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COLLEGE OF MEDICINE

Clinical Student Assessment and Grading Policies

 

Policy Identification Number

 

Policy Title

Grading and Assessment Policy – Clinical Years

Classification

University

Approval Authority

Undergraduate Curriculum Committee

Responsible Entity

College of Medicine – Undergraduate Medical Education

Policy Owner

Clinical Sciences Planning and Evaluation Committee 

 

I.                 Policy Statement

This policy provides information to students, faculty, and course directors regarding criteria for failure and honors in clinical courses as well as procedures for remediation following a failure.

 

II.               Scope

Students enrolled in clinical courses of the College of Medicine’s MD Degree Program.

 

III.              Approval Authority

Undergraduate Curriculum Committee

IV.             Purpose of This Policy

This policy outlines the following for students, faculty, and course directors:

  • Grading and assessment criteria for both failure and honors in clinical courses of both the third and fourth year of the MD Degree program.
  • Procedures for remediation following a failure.
  • Conditions under which a student’s remediation will be disclosed on the Medical Student Performance Evaluation (MSPE).
  • Program standards for provision of formative feedback, summative feedback, narrative feedback, and grade timeliness in the assessment of medical students.
  • Conditions under which a student’s remediation will be disclosed on the Medical Student Performance Evaluation (MSPE).

 

V.               Who Should Be Knowledgeable about This Policy

College of Medicine students

College of Medicine Faculty and Course Directors

College of Medicine Undergraduate Medical Education Deans and Support Staff

 

VI.             The Policy

 

A. 3rd Year Course Failure

 

Each 3rd year course sets criteria for failure, pass, and honors for the course prior to the start of each academic year. These criteria will be made available to students at the beginning of each course in written form. All clinical faculty and rotations will assess the clinical performance of students using the standardized COM Clinical Performance Evaluation (CPE).

 

A student will fail a course if any one of the following conditions is met:

 

  • A Clinical Performance Evaluation grade of

1)      2.5 or lower, or

2)      at the discretion of the course director if the following occurs: one (1) or more ratings of “rarely, if ever” or four (4) or more ratings of “inconsistently.”

  • A remediated written exam grade below the Hofstee cutpoint as determined by the NBME national office for each discipline.
  • A failing grade on any secondary component of the grade.
  • Additionally, a student is eligible for failure at the discretion of the course director for unprofessional behavior. A professionalism form must be completed and submitted to the COM Dean’s office.

 

What if a student fails some component of the grade?

 

If a student fails the clinical component of the grade, the student fails the course.

 

If a student fails the written examination, the student will receive a grade of “Incomplete” (IN) and will have the opportunity to remediate that exam. The student will not be eligible to receive honors for the written exam or for the course as a whole regardless of the score obtained on the remediated exam. A note will be made in the Medical Student Performance Evaluation (MSPE) of the need to remediate the exam. If the written examination is failed a second time, the student fails the course.

 

If a student fails a secondary component of the grade (i.e., OSCE) the student will receive a grade if “Incomplete” (IN) and will have the opportunity to remediate that portion of the grade. The student will not be eligible to receive honors for the secondary component or for the course as a whole regardless of the score obtained on the remediated element. A note will be made in the MSPE of the need to remediate that component. If the secondary component is failed a second time, the student fails the course.

 

If a student fails either the written exam or another secondary component of the course that requires remediation, the second attempt must occur prior to advancing to fourth year or within 6 months, whichever occurs sooner. If remediation is not achieved in this time frame, the student will fail the course. Exceptions will be considered for extenuating circumstances (ex. the first available time for testing falls in the next academic year or the timing of the failure affects preparation for another major requirement).

 

If a student fails a course by any of the established criteria, they will be placed on academic probation and must repeat the course. The Medical Student Performance Evaluation (MSPE) will reflect the academic probation and the academic transcript will reflect the failure and repeating of the course. In cases where adverse actions are rendered following the release of the MSPE, the Dean’s Office will amend the MSPE and will notify the student’s program director and provide details regarding the incident that warranted the adverse action.

 

B. 3rd Year Clerkship Honors

 

The criteria for the designation of honors will be determined by each clerkship and approved by the appropriate academic committees. Each clerkship will publish honors criteria prior to the start of the academic year and will make this information available to students at the beginning of the clerkship in written form. NOTE: Selectives are not eligible for honors.

 

C. Clinical Performance Exam 3 (CPX3)

 

All students must pass this comprehensive Clinical Performance Exam in order to graduate. The minimum criteria for passing and honors are established annually by the director of CPX3, the CPX Committee, and the Associate Dean for Curriculum, Clinical Sciences. Students who do not obtain the minimum passing score will be required to retake the exam within 6 months. CPX3 performance is reported in the Medical Student Performance Evaluation as competency with honors, competency, or competency with remediation.

 

D. 4th Year Course Failure

 

Each 4th-year course sets criteria for failure, pass, and honors for the course prior to the start of each academic year. These criteria will be made available to students at the beginning of each course in written form. All clinical faculty and rotations will assess the clinical performance of students using the standardized COM Clinical Performance Evaluation (CPE).

 

A student will fail a course if any one of the following conditions is met:

 

·        A Clinical Performance Evaluation grade of

1)      2.75 or lower, or

2)      at the discretion of the course director if the following occurs: one (1) or more ratings of “rarely, if ever” or two (2) or more ratings of “inconsistently.”

·        A failing grade on any secondary component (of the grade).

·        Additionally, a student is eligible for failure at the discretion of the course director if the student receives any comments of concern about the professional behavior of the student. A professionalism form must be completed and submitted to the COM Dean’s office.

 

What if a student fails some component of the grade?

 

If a student fails the clinical component of the grade, the student fails the course and will therefore be placed on academic probation and must repeat the course. If the student fails a Medicine Core course, the student must repeat a Medicine Core course. If the student fails an externship or elective course, the student must repeat an externship or elective course, respectively, as specified by the Associate Dean for Curriculum, Clinical Sciences.

 

If a student fails a secondary component of the grade (i.e., OSCE) the student will receive a grade of “Incomplete” (IN) and will have the opportunity to remediate that portion of the grade. The student will not receive honors for the course as a whole regardless of their performance on the remediated portion of the grade. If the secondary component is failed a second time, the student must repeat the course. 

 

If a student fails a secondary component of the course that requires remediation, the second attempt must occur prior to graduation or within 6 months, whichever occurs sooner. If remediation is not achieved in this time frame, the student will fail the course and will therefore be placed on academic probation and must repeat the course.

 

E. 4th Year Course Honors

A student will be eligible for honors at the discretion of the course director if the student achieves a Clinical Performance Evaluation clinical grade of 3.60 or higher with no ratings of “rarely, if ever” or “inconsistently.”

 

F. Clinical Course Assessment Standards

 

1.      Provision of Feedback

In accordance with LCME standards, the directors of all courses in our medical education program must design and implement a system of fair and timely formative and summative assessment of medical student achievement in each course.

 

Midpoint Formative Feedback

Each course lasting 4 weeks or more will offer purposeful opportunities for formative feedback regarding clinical performance and achievement of requirements (i.e., patient diagnosis log) at the mid-point of the rotation. Midpoint feedback should include each of the following elements:

1)      An assessment of the student’s performance

2)      Confirmation of an adequate learning environment (conducive to learning, demonstrates professionalism, safe.)

3)      Confirmation of adherence to education hours policy

4)      Review of diagnosis and procedure logs

 

When midpoint feedback identifies that a student is performing poorly or at risk of failure, the following actions are necessary:

  1.  The faculty evaluator or course director must inform the student of the deficiencies and instruct the student on how to demonstrate remediation of the deficient skills or behaviors.
  2. The course director or coordinator must notify the Associate Dean for Curriculum, Clinical Sciences in the Dean’s Office.

 

Summative Feedback

Each course will provide students with summative feedback regarding their performance in the course in order to help students identify strengths and weaknesses and improve knowledge, attitudes, and skills as they progress throughout their clinical training. The criteria used to derive the course grade will be made available to students at the beginning of each course in written form. All clinical faculty and rotations will assess the clinical performance of students using the standardized COM Clinical Performance Evaluation (CPE).

 

Narrative Feedback

Each course must provide students with a narrative summary of their individual performance in the course. This narrative may include both comments intended for formative feedback and comments intended as a summative description. Summative comments from clerkships will be submitted to the COM Dean’s office for inclusion in the Medical Student Performance Evaluation. Evaluations that have insufficient narrative feedback may be returned to the evaluator or course director with a request for additional feedback.

 

2.      Timeliness

To ensure the timeliness with which medical students are informed about their final performance in courses, final grades will be available within 40 calendar days (not business days) of the end of a course or exam.

 

3.      Disclosing Remediation

Any failure of the clinical component of the grade or a secondary component such as the written examination or OSCE must be reported to the COM Dean’s office by the corresponding course. In addition, the failure and/or remediation of either a written examination or an OSCE must be disclosed in the narrative description of the student’s performance for the clerkship or required rotation. (e.g., “The student passed the examination on the second attempt with a very solid performance.”)

 

VII.         Special situations    N/A

VIII.       Sanctions for Non-compliance  N/A

IX.           Related Information

A.          References, citations

B.          Other

C.          Appendices

 

X.             Communication Plan 

Students enrolled in clinical courses will be educated about this policy at their orientation to the clinical years as well as any time a substantial update occurs. All faculty are asked to review key policies related to education on an annual basis. Course directors will be notified annually via email to review the policy and more often if substantial changes are adopted.

 

XI.           Definitions 

Summative Feedback: feedback derived from assessments used to evaluate knowledge and skill acquisition at the conclusion of an instructional period, typically high stakes.

 

Formative Feedback: feedback provided with the intention of helping students identify strengths and areas where continued improvement is necessary.

 

XVI.       Review Cycle

Policy will be reviewed at least every 2 years.

 

XVI.       Approval History

List original approval date and subsequent review dates

 

Approval Authority

Date Approved

Undergraduate Curriculum Committee

June 16, 2017

Clinical Sciences Planning and Evaluation Committee

June 14,2017

Undergraduate Curriculum Committee

February 17, 2017

Clinical Sciences Planning and Evaluation Committee

January 11, 2017

Undergraduate Curriculum Committee

May, 2015

 

 

 

XVII.      Approval Signature

 

                                                                                                                                                                                                                                                                                                                          

                                  Donna Kern, MD (Signature)                                                                                  Date

             Senior Associate Dean for Medical Education                       

                                                        Title

 

 
 
 

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