Minutes

Educational Policy Council Meeting

May 14, 2001

Carbondale:  Lindegren 310/Springfield:  Lincoln Conference Room

 

 

Present:

Amber Barnhart, MD

Peter T. Borgia, PhD

Terri Cameron, Staff

Donald A. Caspary, PhD

Erik J. Constance, MD

Clint Farris, Class of 2002

Paul J. Feltovich, PhD

Susan Thompson Hingle, MD

Sharon K. Hull, MD

Regina A. Kovach, MD

Jerry A. Kruse, MD

Matthew Lavery, Class of 2003

Theodore R. LeBlang, JD

Tracy K. Lower, MD

Dean K. Naritoku, MD.

David S. Resch, MD

Michael F. Shanahan, PhD

David R Wade, PhD


Absent:

Linda H. Distlehorst, PhD

Joelle Lipcamon, Class of 2004

Rick Markiewicz, Class of 2001

Sandra L. Shea, PhD

John Tomkowiak, MD


 

 

Discussion Items

1.         Minutes

The April 9 minutes were unanimously approved.

2.         Announcements

Dr. Constance announced that Dr. Donna Shalala would deliver the commencement address on Saturday, May 19.

 

Dr. Kovach announced that Dr. Bill McGahee would give a presentation on Tuesday, May 15. from 9 to 10:30 am in the Lindsay Conference Room on the US News and World Report Medical School Rankings and Teams and Medical Error.  It was requested that this session be videotaped.

3.         Response to Dean Getto regarding Year 3 Schedule

Dr. Kruse distributed a draft of the proposed memo to Dr. Getto regarding the Year 3 Schedule.  After review, it was suggested that items be revised as follows:

 

Paragraph 1:  change May to March 26 and responsible to responsibility.

 

Item 2 should be revised to state:  “Your discussion with the Year Three Curriculum Committee should have occurred much earlier in the process.  and your message was not only surprising, the manner of confrontation of the Committee was demeaning to its members and chair, but also inconsiderate of their efforts.”

 

There was much discussion regarding Item 4 and the extent to which changes had occurred in Year 3 and how best to reference those changes in the memo.  It was noted that the Dean did not ask the Y3CC to revert to a pre-C2000 calendar for Year Three, although the Y3CC felt that such action was necessary due to practical implications such as clerkship deferrals.  It was determined that the item should be revised to read: “As a result of these actions, the third year curriculum calendar…”

 

Item 5 should be deleted in its entirety.

 

Dr. Caspary made a motion, seconded by Dr. Feltovich, to send the memo to the Dean as corrected.  The motion passed unanimously. 

 

Dr. Caspary made a motion, seconded by Dr. Shanahan, that a copy of the memo be sent to the Faculty Council.  The motion passed unanimously.

4.         Class of 2002 Step 1 Performance

Dr. Distlehorst provided an overview of SIUSOM student performance on USMLE, Step 1.  Genetics, Microbiology and Immunology performance was below the national mean.  Genetics has been a problem area for SIUSOM students historically.  There was discussion as to what genetics content areas are covered in the exam.  It was noted that the content outline includes both Mendelian and molecular biology issues, but SIUSOM faculty have not had the opportunity to review the exam for several years so cannot determine if one or the other areas is predominant. 

 

Faculty suggested several other formats for presenting the data.  Dr. Distlehorst will develop additional reports for presentation at future EPC meetings.

5.         EPC Faculty Development

Dr. Kruse explained that, in a continuing effort to bring all EPC members up-to-date on the Curriculum 2000 process, abbreviated versions of the faculty development workshops offered to faculty last summer are being presented at the next few EPC meetings.

5.1      Case Format/Design

Dr. David Resch provided the following information regarding the process of case format and design:

Curricular Case Format & Design With Concepts of Small Group Learning

To begin with, the fact must be accepted that one cannot expect to become a skillful practitioner of medicine in four or five years allotted to the medical curriculum.  Medicine is not a trade to be learned but a profession to be entered.  It is an ever-widening field that requires continued study and prolonged experience in close contact with the sick.  All that the medical school can hope to do is to supply the foundations on which to build.


                                  The Care of the Patient.
                                  Peabody, JAMA, 1927

Adult Learning

·         Use experience as a major resource

·         They tend to be life centered. 

·         They use active participation. 

·         They learn best in a comfortable supportive environment.

James, 1983

Expertise Development

·         Want expertise in addition to learning

·         Highly dependent on the application of knowledge gained through learning and experience

·         The development of expertise is dependent on learning from experience, not just having experience.

Chase, 1973; Hayes, 1985; Chi, 1982;
Lesgold, 1988; Feltovich, 1997

Process of Learning

·         Meaningfulness of the Information

·         Encoding

·         Context

·         Practice

Regehr, 1996

Exit Objectives

·         Patient Encounter

·         Clinical Skills

·         Clinical Reasoning

·         Cost and Impact on Patient

·         Communication & Team Skills

·         Self Assessment and Self Study Skills

Case Selection

·         Divided across curricular years

·         Intent for vertical integration across years

·         Year Committees Selected

·         Availability of resources for case

·         Content focusing on Appendix A

Parts of A PBLM

·         Goal Setting for the Encounter

·         Prime Focus

·         Basic Science

·         Clinical Science

·         Psychosocial Issues

·         Patient Encounter

o        Paper

o        Standardized Patient (range 1 - 4)

o        DxR Patient

·         Hypothesis Generation

·         Narrowing List Based Upon Available Knowledge

·         Learning Issues Identification

o        Research Learning Issues

o        Evaluate Materials

o        Evaluated Breadth of Materials

o        Evaluate Applicability

·         Results of Actual Work Up

·         Apply New Knowledge in Group Setting

·         Modification of Hypotheses

·         Evaluation of Group Process

o        Communication

o        Team Skills

Mini Cases

·         More in Year One

·         More Focused Content

·         Meant to Reinforce Faculty Identified Key Learning Issues

·         Basic Format of PBL

Other Supporting Activities

·         Journal Clubs

·         Evaluate Literature

·         Empathy 101 through 401

·         Student Generated Resource Sessions

·         Clinical Experiences

Areas for Potential Change

·         Ethnic Diversity of Cases

·         Review of Cases Across All Years

·         Amount of Built In Redundancy Needed

 

5.2      Small Group Facilitation

Dr. Tracy Lower presented the following information about the Small Group Facilitation training all tutors receive before tutoring:

OBJECTIVES

Participants will:

Develop an understanding of the C2000 Small Group Facilitation process.

 

Develop the required skills of the Small Group Facilitator

NECESSARY SKILLS TO DEVELOP STUDENTS’ CLINICAL REASONING

Development of learning issues

Development of self-directed learning skills

Application of knowledge

Articulation of basic science knowledge

Individual and Group evaluation

Management of group dynamics

RESOURCES

Copy of Dr. Barrows book on The Tutorial Process

Videotape of the entire process

Role modeling and advice from a master facilitator

SCHEDULE

3 SMALL GROUP SESSIONS

EACH SESSION 3-4 HOURS

EACH GROUP COMPOSED OF 5-6 FACULTY

EACH GROUP LED BY A MASTER FACILITATOR

PROCESS

Faculty are put into a PBL working group with a “master tutor”.  They are carried through the entire process.  This allows faculty to appreciate the role of the tutor, the power of PBL to motivate learning and the depth of learning possible.

DAY ONE

Participants participate as students

Master facilitator takes the group through the process up to “self-directed learning”

Master facilitator reviews concept mapping and self/peer/tutor assessment

Discussion of the steps of the tutorial process

DAY TWO-THREE

Participants serve as their own tutor group and they rotate through as facilitators.

Master facilitator uses a “time-in/time-out” approach for practice and discussion of the process.

Participants review individual learning needs and how to address those needs.

GOALS

The facilitator will learn to:

Question and probe the students’ data base

Question and probe the students’ reasoning process

Tying basic science knowledge to the clinical problem

Facilitate interpersonal relationships in group

Provide explicit feedback on performance

Identify and evaluate learning resources

Handling misinformation or mistakes of a student

 

The issue of tutor consistency across the curriculum was discussed.  It was suggested that tutor guides be used during the training process.  It was also suggested that the three half-days is insufficient for training.  In Year One, Master Tutors sat in on training sessions.  Tutor evaluation was suggested for an upcoming EPC agenda. 

5.3      Preceptor Training

Dr. Sharon Hull reported that Doctoring had conducted preceptor training, with four sessions in Harrisburg, Carbondale and Marion.  Content included overview of curriculum, discussion as to how students could work in the office, and a question and answer session.  Each training session lasted 1.5 hours to 2 hours with dinner.  Twenty preceptors participated, and 19 participants rated the sessions as excellent or good (one did not respond). 

6.         EPC Subcommittees:

EPC Subcommittee reports were not given due to time constraints. 

7.         Committee Reports

7.1      Year 1 Curriculum Committee

Dr. Wade reported that students had completed the Year 1 Curriculum and were in the process of taking NBME subject tests.  Students participating in Mentored Professional Enrichment Experiences ill begin those activities following the subject tests.

7.2      Year 2 Curriculum Committee

Dr. Borgia reported that the Year 2 Committee had held a retreat on April 19.  Four subcommittees reported on specific topics:  1) Basic Science Streamer/Rotation/Segment-Related Clinical Activities; 2) Quality and Effectiveness of Segments; 3) End-of-Block Assessments; 4) Small Groups/Tutors.  Each group participated in the development of a composite survey that was distributed to all students and faculty.  Reports on survey data were presented at the retreat, as were student reports, and a report from the Surgical Education Fellow regarding data she had collected from student focus groups.  A meeting is scheduled for May 14 to discuss the motions passed at the retreat and how those recommendations will affect the curriculum.  Dr. Kruse reported that the Dean had met with the Clinical Chairs to discuss the clinical resources available for the Year 2 Curriculum. 

7.3      Year 3 Curriculum Committee

Dr. Kovach reported that Clerkship Orientation is scheduled for July 9.

7.4      Year 4 Curriculum Committee

There was no report due to time constraints.

7.5      Four-Year Doctoring Streamer

There was no report due to time constraints.

8.         Other Business

9.         Next Educational Policy Council Meeting:  Monday, June 11, 2001, 1:30 to 3 pm.