TOPIC / DISCUSSION / Outcomes
MINUTES / The minutes of the 03/05/2012 meeting were approved by the Committee. / Approved
ANNOUNCEMENTS
Support Person / Ann Dowsey was introduced as the new support person for the committee.
NRMP Match Results / L. Chandran presented the results of the match. Stony Brook SOM did better than the national average. One student did not match initially, but matched the following day.
Radiation Oncology ranked below the national average. Match rate was 99.1%. 40% went into primary care which includes OB, Family Medicine, Pediatrics and Internal Medicine.
SUB-COMMITTEE REPORTS
O&A / S. Morrison presented information regarding the proposal on grading in the pre-clerkship courses, Years 1 & 2 of the curriculum. The committee spoke to all stakeholders in this decision and has come up with the following proposal:
  • Removing curving. Performance will be evaluated by numeric grade. Pass/Fail bar must be set.
  • Beginning 2012-2013 all courses in year 1 and 2 will be graded Pass/Fail.
  • Student’s numeric score will be visible in CBase with a display showing the class mean and median
  • Students demonstrating evident marginality are to be tracked and prompt academic advisement put in place.
  • Pass or Fail will be the only grade awarded on transcript for years 1 and 2. No honors grading will be given for individual courses.
  • However, numeric scores are to be averaged over all courses. Students whose year-end mean-score exceeds a certain benchmark are eligible for Year-End Honors.
  • The criterion-based measure of overall excellence is visible to students and in the academic record.
  • There will be no cumulative Systems grade.
Discussion ensued regarding questions of:
  • How to set ranges for marginality, those who require remediation.
  • Recommendation made to have separate passing grade for 2nd year students. 65 has been established as passing grade for 1st year.
  • A threshold should be set to assist the students.
  • Re: End-of-year honors as opposed to individual honors; Students haven’t been asked what their preference would be regarding honors.
  • All course directors need to be on board with moving away from curving-based model.
Motion made to pass model on the following points:
  • Normalization of course grades in 1st and 2nd year will no long occur.
  • At the end of each course students will be given numeric score visible in CBase.
  • Students with evident marginality will be tracked for purposes of support and prompt academic advisement. Marginality will be based entirely on basis of numeric grade data.
Motion put on hold pending further discussion. / Discussion needs to be continued
Agreement to move away from Pass/Fail grading system. To move away from pass/fail or to move away from curving? What exactly is the decision?
Further discussion will take place.
Systems Committee / P. Richman presented information as follow up to declining attendance at lectures. Discussion was held among students and it was suggested to “juice up” lectures using teaching assistants to try to help the lecturers focus more on material that will be useful for students passing Step 1. They thought that would help draw the students into the discussion more, rather than having them study at home from Step 1 books. The proposal was to have TA’s prepare material for the lecturer to present in class. Much discussion occurred regarding whether this was appropriate. Faculty were polled and they thought that was a not a good idea because the faculty felt it was intrusive, that students were not in a position to know what was in the curriculum, and the curriculum should not be predominantly directed at Step 1. Students did not have a rationale for that. There is truth on both sides; what is taught in the lectures is not related closely enough to national curriculum which is represented by Step 1. The TA proposal includes other things besides helping the lecturer prepare a lecture; it includes outreaching to students to get their feedback.
The question was raised about whether teaching styles were being discussed. P. Richman answered that since the attendance has been so low, about half course directors have decided to move away from giving standard lectures and that there is an agreement among some people that class time will be limited to interactive sessions such as small groups, laboratories, C-based learning and other activities that are more interactive and that they would be mandatory rather than having standard lectures.
The issue of uniformity of information being given to students in smaller groups was raised. All group leaders have to be on the same page. One advantage of having one lecturer is that all students hear the same information. One disadvantage is students have other ways of getting information. The question was raised as to whether there are other ways of students getting uniform information.
Discussion ensued on different ideas of how to address the issue of attendance at lectures. One suggestion was to limit the amount of lectures during a course. The point was raised that the students are doing well and are able to get the information from other sources. It was also pointed out that medical students are usually smart, self-motivated individuals and are able to find the information they need through a number of sources. A third point that was raised is that there are other alternatives to lectures such as team-based learning or collaborative learning and as we have many different schools of learning here at Stony Brook, this may be something that can be explored.
P. Richman presented a proposal for changing of the grading for Systems segments. Courses would be paired as follows:
  • Microbiology + Blood Pathophysiology 1
  • Neurology + Psychiatry Pathophysiology 2
  • Pulmonary + Cardiology + Renal Pathophysiology 3
  • Endocrine + Reproductive Pathophysiology 4
  • Gastrointestinal + Connective Tissue Pathophysiology 5
No overall end-of-year Systems grade will be given. Each pair will have a custom NBME exam as the final exam. Pharmacology questions will be included in exam as related to these organ Systems. Pharmacology exam will be given separately.
No curving of grades will be done.
MOTION: Ten system courses will be bundled into five, each of which will be given a single custom NBME exam and individual grade instead of a final end-of-year systems grade. The grade will have a numerical cut off and not a curve. / A proposal was made that a faculty retreat be held to address these issues and that students’ input needed to be included.
MOTION:
APPROVED – To be put into use for next academic year
Competency Task Force /
  • M. Kritzer stated work is done and ready to launch in July.
  • Institutional Learning Objectives (ILO) are completed.
  • Competencies are centered around six residency competencies and 20 ILO’s
  • Students are going to get more educational feedback.
  • Course directors will give competency committee P/F evaluation for the particular ILO they have been charged with.
  • Competency committee is meeting monthly and collecting data. Grading will be competent, not yet competent, or serious concern.
  • A lot of data will be collected on the students’ completion of ILO.
  • Self-evaluations will be done on a biannual basis by students.
  • C3 (Competency-Based Common Clerkship) evaluation form will be used in clerkships.
  • Not every ILO has anchors in every year.
  • Found some gaps in curriculum and new materials have been introduced in patient safety and quality to meet all ILO’s.
  • Many assessments are used, e.g.: NBME exam, self-rating form, reflections and others.
  • Next step is to get the formscomputerized and send out to all faculty.
The question was raised about how to get students and faculty to know this information.
  • Self-evaluation forms are given 3x in year 1, 2x in year 2 and after every clerkship thereafter which are based on ILO’s. There will also be website information and emails.
/ It is agreed that everyone needs to know that there are 6 competencies that are parallel to GME competencies.
1st & 2nd Year Course Directors / R. Cameron reported there were discussions on the competency updates and grading.
Clinical Course Directors / S. Lane reported that anchoring and C3 form were discussed in depth. A lot of course directors did not like the form and it may come down to that there is a faculty development issue. People need to understand what the competencies are and what the form is getting at.
COURSE EVALUATIONS / Change in Course Evaluation Process
H. Fleit and A. Wackett –They would like to introduce a new course evaluation process. A review of the process already in place was done. A couple years ago the school began a very in depth process of reviewing courses with two teams which obtained much more information which included feedback from students, but it was very time consuming and difficult to follow through with the information.
The new system would have two levels of review.
  • Level 1 Process - Several courses to be evaluated each year andall courses would be evaluated over 4 years.
  • Data analyzed would include:
  1. C-Base student feedback
  2. 1st/2nd year, 3rd year and 4th year annual surveys and student focus group feedback
  3. The Graduate Questionnaire
  4. NBME shelf scores
  5. Step 1 or Step 2 sub-category exam scores compared to national average
  6. The Course Director Review form
Courses that had issues with above criteria would then be subjected to a Level 2 Process with an anticipation of approximately 2 preclinical and 2 clinical courses undergoing this process every year. This is a much more in depth process.
  • Flags for this type of review are:
  • C-Base feedback showing that more than 50% or more of responders disagree or strongly disagree to the statement “Overall I am very satisfied with the course.”
  • The course or clerkship falls into the category of most in need of improvement or if majority of students request a level 2 review.
  • Significant issues are raised in student focus groups.
  • The course is below the national mean and demonstrates a downward trajectory on GQ Survey 2 years in a row.
  • Course Director requests level 2 review.
  • Automatic level 2 review occurs 2 years after:
  1. Course has had a change in the course/clerkship director.
  2. A new course is developed.
Discussion raised the points that this process needs to be conducted on all courses and recommendations followed up. / Will this be adapted?
Curriculum Gap Analysis and Remediation / L. Chandran presented a graph showing where there were gaps in the curriculum and what can be done to correct those gaps.
New Curriculum Thread / M. Singh stated that about a year ago she had wanted to start a project to establish an educational program in quality improvement and patient safety across the medical continuum which meant the medical school with the diverse medical education programs and would be interdisciplinary. She presented some background information as to why this was important, one of the reasons being that there was no education and quality improvement in patient safety program here at Stony Brook. Dr. Singh explained how she did intensive research, attended meetings, and met with individuals here at Stony Brook. There were several gaps found in our ILO’s with the main gaps being in #5 (provide safe, timely, effective, efficient, equitable, patient-centered and evidence-based health care) and #20 (Participate in evaluation of personal medical errors, system errors and implementation of potential solutions).
The next step was how to address the gaps. This would be done in a longitudinal thread across all four years.
  1. Two lectures are to be given to start. This will include CPCs, clinical scenarios, code measure which will be taught. Medication error related lectures.
  2. There is a group working on spectrum of patient safety and quality improvement. Interdisciplinary group which includes physicians, nursing, S. Post, A. Wackett ascontinuous quality improvement individuals. This group will be used to evaluate the assignments from the students.
  3. Third major component is A. Wackett’s course on Transition to Residency. There will be assessment and teaching of items related to quality improvement and patient safety.
A healthcare matrix – Vanderbilt Matrix - to be used as tool for students projects for quality improvement and patient safety. It will also be used for students to submit their interactions related to various projects.
ACGME has mandated that there is experiential learning in quality improvement and patient safety. Students should be well prepared to start their residency program.
Discussion ensued regarding the program and how it can be implemented. Several suggestions were given. One suggestion given would be implementing a recording mechanism.Another would be teaming up between all individuals.
MESH / MESH data base has been updated to satisfy outside reviewer.
Director of Clinical Courses / Dr. Huston has excellent teaching credentials. Time and resources for this individual academic advancement package were submitted; Departmental chair sent email stating they would provide anything course director needed. Dr. Huston is on an educational track.
MOTION: Appointment of Dr. Jared Huston as course director for Surgery Sub-I and surgery electives / MOTION APPROVED
NEW BUSINESS
Stony Brook Branding / K. Kaushansky presented new branding - Stony Brook Medicine. Focus will be placed on specific programs in the next couple of months.
NEXT MEETING / May 7, 2012

Attendance:

  • Chairman: Dr. Kenneth Kaushansky
  • Faculty Members (absent *): A. Fontanini MD PhD, P. Fisher MD PhD, L. Krug PhD, L. Mujica-Parodi PhD*, J. Bock MD PhD, L. Merriam MD*, E. Nord MD*, N. Schechter PhD, G. Shuman MD*, S. Vitkun MD PhD, A. Wackett MD, S. Post MD, H. Sussman MD, L. Strano-Paul MD, P. Richman MD, M, Kritzer MD, R. Cameron MD, S. Morrison PhD, S. Lane MD, L. Shroyer MD*
  • Dean’s Office/ExOfficio: L. Chandran MD, D. Paquette DMD, M. London EdD, E. Mylona PhD*, A. White*, M. Singh MD, S. Simon PhD, H. Fleit PhD, W. Rosenfeld MD
  • Students: G. Werneburg, D. Donoho, T. Griffen, A. Iyer*, N. Dasgupta*
  • Recording Secretary: Ann Dowsey

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