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Summary of 5-09-02 CME Minutes 

  1. Graduation to take place Sunday, May 19, 2002
    Impromptu discussion focusing on the significant decrease occurring over the years in the number of faculty marching at graduation
    University (not medical school) policy sends out the invitation three months in advance requesting gown rental orders at that time, when no one is sure of his/her plans.  Some departments offer to pick up the $35.00 gown rental fee; others have no such arrangement.  The presence of the faculty members who taught them represents an important show of support for graduating medical students.  At a time when we are increasing the expectation level for professionalism among students, some discussants feel we should do the same for faculty.  The CLC and CRDC are encouraged to present the issue of how to increase faculty attendance at graduation without imposing personal bias.

  2. Student CME Report:  “Project Standards,” student syllabus initiative
    Mr. Brian Chow (Year I student representative) and Mr. Jim Lan (Year II student representative)
    Mr. Chow summarized the SCME findings that more good sections than bad are contained in the current syllabus.  His presentation consisted of a preliminary list of examples.  The students did not go through the entire syllabus.  Dr. LaManna requested that the Student CME make a formal report to the CME next year.  He suggested that the students prepare a common electronic format—a template that would enable the faculty to fill in a PDF file on the browser.  We currently have guidelines; however, there is no way to force faculty to comply with these guidelines.  Even if the students come up with guidelines, there is no way to mandate faculty compliance.  Mr. Chow listed the SCME findings with respect to the syllabus:

  • Good sections have figures integrated within the text.  This eliminates flipping back and forth.

  • Problem sections are incomplete, non-existent, or contain way too much to read.

  • Make the syllabus available before class so that students can take notes on it in the margins.

  • Discussant’s suggestion to make 2 as the optimum number of PowerPoint slides per page

  • Scan at a higher resolution to make figures legible.  This could be a problem.

  • Have concise learning objectives—a maximum of 5 main points or concepts that the student is expected to know.  Discussant’s recommendation that the SCME figure out what “good learning objectives” are versus “bad learning objectives.”

  • Use proper formatting and spell-check.  SCME consensus that there should be no more than 8 pages of syllabus (excluding figures) for a one-hour lecture.

  • PowerPoint slides need to be available before the lecture.

  • Update and review the syllabus.  Some sections are outdated; other sections have errors; some sections are either inadequate or wordyRewrites are needed.

Mr. Chow concluded by mentioning the Student CME’s future plans:

  • Writing a formal report with examples (syllabus templates).

  • Reviewing any syllabi.  SCME would be happy to go over any syllabus, old or new, if the professor requests it.

  • Making available to faculty the opportunity 1) to send over a new syllabus for review or 2) to test out a new lecture in front of a group of SCME members and receive constructive feedback.

  • Determining the best contact group for syllabus reform—whether to start with the Curriculum Leadership Council, the subject committee chairs, or the Syllabus Office.

  • Starting an electronic bulletin board where students could post errors found in the syllabus and possibly offer a “finder’s fee”

Discussion followed.  Dr. LaManna recognized the CLC as the practical body for the SCME to work with when it comes to implementation of their recommendations.

  1. CLICS (Contemporary Learning in Clinical Settings) Program Update – Co-Directors Dr. Linda Lewin and Ms. Kathy Cole-Kelly
    The original CLICS program sprung from a UME-21 grant (“Undergraduate Medical Education for the 21st Century”) written by Sally Hodder, M.D., and Clint Snyder, Ph.D., running from October 1998 to September 2001.  CWRU received an associate partner grant and chose to focus on issues of ethics, professionalism, and communication.  This stemmed, in part, from student surveys that had shown that CWRU fourth year students did not feel that they knew the faculty well enough to ask them to write letters of recommendation for residency applications, as well as the need for third year students to discuss their experiences in a structured setting and to learn the basics of some core topics that were not included elsewhere in the clinical curriculum.

Mission of the CLICS program:  to provide third year students with a safe environment in which to discuss issues of professionalism, ethics, and communication with patients.  The goals of the program are to encourage students to

  • develop strong relationships with their faculty group leaders

  • address the transition to the third year

  • engage in self-reflection during the core clerkships

  • learn about specific topics that are not addressed elsewhere in the clinical curriculum.

First year of the grant (October 1998-September 1999) – a planning year

Second year of the grant (1999-2000) – Dr. Lewin piloted four individual cases introduced in four separate discussion sessions during the Primary Care Track (PCT) small groups.  These were spread over the year and occurred at three sites:  University Hospitals, MetroHealth Medical Center, and Henry Ford.  Student performance was evaluated through OSCE stations at the end of the third year, when all PCT students take a Generalist OSCE.  PCT students who attended CLICS sessions outscored non-PCT volunteers who did not attend CLICS sessions on the OSCE stations linked to the CLICS sessions.  Dr. Lewin provided a summary of the 1999-2000 CLICS pilot program for third year students at the September 14, 2000 CME meeting.

Third year of the grant (2000-2001) – expansion of the CLICS program to the entire third year class under the co-leadership of Linda Lewin, M.D., and Kathy Cole-Kelly, M.S., M.S.W.  One two-hour session on Tuesday during each four-week clerkship block (4:00 to 6:00 p.m. on the second Tuesday of the block) was set aside for CLICS sessions.  Attendance is required.  There has been no problem with clerkship directors objecting to pulling students off their clerkships, as initially feared.

Post-grant year one (2001-2002) – The course was revised and continued.  Everyone now has a CLICS syllabus book containing the topics, related reading materials, and a list of learning objectives for each session in advance.  There is now flexibility in the order of topic coverage.  During CLICS sessions, students are free to talk about what has happened to them on the clerkships, particularly as the experiences pertain to the reading and learning objectives of the sessions.  In this way, they are encouraged to discuss challenging clinical situations from an ethical and professionalism perspective and develop strategies for dealing with them.

Evaluation table of the CLICS program by students during the 2000-2001 and 2001-2002 academic years
Dr. Lewin referred CME participants to her handout containing a table of student ratings of CLICS session topics during both years.  Each session was rated for 9 different categories.  An average rating of each category as covered throughout all the CLICS sessions appears at the bottom of the page.  Scores improved in most categories this year over last year.  Students rated the following categories as particularly high:

  • This topic is relevant to medical students at the third year level.

  • The faculty leader did a good job.

  • This was a worthwhile exercise.

  • The group members had an opportunity to discuss issues relevant to this topic in a climate receptive to all perspectives.

CLICS is on its way to achieving its stated goals.  Students have been receptive.  The clerkship directors have been supportive.  Student performance remains ungraded again this year.  Dr. Lewin is a proponent of the third-year whole-class OSCE that many hope to see realized.  One CLICS goal is to have closer contact and a central structure; right now everything is spread out.  Plans for the future include adding more CLICS sessions.

Ms. Cole-Kelly continued the presentation.  Some CLICS topics are addressed in the first-two-year ICM (Introduction to Clinical Medicine) curriculum but are not included in the regular third year core curriculum.  Continuity can be achieved when some ICM preceptors (Years I and II) continue as CLICS preceptors with their same small groups.  However, there is a pool for those students wanting to belong to different small groups.  M.S.T.P. (Medical Scientist Training Program) students are randomly assigned to all groups.

At a recent class meeting of present third year students, Ms. Cole-Kelly solicited 29 enthusiastic student responses to earn elective credit as fourth year student preceptors for Year I and Year II ICM, CLICS, and the Interviewing Skills Program.  The talents of Ms. Perry Williamson, who will come in to teach small group facilitation skills for ICM interviewing preceptors, will be made available to CLICS participants.  Ms. Williamson demonstrates techniques applicable to small group teaching.

Dr. LaManna invited a recommendation from the CME to endorse CLICS as a worthwhile part of the curriculum that should be continued under current plans.  Both Dr. Lewin and Ms. Cole-Kelly both sit on the CRDC steering committee.  Dr. Brandt praised the CLICS program as an invaluable asset in our attaining such a good rating in the recent LCME review.  When questioned about funding, since the grant ended last fall, both Dr. Lewin and Ms. Cole-Kelly felt optimistic that the Patient-Based Program would support the program.  Resources are needed to make 150 books for CLICS and for faculty development.
The motion that the CME strongly endorse the continuation of the CLICS program as a valuable part of the curriculum passed unanimously.

  1. CRDC Update
    The new surgery clerkship at the Cleveland Clinic takes 2 CWRU students for each eight-week clerkship.  CWRU has established core clerkships at the Cleveland Clinic in Neurology, OB/GYN, and Family Medicine.

  2. CLC Update
    CLC Retreat to take place June 7

  3. Flexible Program Update
    The Flexible Program Advisory Committee (FPAC) met using the CME minutes of April 11 as a jumping off point.  It will present a plan to the Vice Dean to rename the group to give it parallel status to the other two councils.  Per CME request, the bookkeeping system for awarding Flexible Program elective credit is being tightened up.  The Registrar and his team are reviewing requirements and going over electives created by individual students.  They are revising the catalog, in which preceptors will categorize their elective(s) as either basic science or clinical science.  As Co-Coordinator, Dr. Malemud emphasized that he will not sign off unless the elective sponsor has already signed to award elective credit.  Dr. Chao explained that the Primary Care Track is equivalent to an Area of Concentration.  Every year, a few PCT students drop out of the program.  By the end of the second year, it is too late for them to take additional Type A requirements.  Dr. Malemud promised that he will meet to solve the problem in a timely fashion.

See Curriculum Revision Update section.

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This page was last updated on 04/15/02 by John Graham.

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