College of
Human
Medicine

2018 Curriculum Committee Minutes

November 27

Voting Members Present: A. Avery, L. Munoz, C. Bush, H. Holman, M. Schaefer, J. Fitzsimmons, A. Wendling, S. Ford, 
Ex-Officio Members Present: C. Arvidson, J. Mauerer, M. Thompson, R. DeMuth, B. Mavis, C. Han, R. Schein, D. Wagner, A. Sousa
Guests: C. Change, C. Shafer

Call to order: A. Wendling called the meeting to order at 1:03 p.m.

Approval of October meeting minutes:

Action:  A motion was made and seconded to approve the minutes from the October 23, 2018 meetings as written. The motion was unanimously approved.

HM 615 new course request: M. Thompson provided a copy of the course request (copy appended to minutes on file. After discussion the following revisions were requested:

23) Restriction(s): “Open to students in the College of Human Medicine or in the College of Osteopathic Medicine.”
25) Credits and instructional model: 3 credits to 12 6 credits in increments of 3 credits.

Action: A motion was made and seconded to approve HM 615 as amended. The motion was unanimously approved.  

CMS rules statement: A. Wendling provided a proposed statement to send to the university general counsel (copy appended to minutes on file). After discussion, the following revisions were made:

The CHM Curriculum Committee [by a unanimous vote of X in favor to X opposed] is concerned about the MSU General Counsel’s Council’s recent opinion regarding clinical work by Early Clinical Experience students. The very This unusually conservative billing interpretation by MSU’s General Counsel Council will has resulted in a less authentic compromised educational experience for MSU health professional professions students. By restricting our students’ ability to have a meaningful clinical experience nationally competitive education at MSU Health Care sites, our students’ capacity to receive a nationally competitive education will be is undermined in the specific clinical environment that should be most supportive of this mission.

Action: A motion was made and seconded to approve the CMS statement as amended. The motion was unanimously approved.

EMR training statement: A. Sousa provided a proposed statement to send to all MSU affiliated hospitals (copy appended to minutes on file). After discussion, the following changes were made:

The Curriculum Committee of the College of Human Medicine [by a unanimous vote of X in favor to X opposed] recognizes medical documentation in an electronic health record as a core educational skill for medical students.  It is the cCommittee’s position that students should document their care in a patient’s medical record with supervision and sign off by resident and/or attending physicians. This is consistent with the new CMS policies allowing student documentation to be used for billing in nearly all circumstances. The Committee is especially pleased that some hospital systems make student documentation a useful part of patient care and of the student’s educational experience. activity, and would The Committee encourages all MSU-affiliated teaching hospitals to consider adopting this practice.

Action: A motion was made and seconded to approve the EMR statement as amended. The motion was unanimously approved.

Student Experience Survey report: B. Mavis gave a presentation summarizing the survey (copy appended to minutes on file). Student ratings on the following areas were reviewed: satisfaction with CHM, CHM is person-centered, satisfaction with resources, faculty-student interaction, meaningful learning experience, student-student interaction, emotional climate, perceived stress and quality of life.

MCE  clinical experiences check-in: R. DeMuth reviewed the two parts of concern noted at the 9/25/18 committee meeting: 1) students being dishonest about the form (filling it out themselves) and 2) completing the form on JIT in front of the student does not allow for constructive/honest feedback. Since then the following additional concern has been raised: students telling preceptors their shifts are significantly shorter than they are.

MCE administrative team reviewed data over a week’s time and from 416 clinical shifts expected that week it was noted: 1) 7 had clear concerns of reporting dishonesty (clearly outside expected reporting time or with preceptor concerns), 2) 50 reported earlier than expected, and 3) 2 with concerning comments/reports. 

Then the MCE administrative team met with the Just in Time (JiT) administrative team to look at solutions that may be helpful and ideas brought the table include: 1) “confirm” a percentage of the weekly checklists via follow-up email, 2) allow for filling out at a later time, and 3) allow a delay in which feedback is seen by student. Item 1 was prioritized as high and JiT anticipates this being available by the end of the semester; meanwhile, MCE administrative team is collecting the emails for the sites. It was noted confirmations can be sent randomly and where see patterns of concern manually until the JiT process is available.

Other elements that will be done/looked at: 1) email the class to clarify the forms are to be completed at the end of their shift, 2) change the name of the form for the spring semester, and 3) consider adding a delay in student being able to view feedback.

Curriculum review: Middle Clinical Experience annual report: C. Arvidson provided the committee with the written report (copy appended to minutes on file). Areas reviewed include: calendar, weekly activities, rotations, student performance, student feedback, technology use, strengths and weaknesses, and plans for the 2018-19 iteration of the MCE.

Action: A motion was made and seconded to accept the report. The motion was unanimously approved.

Student mistreatment policy revisions: C. Shafer provided a document with the revisions (copy appended to minutes on file). After review, it was noted additional changes need to be made to reflect new terminology in the Shared Discovery Curriculum. The committee will review and vote on this policy at a future meeting.

Culture of safety – vertical integration of Virtuous Professional: D. Wagner noted she highlighted the MAP, LCE Guide, Student Guidebook and C3 document with what we are doing and how we are assessing safety. The documents will be shared with the committee. She also provided copies and reviewed a document “Culture of Safety: What is it?” (copy appended to minutes on file). A. Sousa noted the document is for the Curriculum Committee and has not been shared with other groups.

Adjournment: 3:00 p.m.                                                   

October 23

Voting Members Present: A. Avery, J. Fitzsimmons, H. Holman, P. Kowalski, M. Liggett, F. Manfredsson, M. Schaefer,  A. Wendling
Ex-Officio Members Present: C. Arvidson, R. DeMuth, C. Han, B. Mavis, R. Schein, A. Sousa, M. Thompson, H. Toriello, D. Wagner
Guests: M. McComb, M. Trottier

Call to order: A. Wendling called the meeting to order at 1:04 p.m.

Approval of September meeting minutes: J. Fitzsimmons noted he attended the September meeting.

Action:  A motion was made and seconded to approve the minutes from the September 25, 2018 meetings as amended. The motion was unanimously approved.

Research certificate: M. Trottier provided a handout and gave a presentation (copies appended to minutes on file). He provided background as to the need/desire for the certificate. Funding the program were discussed. Discussion on this topic will continue at a future meeting.

Curriculum review: Intersessions annual report: H. Toriello provided the committee with the written report (copy appended to minutes on file). An overview of intersession types, structure and timing were reviewed. Assessment, evaluation of the Intersessions and updates/goals for the next iteration of Intersessions were also discussed.

Action: A motion was made and seconded to accept the report. The motion was unanimously approved.

Culture of safety – vertical integration of Virtuous Professional: M. McComb gave a presentation indicating where Virtuous Professional currently exists and opportunities where it could be added in the Early Clinical Experience (copy appended to minutes on file).

C. Arvidson gave a presentation indicating where Virtuous Professional currently exists and opportunities where it could be added in the Middle Clinical Experience (copy appended to minutes on file).

C. Han noted that Virtuous Professional currently exists in the Clinical Performance Evaluations and in Advanced Skills and Knowledge sessions in the Late Clinical Experience and discussed opportunities where it could be added.

H. Toriello gave a presentation indicating where Virtuous Professional currently exists and opportunities where it could be added in the Intersessions (copy appended to minutes on file).

Topics for a future meeting: 1) ask Matt Emery to present where Virtuous Professional is/could be within simulation, 2) ask Christine Shafer to present the Student Resolution Advocate report, and 3) Dianne Wagner to provide a report on the Shared Discovery Curriculum.

3-year model: A. Sousa gave a presentation on the advanced placement model. C. Han gave a presentation on a shortened LCE model. A. Wendling gave a presentation on an integrated residency model. (Copies of all three presentations appended to minutes on file.

A. Wendling, A. Sousa, C. Han, J. Maurer, D. Wagner and M. Liggett will meet as a workgroup to flesh out the models and present at a future meeting.

MCE clinical experiences check-in: Due to time limitations, this item will be discussed at a future meeting.

CMS rules: Due to time limitations, this item will be discussed at a future meeting.

EMR statement: Due to time limitations, this item will be discussed at a future meeting.

 

Adjournment: 3:01 p.m.

September 25

Voting Members Present: C. Bush, J. Fitzsimmons, S. Ford, E. Frost, H. Holman, M. Liggett, L. Munoz, M. Schaefer,  A. Wendling
Ex-Officio Members Present: C. Arvidson, R. DeMuth, C. Han, J. Maurer, B. Mavis, R. Schein, A. Sousa, M. Thompson
Guest: T. Avellino

Call to order: A. Wendling called the meeting to order at 1:07 p.m.

Approval of September meeting minutes:

Action:  A motion was made and seconded to approve the minutes from the September 11, 2018 meetings as written. The motion was unanimously approved.

Proposed Orthopedics department: T. Avellino gave a presentation and provided a handout (copies appended to minutes on file). He noted this is for information purposes only for this committee; the College Advisory Council has voted and approved the proposed department. It was also noted there will be no curriculum changes with the creation of this new department. The committee expressed support for the creation of the department and noted this should benefit students seeking orthopedics residency.

Admissions report: J. Maurer gave a presentation outlining the 2018 matriculating class (copy appended to minutes on file). A total of 6395 applications were received and, through the process, narrowed down to the final selection of 190 matriculating students. The entering class profile was reviewed and the admissions process was discussed.

MCE clinical experiences check-in: E. Frost noted some concerns she and classmates have regarding the MCE clinical experience check-in policy. R. DeMuth noted the policy/form is new this year and gave context as to its creation. After discussion, R. DeMuth and C. Arvidson were tasked to present at the next meeting 1) goals and intentions of the policy, 2) consequences for not following the policy 3) data currently available and 4) options that may exist in JustinTime.

Culture of safety: A. Sousa provided copies of The Virtuous Professional document and a supporting article (copies appended to minutes on file). He noted the Virtuous Physician was created in 1992 and redone in 2014 to become the Virtuous Professional when it was realized it applies to more than just students and physicians. The committee is asked to determine whether or not we are currently engaging the Virtuous Professional in the curriculum, and if so, is it enough or is more needed.

Curriculum component leaders (Early Clinical Experience, Middle Clinical Experience, Late Clinical Experience/Advanced Skills & Knowledge, and Intersessions) were tasked with preparing a 5-minute summary of current accountings of where Virtuous Profession is, think it is and where it may fit within their component. 

3-year model: A. Sousa discussed models offered by other medical schools then discussed options for models that might work for CHM.

The following people were tasked with presenting more on an assigned model: 1) A. Sousa – advanced placement model, 2) A. Wendling & J. Maurer – residency model, and 3) C. Han – longitudinal clerkship model.

CMS rules: Due to time limitations, this item will be discussed at a future meeting.

EMR statement: Due to time limitations, this item will be discussed at a future meeting.

Adjournment: 2:59 p.m.                                                      

September 11

Voting Members Present: A. Avery, C. Bush, M. Colon-Berlingeri, E. Frost, H. Holman, L. Munoz, A. Paganini, A. Wendling
Ex-Officio Members Present: C. Arvidson, R. DeMuth, C. Han, J. Maurer, B. Mavis, A. Sousa, M. Thompson, H. Toriello, D. Wagner
Guest: M. Emery

Call to order: A. Sousa called the meeting to order at 5:34 p.m.

Welcome and introductions: A. Sousa welcomed everyone to the committee for the 2018-2019 year and everyone introduced themselves.

Election of chair and secretary:

Action: A motion was made and seconded to nominate A. Wendling to serve as Chair for the 2018-2019 year. No other nominations for chair were made. By unanimous voice vote A. Wendling was elected Chair.

Action: A motion was made and seconded to nominate H. Holman to serve as Secretary for the 2018-2019 year. No other nominations for secretary were made. By unanimous voice vote H. Holman was elected Secretary.

Approval of July meeting minutes:

Action:  A motion was made and seconded to approve the minutes from the July 24, 2018 meetings as written. The motion was unanimously approved.

Charge for the year: A. Sousa stated the committee charge, as discussed with the Curriculum Committee Executive Committee, for the year will be the following:

  1. Evaluate and make a decision on a 3-year model in the curriculum
    1. Will be a monthly agenda item
  2. Evaluate Culture of Safety in the curriculum
    1. Maximize the use of the Virtuous Professional
    2. For patients, students, faculty and staff
    3. Objectives
      1. A longitudinal thread through the curriculum
      2. Determine whether or not we are doing the right stuff and collecting the right data
    4. Will be a monthly agenda item

EM 631 and 632 new courses: M. Emery provided handouts of the course requests (copies appended to minutes on file). After discussion, the following actions were taken:

EM 631: The committee requested the following change:

24) Familiarity with diagnosis and management of the following common EM complaints

EM 632: The committee requested the following changes:

4) Senior Clinical Elective Sub-internship in Emergency Medicine

22) (FM 641 and MED 641 and PHD 641 and PSC 641 and OGR 641 and PHD 641 and SUR 641 HM 556or (FM 608 and MED 608 and PHD 600 and PSC 608 and OGR 608 and SUR 608)

Action:  A motion was made and seconded to approve EM 631 and EM 632 as amended. The motion was unanimously approved.

MED 619 and 621 course changes: C. Han provided handouts of the course requests (copies appended to minutes on file). After discussion, the following actions were taken:

MED 619: The committee requested the following change:

19) MED 619, MED 621 and MED 628 are similar. MED 628 is a subinternship allows for 3 credit/2 week or 6 credit/4 week enrollment and can take place in an inpatient or outpatient setting. MED 619 takes place in the outpatient setting and is only offered in a 6 credit/4 week option. MED 621 takes place in the inpatient setting and is only offered in a 6 credit/4 week option.

MED 621: The committee requested the following change:

19) MED 619, MED 621 and MED 628 are similar. MED 628 is a subinternship allows for 3 credit/2 week or 6 credit/4 week enrollment and can take place in an inpatient or outpatient setting. MED 619 takes place in the outpatient setting and is only offered in a 6 credit/4 week option. MED 621 takes place in the inpatient setting and is only offered in a 6 credit/4 week option.

Action:  A motion was made and seconded to approve MED 619 and MED 621 as amended. The motion was unanimously approved.

FM 644, MED 644, OGR 644, PHD 644, PSC 644 & SUR 644 new courses: C. Han provided handouts of the course requests (copies appended to minutes on file). After discussion, the following actions were taken:

FM 644: The committee requested the following changes:

5) Based in community hospitals and/or ambulatory sites. Emphasizes interviewing skills, history, physical exam, problem solving and therapy.

30) Clinical Performance Assessments Evaluations

MED 644: The committee requested the following changes:

5) Based in community hospitals and/or ambulatory sites, this is a 2 week clinical experience emphasizing interviewing skills, history, physical exam, problem solving and therapy.

30) Clinical Performance Assessments Evaluations

OGR 644: The committee requested the following changes:

5) Based in community hospitals and/or ambulatory sites, this is a 2 week clinical experience emphasizing interviewing skills, history, physical exam, problem solving and therapy.

30) Clinical Performance Assessments Evaluations

PHD 644: The committee requested the following changes:

5) Interviewing skills, history, physical exam, problem solving and therapy in community hospitals and/or ambulatory sites.

30) Clinical Performance Assessments Evaluations

PSC 644: The committee requested the following changes:

5) Based in community hospitals and/or ambulatory sites, this is a 2 week clinical experience emphasizing interviewing skills, history, physical exam, problem solving and therapy.

30) Clinical Performance Assessments Evaluations

SUR 644: The committee requested the following changes:

5) Based in community hospitals and/or ambulatory sites, this is a 2 week clinical experience emphasizing interviewing skills, history, physical exam, problem solving and therapy.

30) Clinical Performance Assessments Evaluations

Action:  A motion was made and seconded to approve FM 644, MED 644, OGR 644, PHD 644, PSC 644 and SUR 644 as amended. The motion was unanimously approved.

RAD 609 course change: M. Thompson provided a copy of the course request (copy appended to minutes on file). After discussion, no changes were requested to the course and the following action was taken:

Action:  A motion was made and seconded to approve RAD 609 as written. The motion was unanimously approved.

Early Clinical Experience (ECE) update: R. DeMuth noted there was a new interpretation from the University’s counsel of the Centers for Medicare & Medicaid Services (CMS) rules about billing as it applies to the medical students. MSU legal counsel is interpreting the ruling differently than the interpretation the college had received previously. SDC leadership and the ECE team have been sharing this interpretation with our clinical partners. While technically the MSU counsel’s decision only applies to the MSU clinics, the curricular plans needed to be adjusted. Thus far, clinical sites often have viewed the CMS rules differently than the counsel’s viewpoint, but the college has rebuilt expectations so the ECE can function for students with this more conservative legal interpretation. This has led to the following changes in the ECE for this year:

  1. Timing – move the students to the second portion of the ECE clinic curriculum (population health, follow-up phone calls, patient care registries, patient education) sooner so as to maximize their usefulness and engagement in the clinics.
  2. Adjustments to number of clinic days per week – in the fall semester students will go two times per week, as they have in the past. In January and February students go to clinic one time per week.
  3. Addition of a scholarly project – with the additional time in January and February, students will work on a scholarly project that relates to their clinical experience. They will write proposals in the fall, work on data collection in January and February, and present their projects in the last week of the ECE.

The Curriculum Committee discussed their concerns about the MSU interpretation of the CMS rules. Committee members noted that the addition of the CMS language this spring that seems intended to lessen barriers and allow for students to have more clinical engagement made this more conservative interpretation more confusing. The committee is interested in preparing and voting on a statement to send to MSU concerned parties, which will be discussed at a future meeting.

R. DeMuth noted the ECE team will present options for next year’s (2019-2020) ECE at a future meeting.

Adjournment: 7:10 p.m.

July 24

Voting Members Present: A. Avery, C. Bush, M. Colon-Berlingeri, M. Emery, S. Ford, H. Holman, F. Manfredsson, A. Paganini,  A. Wendling

Ex-Officio Members Present: C. Arvidson, L. Bogdan-Lovis, C. Han, J. Maurer, R. Schein, A. Sousa, D. Wagner

Guest: Bruce Wolf, Valerie Overholt

Minutes prepared by: Lisa Galbavi

Call to order: A. Wendling called the meeting to order at 1:03 p.m.

Approval of June meeting minutes: 

Action: A motion was made and seconded to approve the minutes from the June 26, 2018 meetings as written. The motion was unanimously approved.

EM 631 new course: M. Emery provided a handout of the course request (copy appended to minutes on file). After discussion the committee decided to table voting on this course request until the August 2018 meeting.

RAD 612 new course: B. Wolf and V. Overholt provided a handout of the course request (copy appended to minutes on file). After review, the committee asked for the following change:

5) Catalog Course Description: “Become familiar with the sSigns and symptoms of disorders amenable to diagnosis and/or treatment by interventional radiology techniques. Be exposed to the iIndications for and contraindications to basic vascular and interventional procedures., and observe the Observation of clinical and technical aspects of implementation. Gain a basic understanding of Introduction to clinical evaluation and follow up, imaging methods, including and percutaneous image guided procedures., and the fFundamentals of radiation physics, radiation biology., and rRadiation worker and patient protection.”

Action: A motion was made and seconded to approve RAD 612 as amended. The motion was unanimously approved.

MED 626 course change: C. Han provided a handout of the course request (copy appended to minutes on file). After review, the following action was taken:

Action: A motion was made and seconded to approve MED 626 as written. The motion was unanimously approved.

LCE shelf exams: D. Wagner provided a document outlining the request to change the grading system for LCE clerkships (copy appended to minutes on file). After review of the proposal the committee requested the following changes:

  • Since Family Medicine does not use the NBME Shelf Exam, change “subject exam” to “written exam” throughout the document.
  • Add a fifth bullet under “Proposal: the clerkships will use the written exam as follows:
    • Students can only have two (2) written exam remediations that need to be taken at any given time. If a student has three (3) remediations they need to take, they will be required to stop taking clerkships immediately and cannot resume clerkships until they have two (2) or less remediations to take

The committee asked to review how this policy is working, which they will do at the March 2019 meeting. Also, the proposal will be sent to the Lead and Community Clerkship Directors, Department Clerkship Administrators, Community Assistant Deans and Community Administrators.

Action: A motion was made and seconded to approve the LCE written exam grading change as amended. The motion was unanimously approved.

Outgoing members: A. Sousa thanked outgoing student members, Alec (AJ) Haas and Marjorie Liggett, and outgoing faculty member, Matt Emery, for their service on this committee.

Additional item: three-year program: A. Sousa noted that other schools have three-year programs and our college’s Shared Discovery Curriculum provides an opportunity to do this. He discussed how this could potentially work. After review of additional data, the committee will be presented with a formal proposal.

Additional item: EMR training in Advanced Skills and Knowledge (ASK): H. Holman inquired about teaching EMR to students and available resources. A. Sousa discussed resources the college has looked into. D. Wagner noted students are not afraid of various EMR systems and she is not sure we need our own system to teach the students. A. Avery noted that attendings are hesitant to have students on the EMR. A statement will be composed to share with MSU leadership and will be discussed at a future meeting

Adjournment: 2:44 p.m.