med ed
A newsletter for faculty, staff, and students of the University of Minnesota Medical School

No. 376, January 2005

Editor: Kathleen Watson, M.D., drwatson@umn.edu

Editorial Assistant: Allison Campbell, aac@umn.edu

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Imperative for change: Envisioning Curriculum 2010

"Change in medical education will occur whether we want it to or not," Dean Deborah Powell, M.D., told the Education Council in December. "The only question is, will we be leaders of change or followers?" Powell spoke at one of two intense council discussions last month about curriculum and the imperative for change. Powell presented to the council some of the national forces driving change, such as reports linking changes in health-professional education with improvements in health care and patient safety, as well as moves by specialty boards to adopt the ACGME competencies as requirements for maintaining certification. The Education Council, led by Jonathan Ravdin, M.D., and Kathy Watson, M.D., recognizes that our Medical School currently educates outstanding students, residents, and practicing physicians through its medical education programs. Yet more must be done to ensure that we respond flexibly to a changing health-care system, take advantage of the latest knowledge about adult learning, and not only preserve but also advance the excellence of the medical profession. Watson's draft report, "The Imperative for Change," includes this vision: "The University of Minnesota Medical School will be recognized as a national leader in medical education, offering the most attractive, innovative, learner-centered and flexible pathways for students to achieve a medical degree." While most members were positive about the proposed Curriculum 2010 concept, concerns about resources and the ambitious scope of the project were brought forward by council members. After discussion on Dec. 21, the Education Council voted to establish a planning group for the Medical School's new curriculum development initiative. The group will regularly report to the council and the dean over the next six months as they conceive what Curriculum 2010 would look like and begin to form work groups to make recommendations. By mid-January, a Web site featuring supporting documents will be established; watch for an announcement.

Advisor selection, Jan. 10-14

Selecting an advisor is an essential step for students preparing to enter their third year. Not only do students need an advisor's approval to register for courses, but also surveys over the last three years indicate most students found their advisors helpful. Advisors' primary role, says Theodore Thompson, M.D., director of clinical education, is to assist students in selecting their career specialties. In addition, an advisor may take an active role in helping students with schedules, serve as a student's advocate, and become sources for letters of recommendation. The advisor's other role, Thompson adds, "is to be a good friend. That's probably the most important." In recent years, a more selective pool of advisors has been developed, by identifying faculty with interest in education and gaining approval of their department heads. Advisor selection by students takes place online Jan. 10-14, 2005. For physician-advisor questions, contact Thompson at thomp005@umn.edu; for computer-access questions or problems, contact Genne McAndrew, mcand003@umn.edu.

Feb. 8: Listen to a Great Conversation

Medical School cardiologist Anne Taylor, M.D., a researcher on a recent study of the effectiveness of a combination of heart drugs for African-Americans, will discuss that controversial study and other issues of race and gender in medical treatment with Vivian Pinn, M.D., director of the Office of Research on Women's Health at the National Institutes of Health, 7:30 p.m., Feb. 8, at Ted Mann Concert Hall. Tickets for this evening in the University's Great Conversation series are $28.50--or $23.50 for U of M faculty, staff and students, Presidents Club and UMAA members. Call 612-624-2345 or go online to www.cce.umn.edu/conversations and click on Tickets. Taylor is director of the University of Minnesota's National Center for Excellence in Women's Health, author of The Black Women's Guide to a Healthy Heart, and serves as associate dean for faculty affairs in the Medical School.

Students can be barred from patient contact; check your shots

Immunizations offer protection--for your health, for the health of patients you encounter, for the accreditation status of the teaching hospitals affiliated with this Medical School, and for students' enrollment status. Students who are not in compliance with the immunization policy of the University of Minnesota Regents will be barred from contact with patients and a hold will be placed on their enrollment in classes and clerkships. Students, please review your immunization information available in the portal Toolkit and work with Boynton Health Services to achieve compliance and watch for communications from the medical school. For registered students, annual Mantoux tests, titres, chest X-rays, and tetanus/diptheria vaccinations are covered by student fees, after billing insurance and confirmation of insurance status has been received. Theresa Baultrippe in the Medical School can help with specific questions or issues related to status; contact her at 612-624-9473 or t-baul@umn.edu .

Seeing more R.E.D. (Resident Educator Development)

The monthly Resident Educator Development (R.E.D.) program training sessions are in full swing. They are scheduled for every third Friday of the month from 7 to 8 a.m. in B-646 Mayo. Team Leadership is the next teaching topic to be covered, on Friday Jan. 21. Breakfast is provided and parking is validated. All residents who are involved in teaching are strongly encouraged to participate. To find out more, and to register, click on www.meded.umn.edu/red/ .

Admissions for fall 2005: early returns

Applications to our Medical School are up from last year--again. For the Twin Cities campus, the total applicant pool increased by 5.5 percent to 2,284 people. The number of Minnesota residents who applied also increased by 6.5 percent, to 621 applicants. For the Duluth campus, total applications increased more than 50 percent, from 625 to 954, and Minnesota applicants increased 6 percent, from 405 to 430 residents applying.

OSCE in Duluth

The Duluth second-year medical students recently completed the first of two OSCE (Observed Structured Clinical Exam) testing programs. The OSCE consisted of nine stations requiring the student to perform a limited history and/or focused exam on a patient while being observed and scored by a physician. These stations tested the students' knowledge of heart murmurs, alcoholism, spousal abuse, pulmonary embolism, cocaine use, multiple sclerosis, atrial fibrillation, breast exam, and X-rays. For more information about this program, please contact Jeff Adams, M.D., (218-726-7695) or associate administrator Jan Pierce (218-726-7802).

Summer fellowship in cancer research seeks medical student applicants

First- and second-year medical students are encouraged to apply for the 2005 National Cancer Institute Summer Student Fellowship Program at Memorial Sloan-Kettering Cancer Center. This eight-week program is designed to promote interest in oncology and research careers. Twenty-five $5,000 fellowships are available for the 2005 program, which begins in June. Although the fellowship guidelines and online application will not be available on the program's Web site until Jan. 11, the completed application materials are due Feb. 11. The National Cancer Institute is part of the National Institutes of Health (NIH). For information, go to http://www.mskcc.org/summerfellowships .

Course director close-up: Brad Benson

Brad Benson is associate course director for the Primary Care Clerkship, where his educational focus includes evidence-based medicine and health literacy. "The goal," he says, "is to teach medical students how to teach themselves," so that once they're out practicing, they will be able to keep themselves up-to-date. Benson explains that during their clerkships, students put their book learning and theory into practice. "They learn how to identify their own knowledge gaps, fill them in with the best available evidence and then use this information to counsel patients in a way that empowers them to be involved in the decision-making," he says.

As part of the students' primary care clerkship, Benson devised an evidence-based medicine project. This project is designed to help students understand and articulate to their patients complex medical decision-making. "Oftentimes, patients come to their appointments armed with the latest press release on a particular disease or treatment," says Benson. "But what they really need to know is how that translates into practice--that is, its clinical significance."

This project involves answering a clinical question generated in the course of patient care. The student summarizes the answer in the form of a Critically Appraised Topic (CAT). They then translate the CAT into a Patient Education Tool (PET). For instance, if the CAT is on the effectiveness of treatments for post-partum depression, the student may develop a flyer to be left in pediatric and OB/Gyn offices to educate new mothers about the symptoms to watch for, recommending discussion with their provider regarding effective treatments. The ways in which students develop a PET varies, says Benson. In the past, they've produced brochures, fact sheets, even Web pages. Then, the PETs are made available online as a resource available to other students and their preceptors.

The final exam evaluates their abilities to effectively find and interpret scientific evidence using Medline and involves collaboration with Biomedical Library faculty. It also includes presentation of their PET to a standardized patient with direct feedback given to them regarding their communication skills.

"It's important that students know how to obtain medical information for their patients, but it's also critical that they're able to pass that information on in a way that is accessible to patients," says Benson.