the university of arizona college of medicine tucson

The University of Arizona College of Medicine

Agenda for Wednesday, March 18, 2020 4:30-6:00pm Rm. 3230

Announcements: 1. Tucson Evaluation Subcommittee (Cho)2. COM COVID-19 Response Update (de Leon)

Voting Items: 1. Meeting Minutes from Feb. 5th

2. DMH Block Change Form (Attachment) (Woolridge)3. Student Appeals Revisions (Attachment) (Cho)4. CQI Policy Proposal (Attachment) (Givens)5. TEPC Assessment & Evaluation Policies (Attachment) (Cho)6. Emergency Medicine Change Form (Attachment) (Leyva)

Presentations: 1. CQI – Two Question Survey Results: Foundations, MSS, Life Cycle, NS2. Clerkship Assessment and Evaluation (Attachments) (Cho/Leyva)3. TCMS Working Group Meeting Recap on Biostatistics (Amini)

Call to Audience

FUTURE AGENDA ITEMS

Items(s)/Timeframe Time Frame Assigned to

Level 1 Reports: Foundations, MSS, Life Cycle, I&I, NS, Adv. Topics April 15 Cho

Grading and Progression Policy Revision – review of changes April 15 de Leon

Effectiveness of Spiraling Curriculum (Med Ed Distinction Track Project) April 15 Anthony Maltagliati

TCMS Working Group Meeting Recap on Teaching Rubrics April 15

Nervous System Pilot Run of Altered Curriculum (Vanderah) April 15 Vanderah

Level 3 Report May 20 Givens/Cho

Clerkship Review Class of 20/21 May 20 Cho

Faculty Assessment of Student Performance form – Electives Spring 2020 Cho/Warneke

Foundation Block Change Form May 20 Ganchorre

Professionalism Discussion from TCMS Working Meeting June 17 Moynahan

TUCSON EDUCATIONAL POLICY COMMITTEE (TEPC)

AGENDA ITEMS


TEPC Meeting Attendance and Minutes from:

Wed., Feb. 5th, 2020 4:30-6:00pm, Rm 3230

MEETING ATTENDEES

Voting Members Resource Members

Anthony McCoy (2023) X Ah Ra Cho X

Bryan Little (2022) Alex Lopez X

Colleen Cagno X Athena Ganchorre X

David Bear X Carlos Gonzales X

Dawn Coletta X Emily Leyva X

Dieter Mohty (2023) X George Fantry X

Indu Partha X JD Thomas X

Jenny Plitt Jerie Schulz X

Jim Warneke X Kadian Mcintosh

Joe Morales (2022, alternate) Karen Spear Ellinwood

Jordana Smith Kevin Moynahan X

Julie Armin X Kris Slaney X

Josh Yell (2021) Raquel Givens X

Lindsey Lepoidevin (2020) Sean Elliott X

Maddy Banergee (2021) Sonia de Leon X

Maria Czuzak Tanisha Price-Johnson

Marion Henry X Winifred Blumenkron

Muhammad Khan X

Patricia Lebensohn Guests:

Zoe Cohen X Kathy Smith X

Sydney Donzella X

Voting Items: 1. TEPC Meeting Minutes from Jan. 15, 2020.

Vote: A vote was taken, and the minutes were approved.

2. CRC Facilitation Elective Proposal Dr. Smith stated this is an existing elective that was just restructured to ensure the language was up-to-date, and it met the required hours for a credit. Students now have the option to take it for four weeks for one credit, or eight weeks for two credits. Vote: A vote was taken, and the elective was approved.

Meeting Minutes


3. Pathways in Health and Medicine (PHM) Block Change Form Dr. Cagno presented the Block Change Form for PHM, effective for the Spring semester. The sessions have been reorganized with content distributed throughout blocks using a hybrid model. Two new sessions were added to the CPR Block, including Vaping and Journal Club on Health Disparities. There will be a few new speakers for ongoing sessions, as well as some new facilitators in the DMH Block. Vote: A vote was taken, and the PHM Block Change Form was approved.

4. Medical Spanish Elective Proposal Dr. Gonzales presented a proposal for a new Medical Spanish Elective, FCM 896S. Formerly an independent study, it will now be offered as a two unit elective for intermediate Spanish speakers. Currently, there are 35 students enrolled this year. The elective will be a two-credit course featuring 80 hours of on-line working modules, practice sessions with Spanish-speaking standardized patients, and an evaluation by Dr. Gonzales. Discussion: Dr. Warneke noted that many nurses will not let medical students speak in Spanish to patients and serve as a translator to physicians unless they are certified by Banner. This course would not provide certification as it is for intermediate speakers and emphasizes medical Spanish, not conversational Spanish. We need to make sure students are aware of Banner’s official policy, and that this elective does not offer Banner’s certification. Vote: A vote was taken, and the Medical Spanish Elective was approved.

5. CPR Block Change Form Dr. Elliott presented the CPR Block Change Form. There are no significant changes, however elements of Advanced Topics presented by Deb Fuchs have been inserted into the CPR block. There are also small changes in instructional leadership. Vote: A vote was taken, and the CPR Block Change Form was approved.

Call to Audience:

1. LCME Accreditation Survey Visit will take place Jan. 23-26, 2022. Mrs. Givens asked that all Block Directors please be available during those dates.

The TEPC Meeting ended at 4:48 p.m.

Revised: 2/6/2019 sbd

University of Arizona College of Medicine Course Change Request Form

Academic Year 2019/2020

This form is part of the “Policy Regarding Changes to Individual Courses in Years 1 and 2” and is due at the latest two months prior to the start of the block for each academic year. Block/Course directors must present their Block/Change Request Form to TCMS and TEPC. Please submit the form electronically to the Assistant Director, Preclinical Education for appropriate approval and routing. Please include planning calendars for past and present academic years when submitting this form.

Fall 2019 Deadline for Form Submission

Spring 2020 Deadline for Form Submission

Clinical Reasoning Course: • Fall Year 1 (Class of 2023)

May 31, 2019 • Fall Year 2 (Class of 2022)

May 31, 2019

Clinical Reasoning Course • Spring Year 1 (Class of 2023) November 1,

2019

Foundations: May 31, 2019 Life Cycle: June 14, 2019 MSS: July 2, 2019 Immunity and Infection: July 26, 2019 Nervous System: August 16, 2019 Advanced Topics: September 27, 2019 CPR: November 1, 2019 Pathways in Health & Medicine: November 1,

2019 (Spring) DMH: February 1, 2019 Pathways in Health & Medicine: May 31, 2019 (Fall – Class of 2023 & Fall – Class of 2022)

Course: __DMH_________________________ Course Director: ____Dale Woolridge____ Date Submitted: ___1-31-20___________________ ☐ I do not anticipate any major changes to my course. (Please check here and do not complete remainder of form)


1. Please describe any anticipated personnel changes in your course (i.e. lecturers leaving or starting, lecture eliminated, lecturer change only, CRC facilitator leaving or starting, change in key faculty etc.). LECTURERS ELIMINATED FROM DMH:

• Dr. Richard Amini: PHM sessions assigned to new lecturers (two events) • Dr. Amerongen’s histology lectures paired to labs removed and replaced with

flipped content (six events) • Dr. Gordon’s doctor/patient sessions canceled by lecturer (two events)

LECTURER CHANGES: • Alcohol session increased to two hours and delivered by Dr. Palmer as a return to

2018 content • Dr. Pendergrass returning to deliver diabetes content. (two events) • Dr. Klotz returning to deliver two GI lectures. (two events) • Clinical correlate sections added to Team Learning 1,3,4,6 notes. • Team learning GAP format adjusted for group discussion with added questions • Dr. Hasne replacing Dr. Tischler for 9 content lectures (nine events) • PHM sessions split from one day to content on two separate days • Dr. Keith Primeau delivering Dr. Amini’s Clinical Decision Rules lecture • Dr. Deborah Hughes Hallett delivering Dr. Amini’s Systematic Reviews lecture • Dr. Bhattacharyya replacing Dr. Jain for two pathology lectures (two events)

2. Please describe any content changes to the course (i.e. lectures added or deleted, changes in learning objectives to the block, CRC cases (new, modified, or deleted), Team-Based Learning, Lab, or small group activity changes, modifications, or deletions). LECTURES DELETED: NONE

CONTENT ADDED:

• Team Learning 5 – Collagen. Prior Foundation block team learning moved to DMH • Path Lab: Dr. Fuchs/Proytcheva, Anemia, three hour lab; flipped session; content

derived from past foundations material • Clinical Correlations (Flipped) – Endocrine: Thyroid/Parathyroid (Adamas-

Rappaport) SESSION FORMAT CHANGE:

• Nutritional Disorders and Lab Values changed to a flipped format


3. Please describe any structural changes to the course (i.e. any changes to the overall allocation of time dedicated to the various teaching strategies in the course). Please provide a justification for these changes. In 2019 there were six team learning sessions. In 2020 there will be seven sessions. As noted above the collagen team learning had been deleted from Foundations. Hence DMH has picked it up.

4. Please describe changes to the course’s method of student performance assessment (i.e. additional examinations or fewer examinations). Please provide the number, frequency, weighting, and format of each exam for approval. Exam questions will be derived from flipped materials for each histology lab sessions. This content is consistent with past materials that were giving during standard lectures prior to being changed to flipped content. Each flipped lab will follow the same question/lecture ratio resulting in 4-6 questions derived from the associated material LO’s. Exam questions will be derived from Team Learning sessions (one question per team learning). This differs where no exam questions were derived from team learning sessions in prior years

5. Any other anticipated changes or comments regarding your course? NONE

For administrative use only: Disposition of request: ☐Approved by Kevin Moynahan, MD, Deputy Dean, Education Date:_____________________________ AND/OR ☐Approved by Sean Elliott, MD, Interim Associate Dean Curricular Affairs, Date:_____________________________ ☐Sonia de Leon notified ☐Forward to TEPC ☐Forward to Lynda Lehtinen (Tagging) ☐Forward to Raquel Givens (LCME) ☐Forward to Karen Spear-Ellinwood (FID) ☐Forward to Athena Ganchorre (Curriculum) ☐Forward to Ah Ra Cho (Evaluation & Assessment) ☐Forward to JD Thomas (Evaluation & Assessment) ☐Forward to Assistant Director, Clerkship Education (TCCS)

WEEK 1: 2020 Digestion, Metabolism & Hormones; CRC; DP; PHM

Total = 24.5h/student; LECT= 7.5h, LAB=6h, CRC=2h, PHM=4h; LGRP= 1h, DP=4h [lecture=31%]

Mar. 30 31 Apr 1 2 3

FACULTY: Bhattacharyya, Czuzak, Lebensohn, Lynch, Wilson, Woolridge; ANATOMY, HISTO Faculty - labs

SocietiesSocieties

DMH: Self-Assessment #1–Within Mid-Term Session

in Med LearnDelayed Released 4/3/20

9:30-10:20 Intro to DMH

Woolridge 3117

10:30-11:50 Abdominal Wall & Inguinal RegionLonger timeWilson 3117

8:00-8:50 Neural & Endo Regulation of GI Function Lynch 3117

9:00-9:50 Salivary / Gastric SecretionLynch 3117

11:00-11:50 Oral and Salivary Gland DiseaseWoolridge 3117

Assignment 11/4/19Notes DUE 2/3/2020

10:00-10:50 Gastric Mucosal Barrier & Peptic Ulcer Lynch 3117

10:15-12:00 Esophageal and Gastric Disorders

Bhattacharyya 3117

8:00-10:50 LAB: Abdominal Wall & Inguinal Region(ANATOMY)

Radiograph LIST

Czuzak, AnatomyFaculty3105

8-10 Clinical ReasoningDMH #1

Preparation time for FLIPPED Oral Cavity

Histology LAB

Preparation time for FLIPPED Esophagus &

Stomach Histology LAB

HISTO LAB: Oral Cavity FLIPPEDHisto Faculty

3113: TL Grps 1 – 10 from 8:00 -9:30

3114: TL Grps 11-20 from 9:30 -11:00

HISTO LAB: Esophagus & Stomach FLIPPEDHisto Faculty3114: TL Grps 11-20 from 1:00-2:30

3113: TL Grps1 – 10 from 2:30 -4:00

Preparation time for FLIPPED Intestines

Histology LAB

PHM: Healthy Nutrition (Intro)Lebensohn| 3117

PHM: Healthy NutritionLebensohn

Assigned supermarkets activity

PHM: Healthy NutritionLebensohn | 3113-3116

Student preparation time

PHM: Healthy NutritionLebensohn | 3117

Student presentations

1/31/2020

WEEK 2: 2020 Digestion, Metabolism & Hormones; CRC; DP; Spiral

Total = 26.5h/student; LECT= 8.5h, LAB=8h, TL= 1h, DP=4h, LGRP=3h, CRC=2h; [lecture= 32%]

Apr. 6 7 8 9 10

FACULTY: Czuzak, Lynch, Tischler, Vanderah, Wilson, Woolridge; ANATOMY, HISTO, PATH Faculty - labs

Societies Societies

DMH: Self-Assessment #2 –Within Mid-Term Session in

Med LearnDelayed Released 4/10/201:00-4:00 LAB: Abdominal

Structural Features-I(ANATOMY)

Radiograph List

Czuzak, Anatomy Faculty 3105

10:00-11:50 Structural Features of the Abdomen-II

Wilson 3117

10:30-11:50 Secretion of the Intestines / Ions-Water Absorption Lynch 3117

9:00-10:20 Motility and Gastric Reflux DiseaseVideosLynch 3117

8:00-9:50 PATH LAB: Esophageal & Gastric Disorders

Bhattacharyya; Path Faculty3113/3114

8:30 -10:30Medical Spiral CurriculumImmune and Inflammation

Lybarger/Bracamonte COM 3117

10:30-12:00 GI Development / Structural Features of the Abdomen-IVideosWilson 3117

8-10 Clinical ReasoningDMH #2

10:15-11:05Splanchnic CirculationLynch 3117

11:10-12:00 Pancreatic and Biliary SecretionsLynch 3117

HISTO LAB: Intestines FLIPPEDHisto Faculty

3114: TL Grps11-20 from 1:00-2:30

3113: TL Grps1 – 10 from 2:30 -4:00

HISTO LAB: Liver, Gall Bladder, Pancreas FLIPPEDHisto Faculty3113: TL Grps 1 – 10 from 9:00 -10:30

3114: TL Grps 11-20 from 10:30 -12:00

Preparation time for FLIPPED Liver, Pancreas & Gall bladder Histology Lab

TL 1 Acid Reflux MT/ DW

3113: TL Grps1 – 10 from 1:00 -2:30

3114: TL Grps11-20 from 2:30 -4:00

1/31/2020


Total = 27.5h/student, [29h curric time] LECT= 11h, Lab= 3h; TL= 1.5h, Review= 3h; LGRP= 3h, CRC=2h; DP=4h[ lect=40%]

Apr. 13 14 15 16 17

FACULTY: Bhattacharyya, Czuzak, Hasne, Klotz, Pendergrass, Tischler, Woolridge, ANATOMY faculty - lab

Societies Societies

DMH: Self-Assessment #3 –Within Mid-Term Session in

Med LearnDelayed Released 4/16/20

10:15-12:00Gross Lab Practical Review(ANATOMY)Practical Exam List

Czuzak 3105

8:00-8:50 Radiology of the ANATOMY Review (Slic-O)Czuzak 3117

1:00-4:00 LAB: Structural Features of Abdomen II and Posterior Abdominal Wall Gross Anatomy LAB (ANATOMY)

Radiograph List

Czuzak, Anatomy Faculty 3105

9:00-10:20 Insulin Action

Tischler 311710:00-12:00 Medical Spiral Curriculum

Neuro PathVanderah/Rance

COM 3117

TL 2: Lipid Digestion and Absorption

Tischler/Woolridge

3113: TL Grps 1 – 10 from 1:00-2:30

3114: TL Grps 11-20from 2:30 -4:00

8:30-9:50Digestion/Absorption: Carbohydrates, Lipids & Proteins Hasne 3117

10:30-11:30 Blood Glucose HomeostasisWoolridge 3117

9:00-9:50 Metabolic Changes in TraumaWoolridge 3117

8:00-8:50 Endo Pancreas Hormone Biosyn-thesis & Neoplasms Hasne 3117 8-10 Clinical Reasoning

DMH #3

10:00-10:50 Gastroenteritis and PeritonitisKlotz 3117

11:00-11:50 Liver & Hepato Viral& Bacterial InfectionsKlotz 3117

8:00-8:50 Disorders of the Exocrine PancreasBhattacharyya 3117

9:00-9:50 Disorders Gall Bladder & Extra Hepatic Bile Ducts Bhattacharyya 3117

10:00-10:50 Diagnosis & Mana of Diabetes in Adults Pendergrass 3117

11:00-11:50 Medical Treat of Hyperglycemia in Adults Pendergrass 3117Review Type 2 drugs

1/31/2020

WEEK 4: 2020 Digestion, Metabolism & Hormones; DP

TOTAL = 20.5h/student; LECT= 7h, TL=1.5h, EX=1 h; Study/review=4h; LGRP= 1h, DP=4h, CRC=2h; [lec=34%]

Apr. 20 21 22 23 24

FACULTY: Hasne, Rappaport, Tischler, Woolridge, ANATOMY faculty – lab practical

Societies Societies

Study Time

MIDTERM REVIEWHasne, Lynch (?), Tischler,

Wilson (?), Woolridge

DMH: Self-Assessment #4 –Within Mid-Term Session

in Med LearnDelayed Released 4/22/20

TL 3: Heme MetabolismTischler/Woolridge

3114: TL Grps 11-20 from 1:00-2:30

3113: TL Grps 1 – 10 from 2:30-4:00

8-10 Clinical Reasoning DMH #4

10:15-11:45 Clinical Correlations (Flipped) Inflam/GI, etc. Videos Rappaport 3117

10:30-11:50 Glycogen Storage Diseases

Tischler 3117

10:00-11:50 Alcohol Palmer 3117add metab/phsio from foundation 2018; relate to endogenous lipid transport

9:00-10:20 Liver & Adipose Carbohydrate Regulation

Hasne 3117

8:00-9:50Cholesterol Processing and Lipid Transport Hasne 3117

1 to 1:45 PMPractical ExamGroup 1 / ROOM 3117

1:45 to 2:30 PMPractical ExamGroup 2 / ROOM 3117

2:30 to 3:15PMPractical ExamGroup 3 / ROOM 3117

3:15 to 4:30 X1.5Practical ExamDRC / ROOM 3117

3:15 to 5 PMX2Practical ExamDRC / ROOM 3117

1/31/2020

WEEK 5: 2020 Digestion, Metabolism & Hormones; CRC; DP; PHM

Total = 23.5h/student; 24.5/25.5h-DRC; LECT=7.5h, LAB= 2h, TL=1.5h; EX=2.5h [3.5/4.5 DRC], PHM=4h; DP=4h; CRC=2h; [lecture=32%]

Apr. 27 28 29 30 May 1

Societies Societies

2:00-3:00 Liver Tumors

Bhattacharyya 3117

8:00-11:09-MID-TERM Exam DRC 1.5x3h 9 min

9:00-11:06MID-TermExam2h 6 min[attach SA questions

1:00-1:50 Alcohol & Chemical Toxicity - LiverBhattacharyya 3117

8:30-9:50 Intestinal Polyps and Neoplasia

Bhattacharyya 3117

FACULTY: Bhattacharyya, Hasne, Tischler, Woolridge; PATH faculty - lab

Midterm Exam content: thru 4/24 up to 84 questions: max time needsClass: 2h 6 min;DRC 1.5x: 3 h 9 min; DRC 2x: 4 h 12 min

10:00-11:50 Intestinal Cancers PATH LabBhattacharyya; Path Faculty 3113/3114

DMH: Self-Assessment #5–Within Final Session in

MedLearnDelayed Released 5/1/20

10:00-11:50 Intestinal & Pancreatic Disorders PATH LabBhattacharyya; Path Faculty 3113/3114

8:30-9:50Intestinal Disorders and IBS

Bhattacharyya 3117

TL 4: Fuel MetabolismTischler/Woolridge

3114: TL Grps 11-20 from 8:00-9:30

3113: TL Grps 1 – 10 from 9:30 to 11:00

10:15-11:45 Disorders of Lipid Digestion and Transport

Tischler 311711:00-12:00 Lysosomal Storage DiseaseHasne 3117


8:00-12:12 MID-TERM Exam DRC 2x4h 12 min

1/31/2020

WEEK 6: 2020 Digestion, Metabolism & Hormones; LC; CRC; DP; Spiral; PHM

Total = 27h/student; LECT=7.5h, Lab = 4h, TL=1.5h; DP=4h; PHM=4h; LG=4h CRC=2h; [lecture=28%]

May 4 5 6 7 8

FACULTY: Hasne, Lynch, Racy, Tischler, Woolridge; PATH Faculty - Lab

11:00-11:40 AntioxidantsHasne 3117

10:15-10:45 Physiology of Feeding BehaviorLynch 3117

10:45-12:00 Satiety and Hunger Peptide & Hormone Signals Tischler 3117

11:00-11:50 Inherited Disorder of Am. Acid MetabWoolridge 3117

10:00-10:50 Protein Metab; Disorders of Ammonia ProWoolridge 3117

9:00-9:50 Psychology of Eating and Eating DisordersRacy 3117

Societies Societies

10:00-12:00 Medical Spiral Curriculum

CPR (Bloom)

COM 3117

9:00-10:50 PATH LAB: Liver Tumors Path Faculty

3113/311410:00-12:00 Subjects with Clinical Eating Problems (Patient)Professional DressRacy | 3117


MedLearnDelayed Released 5/8/20

Transitions

TL 5: Collagen (Was FND)

Tischler/Woolridge

3114: TL Grps 11-20 from 1:00-2:30

3113: TL Grps1 – 10 from 2:30 to 4:00

3:00-4:30 Nucleotides, Folic Acids, Diseases, and Meds (Was FDN)

Hasne 3117


PHM: Clinical Decision Rules & Practice Guidelines

Primeau| 3117Coordinator: Jennifer Yelich

PHM: Food insecurities, food deserts Panel + Patient

Presentations Cagno | 3117

Coordinator: Jennifer Yelich

8:00-9:50 PATH LAB: Alcoholic Hepatitis/Liver Cirrhosis Path Faculty 3113/3114

Preparation time for FLIPPED Endocrine I

Histology LAB

Preparation time for FLIPPED Endocrine II

Histology LAB

PHM: Systematic ReviewsHughes Hallett | 3117

Coordinator: Jennifer Yelich

1/31/2020


Total = 24 h; LECT= 11h, LAB= 1.5h, Flip=2h;TL= 1.5 h, LGRP=2h; CRC=2h, DP=4h [lecture=45%]

May 11 12 13 14 15

FACULTY: Hasne, Klein, Lybarger, Rance, Tischler, Woolridge; HISTO faculty - lab

Societies Societies

HISTO LAB: Endo Glands FLIPPED

3113: TL Grps1 – 10 from 1:00 -2:30

3114: TL Grps11-20 from 2:30 -4:00

9:00-10:20 Introduction to Hormones

Hasne 3117

10:30-11:50 G-Protein Function and Adrenergic Receptors

Tischler 3117

9:00-9:50 Vitamin A

Tischler 3117

10:00-10:50 Posterior Pituitary, Hypothalamic Hormones Tischler 3117

11:00-11:50 Anterior Pituitary Gland PATHRance 3117

DMH: Self-Assessment #7– Within Final Session

in MedLearnDelayed Released

8:00-9:20 Growth Hormone and IGF-ITischler 3117


Neuro PharmacologyVanderah

3117

TL 6: AnemiaMT/DW

3114: TL Grps11-20 from 1:00-2:30

3113: TL Grps1 – 10 from 2:30 to 4:00

9:30-10:50 Calcium and Phosphate Homeostasis/Vitamin DHasne 3117


11:00-11:50 Calcium and Phosphate-Related Disorders Klein 3117

10:15-11:15 Thyroid Hormone: Biochem and Physiology Tischler 3117

8:00-9:50

Nutritional Disorders and Lab ValuesTischler/Hasne 3117

FLIPPED

1:00-3:00 PATH Lab:Anemia

Path Faculty 3113/3114

1/31/2020

WEEK 8: 2019 Digestion, Metabolism & Hormones; DP; Spiral

Total DMH+LC+CRC = 23.5h/student; LECT= 8.5h, Lab = 4h, TL= 2h; CRC=2h; LGRP= 2h, DP=5h [lecture=36%]

May 18 19 20 21 22

DMH FACULTY: Jones, Klein, Tischler, Woolridge, PATH Faculty - lab

Societies Societies

Adrenal Cortex Hormones

Tischler 3117

10:00-12:00 PATH Lab:Thyroid and Parathyroid



MedLearnDelayed Released

1:00-2:20 Thyroid Diseases

Klein 3117

2:30-3:20 Diseases of the Adrenal & Renin Angiotensin System (RAS) Klein 3117

1:00-3:00 PATH Lab:Adrenal/Pituitary


10:30-11:30 Pharmacology of GlucocorticoidsJones 3117

9:00-10:15 Pharmacotherapy of Thyroid/Antithyroid Drugs

Jones 3117

8:30-9:45 Sex Steroids

Tischler 3117


Cardio Path

RushCOM 3117

Clerkship Shelf Exams

TL 7: Steroid Hormone Related Disease

NO GAPTischler/Woolridge

3114: TL Grps 11-20 from 8:00-10:00

3113: TL Grps 1 – 10 from 10:00 -12:00


Renin-Angiotensin- ANP

Tischler 3117

10:15-11:45 Clinical Correlations (Flipped) Endocrine, etc. Videos Rappaport 3117

1/31/2020

WEEK 9: 2020 Digestion, Metabolism & Hormones;

May 25 26 27 28 29

DMH FACULTY: Tischler, Woolridge

Study Time

Advise students who need to be offered retake exam

on Monday, June 1, 2020

Memorial Day

TL’s Practical Midterm Final Exam

MK 7% MK 6% MK 40% MK 47%

9:00-10:30ReviewTischler/Woolridge 3117

8:00-11:45-FINAL-TERM Exam DRC 1.5x3h 45 min

9:00-11:30FINAL-Term Exam2h 30 min[attach SA questions

8:00-1:00 FINAL-TERM Exam DRC 2x5H min

Final Exam content: thru 5/21 up to 100 questions: max time needsClass: 2h 30 min;DRC 1.5x: 3h 45 min; DRC 2x: 5h

1/31/2020

AY 2019-2020

SYLLABUS MED 806 – Digestion, Metabolism, Hormones

Description of Course

The DMH block offers an integrated presentation of topics that focus on digestion and absorption of food (specifically the protein, lipid and carbohydrate components of food), nutritional aspects of macronutrients and micronutrients, fuel metabolism and storage, and the role of hormones in controlling physiological and biochemical functions in humans. We consider physiological and pathological aspects of intestine liver, pancreas, and gall bladder relative to the digestive process, as well as the normal digestion of proteins, carbohydrates and lipids, the endocrine function important in this process, the control of key secretions, general aspects of blood glucose homeostasis and alcohol metabolism. We cover metabolic processes, from a disease standpoint, and their regulation primarily in liver and adipose tissue. We also include presentations on a wide of variety of nutritional issues including both normal and pathophysiological. The abnormal will delve into consequences of nutritional deficiencies, anemias, inherited nitrogen disorders, eating disorders and obesity/diabetes. Finally, the latter part of the block focuses on the various hormones comprising the endocrine system [except insulin and glucagon covered earlier]. Discussions will consider the biochemistry and physiology of these hormones, mechanisms of action and disorders related to excessive or deficient amounts of the hormones. Gross anatomy, histology and pathology labs are held at various places in the block.

Instructor and Contact Information Course Director: Dale Woolridge, MD, PhD / Emergency Medicine [email protected]

Block Coordinator: Sonya Martyna-Seaman / Curricular Affairs [email protected]

Faculty Name Email Department

Adamas-Rappaport, William

[email protected] Surgery

Amerongen, Helen [email protected] Cellular And Molecular Medicine

Bhattacharyya, Achyut [email protected] Pathology

Bracamonte, Erika [email protected] Pathology

Czuzak, Maria [email protected] Cellular And Molecular Medicine

Hasne, Marie-Pierre [email protected] Chemistry And Biochemistry

Jones, William [email protected] Pharmacology

Klein, Robert [email protected] Pathology

Klotz, Stephen [email protected] Medicine

mailto:[email protected]


2 | P a g e

Lynch, Ronald [email protected] Physiology

Pendergrass, Merri [email protected] Medicine

Racy, John [email protected] Psychiatry

Rance, Naomi [email protected] Pathology

Tischler, Marc [email protected] Chemistry And Biochemistry

Wilson, Jean [email protected] Cellular And Molecular Medicine

Woolridge, Dale [email protected] Emergency Medicine

Course Learning Objectives

During this course students will:

1. Integrate the anatomy, histology, physiology, biochemistry, pathology and pharmacology of: oral cavity, salivary glands, esophagus, stomach, intestine, pancreas, liver and gall bladder. 2. Integrate histology, biochemistry, physiology, pathology and pharmacology as they relate to the endocrine system including the GI endocrine. 3. Describe the metabolic pathways in liver and adipose tissue that are important in fuel storage and mobilization and discuss the regulation of these systems. 4. Discuss inborn errors of metabolism associated with the intestine, liver, and muscle glycogen metabolism. 5. Describe the normal nutritional requirements and use this information to discuss the role of nutrition in metabolism and to evaluate the consequences of nutritional deficiencies.

Faculty provide session objectives specific to the sessions and appear on MedLearn and in the notes for each session. Those specific session objectives form the basis for examination questions. Expected Learning Outcomes

Upon completion of the block the Medical Students will be able to: 1. Students will be able to describe and identify structural, inflammatory and infectious disease

processes of the gastrointestinal tract. 2. Students will be able to describe autocrine, paracrine and endocrine processes in digestion and

fuel metabolism. 3. Students will understand the basic functions of the digestive tract and participating organs. 4. Students will understand how signaling occurs throughout the digestive tract for glandular

secretion, digestion and gastrointestinal transit through peristalsis. 5. Students will learn endocrine function and signaling through the hypothalamic-pituitary-adrenal

axis. 6. Students will learn abnormalities of metabolism through inherent and acquired defects in key

enzymatic process or vitamin deficiencies.

Students will learn under a number of different modalities including team based learning, interactive

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lectures, and case based learning. In addition, students will learn in both the gross laboratory as well as in virtual histology and pathology labs. Finally, students will be exposed to multiple board style questions during the course for self-assessment and content retention delivered each Friday afternoon throughout the block.

For students to learn about Digestion, Metabolism, and Hormones, they will need to know the material well enough to achieve 70% or better on exams and feel comfortable as they matriculate towards clinical rotations. Learning this material will take 8 hours a day for 9 weeks. See https://oia.arizona.edu/

Course Organization and Structure Provide a brief overview of the block structure and key components.

The block is structured in a way that begins with understanding the normal structure and function of each component of the digestive tract including endocrine, paracrine and autocrine regulation for modes of regulation and digestion. As normal physiology is realized, concepts of dysfunction are instilled through the review of pathologic conditions as the result of inflammation, infection and neoplastic change. Topics on metabolic homeostasis and its hormonal regulation is inserted through the block curriculum for the thorough understanding of physiologic energy maintenance, and its alterations resulting in anabolic and catabolic changes as a result of pathologic conditions, metabolic defects and acquired vitamin deficiencies. The later segments of the block build upon this knowledge base and review normal endocrine functioning of the hypothalamic-pituitary-adrenal axis as well as dysfunction and the pathologic effects when regulation becomes disrupted.

Attendance and Absence Policy

This policy establishes guidelines and procedures for attendance and absences in the Preclerkship Phase for mandatory classroom. Participation in learning activities is critical for students to develop into effective physicians. It is important for students to act in a professional manner and demonstrate a commitment to professional responsibilities. See Attendance and Absence Policy.

*Note the policy on Professionalism: 10% will be deducted from your overall Professionalism score for each unexcused absence and/or for repeated tardiness.

https://oia.arizona.edu/

https://medicine.arizona.edu/students/student-policies-forms

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Required Texts or Readings

REQUIRED TEXTBOOKS

ANATOMY Moore KL, Agur AMR, Dalley AF. Moore, Essential Clinical Anatomy. 5E. Wolters Kluwer Health, 2015. AHSL Info Desk: QS 39 M822e 2015

BIOCHEMISTRY Janson L, Tischler M. Medical Biochemistry: The Big Picture. 1E. McGraw-Hill, 2012. AHSL-E-Book; AHSL Info Desk: QU34 J35b 2012

PATHOLOGY Kumar V, Abul KA, Aster JC. Robbins and Cotran Pathologic Basis of Disease. 9E. Elsevier/ Saunders, 2015. AHSL Info Desk: QZ 140 R632 2015 (9E) AHSL E-Book, 9E, ClinicalKey

HISTOLOGY

Ross, MH, Pawlina W. Histology: A Text and Atlas : with Correlated Cell and Molecular Biology. 7E. Lippincott Williams & Wilkins, 2016. AHSL-Info Desk: QS 517 R825h 2016

EMBRYOLOGY

Sadler TW, Langman J. Langman's Medical Embryology. 14E. Wolters Kluwer Health/Lippincott, Williams & Wilkins, 2019. AHSL Info Desk: QS 604 S126L 2019

ENDOCRINOLOGY Gardner DG, Shoback DM, Greenspan FS. Greenspan's Basic & Clinical Endocrinology. 10E. A Lange medical book. McGraw-Hill, 2018. AHSL E-Book, AHSL – Info Desk WK 102 G815 2011.

PHARMACOLOGY

Katzung BG, Masters S, Trevor A. Basic & Clinical Pharmacology. 13E. McGraw-Hill, 2015. AHSL E-Book, 12E, MyiLibrary AHSL E-Book, 12E, AccessMedicine AHSL E-Book, 13E, AccessMedicine

RECOMMENDED TEXTBOOKS

ANATOMY

Tank PW. Grant's Dissector. 16E. Lippincott, Williams & Wilkins, 2016. (Older editions provided for use in Gross Anatomy Lab.) AHSL Info Desk: QS 130 T165G 2013

MICROBIOLOGY

Ryan KJ, Ray CG. Sherris Medical Microbiology. 6E. McGraw-Hill. 2018. AHSL Info Desk: WC 100 S5531 2014 (7E) AHSL-E-Book, 6E, AccessMedicine

** These textbooks will be required in another block.

* REQ = You are not required to purchase these books, but REQUIRED readings are assigned from these resources. + REC = Readings are RECOMMENDED or supplemental from these books. Information is subject to change due to curricular revisions and updates to the AHSL collection and licensing. See Arizona Health Sciences Library for e-book access.

http://aprendo.library.arizona.edu/record=b7087285%7ES9

http://sabio.library.arizona.edu/record=b6702385%7ES1


https://www-clinicalkey-com.ezproxy3.library.arizona.edu/#!/browse/book/3-s2.0-C20110055734





https://accessmedicine-mhmedical-com.ezproxy4.library.arizona.edu/book.aspx?bookid=2178

http://sabio.library.arizona.edu/search%7ES9?/Xgreenspan%27s+basic+%26+clinical+endocrinology&searchscope=9&SORT=DZ/Xgreenspan%27s+basic%26clinical+endocrinology&searchscope=9&SORT=DZ&extended=1&SUBKEY=greenspan%27s+basic%26clinical+endocrinology/1%2C4%2C4%2CE/frameset&FF=Xgreenspan%27s+basic+%26+clinical+endocrinology&searchscope=9&SORT=DZ&1%2C1%2C

http://sabio.library.arizona.edu/search%7ES9?/Xgreenspan%27s+basic+%26+clinical+endocrinology&searchscope=9&SORT=DZ/Xgreenspan%27s+basic%26clinical+endocrinology&searchscope=9&SORT=DZ&extended=1&SUBKEY=greenspan%27s+basic%26clinical+endocrinology/1%2C4%2C4%2CE/frameset&FF=Xgreenspan%27s+basic+%26+clinical+endocrinology&searchscope=9&SORT=DZ&1%2C1%2C







http://ahsl.arizona.edu/

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Required or Special Materials MedLearn ONLINE: MedLearn Online is your main source for information about assignments, activities, resources, etc. We will use it as our main means to provide content as well as administrative information about the block. Schedules have changed while a block is running. Be sure to check MedLearn regularly!

LABORATORY RESOURCES: Note that access to all laboratories is restricted and will require your Cat Card.

Pathology Labs: Pathology laboratories will take place in the Multidiscipline Labs (MDLs). The MDLs (rooms 3113 & 3114 for MS1) are equipped for virtual microscopy.

Aperio Hosted Virtual Slides: The virtual microscope slides Pathology labs are available at the following link: http://www.slidehosting.com/Login.php (username: COM-Tucson; password: @ccess2slides) You may view these slides from any location and on any computer platform using a web browser.

ADDITIONAL RESOURCES:

Gross Anatomy Labs: All cadaver study will be conducted in the Gross Anatomy Laboratory (Room 3105) including the gross brain labs. Many of these sessions will also have radio imaging. To make the most of your learning experience in the Gross Lab, please review notes for each of the sessions in order to identify structures and to test each other.

Assessment Grading Scale and Policies

How student work will be evaluated. Specify the grade distribution for the course. Provide a detailed explanation of the methods of evaluation and how the final grade will be calculated, including components/assignments, weightings, evaluation criteria, explanation of how late work will be graded, and description of extra-credit opportunities. See Grading and Progression Policies. Present this information in the sample table:

Assessment Categories MK PC PRO PLI IPS SBP TL Peer Assessment 30% Attendance and participation in class activities

60%

Cadaver Dissection and Care

10%

Practical Exam 6% Team Learnings 7%

http://www.slidehosting.com/Login.php



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(7 IRAT & 7 GRAT) Mid-term exams 40% Final exam 47% Total 100% 100%

TL Peer Assessment: 30% of Professionalism score. Student feedback is critical to the evaluation of the program and is a major requirement for accreditation. It has been affirmed that, for the purposes of program evaluation for the college, students are required to complete evaluation surveys in Years 1 and 2. Professional Behavior: 60% of Professionalism score. These Attributes of Professional Behavior describe behaviors that medical students are expected to develop during the course of their education, both in the classroom and in the community in which the educational mission operates. See Attributes of Professional Behavior (COM)

Note the policy on Professionalism: 10% will be deducted from your overall Professionalism score for each unexcused absence and/or for repeated tardiness.

Cadaver Dissection and Care in anatomy lab: 10%of Professionalism score. At the end of the block, we will assess the thoroughness of your cadaver dissections, the condition of your cadaver and table in the gross anatomy lab and the timely skinning of your assigned regions. Formative feedback for this assessment will be ongoing from faculty in the laboratory.

Team Learning: total of 7% of MK score. Individual Readiness Assessment Tests, Group Readiness Assessment Tests, and Peer evaluations. Group Application Problems are not graded. Mid-Term Exam: 40% of MK score. Multiple-choice exam delivered via ExamSoft. Covers all of the topics in the first 3 weeks of the block; does not include a practical (laboratory) exam. Final Exam: 47% of MK score. Multiple-choice exam delivered via ExamSoft. Emphasizes material after the Midterm, but some questions also integrate material from before the Midterm.

Practical Exam: 6 % of MK score. A cumulative exam given at the end of the block that covers the structures listed in the syllabus notes for all of the anatomy labs in the block. Cadaver-based identification of structures in the anatomy lab.

Course Evaluations Due Date Mid-Block Student Feedback on Instructors 4/27/2020 End of Block Student Feedback on Instructors 5/29/2020 End of Block Student Feedback 5/29/2020 Team – Learning Peer Survey 5/29/2020

DMH Instructors List for AY 19-20

MID-Block Instructors END of Block Instructors Lynch Amerongen

Pendergrass Bhattacharyya Wilson Hasne

Jones Klein Tischler

https://medicine.arizona.edu/sites/default/files/attributes_professional_behavior.pdf

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Block Director Survey Woolridge

Assignment and Examination Dates

Examinations (See above for session descriptions) Date Medical Spiral Self-Assessment Review Sessions (5) 4/6/2020

4/13/2020 5/4/2020 5/11/2020 5/18/2020

Team Learnings (7) 4/6/2020 4/15/2020 4/22/2020 4/30/2020 5/6/2020 5/11/2020 5/21/2020

Practical Exam 4/20/2020 Mid-Term Exam 4/27/2020 Final Exam 5/28/2020

Classroom Behavior

To foster a positive learning environment, students and instructors have a shared responsibility. We want a safe, welcoming, and inclusive environment where all of us feel comfortable with each other and where we can challenge ourselves to succeed. To that end, our focus is on the tasks at hand and not on extraneous activities (e.g., texting, chatting, reading a newspaper, making phone calls, web surfing, etc.).

University and COM-T Policies See University of Arizona Policies See COM-T Student Policies Subject to Change Statement

Information contained in the course syllabus, other than the grade and absence policy, may be subject to change with advance notice, as deemed appropriate by the instructor.

https://academicaffairs.arizona.edu/syllabus-policies


STUDENT APPEALS COMMITTEE PROCEDURES University of Arizona College of Medicine – Tucson (COM-T)

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TEPC Approved: September 13, 2019; October 16, 2019; Add tepc approval date

Table of Contents Section One: Functions of the Student Appeals Committee ................................................................ 1

Section Two: Procedures Regarding Review of Academic Dismissal Appeals ................................... 1

Section Three: Procedures Regarding Review of Conduct Dismissal Appeals ................................... 3

All time limits referenced in these procedures are calculated using business days. Section One: Functions of the Student Appeals Committee

1) The Student Appeals Committee (SAC) will review Academic Dismissal and Conduct Dismissal decisions issued by the Deputy Dean, Education when the student requests an appeal as defined and outlined in the Student Progress Committee Procedures and Process for Dismissal or the Honor Code Committee Procedures and Process for Dismissal.

2) All SAC decisions require a majority of a quorum of the eligible voting membership. Quorum for the SAC is defined as two-thirds of the eligible membership.

3) The SAC may extend the timeframes outlined in these procedures for good cause and

with notice to the student and the Deputy Dean of Education.

4) The SAC does not have the authority to grant an exception to College of Medicine policies or an extension of time to comply with policy.

Section Two: Procedures Regarding Review of Academic Dismissal Appeals

1) If the student chooses to appeal an Academic Dismissal, the student must submit a written statement to the Chair of the SAC outlining the student’s position on why the student should not be dismissed.

2) The appeal must be submitted within five business days of the Notice of Dismissal from the Deputy Dean of Education.

3) The student is responsible for providing the Student Appeals Committee with any supporting documents that the student believes support the appeal, including the student’s transcript, correspondence with faculty and administrators, and communications from the SPC. This information must be submitted with the written


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appeal statement.

4) The student’s written statement must identify one or both of the following grounds as the basis for the appeal:

a) College of Medicine policies do not require or support the Academic Dismissal.

b) The Academic Dismissal process was not substantially consistent with University or College of Medicine policies and procedures and the process should be repeated or reversed to correct the specific error(s).

5) If the SAC Chair determines that the student’s written appeal fails to identify one or both of the above grounds as a basis for the appeal, the Chair will reject the appeal and inform the student of the deficiency. The student will have one opportunity to resubmit the appeal within five business days of the notice of deficiency from the Chair.

5)6) Once the appeal is accepted, the Chair will notify the Associate Dean, Curricular Affairs and provide a copy of the appeal packet. The Associate Dean, Curricular Affairs will have 5 business days to provide a written response to the SAC addressing the student’s grounds for appeal. The student will receive a copy of the Associate Dean’s response but is not be permitted to submit a response.

6)7) Within 10 business days of receipt of the student’s written appeal statement and supporting documentation, the SAC will meet, review the student’s appeal packet, and discuss the student’s appeal.

7)8) SAC meetings are closed to everyone except members of the Committee, Committee support staff, and counsel to the Committee.

8)9) If the SAC believes additional information is required before a decision is made, the Committee may seek that information from the student or the College administration. The information must be directly relevant to the stated grounds for the appeal. Any information obtained directly from the College and considered in the appeal decision must be shared with the student. The student will have two business days to respond to any additional information.

9)10) Within 10 business days of meeting to review the appeal, the SAC will inform the student of its decision. The decision must outline the basis for the SAC’s decision to grant or deny the appeal. If the appeal is granted, the student will be directed to the Student Progress Committee to determine a plan for successful academic progress.

10)11) The decision will be copied to the Deputy Dean of Education, the Associate Dean of Curricular Affairs, the Senior Associate Dean of Student Affairs, and the Chair of the SPC.

Commented [SDL1]: #6 added/revised by Elizabeth Miller on 12.18.2019. Needs to go to Taskforce and TEPC for approval. SBD

Formatted: Font: (Default) +Body (Calibri), 12 pt


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11)12) The decision of the SAC is final and is not subject to further review. If the dismissal is upheld, the dismissal will be effective on the date of the decision letter.

Section Three: Procedures Regarding Review of Conduct Dismissal Appeals

1) If the student chooses to appeal a Conduct Dismissal, the student must submit a written statement to the SAC Chair outlining the student’s position on why the student should not be dismissed.

2) The appeal must be submitted within five business days of the Notice of Dismissal from the Deputy Dean of Education.

3) The student’s written statement must identify one or more of the following grounds as the basis for the appeal:

a) The hearing was not conducted in a manner substantially consistent with the procedures set forth in the Student Progress Committee Procedures and Dismissal Process or the Honor Code Committee Procedures and Dismissal Process and resulted in an unfair process.

b) The finding that the student violated University or College of Medicine policies or standards is not supported by a preponderance of the evidence or is contrary to law or policy.

c) The student’s conduct does not constitute a violation of University or College of Medicine policies or standards.

d) The student was not given procedural or substantive due process.

e) The dismissal is excessively severe under the circumstances.

4) If the SAC Chair determines that the student’s written appeal fails to identify one or more of the above grounds as a basis for the appeal, the Chair will reject the appeal and inform the student of the deficiency. The student will have one opportunity to resubmit the appeal within five business days of the notice of deficiency from the Chair.

5) If the SAC Chair determines the appeal states the required grounds for appeal, the SAC Chair will inform the Student Progress Committee Chair (SPC) or the Honor Code Committee (HCC) Chair of the appeal.

6) Within five business days of the notice from the SAC Chair, the SPC or HCC Chair must provide the SAC with a copy of all supporting documentation considered during the hearing, a copy of the recommendation to the Deputy Dean of Education, and the audio recording of the hearing.


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7) Within 10 business days of receipt of supporting documentation, the SAC will meet, review the documentation, and discuss the student’s appeal.

8) SAC meetings are closed to everyone except members of the Committee, Committee support staff, and counsel to the Committee.

9) Within 10 business days of meeting to review the appeal, the SAC will inform the student of its decision. The decision must outline the basis for the SAC’s decision to grant or deny the appeal.

10) The decision will be copied to the Deputy Dean of Education, the Associate Dean of Curricular Affairs, the Senior Associate Dean of Student Affairs, and the Chair of the SPC.

11) The decision of the SAC is final and is not subject to further internal review. If the dismissal is upheld, the dismissal will be effective on the date of the decision letter.

The University of Arizona College of Medicine – Tucson Continuous Quality Improvement Policy

Purpose and Summary Accreditation Element 01.01 Strategic Planning and Continuous Quality Improvement requires that a medical school engage in ongoing planning and continuous quality improvement processes that establish short and long-term programmatic goals, result in the achievement of measurable outcomes that are used to improve programmatic quality, and ensure effective monitoring of the medical education program’s compliance with accreditation standards. Implementing this policy at the College of Medicine-Tucson will enable compliance with this Element. “Research by the LCME Secretariat identified factors associated with a severe accreditation action … and concluded that review by a medical school of its performance in at least some of the accreditation elements between full surveys could mitigate this risk. This led to the decision by the LCME to introduce the requirement that such monitoring occur through a school-developed and implemented process … [with the] expectation for monitoring performance in accreditation elements [that] was added… to a previously existing standard (now element) related to strategic planning.

Scope The policy applies to administrators, faculty, students and staff who are involved in the oversight and management of the medical education program leading to the MD degree. This includes the dean’s office, faculty affairs, research affairs, clinical affairs, student affairs, admissions, and curricular affairs.

Definitions Chronicity: Standards/elements that were cited as “not in compliance” or “compliance with monitoring” during previous accreditation visits.

New Elements: Elements new to the standards or elements in which Liaison Committee on Medical Education (LCME) expectations have evolved (as communicated through Association of American Medical Colleges (AAMC) meetings, the LCME website or other communication from the LCME Secretariat).

Operational Elements: Elements that include policies that must be congruent with current operations.

Elements Prone to Slippage: Elements that include language that monitoring is required or involve a regular-occurring process that may be “prone to slippage”

Policy #: Type in Policy Number. Policy Name: Continuous Quality Improvement System for setting goals, improving programmatic quality, ensuring compliance

Category: Grading & Progression Policy Status: Proposed COM-T Phase: Choose Phase.

Choose Phase. Choose Phase.

Effective Date: 10/2/2019

Responsible Unit: Curricular Affairs Revision Dates: N/A Relevant LCME Standard(s):

1.1 Strategic Planning and Continuous Quality Improvement

Page 1 of 4

Drafted 9/4/2019; Updated 2/27/2020 C:\Users\jschulz25\Desktop\Continuous Quality Improvement-CQI Policy-COM-Tucson-PROPOSED.docx

Priority Areas: Other areas of improvement brought forth from the program evaluation process, and items brought forward to the Tucson Education Policy Committee as areas of concern from faculty or students, including results of institutional or national surveys such as internal questionnaires, student feedback surveys and the AAMC Graduation Questionnaire.

Policy The Director for Accreditation is charged to monitor compliance of the medical education program with the Liaison Committee on Medical Education (LCME) accreditation standards and elements. In an ongoing effort to improve the M.D. program and the learning environment, the Accreditation Director, in collaboration with the Associate Dean for Curricular Affairs and the Tucson Education Policy Committee (TEPC), will facilitate the development of both long- and short-term goals. The Accreditation Office will be responsible for implementing a systematic process to collect and review data, and disseminate outcomes to appropriate leadership and administration, including, but not limited to, the TEPC, the Admissions Committee, the Dean’s Executive Committee, various assistant/associate deans, and department heads. The Accreditation Director will also collaborate with leadership and administration to identify action plans to achieve goals, as evidenced by measurable outcomes.

Procedures The Director, Accreditation is responsible for managing the process, as well as receiving and analyzing relevant data. Standing committees and senior administrators within the college contribute to the monitoring effort, and additional associated personnel provide coordination and support the process.

The Deputy Dean for Education ensures that appropriate resources are allocated for these activities, including personnel, information technology systems and infrastructure for the collecting and reporting of data.

Areas for monitoring and/or improvement are identified from the following categories:

1. Chronicity: Elements that have been cited as “not in compliance” or “compliance with monitoring” during previous accreditation visits.

2. New elements: Elements in which Liaison Committee on Medical Education (LCME) expectations have evolved (as communicated through Association of American Medical Colleges meetings, the LCME website or other communication from the secretariats).

3. Operational Elements: Elements that are affected by review or changes to COM-T policies. 4. Elements Prone to Slippage: Elements that explicitly require regular monitoring or relate to regularly

occurring processes. 5. Priority Areas: Other components brought forth as a result of the program evaluation process, and

items brought forward to the TEPC as areas of concern from the faculty or students, including results of institutional or national surveys such as internal questionnaires, student feedback surveys and the AAMC Graduation Questionnaire.

Monitoring of specific elements and data is accomplished with a work plan that indicates the details being monitored, appropriate time intervals and the group responsible. The work plan is presented annually to the TEPC. In addition, relevant areas of CQI projects are presented per the project plan.

Cross References [Include cross references to other policies]


Additional Information Adapted from the University of Arizona College of Medicine-Phoenix. (2018, October 9). “Continuous Quality

Improvement Policy.” Retrieved from http://phoenixmed.arizona.edu/policy/continuous-quality-improvement-policy

Implementing a System for Monitoring Performance in LCME Accreditation Standards [Approved by the LCME® on October 19, 2016]. Retrieved from http://lcme.org/publications/

Barzansky, B., Hunt, D., Moineau, G., Ahn, D., Lai, C., Humphrey, H., & Peterson, L. (2015). Continuous quality improvement in an accreditation system for undergraduate medical education: Benefits and challenges. Medical Teacher, 37(11), 1032-1038.

http://phoenixmed.arizona.edu/policy/continuous-quality-improvement-policy

http://phoenixmed.arizona.edu/policy/continuous-quality-improvement-policy

http://lcme.org/publications/


Additional Notes [This section will NOT be a part of the actual policy and removed when the policy is published. Additional comments, considerations, suggestions, and edits should be provided here if “track changes” and/or “comment box” is not used]

Policy Writing Tip Sheet and Template

General Tips:

• Keep it simple – the policy should be intelligible to a diverse audience (use short sentences, avoid jargon, use common words, avoid prepositions)

• Keep it general – a policy cannot account for all possible situations • Keep it helpful – a policy should tell the reader why it exists • Define key terms as needed • Should be written in the third person • Use the active voice (e.g., “The department proposed new regulations” not “Regulations

have been propose by the department”) • Check for redundancy – make sure the policy you are creating isn’t already addressed

with existing policies or in conflict with existing policies • Differentiate between policies and procedures - administrative procedures should not be

part of a policy. Procedures are the processes or steps followed in order to implement a policy

Language:

• The word “shall” means compliance, also consider the word “must” to indicate compliance or “must not” to indicate a prohibition

• The word “should” or “may” imply choice or a recommendation, means that one can choose to follow a policy but does not have to

Multi-Level List Format: Policy # and Name (Main level)

A. Level 1

1. Level 2

a. Level 3

(1) Level 4

Draft: 2/27/2020 Located: https://medicine.arizona.edu/education/curricular-affairs/educational-policy-committee/policies-forms https://medicine.arizona.edu/faculty-staff/policies

Performance Assessment and Evaluation Policies

Table of Contents TEPC Plan for the Assessment of Student Performance ................................................................ 1 Assessment of Student Performance in a Clerkship ....................................................................... 4 Program Evaluation Plan for The Pre-Clerkship Phase ................................................................... 4 TEPC Procedure for the Regular Review of the Pre-Clerkship Phase Content ............................... 7 TEPC Procedure for the Regular Review of the Clerkship Phase Content (PROPOSED) ................ 8

EPC Plan for the Assessment of Student Performance ....................................................................... 2 Assessment of Student Performance in a Clerkship ........................................................................... 4 TEPC Procedure for the Regular Review of Years I and II Content ..................................................... 4 Program Evaluation Plan for Years 1 and 2 ......................................................................................... 5

TEPC Plan for the Assessment of Student Performance Guidelines and Procedures

(2/20/13 EPC meeting Passed by electronic poll of members) Draft 2/27/2020

Purpose: This plan outlines the system of assessment at the University of Arizona College of Medicine - Tucson. Here, the system of assessment is defined as the grading policies and procedures passed by the Educational Program Committee (EPC), Tucson Educational Program Committee (TEPC) or Phoenix Educational Program Committee (PEPC). Relevant Standards: ED-26. A medical education program must have a system in place for the assessment of medical student achievement throughout the program that employs a variety of measures of knowledge, skills, behaviors, and attitudes. Relevant Standard: 9.4 Assessment System. A medical school ensures that, throughout its medical education program, there is a centralized system in place that employs a variety of measures (including direct observation) for the assessment of student achievement, including students’ acquisition of the

Tuesday, March 01, 2016

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knowledge, core clinical skills (e.g., medical history-taking, physical examination), behaviors, and attitudes specified in medical education program objectives, and that ensures that all medical students achieve the same medical education program objectives. Assessments of medical student performance should measure the retention of factual knowledge; the development of the skills, behaviors, and attitudes needed in subsequent medical training and practice; and the ability to use data appropriately for solving problems commonly encountered in medical practice. The system of assessment, including the format and frequency of examinations, should support the goals, objectives, processes, and expected outcomes of the curriculum. ED-29. The faculty of each discipline should set standards of achievement in that discipline and contribute to the setting of such standards in interdisciplinary and interprofessional learning experiences, as appropriate. 9.6 Setting Standards of Achievement. A medical school ensures that faculty members with appropriate knowledge and expertise set standards of achievement in each required learning experience in the medical education program. 8.1 Curricular Management. A medical school has in place an institutional body (i.e., a faculty committee) that oversees the medical education program as a whole and has responsibility for the overall design, management, integration, evaluation, and enhancement of a coherent and coordinated medical curriculum. 8.2 Use of Medical Educational Program Objectives. The faculty of a medical school, through the faculty committee responsible for the medical curriculum, ensure that the medical curriculum uses formally adopted medical education program objectives to guide the selection of curriculum content, and to review and revise the curriculum. The faculty leadership responsible for each required course and clerkship link the learning objectives of that course or clerkship to the medical education program objectives. 8.4 Evaluation of Educational Program Outcomes. A medical school collects and uses a variety of outcome data, including national norms of accomplishment, to demonstrate the extent to which medical students are achieving medical education program objectives and to enhance the quality of the medical education program as a whole. These data are collected during program enrollment and after program completion. I. Philosophy of Assessment at UA COM-T When the medical curriculum was restructured in 2006, assessment of student performance also was changed fundamentally. Four basic principles guided the changeour in assessment of student performance at the University of Arizona College of Medicine - Tucson.

1. Assessment of student performance will be structured as a system that will be coordinated across courses and across years. In other words, assessment will follow a planned continuum from the first day of medical school to graduation the last.

2. Assessment will be anchored to the educational program objectives and competencies. Student performance throughout the 4 four years must be linked to achievement in the six competencies. This creates continuity for students from the first day of their education to the last day.

3. Best practices of assessment will be followed including evaluation by multiple observers on multiple occasions. These best practices are important not only for the medical knowledge competency, but also for the other competencies for which achievement is best measured using observational strategies.

Commented [ARC1]: Used Raquel’s crosswalk to update to the NEW LCME standard. (ED-26 to 9.4)


Commented [ARC3]: Added 8.1 because I thought it looked relevant (see #1 in the Philosophy of Assessment at UA-COM-T below)

Commented [ARC4]: Added 8.2 because I thought it looked relevant (see #2 in the Philosophy of Assessment at UA COM-T below)

Commented [ARC5]: Added 8.4 because I thought it looked relevant (see #3 & 4 in the Philosophy of Assessment at UA COM-T below)


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4. Where appropriate, assessment will be carried out through self- and peer assessments as well as assessment by faculty. Peer and self-assessment will provide students opportunities to practice critical self-reflection and develop skills for self-regulation. II. General guidelines for system of assessment For a given track, each course will follow a basic approach to assessment of student performance that will be common to all courses of a similar type (e.g., Year 1 and 2Pre-Clerkship blocks/courses, clerkships, electives). Each course may also add course-specific assessment items and strategies. The common guidelines for assessment are:

1. Grading throughout the four-year curriculum is based on successful performance in each of the competencies.

2. Assessment systems may be individualized to account for local resource and program differences. However, assessment methods and grading standards must be identical for required courses and clerkships in Years 3 and 4the Clerkship Phase and Transition to Residency Phase, and adhere to the TEPC Grading Policy. Assessment forms and surveys are designed to measure behaviors and/or benchmarks directly related to the educational program competencies.

3. Some competencies are more appropriately assessed via observational methods and therefore surveys of observed behaviors may be used as performance assessment tools in courses (e.g., CBI –Clinical Reasoning Course (CRC) facilitator & peer surveys in blocks, faculty assessment surveys of student performance in clerkships).

4. Faculty and students will be trained in the use of assessment surveys. 5. In addition to summative assessment, each block or clerkship will incorporate some method of formative

assessment into their curriculum (excluding “Transition to Clerkships,” “Intersessions,” and elective courses).

6. Narrative feedback will be provided when the structure of the curriculum allows. 7. Assessment systems and their applications will be formally reviewed and, if necessary, revised on a

periodic basis by appropriate faculty committees. 8. The assessment systems will include guidelines for setting the frequency of examinations within each block

and course. 9. Final exams occur in the last week of each clerkship, as determined by the clerkship director.

III. System of assessment for Years 1 and 2 (track-specific)

1. The Tucson system of assessment can be found at: http://medicine.arizona.edu/form/tucson-assessment-plan http://medicine.arizona.edu/form/grading-and-progression-policies-years-1-4-com (section I.F.)

2. The Phoenix system of assessment can be found at: http://epc.medicine.arizona.edu/pcontent/phoenix-competencies-assessment#PhxRemediation IV. Program-wide system of assessment 1. Program-wide grading and progression policies can be found at: http://medicine.arizona.edu/form/grading-and-progression-policies-years-1-4-com V. How grading policies are determined

1. Grading policies that apply to the College of Medicine (including both Tucson and Phoenix tracks) are approved by the Tucson Educational Policy Committee (TEPC).

Commented [ARC6]: Removed, no longer relevant.


4

1. As one College of Medicine, general grading policies must be consistent and fair across tracks. Hence, the general policies for grading are approved by the EPC.

2. Required clinical rotations in Year 3the Clerkship Phase are constituted as a single course so grading policies for clerkships in Tucson and Phoenix must- be identical at all sites and approved by the TEPC.

3. Electives must follow the Electives Grading Policy established by the TEPC.

2. Grading policies that are specific to a track are approved by that track’s Education Policy Committee (i.e., Tucson Education Policy Committee, Phoenix Education Policy Committee)

3.2. Revisions to grading policies may be proposed by governance and oversight subcommittees, (e.g., Tucson Curriculum Management Subcommittee (TCMS), Tucson Clinical Curriculum Subcommittee (TCCS), Phoenix Clinical Curriculum Subcommittee), as well as administrators in divisions such as the Office of Medical Student EducationCurricular Affairs. Block directors and students may also propose changes. Any such proposal will be considered by the subcommittee with oversight responsibilities for the course(s) involved, and then submitted to EPC, TEPC or PEPC for approval.

Assessment of Student Performance in a Clerkship NEED TO FIND HISTORICAL OR CREATE/REVISE TO 2020

(Passed October 28, 2009) Draft 2/27/2020

The Years 3 and 4 curriculum is programwide, meaning that the same clerkship blocks are offered at both the Phoenix and Tucson campuses. Because students may enroll in clerkship experiences at either campus, standards for student performance evaluation in clerkships must also be equivalent at both campuses. The Assessment Form for Student Performance in a Clerkship is designed as a core assessment form for all clerkships. However, each clerkship may append additional assessment items, it if desired.

Program Evaluation Plan for Years 1 and 2The Pre-Clerkship Phase (Approved by the TEPC, April 7, 2010)

(REVISED December 5, 2012 and June 5, 2013) Draft

Relevant Accreditation Standard ED-35. 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. 8.3 Curricular Design, Review, Revision/Content Monitoring. The faculty of a medical school, through the faculty committee responsible for the medical curriculum, are responsible for the detailed development, design, and implementation of all components of the medical education program, including the medical education program objectives, the learning objectives for each required curricular segment, instructional and assessment methods appropriate for the achievement of those objectives, content and content sequencing, ongoing review and updating of content, and evaluation of course, clerkship, and teacher quality. These medical education program objectives, learning objectives, content, and instructional and assessment methods are subject to ongoing monitoring, review, and revision by the responsible committee.

Commented [ARC7]: Removed, no longer relevant

Commented [ARC8]: Removed because no longer relevant.



5

Rationale: To meet the requirement of the Educational Policy Committee that each track of the M.D. program ArizonaMed curriculum implement an annual evaluation process, the Tucson Educational Policy Committee (TEPC) establishes the following standards and guidelines for the annual evaluation of blocks. The policies and procedures below direct pilot evaluation processes and establish reporting expectations for subcommittees and other entities that may contribute to the reports. TEPC expects to modify these policies and procedures as needed, based on its experience with pilot reports. Overview of Program Evaluation Plan The program evaluation plan for Years 1 and 2the Pre-Clerkship Phase consists of three levels of reports. The definitions are as follows.

1. Annual Report – A brief report that gives an overview of each block or course every year. Submitted by each block/course director to the Tucson Curriculum Management Subcommittee (TCMS).

2. Level 1 Report – A biennial review of each individual block or course. Composed by faculty other than the block/course director and submitted to the Tucson Educational Policy Committee (TEPC).

3. Level 2 Report on Years 1 and 2the Pre-Clerkship Phase – A triennial review of the segment of the curriculum composed of Years 1 and 2. Composed by the Tucson Evaluation Subcommittee (TEVS) and submitted to TEPC. Years 1 and 2Pre-Clerkship Phase Program Evaluation Policies and Procedures

A. Annual Reports 1. The Office of Medical Student Education (OMSE)Curricular Affairs shall provide each block/course director

with the relevant Annual Report Form and accompanying evaluation data each academic year. 2. The director shall fill out the form, comment on the data and then submit the report to TCMS by the stated

deadline. 3. The director will present a brief overview of their report at the next available TCMS meeting.

B. Level 1 Reports Every required block or course in the Tucson Track of Years 1 and 2 of the curriculumPre-Clerkship Phase will be evaluated. These evaluations will:

a. be conducted by faculty and experts with knowledge of the goals and implementation of Years I & IIthe Pre-Clerkship Phase.

b. inform the TEPC regarding the quality of daily instruction and the adherence of daily delivery to curricular design and plan.

c. inform the TEPC regarding overall block content and the expression of that content across the block d. inform the TEPC regarding student performance outcomes e. inform the TEPC of any new issues affecting oversight since the previous evaluations. f. inform the TEPC on progress related to directives for change arising from the previous evaluations. g. be completed and delivered to the TEPC no later than four weeks following the closure of feedback surveys

for the block.

C. Level 1 Reporting Guidelines


6

Level 1 Reviews of blocks and courses will address the following issues: a. overall quality b. perceived strengths c. perceived weaknesses d. compliance with curricular policies (scheduling templates, instructional templates) and analysis of content D. Process for Level 1 Reviews 1. Evaluation data or reports of data will be generated by the Office of Instructional TechnologyInformational

Technology Services (COM-ITS) and the Office of Medical Student Education –Curricular Affairs for the specific block or course under review.

2. For Level 1 review of courses other than blocks, all evaluation data are delivered to TEVS and course director. TEVS is responsible for the review of courses and delivers those reports directly to TEPC. Because of its multi-year format, Societies is reviewed on a triennial basis. The TEVS will compile submit the Societies Review Report to the TEPC.

3. For Level 1 Block Reviews all evaluation data and reports of data are delivered to the TCMS, TEVS and director of the block under review.

4. Additional processes of Level 1 Block Reviews a) The TCMS, as the group directly involved with the design and delivery of blocks and courses, will also

include a specific review of content provided in the block. Possible issues related to content to be addressed are:

i. evaluating whether the content was up-to-date ii. how well and in what ways the content of the block was integrated, including core and thread topics iii. the relationship of block content to that in other blocks iii. iv. the quality of teaching methods and average instructional quality iv. v. student achievement of goals of the block

b) The TEVS will include in its report comments and recommendations on: i. the integration of content within the block, including disciplines. ii. the design and effectiveness of small-group teaching modalities to integrate content, provide exploration

of new content, promote problem-solving, encourage independent learning. iii. the design and quality of methods for assessment of student performance. iv. specific evaluation of exams and their appropriateness for measuring higher-order thinking and

understanding of links between multiple disciplines. c) TEPC will compile a Biennial Block Evaluation Report for each block based on the

findings and recommendations from two TEPC subcommittees, the Tucson Curriculum Management Subcommittee (TCMS) and the Tucson Evaluation Subcommittee (TEVS). The rational for this two-subcommittee approach is that the TCMS provides the internal viewpoint of instructional faculty, while the TEVS provides an external viewpoint for the same block.

d) The approved Level 1 Block Report with recommendations will be delivered to the respective block director by the TEPC Chair, or the Chair’s designee.

i. Along with the final report, the block director will receive a letter of instructions with respect to TEPC’s expectations for implementation, or reporting timetable on a response to the recommendations.

ii. The letter will also include an invitation to attend a future meeting of the TEPC where, as desired, the final report may be discussed, and at which time the block director may make known to the committee any other issues affecting block performance.

E. Level 2 Report on Years 1 and 2 the Pre-Clerkship Phase An evaluation of the Years 1 and 2Pre-Clerkship phase curriculum as a segment of the curriculum is conducted by the Tucson Evaluation Subcommittee (TEVS). This report is produced on a triennial schedule and is a synthesis of the program evaluation data produced in the preceding years.


7

The Level 2 Report on Years 1 and 2 is submitted to the TEPC for review, and includes recommendations for change as required.

TEPC Procedure for the Regular Review of the Pre-Clerkship Phase Content

(Approved by the TEPC – July 18, 2012) (Revised and approved – December 5, 2012)

Draft 2/27/2020 Rationale: The LCME Accreditation Standard, ED-37, requires that, “A faculty committee of a medical education program must be responsible for monitoring the curriculum, including the content taught in each discipline…” Related Standard: 8.3 Curricular Design, Review, Revision/Content Monitoring. The faculty of a medical school, through the faculty committee responsible for the medical curriculum, are responsible for the detailed development, design, and implementation of all components of the medical education program, including the medical education program objectives, the learning objectives for each required curricular segment, instructional and assessment methods appropriate for the achievement of those objectives, content and content sequencing, ongoing review and updating of content, and evaluation of course, clerkship, and teacher quality. These medical education program objectives, learning objectives, content, and instructional and assessment methods are subject to ongoing monitoring, review, and revision by the responsible committee. For this reason, and as medical knowledge is constantly advancing, it is important that regular evaluation of the content covered in the ArizonaMed four-year M.D. curriculum be conducted. Processes: TCMS Content Surveys The Tucson Curriculum Management Subcommittee (TCMS) shall conduct regular reviews of content within blocks and across Years I and IIthe Pre-Clerkship Phase, following these guidelines. 1. At a minimum of every 3 years, the TCMS and the Office of Medical Student Education (OMSE)Curricular Affairs will compare all content offered in Years 1 and 2the Pre-Clerkship Phase against a nationally-recognized summary of medical school content (e.g., USMLE Step 1 Subjects Outline, or derivative of that outline). 2. Using the findings of the audit, the TCMS will produce a list of topics worthy of more thorough investigation for issues of coverage, integration and increasing sophistication of student learning across Years I and IIthe Pre-Clerkship Phase. 3. Using topics from the list and at a minimum of one topic per year, the TCMS, supported by OMSEThe Office of Curricular Affairs, will conduct a detailed analysis of how that content may be better distributed within and among Tuesday, March 01, 2016 5 blocks (for example, the comprehensive review of immunology content conducted by TCMS in 2011).. 4. The TCMS will produce and deliver to TEPC a report of the review findings for each topic addressed and the plan to improve its coverage. 5. In its annual report to the TEPC, the TCMS will provide progress reports on the implementation of all plans adopted. T3 Longitudinal Curriculum Directors Content Surveys The longitudinal curriculum of the Pre-Clerkship Phase is comprised of the following three-semester long courses: Doctor and Patient (D&P), Clinical Reasoning (CRC), and Pathways in Health and Medicine (PHM).


Commented [ARC11]: I assume the T3 directors are now the “Longitudinal Curriculum Directors” – Doctor & Patient, Clinical Reasoning, and Pathways in Health and Medicine. Please confirm.


8

Each of these courses are taken in sequence. Each longitudinal curricular course has a Director and an Associate Director for each. At a minimum of every 4 years, the T3 longitudinal curriculum directors shall engage in reviews of T3 longitudinal curriculum content following these guidelines: 1. OMSE The Office of Curricular Affairs will produce an audit of all T3 longitudinal curriculum content across Years 1 and 2the Pre-Clerkship Phase. Using the results of that audit, the T3 longitudinal curriculum directors will identify topics of particular concern and convey them to the TCMS, identified by greatest importance. 2. The T3 longitudinal curriculum directors and the TCMS, with support by OMSEthe Office of Curricular Affairs, will conduct a detailed analysis of how one or more of the high-priority topics may be better integrated across Years 1 and 2 the Pre-Clerkship Phase. 3. The TCMS will produce and deliver to TEPC a report of the review findings and the plan to improve coverage. 4. In its annual report to the TEPC, the TCMS will provide progress reports on the implementation of all T3 longitudinal curriculum plans adopted.

TEPC Procedure for the Regular Review of the Clerkship Phase Content (PROPOSED)

NEED TO FIND HISTORICAL OR CREATE/REVISE TO 2020

Commented [ARC12]: Proposed as it does not currently exist?

Formatted: Normal, Left

The Plan for Student Performance

Assessment in Years 1 and 2the Pre-Clerkship Phase: Tucson Located: https://medicine.arizona.edu/education/curricular-affairs/educational-policy-committee/policies-forms https://medicine.arizona.edu/faculty-staff/policies https://medicine.arizona.edu/education/policies

TEPC Policy and Procedures

(Approved by TEPC 1/16/2013) Modified and approved 4/03/2013, Modified 03/01/2016) Draft: 2/27/2020

Relevant Standard: ED-26. A medical education program must have a system in place for the assessment of medical student achievement throughout the program that employs a variety of measures of knowledge, skills, behaviors, and attitudes. 9.4 Assessment System. A medical school ensures that, throughout its medical education program, there is a centralized system in place that employs a variety of measures (including direct observation) for the assessment of student achievement, including students’ acquisition of the knowledge, core clinical skills (e.g., medical history-taking, physical examination), behaviors, and attitudes specified in medical education program objectives, and that ensures that all medical students achieve the same medical education program objectives. Assessments of medical student performance should measure the retention of factual knowledge; the development of the skills, behaviors, and attitudes needed in subsequent medical training and practice; and the ability to use data appropriately for solving problems commonly encountered in medical practice. The system of assessment, including the format and frequency of examinations, should support the goals, objectives, processes, and expected outcomes of the curriculum. ED-29. The faculty of each discipline should set standards of achievement in that discipline and contribute to the setting of such standards in interdisciplinary and interprofessional learning experiences, as appropriate. 9.6 Setting Standards of Achievement - A medical school ensures that faculty members with appropriate knowledge and expertise set standards of achievement in each required learning experience in the medical education program. I. Rationale and Philosophy

All general guidelines and standards contained in “The Program-Wide Grading and Progression Policy,” established by the EPC for Years 1 and 2Pre-Clerkship Phase will be met in this plan. TEPC grading policies for Years 1 and 2the Pre-Clerkship Phase can be found at: http://medicine.arizona.edu/form/grading-and-progression-policies-years-1-4com https://medicine.arizona.edu/sites/default/files/2018-0524_grading_and_progression_policy_nbme_tepc_apprvd_feb_12_2018.pdf . This plan supports fulfillment of the accreditation standard ED-26 9.4 (see below).

Commented [ARC1]: Removing language about Tucson and Phoenix (if applicable).

Commented [ARC2]: Double check on this, as this was on the original document.


Commented [ARC4]: Not sure if this is a part of the old standard or not?


Commented [ARC6]: Non-existent link. Changed to the new link.

II. Assessing Competencies in Years 1 and 2the Pre-Clerkship Phase a. Every block must maintain written objectives for the block as well as objectives for every instructional

session that support the educational program objectives for the curriculum. All examination items must be linkable to those objectives.

b. For blocks in Years 1 and 2the Pre-Clerkship Phase, the patient care (PC) and the systems based practice and population health (SBP) competencies are not assessed as separate competencies. Both PC and SBP are addressed under the medical knowledge (MK) competency. The rationale for this decision is as follows:

i. The PC competency typically addresses student knowledge of the nature of diagnostic tests and the basic and clinical sciences that underlie critical thinking and generating hypotheses for disease symptoms. Tuesday, March 01, 2016

ii. Similarly, the SBP competency in Years 1 and 2the Pre-Clerkship Phase covers knowledge of health care delivery, public health, etc.

iii. In addition, students experience with PC and SBP in blocks during Years 1 and 2the Pre-Clerkship Phase are not derived from direct contact with patients but from classroom activities.

c. All competencies are assessed in the Societies Program/Doctor and Patient course. This includes assessment of PC as a separate competency, because students are performing history and physical exams with standardized patients and inpatientspatients at the bedside. III. Assessment Methods in Blocks:

a. The MK/PC competencies are assessed primarily through the use of multiple choice exams and quizzes. b. The other competencies [Interpersonal and Communication Skills (IPSICS), Practice-based Learning and

Improvement (PBLI), Professionalism (PRO)] are assessed through the use of surveys to assess observed behaviors.

i. Surveys will be completed by faculty facilitators and student peers for CBI in the Clinical Reasoning Course (CRC).

1. Faculty facilitators can provide formative feedback to students before the 1st survey. ii. Student peer performance surveys are completed for team-based learning (TL) at the end of block. iii. Blocks may add specific graded activities, but these must also be linked to the program competencies

and adhere to grading and progression policies. IV. Assessment Methods in Societies Program/Doctor and Patient Course

a. Mentors use rating forms to evaluate students on their bedside performance, oral presentations and written history and physical exams. Students also receive narrative feedback from their Societies mentors on their submitted history and physical exam write-ups.

b. An OSCE with standardized patients is used for summative assessment at the end of Years 2 and 3the Pre-Clerkship Phase and at the end of the Clerkship Phase (previously named as the “Year 2 OSCE” and “Year 3 OSCE”. Additionally, Portfolio Reviews are conducted at the end of each semester at which the mentor and student review individual performance. V. Administration and scheduling of exams

a. Exams in Years 1 and 2the Pre-Clerkship Block will be administered through the electronic exam system that has been developed internally for the Tucson trackthe COM-T uses.

b. Block directors meet with the co-directors of the Societies Program/Doctor and Patient Course and Curricular Affairs administration before each academic year to schedule exam dates. This removes potential conflicts between block exams and required Societies (e.g., Year 2End of Pre-Clerkship OSCE) activities when setting the calendar for each year.

c. Block directors decide the frequency of examinations for their blocks. However, this frequency is reviewed by the Tucson Curriculum Management Subcommittee (TCMS) and the Tucson Evaluation Subcommittee (TEVS) through annual block directors’ reports or as part of the biennial block review process. The Tucson Educational Policy Committee (TEPC) reviews this frequency in the block review report, and determines if the frequency and timing of examinations in each block is appropriate. Where changes are deemed necessary, those changes will be included in the TEPC recommendations back to the block director. VI. Reporting and recording grades:

Commented [ARC7]: CBI has changed to CRC

Commented [ARC8]: Not sure what this is…

Commented [ARC9]: Do we still do portfolio reviews? Not sure what this is…

2 Tuesday, March 01, 2016

a. The ArizonaMed Online-MedLearn Learning Management System gradebook is used to record grades in Years 1 and 2the Pre-Clerkship Phase. Reporting guidelines are:

i. Individual assignments are associated with the appropriate competency(ies) in the gradebook. ii. Individual assignments do not receive a grade of pass/fail etc. Each assignment is instead given a

numeric point value in the gradebook. iii. Individual assignments are summed and contribute to the composite score for each associated

competency. iv. The composite scores appear in the gradebook as pass/fail. The exception is the MK/PC competency,

which is reported as a numerical score. v. The other competencies are calculated as either Pass or Fail as detailed in the TEPC Grading and

Progression Policy. vi. Students do not see individual surveys (nor the scores as stated above). Instead, they can only view

comments from peers and faculty facilitators that are posted to their gradebook account. vii. Block/course grades will be posted in ArizonaMed MedLearn within 1 week (7 calendar days) after

completion of the block/course. 3

1

Clerkship Change Request Form

This form is part of the Policy Regarding Changes to Courses/Clerkships in the clerkship phase. It pertains to all seven of the clerkships as well as the Transition to Clerkships and Intersessions blocks and is due before a new class begins their Clerkship Phase. Please include all changes made since the last report and any anticipated changes for the Class of 2022. The completed form should be submitted electronically to:

• Sean Elliott, Assoc. Dean for Curricular Affairs, [email protected] • Emily Leyva, Assistant Director, Clinical Education, [email protected]

Deadline for Form Submission: Clerkship/Block: EMD-845 Clerkship Director/Block Director Completing Form: Hans Bradshaw Date Form Submitted: 2/24/20

After reading the below criteria, I do not anticipate any major changes to my clerkship/block for the Class of 2022. (Please check here and do not complete remainder of form.) ………………………………………………………………………………………………………………………………………………………………….



2

Please describe any structural changes to the clerkship (e.g., changes to allocation of time to the various teaching strategies such as didactics, labs, or simulation activities, etc.) Please provide a justification for these changes.

Please describe any anticipated personnel changes in your clerkship (e.g., change in clerkship director, clerkship coordinator, block director, key teaching departmental faculty, site directors).

Please describe any content changes to the clerkship and the associated rationale (i.e. changes to the didactic topics, changes to thread content, addition or deletion of required patient encounters or procedures, changes to the learning objectives, addition or deletions of specialty clinics, and/or addition or deletion of clerkship sites).

3

Please describe any changes in the clerkship’s method of student performance assessment (e.g., examinations, grading rubric, etc.). Please include the rationale for such changes.

The following changes must be made to the grading rubric. As it stands, 89% of students have completed the course with a grade of “Honors.” The remaining 11% of students have have completed the course with a grade of “HP.” Based off of data collected, we propose to change the grading rubric to the following: 0% < > 70% - Fail 70% < > 85% Pass 85% < > 90% High Pass >90% Honor This change will bring a grading ratio closer to: 50% Pass 25% HP 25% Honor

Any other anticipated changes or comments regarding your clerkship that was not covered above?

For Administrative use only: Disposition of request ☐ Forward to TEPC ☐ Approved by Associate Dean, Curricular Affairs: ___________________________________________ Date: ____________________ ☐ Signed form forwarded to Assistant Director, Clinical Education

1

Clerkship Change Request Form

This form is part of the Policy Regarding Changes to Courses/Clerkships in the clerkship phase. It pertains to all seven of the clerkships as well as the Transition to Clerkships and Intersessions blocks and is due before a new class begins their Clerkship Phase. Please include all changes made since the last report and any anticipated changes for the Class of 2022. The completed form should be submitted electronically to:

• Sean Elliott, Assoc. Dean for Curricular Affairs, [email protected] • Emily Leyva, Assistant Director, Clinical Education, [email protected]

Deadline for Form Submission: Clerkship/Block: EMD-840 Clerkship Director/Block Director Completing Form: Hans Bradshaw Date Form Submitted: 2/24/20

After reading the below criteria, I do not anticipate any major changes to my clerkship/block for the Class of 2022. (Please check here and do not complete remainder of form.) ………………………………………………………………………………………………………………………………………………………………….



2

Please describe any structural changes to the clerkship (e.g., changes to allocation of time to the various teaching strategies such as didactics, labs, or simulation activities, etc.) Please provide a justification for these changes.

Please describe any anticipated personnel changes in your clerkship (e.g., change in clerkship director, clerkship coordinator, block director, key teaching departmental faculty, site directors).

Please describe any content changes to the clerkship and the associated rationale (i.e. changes to the didactic topics, changes to thread content, addition or deletion of required patient encounters or procedures, changes to the learning objectives, addition or deletions of specialty clinics, and/or addition or deletion of clerkship sites).

3

Please describe any changes in the clerkship’s method of student performance assessment (e.g., examinations, grading rubric, etc.). Please include the rationale for such changes.

The following changes must be made to the grading rubric. As it stands, 89% of students have completed the course with a grade of “Honors.” The remaining 11% of students have have completed the course with a grade of “HP.” Based off of data collected, we propose to change the grading rubric to the following: 0% < > 70% - Fail 70% < > 90% Pass 90% < > 93% High Pass >93% Honor This change will bring a grading ratio closer to: 50% Pass 25% HP 25% Honor

Any other anticipated changes or comments regarding your clerkship that was not covered above?

For Administrative use only: Disposition of request ☐ Forward to TEPC ☐ Approved by Associate Dean, Curricular Affairs: ___________________________________________ Date: ____________________ ☐ Signed form forwarded to Assistant Director, Clinical Education

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30 25 100.00 100 Score Grade Total Students 57

1 UA Angela Wu 23 24.5 91.00 85.0% Honor 0% Fail Average clinical score 26

2 UA Morgan Battaglia 29 24.3 95.00 96.3% Honor 10% Fail Average NBME Score 81.02

2 U of Nevada Jonathan Thorpe 26 23.8 83.00 87.3% Honor 20% Fail Average Workboook Score 23.97

2 Touro Todd Belok 26 24.3 85.00 88.2% Honor 30% Fail Average total score 88.1%

2 UA Joshua Silva 26 23.3 80.00 86.5% Honor 40% Fail2 U of Nevada Patrick Mullett 25 23.3 85.00 86.3% Honor 50% Fail2 UA Robert Jamplis 25 23.3 80.00 85.1% Honor 60% Pass2 UA Bryan Stilson 27 24.3 83.00 89.8% Honor 75% HP Scored less than 88% 29 50.88%

2 UA Alexandra Barbosa 26 23.3 80.00 86.2% Honor 85% Honor Scored more than 88% 16 28.07%

2 UA Stephen Crabbe 27 24.5 88.00 91.0% Honor 90% Honor Scored more than 91% 12 21.05%

2 Indiana U Jonathan Coss 27 24 87.00 90.3% Honor 100% Honor2 UA Claire Lamneck 29 24.5 84.00 93.8% Honor3 UA Darrien Allen 28 24 90.00 93.1% Honor Students who honored 45 78.95%

3 UA Aron Munson 28 23 71.00 86.6% Honor Students who HP 12 21.05%

3 UA Azad Molla Hosseini 27 25 84.00 90.7% Honor3 UA Casey Charlton 25 22.8 69.00 82.0% HP3 UA Savannah Chavez 24 22.8 86.00 84.1% HP3 U of Washington Steven Coppess 29 23.5 86.00 93.8% Honor3 U of Washington Andrew Dahlke 28 23.5 91.00 93.0% Honor3 UA PHX Tyler Hoelscher 25 23.3 83.00 85.9% Honor3 UA Amir Rahimian 29 24.8 75.00 91.3% Honor3 Creighton U Kathryn Wellman 29 24.3 82.00 92.5% Honor4 UC Irvine Kyle Dornhofer 27 24.5 83.00 90.9% Honor

4 Oakland U Jessica Gamerl 24 24.3 80.00 84.7% HP4 UA Ricardo Reyes 26 22.8 64.00 81.6% HP4 A.T. Chris Koerber 26 23.8 80.00 87.1% Honor4 UC Davis Christy Meyer 25 25 84.00 88.3% Honor4 DMU Mitchel Oltmanns 25 24.5 69.00 82.9% HP4 RFU Sam Freedman 27 23.8 88.00 90.5% Honor4 U of NE Travis Kaiser Jones 27 24 88.00 90.3% Honor4 U of C Zara Khan 27 23.5 76.00 87.0% Honor5 UA Ivan Aispuro 27 23.5 84.00 89.1% Honor5 UA Efran Bernal 28 25 83.00 93.0% Honor5 UA Robert Martinez 25 23.5 80.00 85.0% Honor5 UA Jeremy Webb 27 25 88.00 92.0% Honor

5 UA Kheim Tran 24 23.3 79.00 82.6% HP5 EVMS Kerri Kraft 29 22.5 90.00 93.0% Honor5 Reno Nicholas Andrew 30 24.5 87.00 95.7% Honor5 UA Dawn Bowling 28 24.3 78.00 90.3% Honor6 Western Erin Asher 25 21.8 80.00 83.6% HP6 Touro Steware Da Silva 28 24.8 79.00 91.0% Honor6 Rowan U Linnea Russell 26 23.8 81.00 88.1% Honor6 Western U Matthew McDowell 27 24.8 73.00 87.8% Honor6 Kirksville Christopoher Elberts 26 24.8 93.00 91.2% Honor6 Western John Le 22 24.3 91.00 83.7% HP7 U of NE Hannah Hodges 24 24.3 71.00 81.3% HP7 Nova Stefano Correa 26 24.5 76.00 86.8% Honor7 Midwestern AZ Hannah Mitchell 26 25 80.00 88.9% Honor7 Midwestern AZ Aaron Pike 23 24 79.00 81.8% HP7 UA Parastou Sazegar 26 24 74.00 86.4% Honor8 UA Amisha Singh 27 24.3 80.00 89.6% Honor8 UA Abrahan Lara-Pacheco 27 24.5 69.00 86.1% Honor8 UA Paul Maler 26 24 65.00 84.1% HP8 UA Jessica Filon 26 24 72.00 85.3% Honor8 UA Lindsey Lepoidevin 27 24.3 81.00 90.1% Honor8 UA Giuliana Repetti 26 24.5 78.00 86.6% Honor8 UA Magnolia Swanson 25 23.8 77.00 84.9% HP

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30 #### 100 Honor Score Grade Total Students 18

1 UA PHX Shelby Hoebee 27 94.55 90.5% Honor 0% Fail Average clinical score 27

1 W Michigan Ray Young-Tsao 26 92.73 88.7% Honor 10% Fail Average SAEM Score 90.81

1 Mayo Kristyn McLeod 26 98.18 87.3% Honor 20% Fail Average total score 89.8%

2 rsity of Wisco Xavier Schwartz 29 94.55 95.6% Honor 30% Fail2 rsity of Wisco Emily Guy 29 90.91 95.8% Honor 40% Fail2 UA PHX Naomi Onaka 27 83.64 89.2% Honor 50% Fail3 UTSA Ina Prevalska 28 92.73 92.4% Honor 60% Pass3 Rowan U Matthew Fillingame 26 76.36 86.5% Honor 75% HP Scored less than 90% 9 50.00%

3 UA PHX Oluwatosin Ayotund 24 89.09 82.4% HP 85% Honor Scored more than 90% 5 27.78%

4 Western U Syna Daudfar 28 89.09 92.5% Honor 90% Honor Scored more than 93% 4 22.22%

4 UA Bryan Stilson 26 94.55 88.6% Honor 100% Honor4 SBU Shadd Cabalatungan 27 85.45 89.0% Honor Students who Honored 16 88.89%

5 Midwestern Joshua Fuchs 27 92.73 90.1% Honor Students who HP 2 11.11%

5 LSU Mitchell Guedry 27 90.91 90.1% Honor5 Virhinia TechRosemary Mallonee 25 81.82 81.7% HP6 UA Stephen Crabbe 27 96.36 89.5% Honor6 UA Azad Molla Hosseini 28 98.18 93.7% Honor6 UA Amir Rahimian 28 92.73 93.4% Honor

Improving Required Sessions Flipped Classrooms | CQI Project Summary Results

College of Medicine-Tucson Office of Accreditation February 6, 2020

Improving Flipped Classrooms

PAGE 2

Introduction TEPC - Continuous Quality Improvement Project The Tucson Education Policy Committee (TEPC) approved a continuous quality improvement (CQI) project in July 2019 aimed at improving the required interactive sessions (i.e. flipped classrooms) in the medical education program. Several block directors had ideas about improvements to implement in the AY 2019-2020 school year. This summary is based on the changes implemented in the Fall 2019 Foundations, Musculoskeletal System (MSS) and Nervous System Blocks. The summary outlines the method used to study the changes, the results of the findings, and recommendations.

Special thanks to the following educational leaders: Athena Ganchorre, PhD Kadian McIntosh, PhD Karen Spear-Ellinwood, PhD, JD, EdD Claudia Stanescu, PhD Todd Vanderah, PhD


PAGE 3

Overview of a Flipped Classroom Session

Format The general format of a flipped classroom/interactive session involves the following three main components:

1. The pre-session work 2. Assessment of the pre-session learning for readiness 3. Student engagement with the content at a higher cognitive order1 such as

application, evaluation, synthesis.

Figure 1. Overview of Flipped Classroom Session

Pre-session work The pre-session work provides the foundational knowledge of the concepts that will be used during the in-person session. Students study this material to develop a conceptual framework to prepare. The pre-session work includes the learning objectives and learning materials.

• The learning objectives are key to guiding the students’ review of the learning materials.

• The learning materials span all media types including the previous podcast recording of a lecture, a video, a chapter/article, a PowerPoint or a more interactive independent learning module.

1 Brame, C., (2013). Flipping the classroom. Vanderbilt University Center for Teaching. Retrieved [2/6/2020] from http://cft.vanderbilt.edu/guides-sub-pages/flipping-the-classroom/.

1. Pre-session Work

2. Readiness Assurance

Assessment

3. Engagement with content

(higher cognitive order)


PAGE 4

Readiness Assurance Assessment At the beginning of the in-person session, faculty administer a low-stakes assessment to gauge students’ readiness to engage in the content at a higher cognitive order. This is helpful feedback to both the instructor and the learner. Gauging readiness may span a myriad of assessment methods. The common methods used in the three blocks reviewed in this report were vignettes/multiple choice items and completion of tables. Students submitted their answers through audience response systems and the tried-and-true raising of hands. Based on the feedback, the instructor may review key concepts to address gaps in students’ understanding. Student Engagement with Content For in-person sessions, the goal is to spend time primarily focused on activities which allow students to engage with concepts at a higher cognitive order. Typically, students engage in case-based discussions in a faculty-led, large-group format. The exercises that faculty prepare involve application of key concepts, analysis, evaluation and synthesis of the information. The prepared cases are designed based on the learning objectives for the students.


PAGE 5

Improvement Changes Three blocks in Phase 1 of the curriculum engaged in implementing improvement changes in the required flipped classroom format. These blocks were: Foundations, Musculoskeletal System (MSS), Nervous System. The description of these changes employed in each block is outlined below.

Feature Foundations MSS Nervous System

Number of Sessions (taught using the format)

13 18 22

Disciplines Taught (using the format)

1. Histology 2. Clinical

Correlations

1. Histology 2. Physiology 3. Dermatology 4. Rheumatology

and Pharmacology 5. Clinical

Correlations 6. Spiraling Sessions

1. Histology 2. Neuroanatomy 3. Biochemistry 4. Microbiology 5. Virology 6. Neuroscience 7. Neuropathology 8. Pharmacology 9. Substance Use/Misuse 10. Clinical Correlations 11. Spiraling Sessions

Pre-session Material Videos (and companion worksheets for Histo. Sessions)

• Videos – Clinical Correlations and PSIO

• Histo. – Slide Guides and companion worksheets

• Readings/lectures for Derm and Rheum-Pharm

• Podcasts from last year and learning objectives

• New videos for some sessions

Pre-session Workload Histo. – 100 mins. Clin. Corr. – 30 min.

30 min. for most sessions

• All day Wednesday • There was no prep for

Spiral Curr. sessions


PAGE 6

Feature Foundations MSS Nervous System

Session Material Histo. – Slides/worksheets Clin. Corr. - Cases

Histo. – ppt creation Remaining sessions – case-based discussions (board-type assessments)

• Some sessions began with students completing a table

• Others began with board questions

• Sessions used cases • Some concluded with a

summary/diagram Session Time (avg.) 2 hours 2 hours 2 hours Session Schedule Interspersed Interspersed • Thursdays - all day

• Some were scheduled on Monday (Spiraling Curr.)

Session Format Histo. - Faculty leads the class through slides and students complete the associated worksheet. Clin. Corr.: Faculty-led large group discussion which involves application of the content via cases that students learned on their own prior to the session

Histo. - Faculty leads the class through slides and students complete the associated worksheet and ppt. creation. Clin. Corr.: Faculty-led large group discussion which involves application of the content via cases PSIO, Rheum, Derm – case-based discussion with ½ the class and more interactive in the MDL’s

Student complete a poll, self-assessment, or a table, as a quiz/readiness assurance test. The instructor facilitates discussions using think-pair-share and/or case-based, format.

Number of Faculty 7 7 11 (2-3 faculty per session) Faculty Development None Individuals sought

help from FID Director Block director sought help from Karen and then met with her faculty

Observation of the sessions


PAGE 7

Method of Evaluation For a detailed description of the CQI project, please refer to Appendix 1. For the three blocks included in this project, a two-question poll was administered in real time through ExamSoft for students to complete at the end of each required session. The questions were:

1. Did you learn something? (Yes/No) 2. Would you have attended this session had it not been required? (Yes/No) 3. Is there any constructive feedback you would like to provide to improve the

session? (Open response) The poll served two purposes:

1. Tracking student attendance at required sessions 2. Obtaining student feedback (utility and constructive feedback) about

required sessions In addition, in each Block, the block director documented their observations to round out the evaluation.


PAGE 8

Findings The mean response rate of all the session polls was 93.6%. The high response rate is not surprising since this is how student attendance was tracked, and also explains, in part, why there was not 100% response rate. There were 6 polls total that were excluded from the data analysis due to technical issues (the system was down or not accessible) which captured little to no responses. As shown in the Table, an overwhelming majority of students (90% or higher) reported having learned something through this format (perceived value) and 79%-92% report that they would have attended the session had it not been required. Mean of All Session Feedback by Block

(Mean, Percentage) (Range)

Did you learn something? (Yes)

Would you have attended this session had it not been required? (Yes)

Foundations # of Polls=13*

116, 96% (111-120)

100, 91% (88-110)

MSS # of Polls=18

116, 96% (110-121)

100, 92% (65-109)

Nervous System # of Polls = 22**

108, 90% (97-120)

80, 79% (59-101)

*4 polls were excluded due to too low response rate (0-3 respondents) **2 polls were excluded due to technical issues The following are themes found among the student feedback and block directors’ observations:

• Not enough time to properly vet the proposed materials and design of the session

• Variability of the time/effort required to complete pre-session work • Labor intensive to design the sessions especially due to the development of cases

and assessments


PAGE 9

• Faculty’s general perceived discomfort with this format • By using assessments in-class, faculty knew how/what to teach and where to

provide clarification.


PAGE 10

Recommendations The following recommendations emerged from the student and block directors’ feedback to improve implementation of flipped classroom instruction in AY 2020-2021. Pre-session

• Develop pre-session material guidelines to reduce the variability in expectation for students across blocks.

• Pre-session Workload: 20-30 min. long. • Assessment driving learning - Consider coupling assessment to the pre-session work.

Design

• Ensure the learning objectives and learning material are updated and relevant, especially if previous years’ podcast/materials will be used.

Faculty Instructional Development (FID)

• Faculty coaching and review of format to increase their comfort-level. o Faculty should observe an example of a good session o Faculty should be strongly encouraged to watch a video recording of their own

session; the FID director should also watch the recording and give feedback and debrief with the faculty instructor.

Practice Guidelines

• Curricular Affairs and block directors should create criteria (tree branching) of key distinguishing features for each active learning methodology.

o There should be a vetting about whether this is an interactive session and if that is desired, what would make this so?

• Due to the required time and effort to design a quality active learning session, Curricular Affairs and block directors should also mandate a “lock-down” date for all materials to be submitted to the block director as well as deadlines to have engaged with the FID office.


PAGE 11

TEPC Policy • Revise the current FID policy to require faculty instructional development if they are to

participate in teaching active learning2 sessions. o Consider rebranding the sessions to “active learning” – flipped is too

constrained. o As part of our practice, watch 1-2 recordings and debrief with the FID director o Require FID for designing and teaching

Poll Questions

• Consider revising the poll items as follows:

Original Revisions 1. Did you learn something?

(Yes/No) 2. Would you have attended this

session had it not been required? (Yes/No)

3. Is there any constructive feedback you would like to provide to improve the session? (Open response)

1. What concept was clarified for you during…

a. The assessment? b. The in-person session?

2. Would you have attended this session had it not been required? (Yes/No)


4. What concept is still cloudy? (Open response)

2 Active learning includes flipped-classrooms

COM-T Accreditation Ofc. Drafted 07/22/2019; Rev. 7/26/2019; 8/19/2019 Page 1 of 7

Pilot: Improve learning in required sessions

College of Medicine-Tucson CQI Project Plan

STAGE 1: PLAN | STAGE 2: DO | STAGE 3: STUDY | STAGE 4 ACT Project Title: Pilot: Improve learning in required sessions

taught in the Preclerkship Phase Reporter Office:

COM-T Curricular Affairs Office

Project Start Date:

July 29, 2019 Reporter’s Name:

Athena Ganchorre, Block Director, Foundations Block & Executive Director, Curriculum and Integrative Learning

Karen Spear-Ellinwood, FID Director

Project End (or expected end) Date (mm/dd/yy):

September 6, 2019 Reporter’s Title:

See above

Curriculum Phase (if applicable):

Preclerkship Phase Reporter’s Phone:

Dr. Ganchorre: 520-626-2203 Dr. Spear-Ellinwood: 520-626-1743

Approving Dean

Sean Elliott, Interim Associate Dean, Curricular Affairs

Date Approved by TEPC

Wed., 8/21/2019

STAGE 1: PLAN Define, explore and structure a quality improvement project

PROJECT DESCRIPTION 1. What problem are

you trying to fix(PROBLEMSTATEMENT)?

Student perception is that sessions are not useful.

2. What is the rootcause of theproblem?

The lecture-style format of the instructional sessions do not regularly engage students with the content at a higher order cognitive level e.g. application, synthesis, and analysis.

3. What evidence(current data)supports yourproblem?

Student attendance is low at non-required Block sessions.

4. What change doyou want to see inthe process orproblem to correct(GLOBAL AIMSTATEMENT)?

The Foundations Block in AY 2019-2020 has attempted to address the problem by revising lecture-style sessions into flipped classroom format, which are interactive, application-based sessions that are required in the Preclerkship Phase. The Foundations Block format for flipped classroom (among others across the block) is what we would like to model for revising lecture-style sessions into more interactive required sessions in the blocks.

APPENDIX 1



5. What are you trying to achieve (SPECIFIC AIM)?

Improve student perception that sessions are useful to their learning and acquisition of the block content taught in the Preclerkship Phase.

6. Define a timeline for the following project stages:

Plan: July 22 2019

Do: July 29 – Sept. 6 2019

Study: July 29, 2019 – May 29, 2020 (the rest of the AY) Focused on obtaining baseline data

Act: AY 2020-2021 through AY 2021-2022

IMPACT 7. Select the affected population(s) (check all that apply):

REQUIRED PARTICIPANTS ☐ Admissions Office ☒ Faculty Instructors ☐ Societies Directors/ Mentors ☐ Application Dev. Team ☐ Intersessions Directors/

Coordinators ☒ Students

☐ Application of the Basic Sciences to Clinical Medicine Director/ Coordinators

☐ Medical Humanities Directors/ Coordinators

☐ Student Affairs House Deans

☒ Block Coordinators ☐ Med. Stdnt. Records Ofc. ☐ Student Development Office ☒ Block Directors ☐ Ofc. Diversity/Inclusion ☐ Student Financial Aid Ofc. ☐ Clinical Reasoning Course

Directors ☐ Pathways in Health and

Medicine Directors ☐ Transition to Clerkship

Director/Coordinator ☐ Clerkship Directors/

Coordinators ☐ Preparation to Residency

Boot Camp Director/ Coordinator

☒ Other Faculty Instructional Development Director Assessment and Evaluation Unit in Curricular Affairs Ofc.

☐ Elective Directors/ Coordinators

☐ Project Management Team

8. Select the areas where this project aims to impact the goals and strategic priorities of the COM-T medical education program

IMPACT AREA ☒ Achievement of EPO’s ☐ Learning/ Curriculum

Information Technology ☒ Student MK Performance

☐ Content Coordination ☐ Student Satisfaction ☐ Other; Please enter here: ☐ External Stakeholders/

Engagement/ Collaboration ☐ Student Clinical Performance

RESOURCES 9. Do you have the resources

to fix the issue? ☒ YES ☐ NO

10. What resources (new & existing) will you require

Drs. Athena Ganchorre as the Executive Director, Curriculum & Integrative Learning (existing) and Karen Spear-Ellinwood, Director, Faculty instructional development (existing) are needed to support the



and how will you acquire them?

session revisions and ensure standardization across blocks. In addition, an instructional design specialist is required to transform the sessions effectively. If funding for the latter is not available, the rate at which the sessions can be revised into ore interactive formats (flipped classroom) will be delayed. However, we can be strategic about selecting sessions for each block that are primed for revision and complete implementation over 2-3 academic years. To inform session selection for revisions, the real time student feedback about the required sessions will continue to be administered to obtain baseline data throughout the Preclerkship Phase in AY 2019-2020.

ALIGNMENT 11. Does the project aim align

with COM-T medical education goals?

☒ YES ☐ NO

12. Does the project aim align with the COM-T strategic goals?

☒ YES ☐ NO

PROJECT TEAM 13. List the members of the CQI project team:

Name Role Athena Ganchorre Co-Project Leader Raquel Givens Co-Project Leader Ah Ra Cho Project Member J. D. Thomas Project Member Karen Spear-Ellinwood Project Member Sonia de Leon Project Member Sean Elliott (or Associate Dean, Curricular Affairs) Facilitator/Advisor

ACTION PLAN 14. Incorporating the

information gathered throughout the planning process, describe the action plan:

One source of poor student perception of Preclerkship sessions could be the low interactivity/engagement of the sessions. By revising sessions throughout the Preclerkship phase based on realtime student feedback and support/expertise from the FID Director (and possibly an instructional specialist), we can improve the student satisfaction and student perception of the session utility.

STORY BOARD 15. Begin constructing a CQI

Storyboard. Date started: 7/24/2019



STAGE 2: DO Develop and structure the new change/process to all areas for improvement.

16. Who will implement the change?

Dr. Athena Ganchorre, Block Director, will implement the change in the Foundations block.

17. How and to whom do you plan to implement the change and how will this be communicated?

The Foundations syllabus will be updated to reflect the student expectation of completing the poll for tracking attendance at required sessions. The Foundations Director will communicate to her block integration design team and her block faculty instructors of this change. On Day 1 of the Block, she will communicate this student expectation and the purpose behind it (continuous refinement of our instruction/impact on learning). This is the process for subsequent blocks in the academic year.

18. Will you conduct a pilot study prior to full-scale implementation?

☒ YES ☐ NO

19. How will you track and measure change (describe data measurement systems)?

ExamSoft will be used to administer the a 2-question poll to students, and the Qualtrics online survey platform will be used to capture block directors’ feedback and notes about the level of student engagement.

20. How will you spread and maintain the new process/change?

The Foundations Block Director will introduce the poll and the function it serves (attendance) at the “Introduction to the Block” session in the Foundations Block, as will the directors for subsequent blocks.

21. Incorporating the information gathered throughout the implementation process, describe the implementation plan:

Dr. Ganchorre, Foundations Block Director, will implement the change in the Foundations block. She will communicate the change to her block integration design team (core faulty) and block instructors. Dr. Ganchorre will communicate the student expectation of completing the poll for tracking attendance at required sessions in the syllabus for the class of 2023. On Day 1 of the Block, she will communicate this student expectation and the purpose behind it (continuous refinement of our instruction/impact on learning). Directors for subsequent blocks will follow this process. ExamSoft will be used to capture student feedback and Qualtrics will be used to collect the block directors’ feedback and notes about the level of student engagement.

STAGE 3: STUDY Develop and define the plan for evaluating the quality improvement project.

22. How will you monitor progress and how often?

Beginning with the Foundations Block, a two-question poll will be administered in real time through ExamSoft for students to complete at the end of each required session. The questions are:

1. Did you learn something? (Yes/No) 2. Would you have attended this session had it not been required?

(Yes/No)




The poll would serve two purposes:

1. Tracking student attendance at required sessions 2. Obtaining student feedback (utility and constructive feedback)

about required sessions Additional benefits would be to conduct an analysis of correlating at-risk students to attendance (via the polling) In addition, in the Foundations Block, the block director (A. Ganchorre), co-director (W. Rappaport), and core faculty (Z. Cohen) (and the FID director, if available) will complete the FID block director tool for observation, feedback and planning from which a weekly report may be generated. The instructors of the specific sessions will also be encouraged to complete the “Block Observation & Planning Tool” to provide their impressions of the sessions. The FID Director may create a separate tool for the instructors, if necessary, after a substantial amount of data are collected to inform the design. Directors and instructors for subsequent blocks will follow this process.

23. Define how you will check and verify accuracy of the results:

N/A

24. Who will be responsible for maintaining the change?

The Associate Dean for Curricular Affairs with the support of Athena Ganchorre (integrative learning), Karen Spear-Ellinwood (FID), Sonia de Leon (Two-question Poll)

25. How often will you review the process for needed improvements?

The block director may review the student feedback about each session in real time. The Director for Accreditation may check-in with the block director and feedforward to the subsequent block any feedback that might be helpful to inform changes that can be reasonably made before the block begins. Changes requiring TEPC approval may not be instituted without prior notice/permission from TEPC and will be addressed on a case-by-case basis with the assistance of the project team. The Block director, Executive Director for Curriculum and Integrative Learning, and FID Director will review the aggregate data from ExamSoft and Qualtrics no later than 1 month after the end of each block. Based on the results from student polls and block observation and planning tool, they will select sessions for revision and aggregate a summary report of the findings to TCMS and TEPC as part of the Level 1 report of the block.

26. How will you address any new areas for improvement?

The Block director, Executive Director for Curriculum and Integrative Learning and FID Director will then work on revising the sessions for implementation the following academic year.



27. Incorporating the information gathered throughout the evaluation process, describe the evaluation plan:

Data will be collected from the required session feedback poll (Exam Soft) and the block director tool (Qualtrics) for observation, feedback and planning. The block director, Executive Director for Curriculum and Integrative Learning (A. Ganchorre) and FID Director (Karen Spear-Ellinwood) will review the aggregate data no later than 1 month after the block in relation to the final block evaluation results. The results will inform the selection of sessions to revise for the next AY. The results of the surveys and sessions earmarked for revisions will be presented to TEPC in the block change request form (based on submission schedule).

STAGE 4: ACT Finalize the documentation of the quality improvement project and plan for future projects.

28. Share the status and results of the project with team members/leadership/stakeholders.

Date completed (mm/dd/yy): (Expected dates) Mid-Oct. 2019 – pilot findings June 2020 – data collected for the rest of the AY 2019-2020.

29. Discuss the future of this project/change (i.e. future projects, varying approaches, etc.).

30. Update the organizational process map to reflect the change(s).

Date completed (mm/dd/yy): ☐ Not applicable

31. Finalize the CQI Storyboard and submit in the Portal (LINK).

Date submitted (mm/dd/yy):



CQI Storyboard Figure: CQI Storyboard

COM-T Medical Education Storyboard Project Title: Contact Person: Contact Email: Date Submitted

1. AIM STATEMENT 2. PLAN 3. DO

4. STUDY 5. ACT 6. FUTURE CQI

Subject NameClass of ----Rotation: LocationEvaluation Dates

Evaluated by: Evaluator NameClass of ----

Class of 2022 - Assessment of Student Performance in _____ Clerkship1 CONFLICT OF INTEREST OPT-OUT: I am unable to assess this student's performance due to a conflict of

interest (e.g., I have a personal association with the student/family; I have provided health care for the student; I am the student's Society mentor.)

Yes, A Conflict of Interest Exists

No

Curricular Affairs Specific Questions

2 How long did you work with this student?

Less than 1 day

1-3 days

4-7 days (half-week to 1 week)

2 weeks

3 weeks

4 weeks or more

MEDICAL KNOWLEDGE

3 Demonstrates the ability to apply knowledge to specific clinical situations.

Far Below Expectations - NEVER applies basic science or clinical knowledge to clinical situations.

Below Expectations - INCONSISTENTLY applies basic science or clinical knowledge to clinical situations.

Meets Expectations - GENERALLY applies basic science and clinical knowledge to clinical situations.

Above Expectations - OFTEN applies basic science and clinical knowledge to clinical situations.

Far Above Expectations - CONSISTENTLY applies basic science and clinical knowledge to clinical situations.

N/A

4 Demonstrates an understanding of psychosocial influences on illness and treatment.

Far Below Expectations - NEVER understands or recognizes the importance of psychosocial influences in discussing individual patient care.

Below Expectations - INCONSISTENTLY understands or recognizes the importance of psychosocial influences in discussing individual patient care.

Meets Expectations - GENERALLY understands or recognizes the importance of psychosocial influences in discussing individual patient care.

Above Expectations - OFTEN understands or recognizes the importance of psychosocial influences in discussing individual patient care.

Far Above Expectations - CONSISTENTLY understands or recognizes the importance of psychosocial influences in discussing individual patient care.

N/A

5 Demonstrates critical thinking and clinical decision making.

Far Below Expectations - NEVER uses critical thinking and clinical decision making skills. Inconsistent and varied in their thought processes on how to approach the care of patients.

Below Expectations - INCONSISTENTLY uses critical thinking and clinical decision making skills. Inconsistent and/or varied in their thought processes on how to approach the care of patients.

Meets Expectations - GENERALLY uses critical thinking and clinical decision making skills. Inconsistent and/or varied in their thought processes on how to approach the care of patients.

Above Expectations - OFTEN uses critical thinking and clinical decision making skills. Has a HIGH level of comfort in thinking through how to approach the care of patients.

Far Above Expectations - CONSISTENTLY uses critical thinking and clinical decision making skills. Has an ADVANCED level of comfort in thinking through how to approach the care of patients.

N/A

6 Exhibits an appropriate fund of knowledge and an understanding of basic pathophysiological processes.

Far Below Expectations - NEVER understands basic pathophysiogical processes. Lacks in an appropriate level of fund of knowledge.

Below Expectations - INCONSISTENTLY understands basic pathophysiogical processes. At times, lacks in an appropriate level of fund of knowledge.

Meets Expectations - GENERALLY understands basic pathophysiological processes. Can apply an appropriate level of fund of knowledge to clinical situations.

Above Expectations - OFTEN understands basic pathophysiological processes. Has STRONG fund of knowledge to apply to clinical situations.

Far Above Expectations - CONSISTENTLY understands basic pathophysiological processes. Has VERY STRONG fund of knowledge to apply to clinical situations.

N/A

PATIENT CARE

7 Conducts accurate history & physical exams (EPA 1).

Far Below Expectations - NEVER includes important findings from H&P and organization or cohesiveness is lacking in H&P.

Below Expectations - INCONSISTENTLY includes important findings from H&P, and/or organization or cohesiveness is lacking in H&P.

Meets Expectations - GENERALLY includes important findings from H&P. The H&P is generally organized and cohesive.

Above Expectations - OFTEN includes important findings from H&P. The H&P is generally organized and cohesive.

Far Above Expectations - CONSISTENTLY includes important findings from H&P. The H&P is generally very organized and cohesive.

N/A

8 Develops an appropriate differential diagnosis list following a clinical encounter (EPA 2).

Far Below Expectations - NEVER gathers or synthesizes data to inform an acceptable differential diagnosis list. Lacks MAJOR basic medical knowledge to reason through and create multiple differential diagnoses.

Below Expectations - INCONSISTENTLY gathers or synthesizes data to inform an acceptable differential diagnosis list. Lacks SOME basic medical knowledge to reason through and create multiple differential diagnoses.

Meets Expectations - GENERALLY gathers or synthesizes data to inform an ACCEPTABLE differential diagnosis list. Has ADEQUATE medical knowledge to reason through and create multiple differential diagnoses.

Above Expectations - OFTEN gathers or synthesizes data to inform a GOOD differential diagnosis list. Has a GOOD level of medical knowledge to reason effectively and create multiple differential diagnoses.

Far Above Expectations - CONSISTENTLY gathers or synthesizes data to inform a STRONG differential diagnosis list. Has a STRONG level of medical knowledge to reason effectively and create multiple differential diagnoses.

N/A

9 Appropriately documents a clinical encounter in the patient record (EPA 4).

Far Below Expectations - The student's documentation of the clinical encounter in the patient record is NEVER completed and/or is disorganized.

Below Expectations - The student's documentation of the clinical encounter in the patient record are INCONSISTENTLY completed and/or is disorganized.

Meets Expectations - The student's documentation of the clinical encounter in the patient record are GENERALLY completed and/or is organized. Organizes written notes that are sufficient and clearly convey progress of patient and development of problem. (For example, note follows SOAP/ problem-oriented format).

Above Expectations - The student's documentation of the clinical encounter is OFTEN completed and/or is organized, only OCCASIONALLY needs editing/revisions.

Far Above Expectations - The student's documentation of the clinical encounter is OUTSTANDING, completed and is organized, and DO NOT need editing/revisions.

N/A

10 Recommends common diagnostic and screening tests (EPA 3).

Far Below Expectations - NEVER able to explain the basic principles behind standard tests that were performed on assigned patients. NEVER able to explain or misinterprets findings from standard tests.

Below Expectations - INCONSISTENTLY able to explain the basic principles behind standard tests that were performed on assigned patients. INCONSISTENTLY able to explain or misinterprets findings from standard tests.

Meets Expectations - GENERALLY able to explain the basic principles behind standard tests that were performed on assigned patients. Also able to explain or interpret findings from standard tests.

Above Expectations - OFTEN able to explain the basic principles behind standard tests that were performed on assigned patients. Is able to explain the relative value of a test compared to alternatives.

Far Above Expectations - CONSISTENTLY able to explain the basic principles behind standard tests that were performed on assigned patients. Is able to explain the relative value of a test compared to alternatives. The student initiates ADVANCED conversation about additional tests that would be appropriate.

N/A

11 Recognizes when a patient needs urgent/emergent care and can initiate evaluation and management (EPA 10).

Far Below Expectations - NEVER able to recognize when a patient needs urgent/emergent care. NEVER develops or recommends appropriate or safe treatment or management plan.

Below Expectations - INCONSISTENTLY able to recognize when a patient needs urgent/emergent care. INCONSISTENTLY develops or recommends appropriate or safe treatment or management plan.

Meets Expectations - GENERALLY knows when a patient needs urgent/emergent care and can articulate basic considerations of treatment or management plan after initial work up. (Treatment plan includes examples such as next steps for monitoring patient, therapeutics to start now, and follow-up or care).

Above Expectations - OFTEN recognizes quickly when a patient needs urgent/emergent care. Provides a plan for follow-up tests, treatment and continued care of the patient.

Far Above Expectations - CONSISTENTLY recognizes quickly when a patient needs urgent/emergent care. Provides comprehensive and ADVANCED plan for follow-up tests, treatment and continued care of the patient.

N/A

12 Provides an appropriate oral presentation of a clinical encounter (EPA 6).

Far Below Expectations - The student's presentations of the clinical encounter are NEVER complete and/or disorganized during one-on-one, rounds, team meetings.

Below Expectations - The student's presentations of the clinical encounter are INCONSISTENTLY complete and/or disorganized during one-on-one, rounds, team meetings.

Meets Expectations - GENERALLY, the student's presentations of the clinical encounter are complete and organized. Provides sufficient and organized presentation of patient findings during one-on-one, rounds, team meeting, etc.

Above Expectations - OFTEN, The student's presentations of the clinical encounter are WELL-DONE, accurate and complete and only OCCASIONALLY needs editing/revisions.

Far Above Expectations - CONSISTENTLY, the student's presentations of the clinical encounter are OUTSTANDING, accurate and complete and DOES NOT need editing/revisions.

N/A

INTERPERSONAL & COMMUNICATION SKILLS

13 Demonstrates effective listening skills.

Far Below Expectations - NEVER asks patient and family if they have questions. Becomes distracted or inpatient when patient or family asks questions. Dismisses patient or families when they raise concerns.

Below Expectations - INCONSISTENTLY asks patient and family if they have questions. Becomes distracted or inpatient when patient or family asks questions and/or asks patient or family to repeat themselves. Dismisses patient or families when they raise concerns.

Meets Expectations - GENERALLY encourages open-ended questions and addresses questions from patient/family. Listens to other patient presentations by colleagues and residents, attendings and asks questions when appropriate. Uses appropriate non-verbal communication skills, such as looks person in the eyes, pays attention.

Above Expectations - OFTEN steps up independently (but respectfully) to actively listen to patient/family concerns. Listens and actively participates in other patient presentations by colleagues and residents. Uses excellent listening skills with patients/families/health care professionals.

Far Above Expectations - CONSISTENTLY steps up independently (but respectfully) to actively listen to patient/family concerns. Listens and actively participates in other patient presentations by colleagues and residents. Uses excellent listening skills with patients/families/health care professionals and applies information gathered from patient interactions.

N/A

14 Creates & sustains a therapeutically & ethically sound relationship with patients and their families.

Far Below Expectations - NEVER uses medical jargon appropriately (e.g. patient and family do not understand). Does not attempt to answer question(s) posed by patient and families.

Below Expectations - INCONSISTENTLY uses medical jargon appropriately (e.g. patient and family do not understand). Fails to appropriately answer question(s) posed by patient and families.

Meets Expectations - GENERALLY uses terminology that can be understood by patients and families. Provides patient/family with clear instructions and clear explanations for tests and procedures ordered.

Above Expectations - OCCASIONALLY verifies understanding of patient’s message by summarizing or restating it to the patient. Knows how to provide CLEAR instructions and explanations to patients/families.

Far Above Expectations - CONSISTENTLY verifies understanding of patient’s message by summarizing or restating it to the patient. Is able to clarify any misunderstandings and knows how to provide OUTSTANDING instructions and explanations to patients/families.

N/A

15 Collaborates as a member of an interprofessional team (EPA 9).

Far Below Expectations - NEVER obtains important information from and/or inform nursing, house staff, attendings of important information related to assigned patients.

Below Expectations - INCONSISTENT in obtaining important information from and/or inform nursing, house staff, attendings of important information related to assigned patients.

Meets Expectations - GENERALLY provides basic information to nurses, housestaff, attendings, ancillary team care providers for patient care. Gathers and communicates pertinent and appropriate information from other health care professionals (e.g. referrals/consults, handoffs).

Above Expectations - OFTEN works and communicates as a HIGHLY functioning team member, providing and receiving information about his/her patients’ care with all health care professionals (nurses, house staff, attendings, ancillary health care providers).

Far Above Expectations - CONSISTENTLY works and communicates as a OUTSTANDING functioning team member, providing and receiving information about his/her patients’ care with all health care professionals (nurses, house staff, attendings, ancillary health care providers).

N/A

PROFESSIONALISM

16 Demonstrates punctuality, accountability, honesty.

Far Below Expectations - The student is ALWAYS late without approval or informing supervisors. Student does not arrange to complete tasks when absent. Student is not prepared for meeting or task.

Below Expectations - The student is SOMETIMES late on several occasions without approval or informing supervisors. Student does not arrange to complete tasks when absent. Student is not prepared for meeting or task.

Meets Expectations - The student arrives ON TIME for all activities, is prepared in advance for appropriate activities, obtains appropriate approval for necessary absence or late arrival, informs appropriate supervisors and colleagues when absent or late and arranges for work to be completed regardless of absence or tardiness.

Above Expectations - OFTEN, the student STEPS UP MORE THAN USUAL to assist team or others to prepare in advance. The student arrives ON TIME for all activities. Assists team or others in starting on time, completing task on time, and being accountable for the work completed.

Far Above Expectations - CONSISTENTLY, the student GOES ABOVE AND BEYOND to assist team or others to prepare in advance. The student is always prepared and arrives ON TIME for all activities. Assists team or others in starting on time, completing task on time, and being accountable for the work completed.

N/A

17 Demonstrates respect for: physicians (residents/attendings), other health care professionals (nursing, clinic, hospital personnel) & peers.

Far Below Expectations - NEVER acknowledges the effort and values of others contributions, by exhibiting a demanding attitude or impatience with others. Frequently interrupts and acts as if s/he does not have time to wait for answer. Speaks rudely or inappropriately to others.

Below Expectations - INCONSISTENTLY acknowledges the effort and values of others contributions, by exhibiting a demanding attitude or impatience with others. Frequently interrupts and acts as if s/he does not have time to wait for answer. Speaks rudely or inappropriately to others.

Meets Expectations - GENERALLY acknowledges the effort and values of other’s contributions. Pays attention while others are talking and allows others to speak without interruption. Speaks respectfully to others. Displays appropriate body language.

Above Expectations - OFTEN the student goes out of their way to explicitly demonstrate respect to others (e.g. tells staff how s/he appreciates their assistance; compliments others on the task they accomplish).

Far Above Expectations - CONSISTENTLY the student goes out of their way to explicitly demonstrate respect to others (e.g. tells staff how s/he appreciates their assistance; compliments others on the task they accomplish).

N/A

18 Demonstrates respect for: patients and their families.

Far Below Expectations - NEVER acknowledges the patient and/or family, by exhibiting a demanding attitude or impatience with others. Frequently interrupts and acts as if s/he does not have time to wait for answer. Speaks rudely or inappropriately to patients/families.

Below Expectations - INCONSISTENTLY acknowledges the patient and/or family, by exhibiting a demanding attitude or impatience with others. Frequently interrupts and acts as if s/he does not have time to wait for answer. Speaks rudely or inappropriately to patients/families.

Meets Expectations - GENERALLY acknowledges the effort and values of patients and their families. Pays attention while others are talking and allows the patient/family to speak without interruption. Speaks respectfully to others. Displays appropriate body language.

Above Expectations - OFTEN the student goes out of their way to explicitly demonstrate respect to patients and families (e.g. tells the patient/family how s/he appreciates their input and patience; actively listens to patient/family concerns and questions).

Far Above Expectations - CONSISTENTLY the student goes out of their way to explicitly demonstrate respect to patients and families (e.g. tells the patient/family how s/he appreciates their input and patience; actively listens to patient/family concerns and questions).

N/A

PRACTICE-BASED LEARNING AND IMPROVEMENT

19 Appropriately self-assesses and incorporates feedback to improve performance.

Far Below Expectations - NEVER verbalizes areas for personal improvement, and fails to recognize mistakes or inadequate performance. Repeats mistakes that were brought to his/her attention.

Below Expectations - INCONSISTENTLY verbalizes areas for personal improvement, and fails to recognize mistakes or inadequate performance. Acknowledges mistakes that were brought to his/her attention, but continues to repeat behavior.

Meets Expectations - GENERALLY verbalizes areas for personal improvement. Shows some areas of progressive improvement throughout rotation.

Above Expectations - OFTEN demonstrates EXTRA effort and sincerity to improve in response to subtle suggestions. Integrates feedback from SOME sources (e.g. links verbal suggestion from attending with researched topic with comment from patient to change response). Shows specific progression by the end of the rotation.

Far Above Expectations - CONSISTENTLY demonstrates CONSIDERABLE effort and sincerity to improve in response to subtle suggestions. ACTIVELY Integrates feedback from MULTIPLE sources (e.g. links verbal suggestion from attending with researched topic with comment from patient to change response). Demonstrates immediate improvement consistently throughout rotation.

N/A

20 Exhibits skills of self-directed learning and retrieve evidence to advance patient care (EPA 7).

Far Below Expectations - NEVER exhibits skills in learning on his/her own and does not research information unless directly instructed to do so.

Below Expectations - INCONSISTENTLY exhibits skills in learning on his/her own and does not research information unless directly instructed to do so.

Meets Expectations - GENERALLY defines clinical questions that he/she wants to answer, identifies areas of gaps in knowledge. Demonstrates that he/she has researched information from an issue that arose in previous day or days without needing to be directly instructed.

Above Expectations - OFTEN initiates research on his/her own and conducts some additional research. Relates research back to his/her patient care.

Far Above Expectations - CONSISTENTLY initiates research on his/her own and conducts extensive research. Relates research back to his/her patient care and generates more research at the next level.

N/A

SYSTEMS-BASED PRACTICE

21 Advocates for quality patient care and access.

Far Below Expectations - NEVER recognizes an obvious instance of poor access to care, to mention a need for improved quality patient care when an instance of insufficient care occurs with his/her patient.

Below Expectations - INCONSISTENTLY recognizes an obvious instance of poor access to care, to mention a need for improved quality patient care when an instance of insufficient care occurs with his/her patient.

Meets Expectations - GENERALLY inquires about or mentions obstacles to access to care. Recognizes when access to care is difficult and needs to be addressed. Provides instructions or plan for follow up care that address additional efforts to provide high standard of care.

Above Expectations - OFTEN acts to ensure access to care. Works with others to remove/diminish an obstacle to access. Works with other health care professionals or patient to improve quality of care.

Far Above Expectations - CONSISTENTLY and GOES ABOVE AND BEYOND to ensure access to care. Works with others to remove/diminish an obstacle to access. Works very actively with other health care professionals or patient to improve quality of care.

N/A

22 Can identify system failures (e.g. patient safety issues), actively anticipates potential errors, and contributes to a culture of safety and improvement (EPA 13).

Far Below Expectations - NEVER identifies system failures and potential errors. Does not understand how they have a part in contributing to a culture of safety and improvement.

Below Expectations - INCONSISTENTLY identifies system failures and potential errors. Does not understand how they have a part in contributing to a culture of safety and improvement.

Meets Expectations - GENERALLY understands and can identify system failures, actively anticipates potential errors, and generally knows their part in contributing to a culture of safety and improvement.

Above Expectations - OFTEN can identify system failures and how to address potential errors. Understands and knows how they have a part in contributing to a culture of safety and improvement.

Far Above Expectations - CONSISTENTLY can identify system failures and how to address potential errors. Understands and knows thoroughly how they have a part in contributing to a culture of safety and improvement.

N/A

SUMMARY

This section is for you to provide open-response comments on the medical students of their performance. These comments will also help inform the clerkship director as they create an overall summary report about the student which will be included in the MSPE (Medical Student Performance Evaluation Report to the House Deans to be included in their residency application). Please note that students will have access to these performance assessments, but you will not be personally identified in their reports.

23 Based on all the competencies and performance of the student, how would you rate the student overall?

Far Below Expectations - The student is FAR BELOW the level equivalent to their peers at this time of their training.

Below Expectations - The student is BELOW the level equivalent to their peers at this time of their training.

Meets Expectations - The student is GENERALLY/ON PAR the level equivalent to their peers at this time of their training.

Above Expectations - The student is ABOVE the level equivalent to their peers at this time of their training.

Far Above Expectations - The student's performance FAR ABOVE the level equivalent to their peers at this time of their training.

N/A

24 Please provide comments on the overall performance of a student, such as how s/he integrates the multiple competencies and his/her strengths and weaknesses. Consider identifying 2 areas where the student performed well and 2 areas where the student needs to improve.



Class of 2022 Student Feedback on ___ Clerkship


1 The mid-clerkship feedback session helped me to identify how to improve my performance.

Strongly disagree Disagree Neither agree nor disagree Agree Strongly agree

2 Attendings provided effective teaching during this clerkship.


3 Residents and fellows provided effective teaching during this clerkship.


4 A faculty member and/or resident personally observed me taking a patient history during this clerkship.

Yes No

5 A faculty member and/or resident personally observed me performing at least one physical exam (includes whole or partial) during this clerkship.

Yes No

6 The orientation for this clerkship adequately provided me what I needed to prepare for the clerkship.


7 The didactics/lectures for this clerkship were beneficial to my learning in this clerkship.


8 The assignments for this clerkship were beneficial to my learning in this clerkship.


9 The OSCE for this clerkship was effective in giving me a culminating overview at the end of my clerkship experience. (Please select N/A if this clerkship did not have an OSCE)

Comment

Strongly disagree Disagree Neither agree nor disagree

Agree Strongly agree N/A

10 The clerkship experiences I had prepared me to do well on the NBME Shelf Exam. (Please select N/A if this clerkship did not have a Shelf Exam)



11 The degree to which the Clerkship Director was accessible to me when I needed them was:

Comment

Poor Less than Satisfactory Satisfactory More than Satisfactory Outstanding N/A

12 The basic science content I received in the pre-clerkship phase prepared me for this clerkship.


13 How can we better prepare you in the pre-clerkship phase for you to be successful in this clerkship? (content, preparation, clinical skills, etc.)

14 The overall learning environment of this clerkship was:

Comment

Poor Less than Satisfactory Satisfactory More than Satisfactory Outstanding

15 Please provide an overall rating for this clerkship.


16* During this clerkship, I experienced discrimination.

Comment

Yes

No

17* During this clerkship, I experienced humiliation.

Comment

Yes

No

18* During this clerkship, I experienced abusive behavior.

Comment

Yes

No

19 Please comment on any positive aspects of this clerkship:

20 Please comment on any negative aspects of this clerkship:



Class of 2022 Student Feedback on _____ Instruction

Core Clerkship Questions

1 The overall quality of this instructor's teaching was:


2 The ability of this instructor to convey information in a clear and understandable manner was:


3 The quality of this instructor's feedback was:


4 The degree of professionalism this instructor demonstrated was:


5 The degree of respect this instructor demonstrated towards students was:


6 This instructor's availability/accessibility was:


7 This instructor's ability to provide clear expectations on my performance and contribution was:


8 Please provide an overall rating for this faculty/resident.


9 Please add any comments you have on this faculty/resident.



Class of 2022 Student Feedback on ____ Clerkship Sites


1 My overall learning experience at this site was:


2 I understood what was expected of me at this clerkship site.


3 This clerkship site provided educational experiences that corresponded to the learning objectives.


4 I received sufficient feedback on my performance at this site.


5 There was always an attending and/or resident available to me at this site.


6 Patients are treated respectfully at this site.


7 Non-health care providers are treated respectfully at this site (e.g., maintenance workers, support staff).


8 Members of the health care team treated each other respectfully at this site.


9 I was exposed to positive role models at this site.

Strongly disagree Disagre Neither agree nor disagree Agree Strongly agree

10 I was provided an adequate patient load to gain a broad range of learning experiences at this site.


11 I was oriented to the security systems and safety procedures in place while at this site.


12 Hospital or Major Facility only, not applicable for rural site: I was satisfied with the educational resources available to support medical education at this site (i.e. space for clinical teaching, access to library resources, information technology)



13 The attending(s) and/or residents were adequately prepared to provide me a well-rounded educational experience.


14 The overall learning environment of this site was:


15 Based on your experiences, would you recommend this site to another student?

Definitely not Probably not Uncertain Probably yes Definitely yes

16 Please comment on any positive aspects of this site:

17 Please comment on any negative aspects of this site:

the university of arizona college of medicine tucson

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