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MEDICAL EDUCATOR
VOL 1, No 3, JUNE 1999 CME On-line: Establishing a door to life-long learning by Cindy A. Abole, Public Relations Traditionally, the academic ties that bind college students to their alma mater begin to fade after graduation. Not so for physicians. Their umbilical cords to higher learning strengthen over time as the graduates continue to sharpen the skills necessary to practice medicine. “For physicians, continuing medical education (CME) is part of their life-long learning,” said Timothy Carter, M.D., associate professor of neurology and CME committee member. Physicians and other medical professionals are required to undertake further study in their field or specialty. Those three to seven years of additional training ultimately certify them to practice within a specialty. “It is essential for physicians to maintain existing knowledge and skills and continuously add new concepts and approaches to medical practice,” said Marion C. Anderson, associate dean for CME, College of Medicine. “This continuum of physician education extends throughout his or her career to retirement. In January, the South Carolina Board of Medical Examiners approved a requirement that affects practicing physicians. Licensed board physicians must begin to acquire 40 hours of Category 1 CME credits biennially for license re-registration. The College of Medicine reacted quickly by turning to the computer as a vehicle for communicating CME activities and established a website that eventually will enable physicians to register for CME activities and eventually take courses on-line. These technological efforts follow South Carolina’s move to join approximately 25 other states which require documentation of professional accreditation. Since the early 1980s, MUSC has been accredited by the Accreditation Council for Continuing Medical Education (ACCME) to sponsor continuing medical education for physicians. Its purpose is to assure physicians and the public that CME activities have been planned and implemented by a sponsor that has met accreditation standards. In the 1960s, the American Medical Association established the physician’s recognition award which ranks methods for recognizing continuing medical education activities. Category 1 CME credits apply to a physician’s participation through organized events, educational meetings, conferences and other symposia. Annually, the CME office has sponsored 50 conferences as well as other activities which comply with ACCME standards. “Our focus is to develop programs for local, state and regional audiences,” said Odessa Ussery, CME coordinator, College of Medicine. Traditionally, the CME office promoted program activities through advertisements in publications affiliated with professional organizations like the South Carolina Medical Association. Periodically, CME also marketed information at displays affiliated with regional and national conferences and conventions. For the past six months, the CME office has worked with Mary Mauldin, director for educational technology lab, Department of Library Services and her colleagues in crafting the website. The colorful homepage is sub-divided into four photo-laden feature images displaying various sections. Entering the administrative page, visitors can read the program’s mission statement, read the accreditation process, or identify the CME committee and staff members. Another area displays a program list, registration, special initiatives and resource links tying areas like the College of Medicine’s webpage, professional organizations, visitor accommodations or other local interests. Visitors can also download brochures and conference listings, access grand round schedules, obtain information on other CME activities or be placed on an on-line mailing list. The website is user-friendly and provides expanded links to professional societies, medical organizations and legislative updates. MUSC’s CME website will be linked to the search engine currently being designed by the Society for Academic CME. Future features on the website will allow users to review a personal account of stored Category I credit hours. In addition, an on-line committee will recommend guidelines for design and delivery of case-based CME offerings. “Overall, the CME webpage provides expanded capability to better serve physicians by designing quality programs with diversed delivery modalities and flexible and timely delivery,” said Jan Z. Temple, Ph.D., associate professor and director of professional development, College of Medicine The website accomplishes its responsibility for building good outcome measures through ongoing site evaluations. Users can communicate their needs or recommendations by completing a short website evaluation which provides immediate feedback. “The website offers a major advantage: convenience,” Carter said. “Physicians gain access and get information that they can complete at their own pace. More specifically, we want something that's a good use of our time. It’s availability will certainly make our working lives easier." Visit the CME website at <http://www.musc.edu/cme> New exam format to be implemented for years 1, 2 The “cumulative exam,” a feature of the newly revised undergraduate curriculum, should produce a double benefit for students: it will eliminate cycle studying and at the same time prepare them for “the Boards.” Like the USMLE, the cumulative exams in years one and two will encompass all subjects and their interactions. In the past, students faced a multitude of tests each semester—several in each subject—to measure their mastery of course material. The net effect is fewer, but more comprehensive tests for each student. “Preparing for a cumulative exam is an excellent way to bring everything together,” said Stephen Schabel, M.D., Curriculum Coordinating Committee member. “When you’re a practicing physician, it’s not about a biochemistry or a pathology problem, it’s a health problem.” When students take Step I of the USMLE they’ll be accustomed to studying for tests that combine materials from different subjects. Questions for each exam will be submitted by the course directors and lecturers who’ve taught various sections of the curriculum. An exam committee will be responsible for assembling these questions into a comprehensive exam. It is also expected that careful scrutiny of the questions included in these comprehensive exams will result in a significant improvement of exam quality. Three exams will be administered during each semester: two during the course of the semester and one at its conclusion. The week prior to each exam will be dedicated to studying, with no assigned activities for students. Students will still receive grades in each course. A score on questions relating to each course content will determine a student’s grade for the course. For example, performance on pathology questions will count towards a student's pathology course grade. Some questions may be counted for multiple courses. “Our students have always performed well on the USMLE, and these changes will further improve their performance,” Schabel said. Lectures, courses streamlined in Year 2 changes Building on revisions to the first-year curriculum, the Undergraduate Curriculum Committee (UCC) has approved changes to the second year. Curriculum Coordinating Committee members Gabriel Virella, Ph.D., and Stephen Schabel, M.D., developed the recommendations that continue the effort to integrate basic science and clinical experience. Planned changes focus on coordinating course content to eliminate redundancies and reduce the number of hours students spend in the lecture hall. Two major strategies have been adopted: one is to reduce the number of courses to three per semester. The other is to encourage the development of integrated active learning modalities, which promote learning of the content from more than one discipline. Courses in the new curriculum are: Fall semester:
For example, when Infection and Immunity covers the immunological basis of hypersensitivity diseases, Mechanism of Disease I will focus on pathological aspects of the same type of diseases. At the same time, small group experiences designed by faculty will provide a forum for students to discuss in-depth the basic science and clinical aspects of some of these diseases. Special symposia will remain in the curriculum. The AIDS Symposium will continue to be presented during the fall semester of year two. A second symposium on a different topic will be introduced in the spring semester. Virella, vice-chairman for education for the Department of Microbiology and Immunology, and Schabel, vice-chairman for education for the Department of Radiology, expect that second year students in Fall 2000 will be the first to experience the revised version of the curriculum. Changes should be complete by Spring 2001. Don't miss this July 1 is the submission deadline for workshop proposals and posters for the 1999 Spirituality, Culture and End-of-Life Conference to be held Sept. 24-25 in Denver, Colorado. Workshops are one and one half-hour to two and a half-hour sessions that provide extended, focused interactive and skill-oriented learning experiences for participants. Posters can showcase work still in progress, innovations recently introduced, and/or established projects or components of the medical school curriculum. For information, call (301) 984-7162. Continuing Medical Education Conferences: September 10 - 11 MUSC/Clemson CME Weekend Madren Conference Center Clemson, SC 16 - 17 Developments in Digestive Diseases Storm Eye Institute Auditorium 27 - October 2 8th Intensive Review of Emergency Medicine Westin Francis Marion Hotel 30 – October 1 5th Annual Diabetes Fall Symposium Charleston Hilton Hotel October 1 – 2 Spectrum of Mania Westin Francis Marion Hotel 29 - 30 Total Hip Arthroplasty Symposium Charleston Place Hotel November 14 - 18 North American Association for the Study of Obesity Charleston Place Hotel December 3 - 5 Frontiers in Pediatrics Doubletree Suites Hotel 3 - 5 Holiday Update in Anesthesia Embassy Suites Hotel For more information on Continuing Medical Education conferences call 876-1925. Graduate Medical Education Franklin Medio, Ph.D., Angela Ybarra, MHA, and Margaret Brantley, MPA, of the Office of Graduate Medical Education, attended the Association of American Medical Colleges (AAMC) Southern Group on Educational Affairs Annual Meeting in May held in San Juan, Puerto Rico. Medio presented a workshop, “Implementing A Clinical Teaching Skills Course for Residents on an Institution-Wide Basis,” that demonstrated the importance of residents functioning as effective clinical instructors and outlined mechanisms MUSC has adopted to prepare residents for their teaching responsibilities. In addition, he and several colleagues conducted a panel discussion on the “Design and Implementation of Core Curriculum Modules for Residency Education.” This interactive session involved brief presentations of several modules, one in ethics and two in managed care and the discussion of basic concepts used in the development of these core courses. Ybarra presented a poster titled, “Teaching Residents About Managed Care” which detailed the didactic and clinical pilot program implemented at MUSC in July 1998. In addition, Brantley presented a poster titled, “A Novel Approach to Conducting Internal Residency Reviews” which outlined the internal review process developed and implemented at MUSC in August 1998. July Internal Review Schedule Pediatrics Teaching tips FEEDBACK is an important step in the learning process. Without feedback, mistakes go uncorrected, bad habits can develop unintentionally, and learners may drop positive behaviors because of a lack of reinforcement. Giving feedback is a skill. When giving feedback:
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