Discussion Items

1. Minutes

The May 14 minutes were unanimously approved with the following corrections: Under Announcements, Graduation is May 19, not March. In addition, the word “Mendelian” was spelled incorrectly in Item 4.

2. Announcements

2.1 Information Technology (IMPC/EPC Joint Subcommittee; David Resch, MD, Chair)

Dr. Resch announced that the subcommittee is currently composed of four people and recommended that an invitation be sent to all faculty to broaden representation on the group and that there be student representation, as well. Dr. Constance asked to be kept apprised of any initiatives that would result in increased expense to students. He was invited to participate in the subcommittee.

3. USMLE Step 1 Performance

Dr. Kruse directed the attention of the committee to the USMLE student performance report distributed at the May meeting, and a revision of that report, with the data converted to percentile scores, with one standard deviation being equal to the 13^th percentile. It was suggested that a chart be developed for the past two years, demonstrating SIU student performance without comparison to national scores, followed by a report of statistics for all years with trends demonstrating where SIU students are nationally. No statistical manipulations of performance distribution has been done yet. It was also suggested that a review of MCAT performance over the past few years might be beneficial. Dr. Constance explained that MCAT scores tend to provide accurate performance predictions for the first two years of medical school in a traditional curriculum. He offered to share the bibliography of MCAT literature that is used by the Admissions Committee. A brief discussion followed as to how MCAT data might be used by faculty in comparisons to other performance data. Dr. Constance will provide reports of MCAT scores for the past three to five years for the next meeting.

4. 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.

4.1 Technology in the Curriculum (David Resch, MD)

This report was postponed to the July meeting.

5. EPC Subcommittees:

5.1 Educational Value Unit Task Force Update

Dr. Kruse announced that data from the survey has been entered and that the group will review the data at its July 2 meeting.

6. Committee Reports

6.1 Year 1 Curriculum Committee

Dr. Wade reported that the Year 1 Curriculum Committee had held a retreat and would forward a complete report of the retreat to Dr. Kruse in the near future. Most students are currently in Mentored Professional Enrichment Experience (MPEE) activities, although several are remediating curriculum deficits. The remediation consists of several week intensive remediation followed by an exam. Three students will have additional remediation following successful completion of the first session to cover additional content areas. The Year 1 Retreat dealt mostly with technical issues. Overall, the faculty are comfortable with the curriculum, but continue to have concerns about the amount of time available to teach basic sciences now that the year has been shortened by seven weeks. The increased emphasis on clinical skills has also affected the amount of time available to each content area. Areas of potential omission include pregnancy, structure/function of joints, molecular biology, and embryology. Student evaluations of the year suggested more time in the curriculum, as well. Dr. Dorsey, who is administering the MPEE program, has suggested that 12 weeks might be longer than necessary for MPEE. It was also suggested that reducing the length of the experience would allow funding of more projects. Comments and recommendations regarding the MPEE will be brought to the next EPC meeting for discussion. Dr. Kruse asked for a full report in writing.

6.2 Year 2 Curriculum Committee

Dr. Borgia reported that students completed the curriculum the first week in June. Students are remediating in Circulation/Neuromuscular and Infection/Neoplasia. Remediation exams are scheduled for June 15, except for one student who is remediating both blocks. Students who fail remediation exams will have to repeat the segments in the blocks they fail, which will delay clerkships by at least 12 weeks. Most of the remediations were from students’ first rotations. It was suggested that familiarity with the exams over the course of the year might have improved student performance over time. Dr. Borgia responded that a review of student performance across the year did not support early concerns about exam security and that mean performance on the third block was comparable to mean performance on the first block. It was also noted that the original intent was that failure of more than one block (two segments) would result in a repeat of the year. Dr. Borgia responded that, since this was the first year of the curriculum, it was decided that students should be given more flexibility. This has resulted in four students’ deferral of clerkships.

Dr. Borgia also reported that the Year 2 Committee has met three times since the last EPC meeting. He provided a summary of Year 2 activity since the April retreat: The committee voted at the retreat to revert to a non-rotating curriculum; however, after the retreat, the Dean met with the Clinical Chairs, who said that the segment-related clinical experiences could not be accommodated in a non-rotating environment. The committee deadlocked on the issue but then began to discuss alternative ways to structure the curriculum. Five proposals were presented to the committee, and a task force consisting of Dr. Borgia, Dr. Tomkowiak, and Dr. Kruse, was charged with the task of developing a proposal that incorporated the similar concepts of the five proposals. The current plan recommended a minimum number of changes in the curriculum, which allows the committee to focus on addressing the problems identified by faculty and students. This would be the first step to a new, more highly integrated structure. The Infection/Neoplasia and Circulation/Neuromuscular blocks remain paired, but Medicine and Behavior is paired with a new Endocrinology/Gastrointestinal block. Population Health and Preventive Medicine will be integrated across all blocks. Rotations will decrease from 6 to 3, with 24 students per block. Segments within each block will not rotate so that there are four tutor groups for each segment. The Wednesday morning Basic Science Resource Sessions will be eliminated in their current iteration but much of the content will be implemented as planned segment resource sessions. Segment-related clinical experiences are being evaluated and revised as necessary to ensure their utility, and clinical logs will be evaluated more closely throughout the year. Chairs for the new Endocrinology/Gastrointestinal Segment have not yet been named. Concern was expressed regarding the continued pairing of the Circulation/Neuromuscular block, which has been noted by some faculty and students as a major issue due to the amount of information students must learn during this 12-week period. It was suggested that additional integration of cases among segments might be a solution to the problem but that the Year 2 Committee could continue to discussion the issue. There was concern about integrating cases across segments because tutor content expertise would be compromised. Dr. Borgia responded that students would need to depend on resource faculty as content experts, rather than tutors. Dr. Wade suggested that Year 2 follow the organ system approach used in Year 1, Dr. Caspary expressed concern regarding clinical experiences driving what should be a basic science curriculum, and Mr. Lavery suggested that Medicine and Behavior be reduced to five weeks and paired with Neuromuscular; and the same could be done with Circulation and Endocrinology/Gastrointestinal, so that Neuromuscular and Circulation each had seven weeks. After continued discussion regarding how this issue might be resolved, it was suggested that the EPC suggest that the Year 2 Committee reconsider the proposed pairings, recognizing that it is probably too late to make significant changes this year.

Dr. Dunaway made a motion, seconded by Dr. Caspary, that the Year 2 Committee consider the following realignment of the segment pairings: Medicine and Behavior (5 weeks)/Neuromuscular (7 weeks) and Endocrinology and Gastrointestinal (5 weeks)/Circulation (7 weeks). There was much discussion as to how strongly to urge the recommendation to the Year 2 Committee, with concerns noted about EPC’s micromanagement of the curriculum. It was decided to use the word “consider” in the recommendation to the Year 2 Committee, rather than “strongly consider.”

The motion passed with seven members voting in favor, one against, and none abstaining.

6.3 Year 3 Curriculum Committee

Dr. Kovach reported that Clerkship Orientation is July 9. The Anesthesia curriculum was reviewed at the last meeting. The committee has also been discussing use of the NBME’s clinical competency exam for student use as a practice exam and as a baseline for program evaluation. The goal is to administer the exam to the incoming Year 3 and Year 4 students and then repeat that process next year. There has been some student opposition because it is an additional test, so the committee is weighing the value and utility of the exam, and, although it appears that the exam might provide valuable practice and information for students and information that could be useful in continuing curriculum evaluation, the committee does not want to overburden students.

All incoming Year 3 students are being given Portable Digital Assistants to use in tracking clinical encounters and clerkship information. Dr. Constance asked whether the equipment was insured and whether students would be signing paperwork. Dr. Kovach responded that these issues were being handled by the Office of Education and Curriculum. All students are also being required to purchase pagers with statewide capabilities and digital and vibration modes.

6.4 Year 4 Curriculum Committee

Dr. Lower reported that students have submitted their elective requests and schedules are being distributed. The committee is discussing the possibility of requiring logs for all clinical electives but has not yet made a decision.

6.5 Four-Year Doctoring Streamer

Dr. Hingle reported that she and Dr. Hull are reviewing Doctoring activities in Years 1 and 2 to ensure an integrated, cohesive curriculum across the two years, but discussion of these activities was deferred in Dr. Barnhart’s absence.

7. Other Business

7.1 Vertical Integration

Dr. Kruse suggested that this topic be discussed at length at a future meeting, since it is one of the most important concepts of the new curriculum.

7.2 Other

It was suggested that, since EPC falls during clerkship orientation, the meeting should be changed to July 2. The committee will be canvassed to determine whether this is possible.

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

	Minutes