Discussion Items

1. Minutes

The minutes were unanimously approved as submitted. Dr. Kruse asked if electronic distribution would be acceptable in the future, and the Council agreed, although it was suggested that all documents be attached, as well as included in the e-mail. It was noted that the December minutes were exceptionally long, since they included detailed data from a presentation, but will usually be two-to-three pages, depending on the discussion issues.

2. Announcements

Dr. Kruse announced that he would like for the EPC to focus on the curriculum and its quality, which means that routine update reports should be limited to highlights so that there is time for wide-ranging, philosophical discussions about the curriculum. He also noted that there is a long list of curriculum follow-up issues from the Steering Committee that should be prioritized for future meetings. He also suggested two subcommittees: 1) Information Technology (including Evidence-Based Medicine) as a joint subcommittee with IMPC, with three to four members from each committee; and 2) Biotechnology, which would enhance vertical and horizontal integration efforts and include genetics and scientific/medical ethical issues. An e-mail soliciting interest in being on committees will be distributed and a list of members will be presented at the next meeting.

3. Review of Operating Paper

Dr. Caspary reported that he had started with the structure of the previous EPC’s Operating Paper, with reviews by Dr. Borgia and Dr. Naritoku. The proposed changes include: 1) staffing of the committee is at the chair’s discretion, rather than out of the Office of Education and Curriculum; 2) reports regarding curriculum review should be submitted in writing; 3) motions and seconds may be made by voting members only.

Discussion by the Council include the following decisions: 1) the proposed change regarding eligibility for making and seconding motions was changed back to the original wording, which allowed all members to make and second motions; 2) there should be six ex officio voting members: Year Directors, Doctoring Director, Chair of SPC, and four ex officio non-voting members: Associate Dean for Education and Curriculum, Assistant Dean for Curricular Affairs-Carbondale, Associate Dean for Student Affairs, and Assistant Dean for Student Affairs; 3) the staggered terms statement should reference elected and appointed members; 4) it was suggested that the reference to student members should include the statement, “Student members will be elected and confirmed by the Dean,” but there was not consensus, since this is true of all EPC members; and 5) Curriculum Coordinating Committee membership will not be detailed in the EPC Operating Paper but will include a statement to the effect of “as outlined in the Operating Papers of those committees.

There was much discussion regarding staffing of the Council. The intention of the subcommittee appeared to be that, as a faculty committee, the Council should distance itself from the Office of Education and Curriculum. After discussion as to the pros and cons of such action, there seemed to be consensus that the Council might wish to avail itself of additional support, using wording such as, “In addition to staff support from the Office of Education and Curriculum, the chair may designate a recorder who shall…”

The Vice-chair election will be held at next meeting. There was a brief discussion as to whether there should be additional officers on the EPC, such as secretary or treasurer, to ensure that all functions of the committee are handled by faculty. This did not appear to be supported by the Council.

4. Class of 2000 Graduation Questionnaire

Dr. Constance reported that the length of this questionnaire has been increasing each year, which is making it difficult to review. Since the class that completed the questionnaire did not participate in the new curriculum, the data may not be entirely useful. The EPC is the first group to receive the data and will make the decision as to how it should be further distributed. Members noted that there are several trends that need to be addressed at the next meeting, after the Council has had the opportunity to carefully review the document.

5. Comparison of CCX Clinical Reasoning Process with Tutor Group Clinical Reasoning Process

Dr. Barnhart explained that she was responding to an issue brought up at the end of the December meeting regarding whether the small group process used in the curriculum is different from the clinical reasoning process in the Clinical Competency Exam being used for assessment. She noted that the processes are identical, since the faculty involved in the development of both processes based both on the process used by physicians, and the purpose of both processes was to simulate a clinical encounter. In addition, there is a high percentage of faculty who were extensively involved in both processes and ensured that the processes were consistent. The elements of each process are outlined below:

Tutor Group	CCX
Case	Standardized Patient
Patient Data/Learning Issues	Findings
Hypotheses/Learning Issues	Initial Diagnosis/Hypotheses
Lab/X-ray	Lab/X-ray
Final Diagnosis/Learning Issues	Final Diagnosis
Management/Learning Issues	Management
Group Feedback	Patient Satisfaction

6. Update of Curriculum Implementation Process

Dr. Kruse directed the attention of the Council to the list of items suggested by the Steering Committee for monitoring during the implementation process. He suggested that the Council begin to prioritize the list to determine how best to monitor the issues. Most of the issues can be reported at the year level, but the concept of reviewing them as issues that cross multiple, if not all years, seemed to be more in keeping with the concept of the EPC’s responsibility for oversight of the curriculum.

It was suggested that the EPC might begin its focus on the issue of Basic Science Integration in Years 3 and 4. Case format/design and Mentored Professional Enrichment were also suggested as priorities. It was also suggested that subcommittees be established for the issues the EPC sets as priorities (such as Faculty Development and Program Evaluation). There was discussion as to how much direction the EPC should provide and how much responsibility the Year Committees should have for implementation. It was decided that the EPC should call upon the Year Committees to fulfill their responsibilities until and unless the committees fail to do so.

The concept of moving the basic sciences from Year 2 to Years 3 and 4 was questioned, as was the small group process. It was suggested that, as the size of the PBL class grew, problems with the process became evident. It was explained that both of these issues were reviewed at much depth by faculty committees and that the recommendations from the faculty groups emphasized the learning of basic science in the context of clinical medicine using active learning approaches.

7. Educational Value Unit Task Force Update

The Task Force has not met since the last EPC meeting.

8. Committee Reports

8.1 Year 1 Curriculum Coordinating Committee

Dr. Shea reported that students had just begun Week 5 of Sensorimotor Systems and Behavior and that the curriculum is progressing smoothly. Much of the student concern regarding the amount of faculty direction has decreased, although students are still somewhat concerned about whether they are reaching the depth of learning that faculty expect.

8.2 Year 2 Curriculum Coordinating Committee

Dr. Borgia and Dr. Tomkowiak reported that nine students (covering all three assessment blocks) have been given significant remedial activities. Year 2 Progress Subcommittees made recommendations to the SPC, and letters from the SPC have gone to the students. Rotation 3 of the six segments is proceeding routinely. At the last Y2CCC meeting, student representatives brought up two major issues that should be addressed: 1) Basic Science Resource Sessions are not useful to students because they are not segment-specific, and 2) Segment Rotation does not make sense to the majority of students and they would prefer to move through the curriculum together. These issues, which are interrelated, will be discussed at the next Y2CCC meeting. It was noted that attendance at the resource sessions has dropped dramatically. In response to a question regarding assessment of the content presented at these sessions, Dr. Borgia explained that content from the sessions is assessed only where it overlaps learning issues from the segments.

The issue of why more students failed the Circulation/Neuromuscular segment was briefly discussed. It was noted that the Progress Subcommittees used a norm reference system with two standard deviations below the mean signifying failure. Circulation/Neuromuscular included students who were just above the failure level in an effort to help those students begin to address what appear to be significant deficits. Concern was voiced regarding student performance on exam questions compared to performance by past classes, but it was noted that this was not a valid comparison. It was also explained that the exam was only one piece of student performance data.

8.3 Year 3 Curriculum Coordinating Committee

Dr. Kovach reported that the committee continues to review reports from clerkships regarding their responses to student feedback. The subcommittee on online forms has reviewed the forms developed for the four-year curriculum and accepted them for use in Year 3. They have been distributed to the clerkship directors for review. The Year 3 Calendar remains a major issue, but the plan is to resolve the issue and forward a proposal to the EPC in the near future. As soon as the calendar has been set, the major focus of the committee will be on Basic Science Integration.

8.4 Year 4 Curriculum Coordinating Committee

Dr. Lower reported that the Committee has not met since the last EPC meeting. A subcommittee is reviewing new electives, focusing on Basic Science electives.

8.5 Four-Year Doctoring Streamer

Dr. Barnhart reported that Doctoring faculty have been working with Years 1 and 2 student remediations. Doctoring faculty have also offered to help students who passed the exam but performed significantly lower than the mean.

9. Other Business

Dr. Feltovich distributed a copy of a budget appropriation from the Agency for Healthcare Research and Quality (AHRQ) regarding funding to promote improvements in various areas of patient care, including medical errors reduction. He reported that the Departments of Medical Education and Surgery had brought Dr. David M. Gaba to SIUSOM to report on this issue in October. In addition, Dr. Carpenter and Dr. Cooper are working with Dr. Stanley Edinger of AHRQ regarding a possible study of this issue at SIUSOM. Since there appears to be the possibility of funding for this type of study, it was suggested that the EPC might investigate the possibility of developing a curriculum initiative in an area such as clinical pharmacology, which would include drug interactions and prescription error resulting in mortality and morbidity. It was suggested that Dr. Feltovich send an e‑mail to all faculty to gauge interest and that the EPC continue to discuss its possibilities.

Dr. Kruse suggested that EPC members may wish to keep 1:30 to 3 pm on the fourth Monday of the month open on their calendars so that issues that generate lengthy discussion can be continued. He also suggested that the EPC might benefit from an annual retreat and from overview presentations about each year of the curriculum and synopses of the faculty development courses.

Dr. Kruse announced that the staggered three-year terms outlined in the operating paper do not affect current EPC appointments – all of those appointments are for one year, according to the Faculty Council.

Ms. Lipcamon asked if the EPC planned to develop a transition plan for students moving from Year 1 to Year 2. It was suggested that she discuss this issue with Dr. Shea.

10. Next Educational Policy Council Meeting: Monday, February 12, 2001, 1:30 to 3 pm.

	Minutes