KELLOGG/RHI CURRICULUM COMMITTEE MINUTES MARCH 21, 1995 NEXT MEETING: MAY 16, 1995 BRAXTON, WV This meeting was held at the Fort Gay Family Health Care, Fort Gay, WV. PRESENT: Chuck Conner (Spencer Site Coordinator), Jan Fox (MU School of Medicine), Dianne Hughes (Camden on Gauley Site Coordinator), Heather McCutcheon (RHI Site Coordinator), James Mears (WVU School of Medicine - Charleston Division), John Mooney (WV School of Osteopathic Medicine), Sharon Pressman (RHI Site Coordinator), Barbara Rice (Cameron Site Coordinator). and Linda Savory (MU School of Medicine). Also present were: Jacqueline Copenhaver (New River Health Association), Melody Cyrus (MU Student), Kathryn Greenlief (Braxton Site Secretary), Tracy Mohler (Country Roads Site Corodinator), Leslie Plants (Braxton Site Coordinator), Melodie Stewart-Cyrus (MU Student), and Stephen Thomas (Grafton City Hospital Site Coordinator) ABSENT: Natalie Ames (WVU Interdisciplinary Curriculum Coordinator), Helen Baker (WV School of Osteopathic Medicine), Anne Brown (RHI Site Coordinator), William Carlton (Project Director), Anne Cutlip (WVU School of Medicine), David Elliott (WVU School of Pharmacy), Robert Foster (WV School of Osteopathic Medicine), Jean Gross (WVU School of Dentistry), Arnold Hassen (WV School of Osteopathic Medicine), Judith Kandzari (WVU School of Nursing), Sandra Magnetti (Director of Clinical Research), Annie McIntosh (Joint Governing Committee), Richard Meckstroth (WVU School of Dentistry), Cecil Pollard (WVU School of Medicine), Louise Reese (RHI Site Coordinator), Clarke Ridgway (WVU School of Pharmacy) Diana Stotts (MU School of Nursing), April Vestal (Rainelle Site Coordinator) and Tom Whittier (Joint Governing Committee). I. Computer Information Jan Fox informed everyone that Mike McCarthy has put a map of West Virginia on the World Wide Webb (WWW) computer server. This map is organized by community instead of discipline and it will allow anyone with access to the WWW to look at information about each site in West Virginia. Jan is putting profiles of each site WWW computer server and the sites can build from there. All curriculum committee minutes, agenda, notice of meetings, directions to sites, etc. will be on the WWW server. Some of the Advantages of using the WWW Server: 1) Students can be oriented prior to going to a site. 2) Research/report's other people have done can be modified for your use. 3) Track information that has been gathered. 4) Questionnaires can be standardized for all sites and can be compared with other communities. 5) Helpful to students who are trying to gather information for projects. 6) Saves time and money (i.e., less time spent attending meetings and more networking via the computer). 7) It's a good teaching tool for the students. 8) Information about health can be accessed by students at Cabell Midland who are also hooked up with the system. 9) Information from Canada such as "Project Synapse" can be accessed. This has a checklist for the whole managed care team (i.e., what happens when you give a drug). The categories Dr. Savory recommends having on the WWW Server are: 1) Research 2) Site Information 3) TEAM Process 4) Community Service 5) Faculty Development (Case Management) 6) Cases If other categories are needed, contact either Jan Fox (304) 696-7309 or Mike McCarthy (304) 696-6372. Jan also mentioned that Bell Atlantic is installing a computer system for the first year at no cost to the sites. In 1996, the cost will be $150.00 per month per site. This will allow smooth access in the computer system. She also mentioned that there is no way for her to moderate the current system to delete the repeat messages with the old system. Mike McCarthy is holding a meeting with all the site coordinators on March 22, 1995 and he will explain how to get to the map with the sites and other information pertaining to the computer system. (Instructions for accessing this system are enclosed.) II. Community/TEAM Component Chuck Conner discussed a report that Jacqueline Copenhaver compiled with information from various sources pertaining to ways to bring people together at sites. It includes a listing of site coordinators, activities provided by these site coordinators and creative things they do at their sites to bring TEAM together. This is a boundary breaker and it is meant to allow people to glimpse into others on a different level (i.e., set aside positions and titles). (This report will be accessible via the WWW server). The boundary breaker is a group of people getting together and asking non-threatening questions. After 1 hour or 2 of working this process you get a deeper view of who people are and that's a good place to start when you're building a TEAM. You need to be able to let down defenses, set aside titles and positions and things that get in the way and build that way. When you have a continuous turn-over of people you need a wide variety of exercises. Some of the site coordinators have pulled some of this together in their ice-breakers and boundary breakers. Good Example of TEAM Approach: Chuck Conner and Jacqueline Copenhaver were involved in an MDS that was a good TEAM approach. They met at New River and went on a hike to an abandoned coal mining town. Everyone had assignments about Appalachia, women in the coal fields, etc. Everyone had a piece and to make a complete package or view of this everyone had to participate. After the hike everyone met at the New River Health Center to fill in this piece of what is Appalachian culture, what are the traditional values of the Appalachian people, what was it like living and working in the coal mines, etc. At the Spencer Site, Chuck Conner schedules boundary breaking exercises every month that has a 5th Friday with the staff. Everyone comes together and he facilitates these group and TEAM exercises in order to work together as a TEAM and learn and grow together. III. Field Faculty Training Chuck Conner recommends focusing on sending the field faculty to 1 conference (i.e., the RHI conference versus SHEC conference). John Mooney mentioned that a subcommittee for faculty development is being formed. This would involve several people such as: 1 or 2 of the field professors, someone from Morgantown, Marshall University School of Medicine, West Virginia School of Osteopathic Medicine). They will work on staff development year round and they have asked Donald Weston to support this subcommittee. This group will either look at the old field faculty needs inventory or they may send out a new one. Dr. Savory said that she has provided this information to Dan Doyle. IV. Field Preceptor Job Description Information Dr. Savory asked if anyone had any amendments to make to the Field Preceptor Job Description relative to the information that was distributed prior to this meeting. (i.e., things that are in the description that your Field Professor refuses to do, cannot do, is not equipped or taught to do, etc.) Are the Field Professor job descriptions coming on target? - Heather McCutcheon mentioned that she has put together a document with all the commonalities of what all Field Professors should be doing. She will send Dr. Savory a copy of this. - Chuck Conner sees a problem with payment due to the integration of RHI/Kellogg process. When a person is hired through the university the expectations are different than when the person is hired through the site. Are we going to have one model everyone is going to live by and tackle this payment problem? How do you coordinate a system where people are both volunteers and paid people and all degrees in between? Answer: - John Mooney said that the Field Professor expectations of the program are different than the Site Coordinators. The Field Professors are telling students they don't need to attend the multidisciplinary sessions, thus students are getting mixed messages. He feels that the third year students should be told as soon as possible that there are other expectations other than clinical. The fourth year medical students do a little more because they are more comfortable, they know what to expect, and you can lean on them a little more. Dr. Savory asked the Site Coordinators whether or not they feel there is more university support among the Field Professors and students than last year? Answers: - Barbara Rice mentioned that there was a problem with Field Professors not wanting students who are getting paid (i.e., Fellowship Scholarship). - Sharon Pressman has had more problems with students than the Field Professors. The students seem to want the money but do not want to follow all the rules to get it. - The Fellowship Scholarship Committee - Meets April 7, 1995 at Flatwoods, WV. - Dr. Savory recommends writing a letter from this committee explaining how financing impedes our ability to create a uniform product. During the reorganization we will request that Dr. Weston and Hilda Heady address that particular issue. V. Student and Field Professor Representation at the Meeting Melody Stewart-Cyrus a third year medical student from Marshall University spoke about her rural experience at Fort Gay. She had a chance to work with 2 different providers and learn about chronic care, obstetric gynecology, and pediatrics. She is able to do more hands on procedures than she would in a hospital setting. Her rural rotation at Fort Gay has been an enjoyable and educational experience. The difference between a rural rotation and a rotation in town is that in town you have set lectures and reading assignments and in the rural site you are not told what to read and study. If your not a self-motivator it might be more difficult to learn. Dr. Dan Brody, Lead Dental Field Professor at Fort Gay, mentioned that he is gearing the multidisciplinary cases towards situations students are likely to encounter in the future. Their site is also trying to make sure that all of the students get to rotate through all of the disciplines. He has had very good feedback from the students. He hopes to create a model program. Dr. Savory asked Dr. Brody what he perceives as the features that caused his peer Dr. Norman to come to West Virginia and work in a rural practice? Answer: - He got a taste of all aspects of dentistry that you can do at a site. He saw a lifestyle he liked and it was an experience where you got to know your patients and become part of the community. Dr. Art Richards, Medical Field Professor at Fort Gay, appreciates the opportunity of working with students and also learning from the students. He feels it is an opportunity for students to see what life is like in rural health. Doctors also learn a different method of communicating with their patients (i.e., poorly educated and experience difficulty communicating). In a rural setting you also see a lot of diseases you would rarely see in other places. Dr. Savory recommends producing an annual Curriculum Committee report that summarizes activities, services, and outcomes that are measurable. She would like the curriculum committee members via bulletin boards to add information, questions, and measurements. Over a period of 2 months the committee will see what we can produce from networking via the WWW server. The below list will be in an outline format listed under Annual Curriculum Committee Report on the WWW server. 1) Evaluate the curriculum program. 2) Evaluate the field professor performance carrying out the program. 3) Evaluate the student performance carrying out the program. 4) Distinguishing and measuring what we have done from traditional education. 5) What specifically can be done here that isn't done elsewhere, not just hands on. 6) How is this different? All curriculum and Kellogg faculty should enter their responses via computer. Site coordinators are to ensure field professors contribute. VI. Tour of the New Building The building features a large conference room, large resource enter, and 4 dental suites large enough to accommodate teaching. VII. Future Meeting There will not be a meeting during April, the next meeting will be: DATE: May 16, 1995 TIME 11:00 a.m. - 2:00 p.m. PLACE: Braxton, WV The meeting was adjourned at approximately 2:00 p.m. __________________________________ Linda M. Savory, M.D.