Overview of 1998-99 CME Meetings

Arranged Chronologically by Meeting Date and Issues Discussed
(Detailed Digest Available Upon Request)

1. Distribution of our Medical School Objectives Project (MSOP) Curriculum Consortium Poster prepared by Dr. Marcia Wile

2. Presentation and Discussion of Proposal for Modifying the Examination Process Proposal establishes two midterms and two comprehensives—all secured—as the only summative examinations for years one and two. All other examinations to be formative and taken by students on demand online. Passage of interims to be required. Interims will not be secured and should serve as self-assessment tools. Passage of USMLE Steps 1 and 2 remains necessary for graduation.

3. Curriculum Revision

a. Presentation of proposals on Managed Care and Biometry, Clinical Trials, and Public Health

The following "Public Health" theme motion passed unanimously: That the material on epidemiology, public health, and biometry presented by Drs. Green, Neuhauser, and Cebul be developed and integrated as a vertical theme in the curriculum and that these faculty be invited to form the nucleus of a working committee for this important theme that has been endorsed by the Committee on Medical Education. The working committee—inclusive of faculty constituencies participating in this area of expertise—will examine what exists in the current curriculum and make suggestions for a four-year content scheme in this area, will suggest implementation strategies, and will work with the coordinators and Associate Dean of Biomedical Information Technologies.

b. Proposal on Endocrinology presented

1. Discussion of ways to solve the shortage of slots for students at Cleveland sites in both the OB/GYN and surgery clerkships

2. Student reaction to the proposal to change the exam system

3. Curriculum Revision

a. Presentation of proposal on Ophthalmology

b. Presentation of proposal on Dermatology

c. CME plans to gradually authorize additional curriculum themes along the model of the "Public Health" theme. A committee to be established for each theme consisting of experts in that particular area and combining basic science and clinical science representatives

October 8, 1998

1. Update on plans for Henry Ford pilots for first and second year students

2. First whole-school Clinical-Pathologic Conference (CPC) scheduled for Friday, November 20, 1998

3. Involved students and faculty express concern over a recent change in Flexible Program policy made by Flexible Program Coordinator Dr. Tarvez Tucker’s committee that apparently:

a. Requires 4 of the 13 Type A electives to be in basic science

b. Restricts certain courses—primarily in the field of Alternative Medicine—to second year students and considers them as inappropriate for first year students.

The following motion passed: 5 in favor, 2 opposed, 1 abstention.

The CME respectfully requests that the Flexible Coordinator consider a delay in implementing the new restrictions regarding the Type A electives in the first year so that they are to apply to the class of 2003. The CME requests that the Flexible Program Coordinator and her committee make a presentation before the CME regarding these changes.

4. Curriculum Revision

a. Presentation of proposal on Chronobiology and Sleep results in unanimous passage of the following motion:

The CME authorizes the formation of the Chronobiology and Sleep proposal as a matrix, or "virtual," theme with a committee headed by Dr. Kingman Strohl to examine learning objectives already existing in the curriculum, to identify where more learning objectives are needed, to suggest how to work these in, and to bring back a further developed proposal to the CME.

5. Distribution by Dr. Joseph LaManna of his handout "The Role of the Teacher at CWRU"

 

1. Dr. Tarvez Tucker, Flexible Program Coordinator, presented a report on the workings of her Committee to Oversee the Flexible Program. New basic science requirements were upheld, but the decision to restrict credit for Type A electives in Alternative Medicine and the one-to-one fitness elective to second year students was rescinded for this year.

2. Curriculum Revision

a. Presentation of proposal on Assessment and Management of Chronic Care

b. Presentation of the proposal on Geriatric Medicine and Aging that results in unanimous passage of the motion that Geriatrics be added to the list of approved matrix, or "virtual," themes and that a committee of Geriatrics faculty examine where Geriatric Medicine content is taught in the current curriculum, suggest what learning objectives need to be added, and recommend a means to achieve that.

c. Presentation of the proposal on Management Issues of Chronic Medical Problems and Disabilities

1. First whole-school Clinical-Pathologic Conference (CPC) takes place November 20, 1998. Broadcasts from E301 to E401, E501, Henry Ford, Metro, and University Hospital.

2. Dr. LaManna, Dr. Malemud, and subject committee chairs and section leaders to meet with the year one class to address their concerns about next year’s curriculum

3. Curriculum Revision

a. Presentation of proposal on Complementary and Alternative Medicine (CAM)

b. Presentation of proposal on Community Dimensions in Medical Education

c. Presentation of proposal on Acute Illness and Injury results in unanimous passage of the motion that Acute Illness and Injury be added to the list of approved matrix, or "virtual," themes and that a committee of faculty with expertise in acute illness and injury provide a detailed description of what exists in the current curriculum, determine what is missing and specify learning objectives for that material, and provide strategies how the missing information can be incorporated into the curriculum.

1. Update on Dr. LaManna’s report to Faculty Council on the CME’s progress with vertical themes

2. Student CME recommendation that CPR be officially incorporated into the new curriculum

3. Curriculum Revision

a. Presentation of proposal on Child/Adolescent Development and Behavior

b. Presentation of proposal on Children with Handicaps and Their Families

c. Presentation of proposal on Biomedical Ethics

d. Presentation of proposal on Musculoskeletal Sciences

1. Curriculum Revision

Lack of endorsement for Dr. LaManna’s presentation of a proposal for the new curriculum due to

a. Lack of communication primarily concerning omission of information

b. A need for further discussion on several issues to inform and clarify

c. The dilemma of being too vague in places and too specific in others

1. Curriculum Revision

a. Dr. Katz distributed his latest draft of the "Curriculum Reform Proposal, an Alternative to the Proposal of the Millennium Advisory Committee."

b. The motion that the CME endorse Alternative Proposal components I (Starting Assumptions) and II (Educational Goals of Curriculum Reform) amended by Dr. Headrick’s suggestion to include a statement reaffirming Dean Joseph T. Wearn’s core principles and a consensus to declare medical education as the primary mission of the School of Medicine passed unanimously.

c. The motion was made that the CME endorse Dr. Katz’s template to be taken to next Friday’s January 29 meeting of the teaching faculty (section leaders, basic science chairs, and clerkship leaders) for discussion purposes. Teaching faculty are to vote on parts I and II, and the rest of the presentation is to serve as a point of discussion for creating a macrostructure for years one and two. The motion passed unanimously.

d. Dr. Katz went on to present his Alternative Proposal in revised form at the February 5, 1999 Medical Education retreat at Landerhaven.

 

February 11, 1999

1. Curriculum Revision

a. Dr. Katz’s update on creation of the new Curriculum Leadership Council. The Dean has endorsed that the design and oversight of the Year One and Two curriculum will be the responsibility of the teaching leadership, with support and consultative input from department chairs. Dr. Katz to chair the Curriculum Leadership Council. The Dean has asked the Council to generate a revised first year curriculum for the incoming class of August 1999.

b. The following motion passed unanimously: The CME endorses the Curriculum Leadership Council, under the leadership of Dr. David Katz, as the mechanism for renovation and oversight of the first two years of the curriculum.

c. Henry Ford’s enthusiasm to move ahead with pilot programs

 

1. Director of the Cleveland Health Sciences Library announced improved access to databases and electronic journals

2. Request from Core Academic Program Coordinator for prompt submission by students of evaluative letters following a subject committee’s end. These letters provide a necessary component of the annual Core Academic Program report.

3. Director of Residency and Career Planning announced our success in the early match program.

4. Curriculum Revision

a. Brief discussion on how best to proceed with the Flexible Elective Program in the revised curriculum

b. Patient-Based Program Coordinator mentioned the very recent decision by the Dean to reduce the 14-month required core clerkship third year to 12 months and to increase the current 6-month Type B elective requirement to 8 months.

c. Plans under discussion for offering an electives program at Henry Ford for medical students while they are in Detroit.

d. Discussion of current status of the third year curriculum revision process. Dean’s recent decision to reduce the third year curriculum from 14 months to 12 months of required clerkships beginning with the third year class in July 1999 to be achieved by changing both the OB/GYN and Psychiatry clerkships from two months to one and one-half months and by eliminating the one-month Primary Care clerkship requirement.

e. Discussants opposed the Dean’s directive approach to curriculum change on the grounds that it ignores CWRU’s long history of placing curriculum design in the hands of the faculty as represented by 1) the CME, 2) the Faculty Council, and 3) the general faculty. The Dean’s directive has bypassed the established process which uses the aforementioned constituencies to implement curriculum change.

f. The following motion passed unanimously:

That the Dean be invited to attend a CME meeting no later than Thursday, March 4, 1999, to discuss the proposal reducing the 14-month core clerkship third year to a 12-month core clerkship third year after a private meeting with the CME chair and the Faculty Council chair.

March 4, 1999

1. Curriculum Revision

a. Continuation of discussion about the revised third year curriculum

(1) Faculty desire for sufficient time to produce a quality curriculum

(2) Survey by CSR (Committee of Student Representatives) of the second year class shows support for the reduction of the third year to a 12-month core clerkship third year to start this year

(3) Faculty proposal for a 13-month transitional core clerkship third year to begin in July 1999 before implementation of the 12-month third year

b. The following motion passed unanimously authorizing Dr. Marjorie Greenfield to lead a group of clerkship directors in designing a 12-month core clerkship third year.

c. The following motion passed: that the CME recommend a 13-month required clerkship be implemented for the upcoming third year class to begin on July 1999, with the further suggestion that the one-month ambulatory medicine block be dropped and that the Neurosciences clerkship could be taken anytime in the fourth year.

March 25, 1999

1. Curriculum Revision

Dr. Katz provided an update on the progress of the Curriculum Leadership Council on the year one and two curriculum revision. The Year One curriculum is essentially complete. With the start date as August 1999, the Council has focused on problems in coordination, integration, and delivery of the curriculum.

2. Dr. Kent Smith provided an update on the third year/Faculty Council issue. As decided at the March 4 CME meeting, 1) the 12-month core clerkship third year would begin in the year 2000, and 2) the 13-month transitional year would begin in July 1999. Dr. Susan Carter, Faculty Council Chair, has been working with her members, and Dr. Marjorie Greenfield will help lead the clerkship year development effort.

3. Dr. Jay Wish provided an update on the 13-month transitional third year as presented to the year two class.

1. CWRU has access to Ovid’s Evidence Based Medicine Reviews Collection—including the Cochrane Reviews and Full Text Core Biomedical Collection. You can access Ovid on the library home page http://www.cwru.edu/chsl/homepage.htm with a link to MEDLINE.

2. Curriculum Revision

a. Dr. LaManna provided an update on the progress of the Curriculum Leadership Council. The CME’s next major action for the coming academic year might be weaving the vertical themes into the curriculum.

b. Dr. Wish provided a year three curriculum update. The 1999-2000 third year has been finalized. The biggest problem was finding enough slots in the existing clerkship sites due to the loss of Mt. Sinai, the large class size, and the overlap with the current third year students. Dr. Marjorie Greenfield will be chairing a committee to propose future revisions in the third year curriculum for the academic year 2000-2001.

c. The Dean has convened a committee to examine the committee superstructure of the medical education effort. Examination of the leadership structure encompasses the function of the Committee on Medical Education. Dr. Martin Resnick, who has served two consecutive terms on the CME, is chairing the committee to review the curriculum administration.

3. Student concern to remedy the overlapping scheduling of the year two sections Drug Availability and Biodisposition (DAB) and Biological Basis of Disease II (BBD II). These two sections overlap using morning and afternoon hours at a time when students are busy studying for the USMLE Step 1. This schedule was implemented to preserve the three-week study period before the previously fixed-date pencil and paper USMLE Step 1. Now that there is no set date for the online USMLE Step 1, perhaps the year two schedule for next year can be relaxed.

4. The Macy Project Doctor/Patient Communication Skills OSCE, scheduled in early May, is the first step in gathering baseline data on second year students’ communication skills. Standardized patients will be used. The same OSCE stations will be run at New York University and the University of Massachusetts with their year two students. Results will be shared at the end of the three-school project in 2002.

1. Curriculum Revision

a. Dr. Katz announced that the Year One curriculum is essentially complete. The Curriculum Leadership Council is now focusing on matters related to the quality of teaching.

b. Dr. Tom Nosek provided a biomedical information technologies update that included

(1) The IBM ThinkPad 390E as the recommended computer purchase for next year’s entering class

(2) The policy for turning in notebook computers when students leave the medical school program either as a leave of absence or for the M.S.T.P.

(3) Examples of computerized testing to date in our curriculum

(4) The dilemma of the electronic syllabus and the print syllabus

May 27, 1999

1. Curriculum Revision

a. Dr. Nosek gave a presentation on video streaming of lectures. Video streaming broadcasts live over the Web. This form of distance learning enables you to attend a lecture while it is being presented via computer from any place that affords access to the Web. The presentation happens live, and it is then archived for anyone who wants to see it later. Both advantages and possible abuses of video streaming were discussed.

b. Dr. Katz came before the CME seeking its recommendation of the Year One and Two revised curriculum proposal so that it could proceed to the Faculty Council. The restructuring of the curriculum was designed by a consensus process of the Curriculum Leadership Council.

Dr. Katz recommended the following proposal, which was moved, seconded, and passed:

(1) The elimination of Saturday classes

(2) The extension of core time Wednesday and Friday into the noon hour

(3) The re-sequencing of topics between Years One and Two

(4) Grading Anatomy/Histology as a separate subject committee.

1. Recognition of outgoing CME members Drs. James Carter, George Dubyak, and Mark Cohen for their committed participation and insightful contributions during their three-year terms of service

2. Core Academic Program Annual Report, 1998-1999 – Dr. Charles Malemud, Core Academic Program Coordinator

3. Patient-Based Program Annual Report, 1998-1999 – Dr. Jay Wish, Patient-Based Program Coordinator

4. Update on the 12-Month Third Year Curriculum to Begin in July 2000 – Dr. Marjorie Greenfield

5. Update on First Year Curriculum – Dr. Kristi Zakariasen

6. Distribution of Clinical Science Annual Report, 1998-1999 – Dr. Ted Parran and Ms. Kathy Cole-Kelly, Co-Directors

7. Distribution of Physical Diagnosis Annual Report, 1998-1999 – Dr. Baha Arafah, Director

 

Return to CME Home Page