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Summary of September 11, 2003 CME Minutes

  1. Comments from the Chair

Dr. Murray Altose opened the first CME meeting of the academic year and announced that the format of CME meetings would continue to consist of reports from various curriculum planning groups. However, whereas the curriculum councils had previously been organized along preclinical and clinical lines, the councils have been reconfigured this year into a newly created Basic Science Curricular Council , responsible for planning, organizing, and managing the basic science curriculum over four years, and a newly created Clinical Curriculum Council , with the same function for the four years of the clinical curriculum. The Curriculum Steering Council for the CCLCM remains intact. The Flexible Program Council will be modified to incorporate Dean Horwitz's vision of civic professionalism, public health, scholarship and research, and hands-on practical leadership skills into the curriculum .

This past summer, nominations for both Basic Science Curriculum Council and Clinical Curriculum Council chairs were requested. Dr. Henson and Dr. Altose interviewed all applicants and recommended Dr. Linda Lewin as Clinical Curriculum Council chair and Dr. David Katz as Basic Science Curriculum Council chair. Dr. Altose highlighted the qualifications and experience of these candidates. The motion that the CME endorse the appointments of Dr. Linda Lewin as Clinical Curriculum Council chair and of Dr. David Katz as Basic Science Curriculum Council chair passed unanimously. The CME will inform the Faculty Council of these nominations. The Dean and the nominees will meet to negotiate expectations on both sides.

  1. Comments from the Vice Dean for Education and Academic Affairs

Dr. Lindsey Henson highlighted progress of the clinical curriculum , as evidenced by ongoing 1) retreats, 2) collaboration of faculty from both the University and College programs, 3) delineation of both learning objectives and skills expectations, 4) redesign of the third and fourth years to increase the amount of flexible time, and 5) improvement of feedback and monitoring clinical skills to ensure proper preparation for the Clinical Skills Examination (CSE). Again this year, Dr. Henson is sending a small group of faculty to the Harvard Macy Program. July 2006 marks the start of the new Year III curriculum for both the University and College programs.

Along with the University of Washington , SUNY (the State University of New York ) Upstate , and Harvard, CWRU received a prestigious grant funded by the Josiah Macy Foundation for the New York Academy of Medicine/AAMC. This grant supports programs for strengthening the fundamental clinical training of medical students by focusing on the clinical transaction . Clinical transaction “combines multiple skills—the physician's gathering of information from a patient, organizing and synthesizing it into a diagnostic and therapeutic plan, and communicating that plan to the patient in a way that creates a therapeutic partnership.” (Grant Proposal: A Clinical Transaction Development Pathway, April 30, 2003 ) Dr. Linda Lewin wrote the grant along with Dr. Terry Wolpaw, Dr. Klara Papp, and Ms. Kathy Cole-Kelly. CWRU is proud of its achievement in such a highly competitive pool of medical schools and looks forward to working with the other grant recipients.

Dr. Henson recapped Dean Horwitz's vision . The intent is to incorporate the following as an integral part of the curriculum, not to treat these areas as add-ons:
•  Civic professionalism
•  Public health
•  Scholarship and research
•  Hands-on practical organizational behavior leadership skills.
Dean Horwitz would like to develop a new Year I curriculum for 2005.

Dr. Terry Wolpaw became the Associate Dean for Curricular Affairs in August. Shortly, she will present the structure of the new Office for Curricular Affairs (OCA). The office will have two roles: First will be to facilitate the development of our curriculum through sharing in curricular planning, faculty development, assessment, and educational research. The second role will be to create an instructional support network to help faculty with course delivery. The OCA plans to add three faculty associates who will join the office for a percentage of their time: one as a faculty development consultant; one to head the implementation of a new grant through the Macy Foundation, New York Academy of Medicine, and the AAMC to design a clinical transaction pathway; and a third associate, also helping with the new grant, who will develop a clinical portfolio and direct the evaluation portion of the grant.

The Scholars Collaboration in Teaching and Learning program, originally awarded $175,000 for its 2002-03 start-up year from the Provost Opportunity Fund, will continue this year and be supported by the School of Medicine . The School has been very fortunate to receive a $1 million endowment for medical education that will come to the school over five years. The Scholars Collaboration is one of the programs that will receive partial support through this generous gift. Dr. Henson will provide the remainder of the support for the Scholars Collaboration from her budget. Scholars have just been chosen for the 2003-04 academic year and will be officially announced at a Deans' reception October 1 st . Eight faculty, eight Year II students, and eight Year IV students will participate in the program this year. One resident will join this year as a pilot. The program hopes to incorporate more residents in future years.

Important dates:

  • Cancelled due to weather conditions on the East Coast with plans for rescheduling: Aviad Haramati, Ph.D. , Professor and Director of Education in the Department of Physiology and Biophysics at Georgetown University School of Medicine and leader of an NIH-funded project to develop a model Complementary and Alternative Medicine curriculum for medical students, will conduct a seminar on “Challenges and Responsibilities of Medical Science in the Education of Physicians.”
    Immediately preceding the lecture , Dr. Haramati would like to meet with a small group of key organ system/basic science educators for an informal discussion “Creating a More Stimulating Teaching and Learning Environment.”
  • September 26, 2003, 7:00 a.m. to 10:00 a.m. Intercontinental Hotel – Morning Workshop entitled “Active Teaching/Active Learning” with demonstrations of the three different interactive teaching methods by faculty from the Harvard/MIT HST Program, Albert Einstein School of Medicine, and Baylor School of Medicine. Participants can sign up for small group curriculum development sessions with one of the three presenters from 10:00 to 11:00 a.m.
  • February 27, 2004, Landerhaven – Annual CWRU Medical Education Retreat focusing on the Assessment of Clinical Skills and Incorporating Advanced Basic Science Skills into the Clinical Years

Dean Ralph Horwitz will attend the September 25 CME meeting to create a dialog with the CME and to describe his vision spanning all four years of the curriculum.

  1. Report from the Flexible Program Council

    Dr. Kent Smith, Flexible Program Council Coordinator, mentioned the priority among the four society deans to make use of the Flexible Program to coordinate the four areas of Dean Horwitz's vision, particularly civic professionalism. The names of the four societies into which the current Year I and Year II students are divided and their respective deans follow:
    •  David Satcher Society – Dr. C. Kent Smith
    •  Frederick Robbins Society – Dr. Robert Haynie
    •  Emily Blackwell Society – Dr. Elizabeth McKinley
    •  Joseph Wearn Society – Dr. Steven Ricanati

    For the first time, Year I students are able to take one Type A elective during Period I. The majority of the class chose to take advantage of this option.

    Desire to avoid social isolation of students in the College program prompted discussion. Clinical Learning Groups (CLGs) currently existing in ICM (Introduction to Clinical Medicine) will allow once-a-week small group interaction among individual College and University students. Plans are being made for shuttle services to run between the Cleveland Clinic and the School of Medicine . September 2004 is the targeted date for the first CLG session incorporating both College and University students.

    Ms. Connie Liu, who so effectively represented her classmates at the CME during Year I, has chosen to pursue a dual degree and entered the Health Services Research Ph.D. program. As she must take a graduate course that conflicts with scheduled CME meetings and, in addition, will not be in the Class of 2006 when she returns as a medical student next year, Mr. Michael Buschur, student CME representative, will become the Acting Year II representative until a formal election is held.

    A brief discussion about “community service learning” followed. The goal is to pare down course requirements to make room for incorporating community service into the curriculum. There will be many task forces involved in revising the curriculum, and student representation is not only welcome but necessary.

  1. Report from the Cleveland Clinic Lerner College of Medicine Curriculum Steering Council

    Dr. Andrew Fishleder, Co-Chair of the CCLCM of CWRU Curriculum Steering Council, highlighted progress pertaining to 1) organ system blocks, 2) the research curriculum, 3) the clinical curriculum, and 4) overall calendar for ICM.

    Revised course plan presentations by all Year I organ system block leaders should come before the Curriculum Steering Council for final approval by the end of December. Year I organ system blocks already contain weekly “themes,” learning objectives, and PBL case topics. PBL cases and tutor guides should be completed by the end of December.

    A weekly seminar on Fridays from noon to 1:30 p.m. has been approved by the Curriculum Steering Council and will represent a joint planning effort by the organ system block leaders and the Research Committee focusing on cutting edge topics.

    The College program was originally conceived with one-half day in Year I and one half-day in Year II dedicated to clinical activity. The decision was made to increase the amount of Year II clinical activity to two half-days per week, thereby allowing for 1) a weekly continuity clinic (Clinical Learning Group), and 2) a clinical activity related to the appropriate organ system and/or an introduction to acute and inpatient care.

    While the College and University organ system courses have differing start dates in both Year I and Year II, it was recommended that the Introduction to Clinical Medicine (ICM) component start and end at the same time for all students. ICM currently encompasses the Clinical Learning Groups of Years I and II and Year II CPDP (Core Physician Development Program).

    The LCME site visit to the College will take place September 12, 2004.

  1. Health Sciences Library Update

    Mrs. Virginia Saha, Cleveland Health Sciences Library Director, announced a reception to be held Friday, October 24 from 4:00 to 7:00 p.m. to celebrate completion of the library renovation. Wireless capabilities now extend throughout the entire library. The enlarged study carrels have been well received by the students. Electrical floorplates near the study carrels means the limited battery life of laptop computers is no longer a problem. There is a training room which will utilize laptops with wireless network connectivity for hands-on instruction. Group study rooms have been upgraded, and the larger ones can comfortably hold 10 to 15 people.

See Curriculum Revision Update section.

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