a learning community / college system within the SOM.
Create mechanisms for enhancing and rewarding resident and student participation in clinical performance teaching.
g.Expand and integrate UME and GME faculty development efforts related to clinical performance education
B. Clinical Performance Learning Culture: implement specific changes designed to advance clinical performance learning.
This recommendation addresses impediments to students' active participation in clinical learning experiences as well as the need for a more permissive and effective clinical learning environment. Both student-centered and institutionally-centered educational expectations are paramount in this process.
Create a four year faculty and student mentorship program.
b. Create formal student, resident, and faculty development processes that explain and assure adherence to the 12 UVA objectives of medical education7, and the role that each teacher has in achieving fulfillment of this goal on the part of every graduate of the SOM. c. Identify and remove both student-centered and institutionally-centered barriers to student participation in clinical care learning opportunities.
C. Continuous Clinical Performance Assessment: create an integrated clinical skills assessment, feedback, and improvement process that supports the achievement of students' basic clinical competency.
This recommendation addresses the need for a developmental and coordinated assessment process for clinical performance education that specifies and enforces standards for students' clinical performance achievement.
a. Centrally coordinate and improve the system of clinical skills assessments. b. Create additional web-based assessments for selected clinical skills. c. Create a comprehensive plan for utilizing simulation in skills assessment. d. Create skill improvement programs individualized to each learner and competency.
D. Specific Clinical Skills Curricular Recommendations.
This recommendation gives specific emphasis to selected clinical skill development elements in the UVA curriculum.
a. Adopt the Working Group modified set of the AAMC recommended clinical skills and incorporate their learning and assessment into the UME curriculum. b. Integrate and enhance physical examination skill learning in years 1 through 4. c. Expand the clinical skills educator program to all clerkships. d. Review and expand the clinical skills passport concept. e. Establish a procedural skills course in the clerkship year. f. Create a unified and expanded plan for utilizing simulation and CSTAP for clinical skills teaching throughout the curriculum.
The next Curriculum Committee meeting will be October 2, 2008.