Shield of the SOM Committee on Medical Education
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Summary of November 13, 2003 CME Minutes

  1. Report from the Student CME

At the November 11 Committee on Student Representatives (CSR) meeting, the desire for better communication of Dean Horwitz’s vision to the students was stressed, particularly how curricular changes would affect their requirements and expectations.  Would research be mandatory or just more highly encouraged with expanded resources available?  To what extent will Problem-Based Learning be integrated into the curriculum to replace lectures?  While lectures may be a passive learning activity, students oppose their total elimination from the curriculum.  Dr. Altose assured the students that should we embark on developing a new curriculum, there would be strong student involvement and participation in this endeavor.  Dr. Altose stated that the CME will apprize the Dean of the students’ concerns.

Mr. Jason Garnreiter mentioned a new development in Year II this academic year.  DAB (Drug Action and Biodisposition) has become a longitudinal committee.  Co-Chair, Dr. John Mieyal has already started designing and implementing quizzes that will run throughout the year and serve to update the students.  Overall, this activity has been well received by the students, and Dr. Mieyal is revising the quizzes based on student feedback.  Focus is also on refining the post-examination review session process to transform what amounted to a complaint session into a learning tool.  As this is the first year of the longitudinal pharmacology committee, Dr. Mieyal is aware that fine-tuning is needed and would like to organize a class meeting/feedback session.

  1. Report from the Associate Dean for Curricular Affairs

Dr. Terry Wolpaw, Associate Dean for Curricular Affairs, circulated the mission statement and goals of the new Office for Curricular Affairs (OCA).  Some schools have two separate offices—one office that deals with such matters as faculty development, curriculum development, assessment and evaluation, and educational research—and another office that provides support for the teaching faculty.  At CWRU, there is no faculty support office.  Because of this, Curricular Affairs is proposing that it develop a faculty support arm.  The OCA has begun by designing and preparing to pilot the Instructional Support Team (IST) to “provide educational support services that will facilitate the planning and delivery of the ongoing basic science and clinical instructional activities.”  The IST plans to offer support for committee chairs in the administration, implementation, and evaluation of their committees.

Mr. Craig Hull will head the Instructional Support Team with the help of the Director of the Office for Curricular Affairs, Ms. Minoo Golestaneh.  Ms. Golestaneh and Mr. Hull assembled and recorded focus group discussions to determine:  1) the kinds of support that the subject committee chairs indicated they needed, and 2) the “best practices” insights shared by experienced program administrators known for providing excellent support to the subject committees.  The IST will pilot the program with two subject committees that teach in the spring:  Year I Fundamentals of Therapeutic Agents (FTA) under the leadership of Dr. Amy Wilson-Delfosse and Year II Gastrointestinal under the leadership of Dr. Kevin Mullen.  Both of these subject committee chairs have already completed a pre-test survey, indicating the anticipated degree and range of their own efforts expended running the committee assuming they would receive no support.  After the pilot, these subject committee chairs will complete a post-test survey, indicating the actual allocation of their own efforts in various areas having received support by the IST.  The survey covers the following areas:  scheduling, faculty development, syllabus, rooms, books, examination, evaluation, and post-committee activities.  Dr. Wolpaw thanked Dr. Marcia Wile for her help in designing the survey.  Dr. Wolpaw will share the results of the survey, determining whether the IST was 1) well received and 2) effective, with the CME.  The IST hopes to establish a “cycle” of support for the subject committee, beginning five to six months before the committee starts, continuing while the committee takes place, and lasting until approximately eight weeks after the committee ends.

Dr. Wolpaw explained that a new Year II elective is being piloted that may eventually become a part of an Area of Concentration (AoC) in “Developing Skills in Medical Education.”  A member of the IST and two to three students will review last year’s FTA syllabus.  With the support of Dr. Wilson-Delfosse, they will offer suggestions on ways that the syllabus could serve as a more effective learning tool.  The students will benefit as they review basic science material and develop skills in evaluating instructional materials.  The IST and students will read through the syllabus and track changes, which the committee chairs can choose to accept or ignore.

The Office for Curricular Affairs is piloting a system and hopes that the Dean will decide to extend the support provided by the IST to all the subject committees that need the team’s help.

IST plans to act as “bridges” with the Office of Biomedical Information Technologies.  IST’s role will be to make BIT services more available.

Evaluations for the subject committees, clerkships, and ICM will be examined by a different team, the Evaluation Support Team (EST).  A part of the “evaluation cycle” will be for the committee chair to develop an action plan.  This can be presented to the CME and shared with the students so that they know that their suggestions were heard. 

Dr. Altose welcomed the pilot of the Instructional Support Team as a means of freeing up the subject committee chair from so many of the day-to-day tasks of running a committee.

Dr. Wolpaw next presented highlights from a recent 13-School Consortium Report on Curriculum Development.  While CWRU received a stellar LCME review, the next LCME self-assessment coming up in six years will have some new criteria:

  • We need to be able to document the kinds of patients our students see.  The PDA may be a vehicle for doing this.  We would want to figure out how to utilize the documentation process to facilitate learning.

  • Each student needs to be observed when taking a history or performing a physical examination and receive feedback.  This needs to be documented.

Many schools have simulation centers that are up and running or in development.  We need to provide an opportunity where mistakes can be made and learned from by creating safe simulated clinical situations.  A committee is working on the development of a center at CWRU that might eventually be located on the West Quad.  Dr. Wolpaw expressed her desire to work with Clinical Curriculum Council Chair, Dr. Lewin, on these matters.

  1. Report from the Clinical Curriculum Council

Dr. Linda Lewin, Clinical Curriculum Council Chair, announced that the first meeting of the CCC will take place Tuesday, November 24.  Dr. Lewin has been meeting with the many small group components of the CCC, encouraging each of them to choose a CCC representative.  Interest in the following topics has been widespread:  1) evaluation, and 2) drafting a job description for the clerkship director in terms of time and support, similar to that for an academic endeavor.  Dr. Lewin was enthusiastic about the cohesive, supportive nature of the small groups and is concentrating on creating the right structure to incorporate them.

  1. Report on the Biochemistry Subject Committee

Dr. Altose explained that in the absence of a Basic Science Curriculum Council chair, individual subject committee chairs will provide reports to the CME.

Dr. William Merrick, Biochemistry Committee chair, provided a summary of his Year I committee.  This year marked the introduction of “PBL-light,” a series of questions integrating material over three to five lectures, assigned to groups of students and answered in small group format.  Also introduced this year was the formative two-week online interim examination—administered two weeks into the four-week committee.  The Biochemistry Committee eliminated cameo lectures, with just one faculty member presenting only two hours’ worth of lecture.  On average, individual teaching faculty were each responsible for four to twelve hours of lecture.  Overall, 95% of the lecture material was delivered by six faculty, who also served as small group leaders.  This led to better student interaction with the faculty.  Dr. Merrick cited the following difficulties:  1) disappointing appearance of the printed syllabus due to a new duplicating machine, and 2) insufficient number of chairs in the small group rooms.  When asked for an action plan to improve student learning next year, Dr. Merrick recommended:

  • Improving PBL-light questions and getting students onboard early in understanding the goals for these sessions

  • Providing students with sufficient practice to get used to the format of the formative two-week interim examination

  • Shifting lectures so that four will be the minimum number of lectures delivered by a faculty member.

Year I student representative Mr. Chris Utz stated that his classmates regard Biochemistry as one of the most well-organized committees.  He singled out other strong features:

  • PBL-light’s usefulness in synthesizing material

  • Availability of lecturers

  • Afternoon review sessions

  • Reinforcement provided by video streaming after attending lectures

  • Interim exam’s role as a wake-up call.

  1. Report from the Flexible Program Council

Dr. C. Kent Smith, Flexible Program Coordinator, mentioned that this was the first year that Year I students had the option of taking a Type A elective during Period 1.  More than two-thirds of the Class of 2007 took advantage of this opportunity.  However, approximately 20% of this group had to drop, citing the demands of Physical Diagnosis and ICM.  It is significant to note that the majority of Year I students signing up for a Type A elective during Period 1 successfully completed the requirement.  They enjoyed the option for early involvement in the electives program and the variety of topics in addition to the basic science core program open to them.  Dr. Smith will provide more information on the nature of the electives taken as requested by the students:  what electives entail, how to get MAPs (Medical Apprenticeship Programs), and what is necessary for AoCs (Areas of Concentration).  Dr. Smith expressed reservations, however, about pushing students too early toward AoCs.

  1. Health Sciences Library Update

Mrs. Virginia Saha, Cleveland Health Sciences Library Director, reported that the October 24 reception celebrating completion of the renovation of the Health Center Library was enthusiastically received.  She recently attended a National Library of Medicine symposium on renovation, where recommendations validated CWRU’s own choices for glass walls, group study rooms, a training room, and, particularly relevant today, wireless access.  Our library facilities are much more sophisticated than those of many other schools.  The next step in the process consists of decorating our walls with inspiring artworks.  Please contact Mrs. Saha at vmg2@cwru.edu with any suggestions.  Dr. Altose, who attended the reception, complimented Mrs. Saha and her staff on their significant accomplishments requiring such close attention to detail.

See Curriculum Revision Update section.

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