Shield of the SOM Committee on Medical Education
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Summary of February 12, 2004 CME Minutes

  1. CME Chair Dr. Murray Altose introduced Mr. Kimathi Blackwood, the new Year IV student representative during Mr. Jim Lan’s absence.

  2. Report from the Student CME

Mr. Chris Utz, Year I student representative, mentioned that the current Student CME team—a component of the Committee on Student Representatives (CSR) that writes the subject committee evaluation letters that are sent to the committee chairs—welcomes faculty suggestions for improving the system.  There are currently three existing mechanisms for student feedback:  1) the weekly face-to-face feedback session, 2) the electronic survey completed at the end of a course that yields a quantifiable measure of the committee’s success that may be useful to faculty in terms of promotion and evaluation of faculty leadership, and 3) the Student CME letter, which is written by a committee of students.  In the past, weekly feedback sessions tended to concentrate on problem areas.  In an attempt to correct this bias resulting from self-selected representatives, there is now a random assignment of individual students to attend the feedback sessions.  The group attending the feedback session should represent the opinion of the whole class.  The student CME committee compiling the Student CME letter is expected to attend all the events and create a written summary.  However, basic science subject committee chairs present at the CME meeting concurred that there are often gaps in the written letter, making it less than ideal as a comprehensive information gathering tool as was originally intended.  There have been problems with timely receipt of the letter, some inconsistencies contained within the letter, and the impression that the letter was written by a small group rather than representative of a class consensus.  By contrast, the online evaluations yielding quantitative data are considered more useful by the subject committee chairs.

Students requested clarification as to the intended goal of the Mary Ann Swetland Center for Environmental Health.  The February 3 inauguration of the center included a lead toxicity workshop, student-generated posters, and an evening reception involving poster presentation.  Students felt the concept was good but would have liked 1) more involvement in planning and organizing the project, 2) more time to prepare the posters based on their original grant proposals, and 3) access to individuals with grant writing expertise.  The consensus among students was that if this is to become a yearly event, it should be more student-centered.

When asked for the fourth year student’s perspective, Mr. Kimathi Blackwood mentioned the challenge of getting grades back in a timely manner from the clerkship directors (an issue addressed by the recent creation of the online student grading system), and a personal endorsement for the current CSR project of matching a Year II student to shadow a Year III student.

  1. Basic Science Curriculum Report on the Cell Physiology and the Neuromuscular Committees

Dr. George Dubyak explained that Cell Physiology and Neuromuscular are the first two subject committees in the Homeostasis I section.  Dr. Dubyak has chaired the Cell Physiology committee for the past several years.  It serves as a “bridge” between Biochemistry and Cell Biology, Molecular Biology, Development, and Genetics on one side and the organ systems on the other.  Cell Physiology is where the students get the “nuts and bolts” common to all organ systems.  Year I Homeostasis is a long multi-committee section running from mid-October to mid-February offering special challenges.  The students start anatomy and encounter heavy doses of histology while being asked to juggle Cell Physiology and Neuromuscular, which run concurrently.  Dr. Dubyak divided the Cell Physiology content into three major topics, or “subsets,” along with their learning objectives.  It should be remembered that students have not yet gotten into the organ systems.  They are presented with what appears as a disembodied assemblage of facts and concepts.  Cell Physiology has ties to what comes before and after the course.  Cell Physiology is included in Homeostasis I which includes the following organ systems:  Neuromuscular, Cardiovascular, Pulmonary, Renal, and Gastrointestinal.  The 12 one-hour Cell Physiology lectures are delivered by an optimal core of three faculty.  Three formative quizzes, one for each of the subsets, are given online over a 24-hour period and each relates to a single vignette.  Students are divided into eight small groups for the three one-hour small group discussions occurring subsequent to completion of each of the quizzes.  Dr. Dubyak described the strengths of Cell Physiology:  a short, compact committee integrating well with the concurrent Neuromuscular and immediately following Cardiovascular committees.  The small number of core faculty is another desirable attribute.  Cell Physiology provides a very detailed syllabus.  Dr. Dubyak described weaknesses:  1) As common with all committees, lectures could probably be compressed and more directed.  2) There is the challenge of coordinating what appear to be “disembodied” facts and concepts prior to the onset of the organ systems-based committees.  Changes for the coming year will be small, incremental changes.  There will be a continuing emphasis on small groups, which have been well received by the students.  If necessary, Dr. Dubyak could compress the material by having a single introductory lecture for each small group.  However, since compression means less lectures and less teaching time, this approach would result in more out-of-class study time for the students.

Dr. Stephen W. Jones provided an overview of the Neuromuscular committee that he chairs.  The Neuromuscular committee marks the beginning of the organ system-based curriculum and covers the basic principles of nervous system function.  For scheduling reasons, Neuromuscular is taught concurrently with cell physiology, gross anatomy, and the physiology and histology of bone.  Neuromuscular interacts with the following committees:  cell physiology, the several component committees of Homeostasis, and the Year II Nervous System Committee, for which it provides the foundation by explaining how nerve cells work.  Dr. Jones listed the four main content topics.  He provided the distribution of the approximately 33-hour committee:  18 hours of lecture, 4 hours of small group conferences, 8 hours of lab (including 2 computer labs and nerve histology), and 3 hours of clinical correlations.  Dr. Jones is satisfied with the choice of what is covered—including what is intentionally not covered as well—in the committee’s content.  He feels that Neuromuscular is a strong committee with a coherent subject area that has earned positive student feedback.  Issues being addressed include logistical problems caused by the standing Society for Neuroscience meeting, which affects one-half of the committee’s faculty.  Additionally, Neuromuscular has nine lecturers, some of whom deliver only two lectures.  There could be more focus on integration.  There needs to be follow-up to ensure inclusion of related topics elsewhere in the curriculum.  Perhaps the syllabus and lecturers merit some review, as they have been largely unchanged over the past ten years.

Year I student representative, Mr. Chris Utz, felt that both the Cell Physiology and Neuromuscular committees are well-organized.  Having developed a bit of perspective, he does appreciate their content much more now.  He found the computer labs very helpful.  He favors more small groups, particularly clinical correlation conferences.

  1. Clinical Curriculum Council Report

Dr. Linda Lewin, Clinical Curriculum Council Chair, mentioned that in response to student concerns about the disparity in evaluation among different sites of the same clerkship raised at the December 11, 2003 meeting, the CCC launched an examination of data furnished by the Registrar.  Upon investigation, it was decided that the issue does not seem limited to different sites of the same clerkship but extends to the entire matter of grade distribution in general—percentage of honors, commendable, and satisfactory awarded.  The CCC has decided to revisit this issue.  It will develop a recommendation to bring before the CME pertaining to what the grade distribution should be and how to monitor it.  A new online evaluation system piloted this summer for Dr. Preston’s Neurosciences clerkship should address the need for timely receipt of grades from the clerkship directors by affording easy accessibility, simplifying the grading process, and guaranteeing instantaneous grade transfer.  Beginning in July 2004, all clerkship evaluations will be done online.  Timeliness of grading is particularly relevant to the Committee on Students and in the composition of the Dean’s Letter.

  1. Cleveland Clinic Lerner College of Medicine Curriculum Steering Council Update

Dr. Andrew Fishleder, Cleveland Clinic Lerner College of Medicine Curriculum Steering Council Co-Chair, announced that 1) assessment in the College program, and 2) the clinical research curriculum will be brought before the CME in the immediate future.

  1. Information Management Update

Dr. Thomas Nosek, Associate Dean for Biomedical Information Technologies, is looking into the matter of ownership of test questions and content provided by faculty in the eCurriculum.  He has already met with Case’s legal office and will next talk with the Vice Dean for Education and Academic Affairs before bringing a report to the CME within the coming month.

Video streaming of eCurriculum lectures has become very popular.  So much so, that streaming each lecture has become the default system.  Students have expressed enthusiasm for a new program that enables the individual to control the speed of a video stream.  One can watch a lecture at up to 2.5 times the normal speed while retaining a normal-sounding audio.  Students like this program for its increased speed as a review mechanism and, on the other hand, its option for slowing down a “fast-talking” lecturer.

There remain questions as to the number of times a student can remediate with a subject committee chair.  Dr. Nosek reiterated that his office allows remediation one time only and should the student fail, he/she goes before the Committee on Students.  However, discussants mentioned that the Committee on Students has been known to refer the student back to the committee chair to remediate again.  The original policy stated that if the student fails the remediation, the Committee on Students is to design a plan.  The student usually re-remediates during the summer and is delayed in starting the clerkships.  Discussants felt that two matters need to be decided:  1) Should a student be allowed to re-remediate?  Who designs that system?

Discussion turned to copyright issues—specifically, using copyrighted photos/figures from textbooks.  There is a program where all primary texts are in electronic format.  Dr. Nosek acknowledged that it would be expensive for the students.  However, a site license for this program would enable the faculty to have rights to include all the figures contained in the print syllabus, eCurriculum, and in PowerPoint presentations.  One discussant raised the question of whether or not the School of Medicine would provide each student with a notebook computer this coming year.  Dr. Nosek explained that since 1993, each entering medical student has been given a notebook computer that is maintained by the Office of Biomedical Information Technologies for four years, after which time it belongs to the student.  The student pays a computer fee during those four years to cover maintenance by the BIT office.  The Vice Dean has favored maintaining this arrangement at least until the 2006-2007 academic year, which marks the onset of the new curriculum.  One of the main advantages of providing students with laptops is that the BIT office controls the computers and guarantees that they are in working order for our electronic exams.  Dr. Altose tabled further discussion of this issue until the Dean’s office has completed its own discussion.

  1. Health Sciences Library Update

Mrs. Virginia Saha, Cleveland Health Sciences Library Director, mentioned that the Case Western Reserve Copyright Compliance Policy relating to federal copyright laws on use of print and digital materials had been passed by the Faculty Senate with an amendment offering university support only in instances where a faculty member unintentionally infringes copyright.  In most instances, faculty, staff, and students are responsible for the legal consequences of copyright infringement with the university assuming no liability.  To view the policy, go to Copyright @ Case at  Mrs. Saha is currently developing a presentation to explain the Case copyright policy to departments on campus and at affiliated hospitals.  Dr. Nosek and Mrs. Saha hope to gather all the subject committee chairs together for an informational session.

Changes in the library’s site licenses for some online journals have led to password access for a few titles which had previously been more openly accessible.  A notice is found on the library’s electronic journal page price increases for the site licenses precluded maintaining previous direct access.

  1. Geriatric Summer Scholars Program Update

Dr. Jerome Kowal, Associate Dean for Geriatric Medicine at Case, is the Principal Investigator for the American Federation for Aging Research (AFAR) Medical Student Geriatric Scholars Program, which supports hands-on clinical geriatrics and summer research projects in aging for first year medical students.  During the past ten years, the national AFAR program has funded over 650 medical students from 80 different medical schools across the U.S.  Dr. Kowal is a member of the Boards of Directors of both the Ohio chapter of AFAR and the national AFAR organization.  Funded Medical Student Geriatric Scholars each receive a $4,000 stipend.  Recent cutbacks in funding have placed additional strain on the national program and resulted in a search for alternate sources of support on the local level.  Dr. Kowal has been instrumental in regionalizing the program across Ohio and securing local support.  He works with a group of Columbus fundraisers to promote research and education in geriatrics in Ohio.  Last summer 11 Ohio students, including four from Case, received $4,000 summer scholarships.  In 2003, Dr. Kowal was PI on a grant awarded to AFAR-Ohio for $50,000 over two years from the Cleveland Foundation to support 10 Ohio student scholar positions from the greater Cleveland area.  Four students were funded in 2003, and six students are to be funded for 2004.  Matching support from the Mt. Sinai Foundation would make funding possible for an additional six Cleveland-based student scholars during the 2004 and 2005 grant periods.  Applicants write a formal proposal, initially to the national AFAR program.  If they are not awarded support, they can choose to re-apply on the local level to the AFAR-Ohio affiliate in Columbus.  Eleven students from Case have applied for 2004 funding.  Case Western Reserve University’s geriatric program has been honored by the Hartford Foundation as one of 27 Geriatric Centers of Excellence across the United States, and it serves as the training center for the Ohio-based AFAR scholars.  Student scholars benefit from a close working relationship with their mentor.  Dr. Kowal explained how much he enjoys participating in the program, which offers students a hands-on clinical experience and a comfortable way to become involved in aging-related research.  Clinical and didactic training pertaining to care of the elderly accompanies the research activities.  The summer program takes place at University Hospitals, Metro, and the V.A.  The participating Year I students sit in on the didactic programs designed for entering geriatric fellows.  Dr. Kowal was congratulated for his persistent efforts in finding support for the Geriatric Scholars Program.  Dr. Kowal concluded his remarks by urging students to continue attending programs supported by various student interest groups and to maintain their interest by considering pursuing an Area of Concentration in Geriatrics.


See Curriculum Revision Update section.

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