Medical Education Committee Minutes: April 23, 2002

Progress Report on Pediatrics VIG
By Leslie H. Fall

  • 1) We have received and reviewed in depth much of the first and second year syllabus/curriculum. I must say, getting this material was one of the most difficult and time consuming parts of this process. There is still material, after 2 years, that I have been unsuccessful in obtaining. This would be an important process to improve for future VIGs.
  • 2) We have sent out to the pediatric faculty a survey that asks their opinion of the current 4-year curricular content in pediatrics, the "optimal" 4-year curricular content and an area for open suggestions. The survey content was directed by specialty (i.e. we asked John Modlin about pediatric ID, Carol Stashwick about adolescent medicine, etc). I have received all of these and just need to compile the data.
  • 3) I have met with Nan Cochran to review the pediatric content of On Doctoring. We both have agreed that there needs to be a permanent pediatric member of the OD curriculum committee. I have spoken with John Modlin about this and I am currently filling this role.
  • 4) We have held quasi-focused interviews with 8-10 3d and 4th year medical students regarding their thoughts and experiences; about half of them went into pediatrics and half did not.
  • 5) We have reviewed the NBME and AAMC survey data related to pediatrics
  • 6) I have spoken informally with many of my COMSEP colleagues regarding integration of a unified pediatric curriculum across all 4 years of the medical school curriculum.

As action items with respect to On Doctoring, I have already given the 1st year OD lecture on the HEENT exam and have arranged for interested students to do their required inpatient H& Ps on pediatric inpatients. About 4-5 students took advantage of this last year. I have also supplied Nan with 2 pediatric cases to be used when students do required "assessment and plan" write-ups. We agreed that many students would benefit from 2-3 half-day experiences in pediatric offices during the first and second year OD course. I am working to arrange that for next year, if possible, and if not, then the year after. Finally, we agreed that more DHMC pediatricians should be OD preceptors and I am working with Nan to recruit them.

The biggest recommendations coming out of the VIG so far are:

  • 1) To create a longitudinal "subcourse" in SBM, much like pharmacology and pathology, entitled "Pediatric Medicine." We have found that the biggest "hole" in the students' experience is in understanding the scientific foundations of pediatric medicine. Much of this material in SBM is currently relegated to "mention" status at the end of a lecture, or not given sufficient time, even if taught by a pediatrician (i.e. "cover all of pediatric GI in one hour"). We will likely recommend 2-3 course hours per appropriate course. I know, this is "the biggie" in terms of difficulty, but I feel very strongly that this is necessary. I would ask John to identify a member of our department to oversee this course.
  • 2) Much of the pediatric content that is taught in the second year is not coordinated, so that some topics are covered multiple time in multiple ways in different courses (unbeknownst to those teaching it), and some topics are given inappropriate focus (i.e 1-2 hours of neonatal respiratory physiology and almost no core teaching on asthma). This would be addressed with #1, above.
  • 3) To work further with Nan to improve the consistency and quality of the pediatric teaching in OD
  • 4) To move the Child Health and Development course to earlier in the 2nd year as an introduction to the "new and improved" pediatric content that would be covered in SBM and OD.
  • 5) Much of the pediatric content in year 1, 3 and 4 is either fine or will be secondary in focus (i.e. fine-tuning) after implementing the more important changes in year 2.

Leslie H. Fall

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