Medical Education Committee Minutes

Tuesday, April 23, 2002

DARTMOUTH MEDICAL SCHOOL

ASSOCIATE DEAN FOR MEDICAL EDUCATION
Hinman 7005
306D Remsen
Hanover, NH 03755-3847

Telephone 603-650-7679
Facsimile 603-650-6841

David.Nierenberg@Dartmouth.edu

To:

Members of Medical Education Committee

From:

David W. Nierenberg

Subject:

Minutes - Meeting held Tues., Sept. 17, 2002 - 4:00 -5:30 pm, 758 Borwell

Members Present:

Jim Bell, Patty Carney, Duane Compton, Seth Crockett, Leslie Fall, Dale Gephart, Don Kollisch, Petra Lewis, and Dave Nierenberg = 9

Members Absent:

Jim AuBuchon, Katherine Bardzik, Todd Burdett, Ryan Knapp, Martha McDaniel, Gene Nattie, Will Nugent, Deb Peltier, Kristen Redborg, Ginny Reed, and Eric Shirley = 11

Guests:

Steve Andrews, Bill Garrity, and Lori Alvord = 3

A. REVIEW OF MEMBERSHIP LIST

I. Dave introduced the new members of the Medical Education Committee and reviewed the status of the members carried over from the last academic year:

  • a. Dale Gephart replaces Marlene Sachs as a standing voting member;
  • b. James AuBuchon replaces Ethan Dmitrovsky as an individual voting member (representing a department chairman)
  • c. Donald Kollisch has agreed to serve as an individual voting member for another three years;
  • d. Leslie Fall has agreed to serve as an individual voting member for an additional two years; and
  • e. Seth Crockett reports that William Nugent III will replace Justin Wheeler as a student voting member.

B. Discussion of change of meeting time:

Most of the attending members (and one member sent word) agreed that the dates scheduled for the MEC meetings were no better or worse than any other day. No further discussion ensued.

C. Discussion of last academic years' accomplishments:

  • a. Dave quickly reviewed and elaborated upon the MEC Minutes Summary '01-'02 which was distributed to members present (and subsequently to absent members).
  • b. He then reported on the results of the changes to 3rd year in the Peds/Ob/Gyn/WH disciplines and to the workshops, Intro to Evidence-Based Medicine, Substance Abuse, and Intro to Multidisciplinary Teams. He reported that the student feedback was positive and that the blocks worked out well.
  • c. Petra Lewis reported that the one-hour Intro to Radiology did not work out as well and would be revised for more interaction. More workshops are planned.
  • d. Dave reported that the students' evaluations were, for the most part, very positive but questions arose regarding the scheduling.

C. Pending VIG reports:

Dave Nierenberg reported that two Vertical Integration Groups that are in progress, Pediatrics and Professionalism, would be updated at the January and April MEC meetings respectively.

D. Developing a "competency-based curriculum" introduction:

I. Dave Nierenberg reported that currently, DMS has educational reasons and accreditation requirements requiring the MEC to incorporate measurable competencies into the UME curriculum:

  • a. The ACGME and the ABMS now require core competencies in all residency and fellowship programs (see Attachment A);
  • b. Two years ago, the LCME (which accredits all medical schools) inserted language to require each medical school to include educational goals and measurements of competency into its curriculum plans;
  • c. A movement toward developing competency-based curriculum makes DMS look good as well as being a quality method of teaching.

II. Dave Nierenberg presented a list of "Musts and Shoulds" created by the LCME:

(See Attachment B)

III. Possible Implementation:

  • a. Leslie Fall proposed that a workshop for be created so that course directors could be updated on the competencies and thus be working toward the same goals;
  • b. Dave Nierenberg mentioned that the process was not new, only requiring course directors to be more specific in their goals and outcomes;
  • c. Dave would like to survey course directors about how they currently evaluate how much their students are learning;
  • d. Worth Parker and Rich Rothstein will be working with the Medical Education Committee to incorporate measurable competencies into the curriculum.
  • e. The MEC will move forward with reviewing and improving this document at our next meeting

E. The "Witters Group" Report:

I. Dave Nierenberg reported that the Report of the Committee on Physician-Scientists/The Promotion of the Science of Medicine Within the DMS Curriculum was generated by a group led by Lee Witters (See Attachments C&D) to address issues of apathy of students towards the importance of basic sciences in medicine.

  • a. The report came about because (former) Dean Baldwin read in an earlier AAMC Matriculation Survey that students at Dartmouth thought science might not be as important at DMS as at other schools , and some basic science faculty were also concerned about this observation
  • b. Dave received the report at the end of the last school year.
  • c. Although the report was not officially submitted to the MEC, Dave Nierenberg proposed that it be treated as an unofficial Vertical Integration Group (VIG).
  • d. Ethan Dmitrovsky has initiated action on one of the points by inviting four experts (Distinguished Lecture Series) to come to Dartmouth to speak about scientific breakthroughs in medicine. The MEC will support and add to the events, encouraging MD, MD/PhD, and PhD students to attend.

F. Other items:

I. OSCEs (practical exams) in USMLE Step II :

  • a. Dave Nierenberg reported that in the fall of 2004, every Year 3 class must take a 10 station OSCE exam (in 6 locations nationwide) for practical skills competency.
  • b. Patty Carney saw the beta versions of the exams and has modeled the new OSCEs at DMS after them;
  • c. Petra Lewis expressed the opinion that the USMLE OSCEs would be good practice for the recertification examinations that follow medical school and residency;
  • d. Seth Crockett reported that the student consensus is that the pass rate is too high to be useful, that the travel expenses and testing fee would be a burden to students, and that they have not received much information about where the concept originated;
  • e. Patty Carney wondered if it would be possible to get the results of the Step II OSCEs for evaluating our own OSCEs.

II. Setting priorities for future meetings:

The order of importance (and chronology) for issues to be discussed and acted upon in the near future are as follows:

  • a. Competencies;
  • b. Witters Report;
  • c. Pediatric VIG (Jan. 03); and
  • d. Professionalism VIG (Apr. 03)

Agenda for next MEC meeting on Oct. 15, 4 to 5:30 pm, 758 Borwell:

  • a. Introduction of Steve McAllister and Bill Garrity as non-voting, ex-officio committee members;
  • b. Introduction of the new student representatives;
  • c. A quick summary of the results of the MBME Steps I & II; and
  • d. Proceeding with plans for Competency Based Curriculum.

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