Shield of the SOM Committee on Medical Education
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Summary of 2-28-02 CME Minutes 

  1. Clinical Rotation Development Council (CRDC) – Dr. Christopher Brandt, chair

No structural changes will be made in Year III for the upcoming 2002-2003 academic year.  There is an August deadline for determining whether any changes will be made for the third year during the 2003-2004 academic year.  The two one-week Psychiatry rotations continue to be a challenge.

  1. Curriculum Leadership Council (CLC) – Dr. William Merrick, chair

Quarterly meeting to take place March 6, 2002

One area requiring attention is the result of demands on the clinical faculty’s time.  To spread the load of running a subject committee, a “Junior CRDC” has been suggested in which a clinical representative from each hospital campus would act as a co-chair.  Thus, each co-chair would sit in on about one-third of the subject committee.  Co-chairs might meet weekly to monitor coordination.  Conversations between a given hospital’s CRDC representative and the “Junior CRDC” representative could address whether there were gaps in the basic fund of knowledge required for the third year clerkships.

  1. Results of an Outcome Assessment Study that determined the Level of Performance of the School’s Year 2000 Graduates as Interns – Dr. Richard Aach, Associate Dean for Residency and Career Planning

Aim of the survey:  to assess how well the School prepares our students for residency training

In June 2001, a survey form was sent to the program director of each of the 135 graduates from the Class of 2000 who entered a residency training program.  The grading scale ranged from 1 (poor) to 5 (outstanding).  Program directors were also asked to evaluate the Dean’s Letter.  Responses were received for 99 (73%) of the 135 students who graduated and entered residency programs in July 2000.  This is equivalent to between 45 to 49 residency programs.  In the majority of the approximately 14 skills assessed, the mean ranking of resident performance fell in the 4.0 range.  Dr. Aach summarized that:

  • Overall, our graduates performed well as interns, indicating that the School is accomplishing its goal of preparing them to be excellent physicians in whatever field they enter.

  • They performed better in some areas than others—we could focus more on one or two areas for improvement.

  • There exists a relationship between performance as a house officer and performance as a medical student in the core clerkships and on the USMLE exams.  This observation has been found in other studies published in the literature.

  • Only a few students (one or two) were judged to have performed poorly, and that was primarily due to non-cognitive issues.

Dr. Aach discussed the survey response to the Dean’s Letter.  The Dean’s Letter was of value for 84% of the 99 students.  Program directors indicated that the Dean’s Letter was not helpful for 5%; most indicated that they already knew the student.  Many respondents would have preferred that we give class ranking or rank order.  The survey indicated that the Dean’s Letter was judged to accurately reflect the student’s attributes; the mean assessment for accuracy was 3.8.  There was a definite correlation between a strongly positive response and the graduate’s performance in medical school.  Dr. Aach mentioned that CWRU’s Dean’s Letter does indicate “outstanding,” “excellent,” “very good,” and “poor,” largely based on third year performance with some input from the fourth year electives, research, extracurricular activities, leadership skills, and community service.  CWRU does not give a grade distribution.   The Patient-Based Program Coordinator mentioned that the core clerkship grading percentages usually break down this way:  35% for honors, 40% for commendable, and 25% for satisfactory.

With respect to Early Match, Dr. Aach mentioned that one student had matched in ENT, three in Neurology, and two in both Ophthalmology and Neurosurgery.

  1. Use of Personal Digital Assistants (PDAs) in Medical Education – Dr. Tom Nosek, Associate Dean for Biomedical Information Technologies

Last year Dr. Smith and Dr. Nosek worked together with Dr. Jason Chao and Dr. Jay Wish on the course direction of PDAs and core clerkships.  They tried to put together a core group of programs that would be used from clerkship to clerkship.

Dr. Nosek mentioned the existing CWRU policy of giving each matriculating first year medical student a notebook computer.  Additionally, the idea of providing all third year students with PDAs was considered, but approximately 50% of the students already have PDAs, and the clerkship directors have not integrated the use of PDAs in the core clerkships.  So the idea was rejected, and Dean Berger instructed Dr. Nosek to redirect the money that he earmarked for PDAs to the electronic curriculum.

This year, Pharmacology faculty who teach in the Year I subject committee Fundamentals of Therapeutic Agents (FTA) and the Year II subject committee Drug Action and Biodisposition (DAB) wanted the students to use the pharmacological database “ePocrates” that can be downloaded free of charge on all PDAs with the Palm Operating System (OS).  The PDAs allow easy access and portability.  The course directors, Dr. Smith, and Dr. Nosek wrote a memo to the first year students recommending that they buy a PalmOS-based PDA so that they would have access to ePocrates.  No one particular PDA was recommended.

Dr. Jason Chao, co-director of the Family Medicine clerkship, will be using PDAs in the Family Medicine clerkship.  Dr. Chao obtained a three-year grant starting in July 2001.  The planning and programming year runs from July 2001 through June 2002.  July 2002 through June 2003 will be the implementation year for the Family Medicine clerkship.  Students who do not have PDAs will be provided with one, and students already having a PDA will have the recommended software loaded onto their own PDA.  The PDA log can provide instant access to a spreadsheet that will show if there exists a skewed patient distribution.  This issue can then be addressed before the clerkship is over, unlike the set-up created by the paper/pencil log program that has previously been used.  Family Medicine plans include loading the following applications on the PDA:  1) ePocrates (which is free), 2) a medical textbook, such as 5-Minute Clinical Consult, Merck Manual, or abbreviated Harrison’s, 3) a calculator for analyzing medical formulas such as blood gases or BMI, and 4) a tracking program, which will identify the software programs that are the most useful to the students.

Keeping patient medical records is not currently doable for medical students.  Confidentiality is a major issue when dealing with students writing up patient notes.  Dr. Chao only asks the medical student for age and sex of the patient; he does not want any violation of patient confidentiality.  In addition, none of the hospitals has wireless to connect up, so doctors are not able to write up their notes.  Entering patient notes is a tedious process.  There is no way of downloading and printing out.  Entering patient notes via a PDA, instead of being a time-saver, would make the task even more labor intensive.  Every hospital has a computer with this information on it anyhow.  Residents who have their own PDAs tend to use them for their textbooks, ePocrates, and calculator.

The CME is interested in both the faculty and student response regarding PDA use in the FTA subject committee.  Real utility will occur when we can tie FTA and DAB with the clerkship years.  Our clerkship directors share the common ground of the necessary core material.  Dr. Nosek recommended having the third year clerkship directors consider PDAs and then define a list of their needs.  It is possible to create new software to fill the clerkships’ needs.  There is also the prospect of students being able to identify what resources are important for each clerkship.  Dr. Chao will give an orientation session on the use of PDAs to the students this July.  Dr. Chao estimates that he will buy only between 15 and 20 PDAs; that is all he needs for each month-long Family Medicine rotation.  The month-long Family Medicine clerkship runs 12 times a year.  PDA logs will indicate the number of patients and diagnoses.  Dr. Nosek referred to Dr. Chao’s initiative as providing a student activity that justifies the cost of the university-provided PDAs for now.

Dr. Nosek will provide a follow-up report on the clerkship directors’ response and feedback from the FTA and DAB subject committees at the May 9 CME meeting.

See Curriculum Revision Update section.

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This page was last updated on 12/12/01 by John Graham.

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