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Summary of October 28, 2004 CME Minutes

  1. Dr. Louis Binder, Acting Chair, presided over the meeting during Dr. Altose’s absence.  He introduced the newly elected Year I student CME representative, Mr. Leland Metheny."
     

  2. Report from the Biochemistry Subject Committee

Dr. William Merrick, Biochemistry committee chair, presented highlights of an update on this year’s committee.

Dr. Merrick began with the positive accomplishments. 

  • Test performance and construction:  This year’s class performed slightly better than recent previous classes.  This might be attributed to increased faculty interaction with the students in small groups and reviews.  This is the first year that Biochemistry has approached the 50% mark in offering a non-multiple-choice-question format on the interim exam.  This format is more educational for students and for faculty as well; it allows the faculty to address perceived weaknesses in subsequent lectures and gauge how the students feel about the overall flow of the committee.

  • This was the second year that the “PBL light” small groups were offered.  This type of self-directed student learning with faculty acting as facilitators rather than content experts was well received by the students. 

  • Dr. Merrick recognized the following for their valued contributions to the committee:  Ms. Patti Qualich (syllabus), Mr. Eugene Bates (Audio Visual), Dr. Marcia Wile and Ms. Tanya Long (examinations). 

  • Student feedback rated the formative midterm as helpful in preparing for the final exam.

  • Cohesive core of faculty lecturers with four as the minimum number of lectures delivered by any one person.  Seven faculty delivered the major content of the committee.

  • Clinical correlations went well.

  • In an attempt to eliminate any “hidden agenda” for student expectations, “ground rules” setting a tone for professionalism were included in the Biochemistry syllabus this year indicating behavior in certain settings.

Dr. Merrick next delineated the negative aspects of the committee:

  • Quality of the print syllabus, particularly the figures, needs improvement.  Dr. Nosek responded that a Web site with commercially-created free illustrations has been identified for use next year. BIT staff will work with the faculty to incorporate the desired illustrations.

  • Students were distracted this year by policy/logistical uncertainties caused by recent changes:  (Remarks occurring later during the CME meeting have been incorporated into the following section of Dr. Merrick’s presentation for coherence.)

  1. Whether they would receive Type A elective credit for Biochemistry Review afternoon sessions—As Dr. Merrick was unaware of the CME decision to allow Year I students to earn “one” Type A elective credit during the first period (previously Year I students were not allowed to take any electives during Period 1), the awarding of two elective credits for attending 12 Biochemistry Review sessions (one hour each) was changed to the awarding of one elective credit for the review sessions taken.

  2. Conflicting afternoon scheduling of both Biochemistry Review sessions and Foundations of Clinical Medicine Communications Workshops—As the new mandatory Communications Workshops are scheduled according to society in which the student belongs, some students were prevented from attending the Biochemistry Review sessions.  Thus, not everyone had equal access to the review sessions.

  3. Confusion over expectations for the Histopathology exam.

  • Change in the Microsoft software program this year led to anxiety-causing delays for approximately one-third of the Year I students taking the four-hour Biochemistry online interim, their first major exam.  Dr. Nosek responded that his staff rewrote the whole program and are still rewriting it in order to solve this problem.  He is optimistic that this kind of disruption is no longer an issue.  Students affected at the time were given extra time to finish the Biochemistry exam.

  • Non-existent temperature control combined with fluctuations of small group room temperatures made for uncomfortable settings.

  • For the first time this year, the Biochemistry interim examination took place on Friday rather than Monday, thus significantly decreasing the students’ study time and resulting in poorer class attendance during the last week, as some students sacrificed learning new material and studied at home.  The last week of Biochemistry class attendance is usually at or near 100%; this year it decreased to 75% in spite of the fact that some new material and several Clinical Correlations were presented.  Another consideration that may or may not be factored into the scheduling process is that either Rosh Hashanah or Yom Kippur regularly occurs during the Biochemistry committee.  Specific dates of the holidays change from year to year.  Current practice is that classes are held as scheduled, but those students observing the Jewish high holidays are excused from classes.  A system has been in place for quite some time to accommodate late-takers of examinations—they all take the exam two working days subsequent to the original date the exam was given.

Dr. Binder asked the student CME representatives present for their input.  Mr. Brian Chow, Year IV student representative, recalled that conflicts with review sessions were not new.  In his “A Student’s Perspective on the Last Two Years,” presented at the May 2003 CME meeting, Mr. Chow mentioned the fallacy of the “free afternoon.”  He inquired as to the current state of the medical school calendars and reiterated that they were designed with a purpose and a need to fill.  Mr. Chow referred to elective credit offerings for reviews as preventing first year students from getting bogged down with electives during their first weeks and alleviating the drain on high-demand electives for second year students.  Mr. Chow concluded by mentioning that Biochemistry was always regarded as one of the best subject committees.

Year I student representative, Mr. Leland Metheny wished to address the professionalism issue raised by Dr. Merrick.  He explained that for the second clinical correlation students were unsure when the patient was coming in, so some students slacked off.  Dr. Merrick replied that there is always uncertainty—everything depends on if/when the patient wants to come in.  Mr. Metheny took the Biochemistry Review elective and was not concerned about not earning two elective credits even though he went to more than 12 reviews.  He noted that the confusion did bother some of his classmates, however.  Mr. Metheny noted that there were many clinical correlations during the last week and many students did not come.  All the Biochemistry teaching faculty sit in on all the lectures and conduct the review sessions.  Biochemistry reviews are targeted for nontraditional “bent arrow” students whose knowledge of the sciences may need refreshing and for those medical students entering with only a minimal science background.  The idea is to provide the student with solid Biochemistry skills needed throughout the first two years.  Dr. Merrick expressed concern that the Foundations’ Communication Workshops schedule might make the Biochemistry Reviews inaccessible to students who really need them.

Discussants expressed interest in the “review session as electives” and the scheduling dilemma and found these issues worthy of further investigation. 

  • Should the CME policy of allowing Year I students to earn one Type A elective credit during Period 1 be increased to two credits?

  • Should awarding Type A elective credit for review sessions—which are not new material—continue to be allowed? 

  • As a separate—yet related—matter, should awarding Type B elective credit for the popular reading electives (not new material) as students study for the USMLE Step 2 continue to be allowed?  This was not felt to need further review at this time.

  • Should there be a “dedicated time slot” for basic science reviews—i.e. one late afternoon 2-hour slot per week?  All subject committees try to hold at least one major review before an exam and that review is not in the morning.  While Biochemistry offers the most review sessions, some other committees hold frequent review sessions.  At today’s CME meeting, the three “principles” necessary to work out the scheduling conflict were present—the Basic Science Curriculum Council Chair, the Flexible Program Coordinator, and the Foundations of Clinical Medicine Co-Director.  Some ground rules were laid down:

    • No activity could be added to the schedule without first going through Ms. Minoo Darvish, who has responsibility for the schedule.

    • Scheduling of activities would not be based on the “first come first served” principle but rather “negotiated.”

    • Reviews should not add new material.  The Biochemistry Review elective is intended to encourage mastery of the material for all students and to help those students in particular who are weak in science.

Acting Chair, Dr. Binder noted that we would be setting a precedent and need to give some thought to the degree of rigor inherent in declaring a review an elective.  For example, how many hours of review are necessary to qualify as an elective?  In addition, logistics have to be taken care of—room reservations, planning of both faculty and student schedules.

Dr. Dan Wolpaw moved that the parties involved (representing the course committee heads—subject committees and Foundations of Clinical Medicine—and the Flexible Program Coordinator) gather more information, get together, and propose a plan at a future CME meeting with regard to setting aside dedicated time for late afternoon review sessions.

Dr. Peggy Stager seconded the motion.

The motion passed unanimously.

Dr. Smith and Dr. Amy Wilson-Delfosse will put together a proposal using Dr. Merrick’s input.

  1. Flexible Program Council Update

Dr. Kent Smith, Flexible Program Coordinator, mentioned his appreciation to Dr. Sach, who assumed responsibility for the Thoracic Imaging Type B elective during Dr. “Chip” Gilkeson’s convalescence.  Type B elective evaluations of students are being returned in a timely manner.

  1. Clinical Curriculum Council Update

Although his term does not officially begin until November 1, Dr. Dan Wolpaw, the new Clinical Curriculum Council Chair, mentioned that the central issue is standardization of the process to get clerkship evaluations submitted.  The online evaluation form exists.  There are still problems in getting timely assessments on the students from the clerkship directors.  There are still some technology problems, but the focus is on getting the clerkships on board in coordinating this evaluation effort.

  1. Update from the CCLCM Curriculum Steering Council

Dr. Andrew Fishleder, Cleveland Clinic Lerner College of Medicine Curriculum Steering Council Co-Chair, mentioned that course directors will present feedback and revision recommendations to the Curriculum Steering Council when each course is completed.  The Fundamentals of Molecular Medicine course and Research course from this past summer will be presented to the CSC on Friday, October 29, for discussion.

  1. Health Sciences Library Update

In response to the Year II student representative’s feeling that more students would use eMedicine if they had a subscription to the site, Mrs. Virginia Saha, Cleveland Health Sciences Library Director, announced that a 30-day trial for eMedicine has been set up as of October 27Mrs. Saha would like feedback from both students and faculty in evaluating this resource and thereby helping to decide selection of site licenses to purchase.  Mr. Utz mentioned the strength of the eMedicine database when researching a particular disease.  It presents basic pathology, basic symptoms, management of the disease, and drugs.  Mr. Utz mentioned that students use it in CPDP to look up a disease and find out the tests to run on a patient.  The strength of the eMedicine database, however, is not in identifying a disease from symptoms given.  Mrs. Saha mentioned that she will also set up a trial on First Consult, which deals with clinical point of care, through MDConsultMDConsult has now has been increased to four simultaneous users.  Discussants at the VA and Cleveland Clinic mentioned their high regard for Up-to-Date, a “fabulous” but expensive resource.  Mrs. Saha would like to coordinate her site license purchases with the hospitals with the goal of sharing and eliminating costly duplications wherever possible. 

  1. Faculty Development Update

Dr. Terry Wolpaw, Associate Dean for Curricular Affairs, was happy to announce that between 65 and 70 faculty have signed up for sessions offered in the yearlong faculty development workshop series.  Each workshop session gets evaluated and the responses have been very positive.  Seven faculty—only 5 were anticipated—signed up for the “Active Lecture” certificate program that requires substantial pre-preparation:  making a video of a lecture prior to the first workshop.

The Dean is offering a total of $10,000 in awards to faculty delivering educational presentations at educational meetings.  For purposes of clarification, clinical presentations do not qualify; those are subsidized by the department.  A maximum of $1,000 per award will go toward airfare and one night in a hotel.  A committee composed of Dr. Terry Wolpaw, Dr. Dan Wolpaw, Dr. Amy Wilson-Delfosse, and Dr. Klara Papp will determine criteria for the awards.  Each submission should be a scholarly work meeting the standards of Glassick’s criteria, as was used in the “Best Contribution” narrative.  The specific criteria to be used in giving the awards will be determined by the committee.  There may be a need to offer faculty development workshops on writing abstracts for this project.

  1. Update from the Associate Dean and Director of Residency and Career Planning

When asked about the Dean’s Letters, Dr. Richard Aach, Associate Dean and Director of Residency and Career Planning, replied that everything has been successfully transmitted for the Class of 2005.

 

See Curriculum Revision Update section.

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