The Ohio State University College of Medicine

Executive Curriculum Committee Meeting Minutes

Date:3/26/2013 Location: 150 Meiling Presiding Chair: Stanley I. Martin, M.D. Call to order: 4:05PM Minutes recorded by: Stanley Martin Adjourned: 5:15PM

Member attendance Name Role Present Stanley Martin Chair, Faculty member Y Daniel Clinchot Vice Dean for Education, Faculty member Y John Davis Associate Dean for Medical Education Y Sam Colachis Faculty member Y Nicholas Kman Faculty member Y Thomas Mauger Clinical science chair N Cynthia Kreger Chair, Academic Review Board N Amy Lovett-Racke Faculty member N Pat Ecklar Assistant Dean, Affiliated program Y Doug Knutson/Nanette Lacuesta Assistant Dean, Affiliated program N / N Curtis Gingrich Assistant Dean, Affiliated program N Mary McIlroy Academic Program Director, Assistant Dean, Aff Prog Y Larry Schlesinger Chair, Basic Science Department N Douglas Post Academic Program Director, Assistant Dean, Med Ed Y Douglas Danforth Academic Program Director Y Leon McDougle Academic Program Director, Associate Dean Diversity N Cynthia Ledford Assistant Dean, Med Ed N Sorabh Khandelwal Assistant Dean, Med Ed Y Keerthana Bolisetty Med student representative Y Kevin Heinsimer Med student representative Y Additional attendees Eric Ermie Agenda items Item 1, Approval of minutes Item 2, Educator training on teaching and assessment Item 3, Annual entire curriculum review policy Item 4, ABRC discussion Item 5, USMLE Step 1 sand Step 2 CK/CS review and discussion

Executive Curriculum Committee Agenda

2

Item 1, Approval of last meeting’s minutes Presenter: Dr. Stanley Martin, Presiding Chair Discussion

1. The meeting minutes from February 26, 2013 were reviewed by the committee and approved.

Item 2, Educator training on teaching and assessment Presenter: Dr. John Davis, Associate Dean Discussion

1. Residents, graduate students and postdoctoral fellows involved in the teaching of medical students should be familiar with the educational objectives of the course or clerkship and be prepared for their roles in teaching and assessment.

2. The role of who is responsible for this at the GME level vs. the medical school and the value of a universalized approach was discussed

3. A proposal was put forward that the medical school adopt a proposal in line with the LCME standards and that the Academic Programs be responsible for developing and implementing the policy (see attached).

Action Items

1. The committee voted and approved the proposal 2. Dr. Sorabh Khandelwal volunteered to develop a working group to try

and develop an approach that could be broadly implemented at the GME office level. This will be brought back to the ECC later for review and discussion.

Item 3, Annual entire curriculum review policy Presenter: Dr. John Davis, Associate Dean Discussion

1. A proposal was put forward to concretely establish when the ECC would review and revise the overall educational program as a whole (see attached).

2. A suggestion was put forward to edit the proposal to say “within one year of the completion of the cycle of the individual academic program reviews.”

Executive Curriculum Committee Agenda

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Action Items

1. The Committee voted to approve the recommended proposal with the suggested edit.

Item 4, ABRC discussion Presenters: Dr. Mary McIlroy, Academic Program Director/Assistant Dean Discussion

1. The ABRC has a responsibility to expedite student reviews in a fair, balanced and timely manner. Dr. McIlroy brought forth concerns that the ABRC quorum deviated from other committees.

2. Dr. McIlroy proposed an amendment to the handbook to establish a quorum as being made of 5 members, not the previous 7, in order to more effectively organize meetings.

Action Items

1. The Committee voted and approved the proposal effective immediately.

Item 5, USMLE Step 1 and Step 2 CK/CS review and Discussion Presenters: Mr. Eric Ermie, in lieu of Dr. Cynthia Ledford Discussion

1. The scores from this past year’s USMLE Step 1 and Step 2 CK/CS examinations were reviewed. Of note, the USMLE Step 1 average was 233, higher than the national average. Of the 217 students who took it, 213 passed. USMLE Step 2 scores were equally if not better comparatively speaking (see attached).

2. A proposal was put forward to move the deadline for USMLE Step 2 takers from December 31 to October 31 to help prevent complications of MSPE and identify the few failing or uncooperative students earlier in the academic year.

Action Items

1. The proposal was tabled for further discussion.

Comment [DJ1]: …achieve uniformity amongst review committees.

Draft Proposal for Overall Educational Program Review

In keeping with the mission of the Executive Curriculum Committee’s (ECC) charge to:

Review and revise the academic programs to achieve a logical sequencing of the various segments of the curriculum, content that is coordinated and integrated within and across the academic periods of study (horizontal and vertical integration), and methods of pedagogy and student evaluation that are appropriate for the achievement of the college’s institutional objectives.

And in keeping with the requirement by the Liaison Committee on Medical Education (LCME) that:

The objectives, content, and pedagogy of each segment of a medical education program’s curriculum, as well as of the curriculum as a whole, must be designed by and subject to periodic review and revision by the program’s faculty. (ED-35)

This policy is proposed to address the need to review and revise the overall educational program curriculum as a whole.

Currently, ECC policy exists for review of individual academic programs, both in terms of frequency of review (at least once between LCME review cycles) and content/form. However, no policy currently exists for review of the overall educational program.

Proposal: The overall educational program (curriculum as a whole) will be reviewed at least once between LCME review cycles, and within one year of the completion of the individual academic program reviews.

Draft Proposal for Policy Regarding Use of Trainees in Teaching and Assessing Medical Students

Acknowledging the fact that trainees (e.g., residents and fellows) serve a valuable role in the education of our medical students, and in accord with the policy of the Executive Curriculum Committee that:

The Executive Curriculum Committee reviews and revises the academic programs to achieve a logical sequencing of the various segments of the curriculum, content that is coordinated and integrated within and across the academic periods of study (horizontal and vertical integration), and methods of pedagogy and student evaluation that are appropriate for the achievement of the college’s institutional objectives.

And in accord with Liaison Committee on Medical Education standards that state:

At an institution offering a medical education program, residents who supervise or teach medical students and graduate students and postdoctoral fellows in the biomedical sciences who serve as teachers or teaching assistants must be familiar with the education objectives of the course or clerkship (or, in Canada, clerkship rotation) and be prepared for their roles in teaching and assessment (ED-24).

This proposal is made for a policy regarding the use of trainees in teaching and assessing medical students.

Policy proposal: All trainees (including, but not limited to residents, fellows, graduate students, and other medical students) who participate in medical student education will have specific training about their roles in teaching and evaluation. This training should include communication about the specific learning objectives associated with the teaching activity, as well as training specific to their role in teaching/supervising. The mechanism for implementing the policy will be delegated to the individual academic program responsible for the activity. Likewise, the academic program will be responsible for instituting a process for monitoring compliance with this policy.

USMLE Step 2 CK & CS Performance

Cynthia H. Ledford, MD Assistant Dean for Evaluation & Assessment

Data Sources

• NBME Annual report for Step 2 CK – 1999- 2012 (August 9, 2012)

• NBME Annual report for Step 2 CS – July 2011 – May 19, 2012

The Ohio State University College of Medicine Step2CK Annual Report First time takers July 2011 – June 2012

Performance on FIRST ATTEMPT

Performance on most recent REPEAT ATTEMPT

Examinees from OSU

All US/Canada

Examinees from OSU

All US/Canada

Number Tested

205 19892 1 247

Number Passing

204 19488 1 216

Percent Passing

100 98 100 87

Mean (SD) Mean (SD) Mean (SD) Mean (SD) Total Test 244 (20) 237 (21) --- (---) 203 (14)

The Ohio State University College of Medicine Step2CK Annual Report 2010-2011 First time takers July 1 2010 – June 30 2011

The Ohio State University College of Medicine Step2CK Annual Report 2010-2011 First time takers July 1 2010 – June 30 2011

[Med 2013]- Progress toward completing Step 2 CK

# as of Sept 2012

Delay Grad

# to grad

1st Pass

1st Fail

1st Pend 1st Not done

2nd Pass

2nd Fail

2nd Pend

2nd Not done

With Draw

207 1 206 202 2 - 2 1 1 - - 0

1 student took LOA without taking 2CK 1 student (2 failures) needs to delay graduation 2 others remain at risk for not graduating

Performance of Examinees Taking USMLE Step 2 Clinical Skills (CS) for the First Time in the Academic Year

July 2011 to May 19, 2012

Performance of Examinees Taking USMLE Step 2 Clinical Skills (CS) for the First Time in the Academic Year

July 2011 to May 19, 2012

[Med 2013]- Progress toward completing Step 2 CS

# as of Sept 2012

Delay Grad

# to grad

1st Pass

1st Fail

1st Pend 1st Not done

2nd Pass

2nd Fail

2nd Pend

2nd Not done

With Draw

207 1 206 204 2 - 1 - 1 0

1 student took LOA but had passed CS (delay) 1 student (1 failure) needs to delay graduation

[Med2013] USMLE exam dates 2012-2013

0102030405060708090

100

Step 2 CKStep 2 CS

Decisions and discussion Handbook Language: Med 3-4 • Students must take and post a passing score on a

national administration of both portions, clinical knowledge and clinical skills, of Step 2 of the USMLE to be eligible to graduate from the College of Medicine with the M.D. degree. All students must pass Step 2 CK and Step 2 CS by May 1 to be certified for graduation. Residency programs are increasingly requiring a confirmed passing Step 2 score prior to submission of the February student ranking in the National Residency Match Program. Med 4 students are required to take Step 2 CK and Step 2 CS by December 31 or have written permission from the Associate Dean for Student Affairs and Medical Education Administration to postpone. While the College does not set a limit on the number of attempts a student has to pass Step 2, the 6-year Rule (See Requirements for Graduation) effectively sets a time limit on passing and posting a score for Step 2. In addition, the National Board of Medical Examiners only allows 3 attempts in any 12-month period. For more information:

Medical Student Handbook 2012-2013 Ver. 2 9/19/12 6b-16 • Med 4 students are required to take Step 2 CS by

the first Saturday in November • Students with a failing CS score who have not

retaken the exam by the last Saturday in January will be removed from the Residency Match since the College will be unable to certify that the student is likely to graduate.

• Med 4 students are required to take Step 2 CK by December 31

• Those who do not have a passing CK score by the third week of February will be removed from the Match since the College will be unable to certify that the student is likely to graduate.

• All students must pass Step 2 CK and Step 2 CS by April 1 to be certified for graduation.

Change of deadline

• Move December deadline for CK to end of October?

USMLE Step 1 Performance

Cynthia H. Ledford, MD Assistant Dean for Evaluation & Assessment

Data Sources

• NBME Annual Report for Step 1 – March 21, 2013

The Ohio State University College of Medicine Step 1 Annual Report First time takers 2012.

Performance on FIRST ATTEMPT Performance on most recent REPEAT ATTEMPT

Examinees from OSU

All US/Canada Examinees from OSU

All US/Canada

Number Tested 217 21219 1 182

Number Passing

213 20218 - 132

Percent Passing 98 95 - 73

Mean (SD) Mean (SD) Mean (SD) Mean (SD)

Total Test 233 (19) 227 (21) --- (---) 197 (14)

*Does not include one student from last year’s med 2 class that took his first attempt in February of this year. *The failed second attempt is an IMSP student who has not yet taken his third attempt

Program 1st Pass

1st Fail

1st Pend 1st Not done

2nd Pass

2nd Fail

2nd Pend

2nd Not done

With Draw

Average (SD)

IP 181 3 - 0 0 0 1 2 0 232.56 (20.41)

ISP 37 1 - 0 0 0 1 0 0 230.84 (19.60)

School 218 4 - 0 0 0 2 2 0 232.27 (20.24)

Step 1 Information by program and total for school with scores to date:

• Three of the students who failed took LOA’s instead of the late start to med 3 option.

• One student was already on a research LOA and failed to comply with the deadline for taking the exam the first time resulting in a significantly late 1st attempt.

• Of the failing students three were IP, one was ISP. • Our highest previous average on step 1 as a school was 2009 with

227 • This ties for the furthest above the national mean we have been

with the 2004 results