April 24, 2003 CME
Report from the Curriculum Leadership
Dr. William Merrick, CLC chair, highlighted the quarterly CLC meeting held on March 5. He
began by summarizing the “chairman’s remarks”:
review focusing on the 20 questions that proved most difficult for
the students has become semi-standard. This explanation of the thought
process leading to the correct answer and pointing out misconceptions
has been well received by the students and successfully incorporated
into the established testing environment where exams are secure and
students do not have access to them.
With the onset of
the new academic year, a concerted effort will be made to provide
students with examples of professionalism and to further a
collegial relationship between faculty and students.
is in place. Next year Winter Break will start the
Saturday before Christmas with school resuming the Monday after New
Year’s Day. Spring Break is designed to occur after
completion of a subject committee. In order to achieve this,
Spring Break will be staggered—Year I students will not be on
vacation the same week as Year II students.
There has been some
change in the exam process. Dr. Marcia Wile remains in charge of
providing committee chairs with the results of their exam and the
technical feedback. The decision to drop an exam question or to change
the pass mark remains at the subject committee chair’s discretion. A
mathematical equation is already in place, and this formula can be used
to modify the pass mark when appropriate.
The students have
provided a preferred syllabus model. Two syllabi were presented
as “ideals.” Dr. Merrick will be working with Year II student Ms. Jaime
Rice on implementation of this project.
A concerted attempt
will be made to eliminate the single “cameo” lecture by a faculty
member for the coming year.
Dr. Merrick next
summarized the rest of the March 5 CLC meeting:
will be integrated as a longitudinal committee in Year II.
Examination questions throughout Year II will account for 35% of the
student’s grade and the Drug Action and Biodisposition (DAB) subject
committee examination will account for 65% of the student’s grade.
of lectures has been well
received by students and not affected class attendance. Relevant
copyright issues are being researched by Dr. Henson. A vote by
the CLC has resulted in adoption of the following policy starting with
the coming year: All lectures will be audio streamed and video
streamed unless 1) the faculty member indicates he/she does
not want the streaming, or 2) a patient is present, or a patient’s
confidentiality could be compromised.
In general, faculty
feel that the remediation process is working. The main concern
is the distracting effect of the new committee on the weak student
remediating a past committee.
See Ms. Minoo
Golestaneh for a calendar of future CLC meeting dates.
Report from the
Clinical Rotation Development Council
Brandt, CRDC chair, described
the efforts to review the clinical curriculum in both the “college” and
the “university” programs. A small ad hoc committee has been created in
anticipation of the May 21 retreat dealing with clinical curriculum
planning for the CCLCM.
orphan topics (otolaryngology, orthopedics, emergency medicine, and
ophthalmology) were covered during specific core clerkships. With the
revised, more flexible scheduling of clerkships going into effect for the
coming year, the CRDC will determine whether these topics should remain
where they are or if they would be better served as two-week electives.
Report from the
Flexible Program Council
Dr. Kent Smith
announced that he is at present overseeing the Flexible Program. A memo
has been sent to all department chairs encouraging sponsorship of two-week
Type B electives in the third and fourth years. The increased flexibility
in the new Year III core clerkship schedule is conducive to two-week
elective offerings which afford the student exposure to new areas before
residency selection. The one-month Type B electives will continue.
Dr. Smith described
the newly created advising system of four “societies” with their
respective deans following the same students from Year I through all four
years. This new organization will serve to guide students through the
many elective opportunities in the curriculum.
Dr. Linda Lewin is
developing a second and third year continuity experience in the Primary
Care Track. This will offer elective Type A credits now and probably Type
B in the third year. This learning model may be applied to all
Comments from the
Dr. Murray Altose recalled how the curriculum councils were established by Dean
Berger to develop new initiatives during the curriculum revision. Now
that the medical school has entered a different phase, it is the feeling
of Dean Horwitz, Dr. Henson, and Dr. Altose that it is time to redefine
expectations of the councils. The CLC and the CRDC were originally
intended to be two separate bodies focused on different content and
different years of the curriculum—the CLC as overseeing the first two
years of undergraduate medical education and the CRDC as overseeing the
third year. There now exists the desire for an expanded council
perspective over all four years of undergraduate medical education. In
addition, Dean Ralph I. Horwitz has delineated the following as
priorities: 1) professionalism, 2) scholarship among medical
students, 3) community participation, and 4) a revisited electives
program reflecting this agenda. Dr. Altose suggested the concept of
one council overseeing the basic science curriculum over the full four
years, a second council overseeing the clinical curriculum over the full
four years, and a third council that would focus on a curriculum that
addressed student scholarship, professionalism, and community service.
Dr. Altose pointed out
that the curriculum councils would be expected to address: 1) curriculum
content, 2) presentation, 3) evaluation, and 4) continuity within the
four-year undergraduate medical experience, and to promote innovation and
The call for a “grass
roots” group responsible for ensuring continuity and innovation yielded
the following concerns by discussants: 1) Oversight committees are not
necessarily the best place to develop operational details. 2) A
commitment this significant requires sufficient resources to make the time
available to engage the parties needed.
Dr. Altose pointed out
that the curriculum council chairs are appointed by the Dean or the Dean’s
designee. (CME Charge, Appendix I: “Each chair is appointed by the Dean
of the School of Medicine, in consultation
with the Vice Dean for Education, the Faculty Council, and the Committee
on Medical Education.”) Dr. Altose suggested that these appointments
include expectations on both sides regarding the “product” and the
“resources,” respectively. In the meantime, Dr. Louis Binder’s committee
(formed February 13, 2003) to evaluate the curriculum components of the
first two years will remain on hold.
Vertical Theme Update
Wiesner, M.D. (Director of the Center for Human Genetics) and Anne
Matthews, Ph.D. (Director of Genetic Counseling) presented an update
on the progress of the Cancer Genetics vertical theme. (They first
addressed the CME at the February 14, 2002 meeting.) They have also
submitted their Essentials of Clinical Cancer Genetics
proposal to the National Cancer Institute, with the endorsement of the CME,
to create a stand-alone Internet-based curriculum applying the principles
of cancer genetics to clinical practice, genetic counseling, and patient
care that would fit into the CWRU School of Medicine curriculum and could
go out to other schools.
The essential units of
instruction are broken down into 11 topics. (To view them, log onto the
CWRU eCurriculum, Vertical Themes menu, Cancer Genetics link. Each unit
links to its learning objectives.) To date, only the first unit, “Cancer
as a Complex Human Disease,” has been developed. A genetic counseling
video complements this site. Additional videos and animations are planned
to illustrate concepts. This first module will need to be further
developed. Dr. Wiesner projected a chart indicating the number of
existing exam questions pertaining to general as well as specific
knowledge of each of the 11 proposed topics during the 1999-2000,
2000-2001, and 2001-2002 academic years. Several topics were not covered
at all or had very few references. The targeted sites for inclusion of
new cancer genetics material are the Hematology/Oncology section in Year
II and the Basic Genetics component of the Molecular, Cellular and
Developmental Biology Section in Year I.
Dr. Klara Papp is
working with Drs. Wiesner and Matthews to incorporate a three-tier
conceptual framework for students:
recall of factual knowledge
comprehension by applying facts to new situations
clinical problem solving through assessment and selection of appropriate
course of action
Dr. Wiesner projected
a chart describing the evaluation section of the grant that will measure
mastery of the concepts taught in the “Essentials” curriculum during the
Hematology/Oncology Year II August subject committee and the OSCE exams
occurring throughout Year III—as administered to individual classes listed
by their entering year: 2003, 2004, and 2005. If funded,
the electronic Essentials of Clinical Cancer Genetics curriculum will
start development and implementation in 2004. The table denotes a means
of evaluation and comparison of student exposure to the new material. The
class entering in 2003 remains the control group (the group without
exposure to the Essentials of Clinical Cancer Genetics curriculum) through
graduation. The classes entering in 2004 and 2005 will each be exposed to
the “Essentials” curriculum via the enhanced Year II Heme/Onc Committee
offerings and the Year III OSCEs.
Dr. Wiesner presented
reasons why cancer genetics would be a strong vertical theme:
principles have a strong link to pathophysiology and disease expression.
Adaptability of the
electronic framework to other related courses
Easy linkage with
other sites (CWRU and non-CWRU)
Ease in updating
Its course offerings
could improve completeness and accuracy of the curriculum.
Dr. Wiesner concluded
her presentation with a chart indicating current Cancer Genetics offerings
and potential offerings throughout the four-year curriculum. There are
plans to build on a case-based model. The current Year I Genetics subject
committee and both the Year II Hematology/Oncology subject committee and
the Gastrointestinal/Metabolism/Nutrition subject committees could be
enhanced by a Type A elective in the Molecular Genetics of Cancer.
Current Year III offerings include Family History in Primary Care and
Genetic Testing for Breast Cancer. Two Type B electives could be offered
for Years III and IV: 1) Hereditary Cancer Syndromes, and 2) Clinical
Evaluation and Counseling in Family Cancer. Currently, there are only two
places in the clinical curriculum, both in Family Medicine, where clinical
cancer genetics is taught—lectures delivered by Dr. Louise Acheson and Dr.
Mrs. Virginia Saha announced that renovation of the Health Center Library should be
completed by mid-July. All journals published prior to 1970 are being
moved to the Allen Memorial Library. The Health Center Library has added
some new databases to its collection, including Incyte’s Proteome
BioKnowledge Library. The Library is considering joining BioMed Central,
so that fees will be waived for authors contributing papers to the
database which is an alternative to the traditional format.
A memorial service
will be held today at 6:00 p.m. in Rainbow Babies &
Childrens Hospital for CWRU graduate Dr. Dale Williams, Class of 2000.
See Curriculum Revision Update section.
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