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Summary of January 22, 2004 CME Minutes

  1. Dr. Louis Binder served as Acting Chair during Dr. Altose’s absence.
     

  2. Report from the Student CME

Mr. Christopher Utz, Year I student representative, and Mr. Jason Garnreiter, Year II student representative, mentioned that at the last CSR (Committee on Student Representatives) meeting, there was consensus on the need to revamp the student evaluations with the goal of contributing constructive criticism to improve the subject committees.  Current stage of the project is finding someone to spearhead this initiative.  Mr. Kimathi Blackwood is the new Year IV temporary student representative for Mr. Jim Lan during his absence.  The students’ meeting with Dean Horwitz has been changed to Monday, February 2, 1:00 to 2:00 p.m., in Frohring Auditorium in the BRB.

  1. Report from the Hematology/Oncology Committee

Dr. Timothy O’Brien, co-chair of the Hematology/Oncology Committee, provided an overview of this, the first committee of Year II.  The majority of content hours concentrate on benign and malignant hematology, with the students receiving only “broad concept” exposure as an introduction to oncology.  Dr. Larry Kass, the committee’s other co-chair, oversees the pathology aspects of the committee.  The three-week “Heme/Onc” committee consists of 66 hours, divided as follows:  41 hours of lecture, 17 hours of small group case discussions, and 8 hours of lab (5 hours of labs plus 3 hours of lab exercises).  The “optional” four-hour review session replete with Danishes is held Saturday before the Monday exam and gets a 90-95% student turnout.

Dr. O’Brien listed recent changes:

  • Minimizing “cameo” lectures

  • Expansion of small group cases

  • Videostreaming demonstration of a bone marrow biopsy

  • Links to the ASH (American Society of Hematology) website for “clinical correlations”

  • Audience interaction questions at the end of a lecture (using “Who Wants to be a Millionaire” multiple-choice-question format)

  • Conversion of all pathology slides to digitized format by Dr. Kass

Dr. O’Brien next listed accomplishments:

  • Overall rating of “excellent” by 82% and 86% of the students, respectively, for the past two years

  • Firsthand feedback from students encountered on the wards by Dr. O’Brien with recall of valuable small group discussion material

  • Invitation to Dr. O’Brien to give a presentation at the American Society of Hematology (ASH) for 2004 with emphasis on small group case expansion and audience interaction

Dr. O’Brien cited the following as areas requiring attention:

  • Difficulty in recruiting faculty for lab demonstrations has resulted in some disorganized demonstrations during lab exercises.

  • Perhaps 41 hours of lecture is too much passive learning.

Dr. O’Brien concluded his presentation by enumerating future plans:

  • Further expansion and revision of small group cases

  • Further reduction in number of “cameo” lecturers

  • More audience interaction questions at the end of lectures which illustrate key teaching points

  • Perhaps a new textbook

  • Videostreaming of lab demonstrations

Year II student representative, Mr. Jason Garnreiter, mentioned that his classmates regard “Heme/Onc” as an excellent committee—a model committee—where faculty are interested in the students’ learning and put much effort into their teaching.  It is one of the least reinforced committees throughout Year II—the material is not frequently used.  Mr. Garnreiter felt that the small groups are excellent and that there is not too much passive learning.  He liked the interactive questions and would like to see them used more.  Efforts have been made to expand application of the interactive questions to all subject committees by the Office of Biomedical Information Technologies in their pre-committee meetings with the chairs.

  1. Comments related to the Clinical Curriculum Council

Dr. Linda Lewin, Clinical Curriculum Council (CCC) Chair, was absent from the meeting, but Dr. Thomas Nosek, Associate Dean for Biomedical Information Technologies, presented an update on the online student evaluation system for the clerkships.  The Neurosciences clerkship pilot of this system started in July 2003.  The proposal to expand the online student evaluation system for use in all the clerkships starting in July 2004 was approved by the CCC.

  1. Report from the Flexible Program Council

Dr. Kent Smith, Flexible Program Coordinator, encouraged students to get to know Dr. Claire Doershuk, appointed by the Dean to the newly created position of Associate Dean of Medical Student Research at the School of Medicine.  She has already been of great help to students applying to the Howard Hughes Medical Institute-National Institutes of Health Cloisters Program.

Dr. Smith announced that three of the four society deans have moved into their new offices in E423.  Dr. Haynie will remain in E421.

  1. Information Management Update

Dr. Thomas Nosek, Associate Dean for Biomedical Information Technologies, mentioned the new ePortfolio system that affords students the opportunity to upload information, easily update/revise it, and share selected entries with parties of their choosing.  At Dr. Doershuk’s request, the ePortfolio has a place for students to record their research experience prior to entering the School of Medicine and since coming here.  It is expected that the ePortfolio system will go online within a few weeks.

  1.  Update from the Office of Curricular Affairs

Dr. Terry Wolpaw, Associate Dean for Curricular Affairs, announced that the annual retreat February 27 will focus on 1) teaching, and 2) curriculum.  There will be a series of morning workshops.  Question-and-answer sessions will take place in the afternoon.  Approximately 30 posters have been received for display on educational works-in-progress.

  1. Clinical Transaction Portfolio Project

Lynda Montgomery, MD, MEd, is a member of the Department of Family Medicine and Director of the Clinical Transaction Portfolio Project, for which Dr. Lindsey Henson is the Principal InvestigatorDr. Klara Papp is in charge of the evaluation piece for the project.

Dr. Montgomery began by presenting background.  Nationwide, there is an outcry for improvement in teaching clinical skills.  Financed by the Macy Foundation and administered by the New York Academy of Medicine (NYAM) and the Association of American Medical Colleges (AAMC), the enhancing education for the Clinical Transaction program grant was designed to address this deficiency.  The clinical transaction involves everything required during a student/patient encounter: history taking, physical examination, clinical reasoning, and communication skills.  Case was one of the four initial grant recipients, which has been expanded to six, in a very competitive pool.  September 2003 marked the beginning of the planning year.

Dr. Montgomery next described the intended project.  Forty-five volunteer current Year II students will be randomized into three groups of 15 students each for the pilot starting this July.  All students (control group and two intervention groups) will be assessed using a case-based Clinical Skills Exam (CSE) upon entering Year III and again near completion of Year IV—a “before” and “after” assessment.  All three groups will also pursue their usual clerkships and electives during Years III and IV.  Both of the two “intervention” groups will participate in a Structured Clinical Instruction Module (SCIM), a “teaching OSCE” where clinical transaction skills are taught by standardized patients, faculty, and peer students.  During the SCIM, students will be observed going through a case and receive feedback.  The students in the Clinical Transaction ePortfolio intervention group will not only be assessed by the Clinical Skills Exam and the SCIM, but will complete an online portfolio during their normal clerkships where they will collect data, be observed by faculty who will provide formative feedback, and have a different set of faculty serve as portfolio advisers to mentor and advise them on how to become better physicians.  Through their portfolio advisers, the students will be able to upload comments from patients and faculty and their own comments as well onto their portfolio.  The portfolio will not in any way affect class standing, grades, etc.  The sole purpose of the project is to make the students better physicians.  Additionally, it is hoped that participating faculty will benefit by enhancing their own teaching and devising new ideas for teaching through observation of students and delivery of on-the-spot feedback.  The projected hypothesis for the pilot is that, of the three groups, the Clinical Transaction e-Portfolio intervention group will score higher on the Year IV Clinical Skills Exam, rate their clinical transaction knowledge and skills more highly, and be more confident of their abilities to evaluate and improve self-identified weaknesses.

Note of clarification:  The Clinical Transaction Portfolios are separate and distinct from both the Cleveland Clinic Lerner College of Medicine portfolios and the Student ePortfolios described by Dr. Nosek earlier in the meeting.

Dr. Terry Wolpaw emphasized the student-driven design of the project.  The longitudinal format lets students develop their learning goals of the clinical transaction, based on their clinical experiences.  Fostering self-reflection and self-directed learning is part of the project’s goals.  The intent is not to have the faculty taking primary responsibility for student development.  The faculty are to make explicit what is not clearly articulated now.  The faculty’s role is to “articulate” and to “facilitate” so that the students are able to take primary responsibility for their own development.

  1. Health Sciences Library Update

Mrs. Virginia Saha, Cleveland Health Sciences Library Director, distributed a one-page summary of the Case Western Reserve Copyright Compliance Policy involving federal copyright laws on use of print and digital materials. The policy is awaiting approval by the Faculty Senate.  Policy pertains to faculty, staff, and students alike.  In most instances, the university assumes no liability, and the individual is responsible for the legal consequences of copyright infringement.  (At the Faculty Senate meeting on January 26, 2004, it was affirmed that Case will support a faculty member who unintentionally infringes copyright, and language to that effect was added to the policy.)  For more information go to Copyright @ CASE at http://www.cwru.edu/UL/c/ or consult the following Web site:  http://www.cwru.edu/UL/c/cpolicypage.htm.  Rules for using online resources are even more complex than for paper resources.

Dr. Nosek mentioned his intent to conduct copyright information sessions at two separate times for subject committee chairs in the Computer Lab, which could then be videostreamed and put on the eCurriculum.  One large general session could be held in the lecture hall, videostreamed and also put online.  It was suggested that Dr. Nosek hold a session for the Clinical Curriculum Council as well.

 

See Curriculum Revision Update section.

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