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CME AGENDA - February 26, 1998

  1. Approval of Minutes
  2. Announcements
  3. Student CME
  4. Millennium Curriculum Project Update
  5. Continuation of Discussion on Physical Diagnosis Pilot Proposal Drs. James Carter, Dr. Baha Arafah, Dr. Ted Parran, Ms. Kathy Cole-Kelly
  6. Other Business

Summary of Minutes

1. Continuation of discussion of Physical Diagnosis pilot proposal begun during January 22 CME meeting. Dr. Baha Arafah, Director of Physical Diagnosis, presented his input and clarified certain issues. He expressed a preference for beginning the Physical Diagnosis pilot during the second part of the first year after January or February rather than during August or September when students are just starting medical school. The three components of Physical Diagnosis are: 1) PD 1, which consists of lecture, 2) PD 2, where students perform regional exams on each other and briefly see patients, and 3) PD 3, the major component, where students see actual patients on the wards and do histories and physical exams. The pilot proposal replaces only PD 1 and PD 2. The difficulty of recruiting faculty to teach PD 3 remains. Only recently has the decision been made that the chairs of the Departments of Medicine at University Hospitals, the VA, and Metro will now have trouble providing PD faculty with both financial support and protected time. The aim of the pilot proposal is to conserve faculty time, not to save money; standardized patients have to be paid. Due to the necessity of creating a different ongoing Physical Diagnosis experience for the second year students who participate in the year one pilot, it was suggested to reduce the number of students in the pilot from 32 to 8 or 16. We currently do not have enough space for 32 students. Once the Millennium Curriculum begins, clinical contact will be built into the second year of the curriculum.

The following motion passed 7 in favor, 0 opposed, and 1 abstention:
Replace what is now PD 1 and PD 2 with a pilot Physical Diagnosis proposal as outlined in the handout that would utilize a maximum of 32 randomly selected students (probably fewer), that would move the beginning of Physical Diagnosis to year one, and that would make use of both fourth year student preceptors and standardized patients. Implementation of the Physical Diagnosis pilot proposal depends on the availability of sufficient resources.

2. Dr. LaManna brought up the whole school CPC (Clinical-Pathologic Conference) as a useful educational tool and supported forming a subcommittee to design and implement the whole school CPCs as a pilot in the curriculum to find out if we have the capability to transmit to distant sites on a regular basis. Leadership of the subcommittee should include representatives from the departments of Medicine, Surgery, and Pathology. Senior clinicians and basic scientists would be involved in presentation of the CPC to contribute to a worthwhile experience for the medical students.

Discussion consisting of arguments "for" and "against" followed. Negative concerns focused on 1) programs competing for the same time slot, 2) reluctance to relinquish time on the wards and interrupt clerkships, 3) the need for the CPC to be more than just a mere "TV show," 4) possible divisive nature of the CPC in that everyone would be at a different place in a different time and basic science would be separated out of the clerkship, 5) doubts about the state of our technology. Positive arguments in favor of the CPC included: 1) There is no better way to teach Pathology, 2) Reasoning, clinical decision-making, and pathological disease are constants in medical education, 3) We already possess certain capabilities to transmit to 350 people nearby, and we need to push the system to find out what we can do, 4) The CPC is an excellent teaching tool and integrative mechanism that students use repeatedly over a lifetime, and 5) It is unrealistic to expect to coordinate everythingcertainly medical practice is not a neatly coordinated package.

The following motion passed: 6 in favor, 0 opposed, 1 abstention.
The CME should establish a subcommittee with the charge to design and carry out a series of four whole school CPCs (Clinical Pathologic Conferences) during the 1998-1999 academic year, as a pilot project for possible future incorporation of an extended whole school CPC series into the regular curriculum.

The motion was presented at the February 27 Medical Education Retreat at the Ritz-Carlton.

3. Dr. LaManna next proposed that the CME endorse the concept of vertical themes in the new curriculum. A vertical theme consists of a group of faculty members who help to organize the curriculum content of a single topic area through all four years of the curriculum, including basic and clinical science, advanced study and professionalism aspects of the topic. These vertical theme committees representing a broad perspective and interdisciplinary nature would exist in parallel with the horizontal subject committees and sections that currently operate.

The motion that the CME endorse the establishment of vertical themes in the Millennium Curriculum passed unanimously.

The motion was presented at the February 27 Medical Education Retreat at the Ritz-Carlton.

4. Millennium Curriculum Project Update

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This page was last updated on 3/9/98 by Daphne Cook.

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