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Summary of May 27, 2004 CME Minutes

  1. Comments from the Chair

Dr. Murray Altose welcomed Dr. Michael Nieder as the new Clinical Curriculum Council Chair.

  1. Faculty Development Update

Dr. Terry Wolpaw, Associate Dean for Curricular Affairs, thanked the CME for endorsing the Scholars Collaboration in Teaching and Learning (SCTL) program that has secured support from the Clowes Endowment for Innovations in Medical Education.  The SCTL will begin its third year by pairing 10 faculty, 10 Year II students, and 10 Year IV students into working triads.  Each faculty member receives a $2,000 honorarium for participating in the SCTL, and each student receives a $1,000 scholarship.  Interested faculty are encouraged to submit project proposals, with a focus this year on meeting the Dean’s vision.  Think of innovations and submit a proposal, as applications will become available soon.  Mark Gelula, Ph.D., from the Department of Medical Education at the University of Illinois at Chicago, continues to serve as the visiting faculty development consultant.

Dr. Altose asked about the continuity in sustaining the eight ongoing projects created by last year’s SCTL members.  Dr. Wolpaw explained that it is currently the sole responsibility of the faculty member to carry on the projects initiated.  Dr. Altose suggested looking into a more formal basis to move these projects forward, as he was very impressed with the presentations at the annual Landerhaven retreat.  Dr. Wolpaw suggested the formation of a small academy, which would provide modest resources for education funding and ongoing project support and be available to those who participated in the program.  Dr. Altose recommended pursuing a means of support for the implementation phase of the SCTL.

  1. Update from the Office of Curricular Affairs

Dr. Terry Wolpaw, Associate Dean for Curricular Affairs, would like to intermittently update the CME on the activities of this new office to publicize the many services/projects it offers.  She distributed a handout listing the purpose of the OCA as oversight and support for 1) curriculum development and implementation, 2) curriculum evaluation and outcomes assessment, 3) faculty development programs, and 4) resources management (i.e., support for teaching and grant opportunities) related to these activities.  With respect to faculty development, Dr. Wolpaw is especially enthusiastic about an upcoming program that Dr. Mano Singham of UCITE (University Center for Innovation in Teaching and Education) will be offering in conjunction with the medical school during the 2004-05 academic year, consisting of twelve faculty development sessions—6 sessions, each offered twice.  Dr. Wolpaw will e-mail CME members, subject committee chairs, and clerkship directors for preferences on topics of interest.

  1. Overview of the Years I and II Endocrinology Committees

Dr. Thomas Murphy began his teaching involvement with endocrinology at Case in 1986.  As the current co-chair of the Endocrinology Section of the Endocrinology/Reproductive Biology committees for both Years I and II, Dr. Murphy expressed satisfaction that both endocrinology components have been consistently well received by the students.  Dr. Murphy explained that Year II receives “higher marks” than Year I from the students, perhaps because the Year I combined Endocrinology/Reproductive Biology covers so much material during its short thirteen-day duration:  all basic endocrine physiology, all basic reproductive biology physiology, endocrinology/reproductive biology histology, and endocrinology/reproductive biology anatomy.  There has been a concerted effort to pare down to the core material yet cover “normal” physiology effectively so that the Year II committee can provide an extensive review/reinforcement of basic physiology along with the pathophysiology.

Dr. Murphy presented the survey results of evaluations by the students, which enabled comparisons of the two committees by year.  (The figures represented the combined Endocrinology/Reproductive Biology committee results for Year I, and results for Endocrine alone for Year II.)  Students gave solid marks to the Years I and II committees in the following selected areas:

Lectures – rated as “valuable” or “extremely valuable”
Small Groups – rated as “valuable” or “extremely valuable”
Small Group Leaders – receiving a “3” or a “4” on a 4-point scale with 4 being the best score
Overall committee rating as “excellent” or “good”
Student confidence on having learned the material
Exam as representative of what was taug

Dr. Murphy feels that committees of both years are designed to accommodate the varied mix of learning styles found in our student body by offering:

  • Lectures enhanced by slides

  • Small groups with an interactive, intimate setting

  • Syllabus (Year II singled out for its excellence by several students in their comments about the committee—comments praising the Year I syllabus were balanced by a number of complaints, though several of those complaints were specifically aimed at the reproductive biology portion.)

  • Recommended textbooks

  • Small group answer sheets generating extensive discussion and e-mailed after each small group

  • Review sessions after both Years I and II accompanied by handouts

When asked if he regards attendance as a problem, Dr. Murphy explained his philosophy.  Different students learn best in different ways.  We must provide many ways for the student to learn.  Examples such as watching a videostreaming of a lecture or reading at home in place of coming to class are acceptable to him.  The students who come to small groups are enthusiastic and want to be there. At the present time, we are not able to prove that attendance correlates with exam scores.  Dr. Murphy’s priority is preparing the students so that they know the material for the wards, and this can be accomplished in more than one way.

Dr. Murphy is particularly proud of the pairing of basic science and clinical preceptors in all but one small group.  (Dr. Murphy explained that the difficulty in finding basic scientists comfortable with their knowledge of thyroid physiology has kept this particular small group precepted solely by clinicians in both Years I and II.)  The small group “dual leadership” has served to consolidate the knowledge about basic physiology and correlate it with the clinical knowledge.  Dr. Murphy singled out as other notable accomplishments the review sheets and Year II syllabus.  Relevance of lectures is reviewed by the committee chairs on a regular basis.  A new lecture was added this year on Surgical Endocrinology given by Dr. McHenry.

Dr. Murphy has encountered no major problems.  Change is incremental in order to keep “on top of” problem solving.  His biggest challenges consist of:

  • Recruiting small group leaders and, to a lesser extent, lecturers.  As is true nationwide in academic medicine, a tiny core do the vast majority of small group teaching.

  • Continuing to streamline the Year I Endocrinology/Reproductive Biology committee while preserving its efficient content.

Dr. Murphy mentioned that improvements are done yearly.  The two co-chairs open up the endocrine Grand Rounds to whomever wants to attend.  Recommendations for what to drop and what to add to the course are considered.  Dr. Murphy regards his as a solid committee and does not anticipate major structural changes.  Evidence of ongoing improvement is found in the tinkering with small groups.  The decision was made for the coming year to replace a labor-intensive small group devoted to a calcium-related disease that is a rather rare problem with one focusing on hyperparathyroidism, a more common disease.  In response to the student request for more figures in the syllabus, Dr. Murphy plans to insert a figure showing the regulation of the hypothalaic-pituitary axes, though such figures are also available in the PowerPoint presentation figures from lecture.  Dr. Murphy wants to provide better feedback to lecturers and small group leaders.  However, because students are not always “kind” or “right,” the subject committee chair cannot directly distribute what is submitted.  The necessary breaking down of survey feedback and editing of the comments is a time-consuming project for the committee chair.  Perhaps the Office of Curricular Affairs evaluation initiative can be of some help.

Dr. Altose brought up the possibility of a contemporaneous online evaluation of the lecturer by the students.  Online feedback forms immediately following the lecture rather than at the end of the committee when students do not recall the lecturer’s name or the lecture title have already been suggested by the students.  Later in the meeting, Dr. Nosek mentioned that this idea had been tried in the past.  Initially, students were very enthusiastic about completing the short form daily on lecturers in the Homeostasis committee a few years ago.  However, with time, they lost interest.  Dr. Nosek felt that incentives would be needed to motivate the students to complete the evaluations.

Dr. Murphy favors maintaining the current structure, where all normal physiology is covered in Year I and the extensive review/reinforcement of basic physiology takes place in Year II when learning the pathophysiology.

Year II student representative, Mr. Jason Garnreiter, agreed that Year I contains much new information in a short time.  Yet, Year I as it is currently structured paves the way for a more interesting Year II that also serves to reinforce the material.  Both years of endocrinology are well received by the students.  All the endocrinology leaders/teachers are perceived to be interested in teaching.  The committee chair is respected for making the huge time commitment to attend all the lectures.  He knows what is going on in the committee.  Students enjoy the pairing of basic scientists and clinicians as small group preceptors and their spirited “power struggles” for more floor time.

Dr. Haynie provided an update by mentioning that there are plans for students to develop a white paper on appropriate feedback to address the issues that Dr. Murphy and other committee leaders have raised.  Dr. Murphy concluded by stressing that the vast majority of students do give appropriate feedback.  It is the occasional other comments that are at the root of the problem.

  1. Report from the Clinical Curriculum Council

Dr. Michael Nieder, new Clinical Curriculum Council Chair, is looking forward to the tremendous opportunities to enhance medical education.  Dr. Nieder is focusing on two projects for the summer.  First, he wants to work with the Foundations of Clinical Medicine leaders to define expectations for student mastery prior to entering the clerkships.  Dr. Nieder hopes to encourage communication between the six “Foundations” components:  Year I Science of Clinical Practice Seminars (Tuesday mornings), Year II Core Physician Development Program, Physical Diagnosis, Communication Skills, Family Clinic, and Preceptorships (beginning in Year I of the College Program, and in Year II of the University Program).  Clerkship directors have expressed the desire for a more disciplined, clinically-ready student.  Focus is on creating a four- or five-year continuum requiring a knowledge of basic science on the wards and later on in one’s career to pass the licensing exam in one’s own discipline.

Dr. Nieder’s second project will be acquiring a better understanding of the clinical years by working with the Associate Dean for Curricular Affairs to enhance the curriculum via innovative pilots.  Our immediate task of integrating the University Program curriculum with that of the College Program over the next several months, in preparation for a joint third year, will, hopefully, lead to some pilots.  Dr. Nieder’s plans also include addressing adult learning and determining what is needed in clinical practice.  Our students need to be equipped to start residency.

  1. Report from the Flexible Program Council

Dr. Kent Smith, Flexible Program Coordinator, mentioned that things are going well in the Flexible Program.  Fourth year students are taking Type B electives, which are four-week long rotations.  Some of these electives are available for a two-week option.  One credit is given for each one-month rotation.  Of the seven and one-half required Type B elective credits, 6 credits must be clinical.  Most students take an AI (Acting Internship).  Heavily subscribed are the Medicine and Pediatrics AI’s.  Subspecialty rotations and AI’s in Orthopaedics and Ophthalmology are also popular.  Ms. Carol Chalkley is currently working on developing an online evaluation of the Flexible Program electives.  Some third year core clerkship components may be carried over to the fourth year.  The remainder of Year IV is quite flexible, although an Area of Concentration (AoC) can narrow the field somewhat.  Dr. Smith clarified that a student cannot take more than 3 identical electives in the same field.

The issue was raised whether we plan to keep Year IV basically open or whether we plan to impose specific requirements.  It was suggested that since the Class of 2005 is the first class required to take the USMLE Step 2 CS, we might want to promote some ambulatory setting electives as preparation.  Dr. Smith is supportive of this.

  1. Update from the Office of Biomedical Information Technologies

Dr. Thomas Nosek, Associate Dean for Biomedical Information Technologies, provided an update on current projects:

  • Students liked the different Word formats for the eCurriculum that allow editing by faculty for quick corrections/updates of the syllabus and by students for individualized saving in the desired study format.  One feature, however, the split screen, cannot be retained.  Dr. Nosek plans to meet with the subject committee chairs to make them aware of their new capability to download the files, edit them, and send them back to the BIT office.

  • The ePortfolio is the “vehicle” of choice for Dr. Claire Doerschuk (Associate Dean for Student Research), Dr. Lynda Montgomery (in charge of the Clinical Transaction Development Pathway pilot), and the society deans.  Students will make use of the ePortfolio in compiling “My Dean’s Letter.”

  • The eCurriculum now bears the infinity symbol on its homepage, indicating “Infinite Possibilities” of the integrated health sciences curriculum at Case for the Medical, Dental, Nursing, and Graduate Schools.  Currently, we have access to the eCurriculum for the School of Dentistry, and the School of Dentistry has access to the eCurriculum for the School of Medicine.

  • Re-implementing the daily online evaluation of lecturers, as suggested during Dr. Murphy’s presentation, is no problem.  (This is discussed earlier in the minutes.)

Dr. Nosek brought to attention an unanticipated violation of the Computer Ethics Policy by five of the students.  Copyrighted materials had been digitized and inappropriately placed onto a file transfer by five students.  Case’s system is such that identifying the individual(s) at fault is not a problem.  However, Dr. Nosek was not expecting this action and was further surprised that other students were using the copyrighted material without bringing it to his attention.  During orientation, each student signs a hard copy indicating that he/she has read the Computer Ethics Policy and will abide by it.  The individual, not the university, is held liable should there be a breach of Computer Ethics Policy.  In addition to impending legal action, concern was expressed that such an act could restrict/jeopardize the collaborative nature of the file transfer, which enables the students to share material to help each other.  Valuable study aids such as lecture notes compiled by students and faculty-distributed materials (all students have access, so there is no hoarding) as well as Doc Opera photos are posted on the file transfer.  Over 4,000 files are posted there.  To have a staff member view 4,000 files before each is uploaded is quite timely and costly.  It was decided that this is an issue that the Dean’s office needs to address.  For the present, the file transfer area has been closed.


See Curriculum Revision Update section.

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