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American University of BeirutFaculty of Medicine
The Impact Curriculum and Evaluations
Prepared by Caroline Haddad
Curriculum Implementation Officer
November 2016
Outline
I. The Impact Curriculum
II. Mission and Vision
III. General Description of the Medical Program
IV. Learning Activities
V. Student Assessment and Feedback
VI. Moodle
VII. Evaluations
I. The Impact Curriculum
In 2013-2014, the AUBFM started implementing a new curriculumwhich it called The Impact Curriculum, starting with Year 1, tobe phased in gradually over time. The Impact Curriculum is subjectto constant examination, monitoring, revision and renewal.
The term “Impact” reflects the goals that the AUBFM has set forthis curriculum: to impact and transform you into physicians whoexcel in all domains of medicine, in the hope that you, in turn, willimpact and transform your environment as healers, scholars,educators and advocates.- vision
II. Mission and VisionI. Mission
The mission of the Impact Curriculum is to provide students with an educational program and learning environment in which they will acquire in-depth knowledge, superior skills, humanitarian values, and professional excellence. The Impact Curriculum is a student-centered, competency-based, integrated, dynamic curriculum that emphasizes active and contextual learning, teamwork, critical thinking, problem solving and self-reflection, and offers students opportunities to pursue scholarly work and to acquire leadership skills and qualities.
II. Vision
The vision of the Impact Curriculum is to graduate physicians who will impact and transform society as healers, scholars, educators and advocates.
III. General Description of the Medical Program
The program is built on a solid infrastructure of:
1) Basic medical sciences for which 2 academic years are devoted (pre-clerkship years). Although, the basic concepts of the various components of the basic sciences are the main focus of attention, sufficient emphasis is placed on current developments, on the experimental background, on laboratory exercises, to lay the grounds for selected students to pursue a career in the basic medical sciences or in academic clinical medicine. During these two years, there is sufficient integration of the clinical sciences (knowledge and skills) with the basic science content, providing relevance and equipping students with the basic skills to transition to the third year effortlessly.
2) Clinical clerkship component of the program, which covers a span of two years, focuses in depth on medical problems which are of specific concern in Lebanon and the region.
The graduate of the program, therefore, will possess sufficient background in the basic sciences and the clinical disciplines to pursue a variety of graduate programs, basic or clinical.
Years 1 and 2
The educational approaches accommodate different learning styles in students and include:
• Lectures: which introduce topics, discuss complex phenomena and mechanisms, or integrateinformation
• Laboratory sessions: where principles and information relayed in lectures or readings is exploredin more depth and at a more leisurely pace, with actual experiments or demonstrations. Labsessions are frequently integrated with case discussion sessions as well.
• Small group learning sessions: (e.g. case-based discussions, team based learning, problem basedlearning sessions) in which students collaborate, using their existing knowledge and experience, todeal with complex issues, solve problems, negotiate meaning and establish more intimate contactwith academic staff. This allows students to practice their communication skills in an environmentthat fosters mutual respect and tolerance.
• Independent work: which promotes autonomy, self confidence, creativity and self-learning skills.
General Structure of the Curriculum in years 1 and 2.Duration Year 1 Remainder of Year 1 and All Year 2*
Thread Foundations Block Organ-System Based Integrated Courses
The Science of
Medicine
Topics include: e.g. e.g. e.g.
Gross Anatomy
Histology The BloodThe Cardiovascular
SystemThe GI System
Biochemistry
Genetics in Health and Disease
Basic Cell Physiology and Biophysics
Basic Pathological Processes
Principles of Drug Action
Microbiology
Immunology
Fundamentals of Medical Research - Epidemiology
Biostatistics and Evidence Based Medicine
Epidemiology, Biostatistics
and EBM (includes group research project)
The Art of Medicine
Becoming a Doctor
Clinical and Communication
Skills
Becoming a
Doctor
Clinical and Communication Skills
Socio-cultural/
moral context &
professional
development
Ethics, Professionalism, and
HumanitiesEthics, Professionalism, and Humanities
Global Health and Social
MedicineSocial and Preventive Medicine
Personal and Professional
DevelopmentPersonal and Professional Development
A typical week in years 1 and 2.Actual times may differ depending on the course
Monday Tuesday Wednesday Thursday Friday
8:00 Lecture Lecture Lecture Lecture Lecture
9:00 Lecture Lecture Lecture Lecture Lecture
10:00
10:30
Small GroupEthics
Humanities
Social
Medicine
Small Group Small Group Small Group
Case based Case based Case based Case based
Or Lab Or Lab Or Lab
11:30
12:30 Lunch Lunch Lunch Lunch
13:00Clinical
SkillsLunch
Clinical
Skills
14:00Learning Communities
15:00 Section 1 Section 2
16:00
Years 3 and 4
During Years 3 and 4, learning arises from, and is embedded within, the daily clinical experiences of the students as individuals or teams. The knowledge and skills learned during Years 1 and 2 are further developed in a deliberate and spiral manner that reflects the increasing complexity of the knowledge and tasks required of the students. Thus, learning in these years is:
• In Year 3, students pass through 6 clerkships: Internal Medicine, Surgery, Pediatrics,Obstetrics and Gynecology, Psychiatry, Emergency Medicine .
• In year 4, students reinforce their knowledge and skills in Internal Medicine, Pediatrics,Emergency Medicine, and primary care (Family Medicine), and are given the chance toexplore their interests through elective rotations. In addition, students will gain anunderstanding of the role of the health care system in the overall delivery and quality ofcare through a rotation in Public Health. The principles of epidemiology become directlyintertwined with practice through sessions in Evidence Based Medicine.
General Structure of Year 3Thread Year 3
Science of
Medicine
Internal
MedicinePediatrics Surgery
Obstetrics
and
Gynecology
PsychiatryAnesthesiolo
gyVacation
12w 8w 9w 8w 4w 3w 4w
Evidence Based Medicine
Art of
Medicine
Becoming a
Doctor
Clinical and Communication Skills
Socio-
cultural/
moral
context &
professional
development
Ethics, Professionalism, and Humanities
Social and Preventive Medicine
Personal and Professional Development
Thread Year 4
Science of
Medicine
Internal
MedicinePediatrics
Emergency
Medicine
Neurolog
y
Family
Med
Public
HealthSelectives: Electives
Capstone
CourseVacation
8w 4w 6w 4w 4w 2w 8w 8w 1w 4w
(Ophthalmology,
Otolaryngology,
Radiology,
Dermatology,
Surgery)
Evidence Based Medicine
Art of
MedicineBecoming Clinical and Communication Skills
Sociocultural
/ moral
context
a Doctor Ethics, Professionalism, and Humanities
Social and Preventive Medicine
General Structure of Year 4
IV. Learning Activities1. Lectures: cover the main learning objectives of the course.
2. Laboratory sessions:Learn the anatomy of the human body, Analyze a histological or pathological slides, Conduct and analyze experiments or procedures/techniques, Correlate laboratory findings with clinical findings and reasoning.
3. Team based learning (TBL) sessions: engage the students in team work that aims to solve complex, real, clinically-oriented or experimental problems related to the topics. being studied.
4. Case or problem-based learning: like TBL, involve small group work and clinically based cases and scenarios or experimental studies that require reasoning skills, but involve more open ended questions and discussion.
5. Clinical Skills sessions: Hands on sessions in which students learn the art of history taking, physical examination, communicating with the patient and clinical reasoning.
6. Reflective discussion sessions: conducted in small groups, allow student to reflect on experiences, events and ideas, express opinions, and argue and defend positions. This approach is particularly employed in sessions related to ethics, humanities, and personal and professional development
7. Teaching Rounds: Students rounding on the wards conduct rounds with the resident in charge and with the attending physician in which they present and discuss their patients focusing on their problems, the diagnostic and management plan followed and the bases for their decisions that integrate scientific, social, economic, cultural and other factors.
8. One-on-one teaching: in ambulatory settings and on the wards, students interact with attending physicians and residents in one-on-one encounters during which patients are presented and discussed.
9. Clinical Conferences: focus on presentations of patients seen on the ward or in ambulatory settings or medical topics: include OPD conferences, mortality and morbidity conferences, grand rounds
V. Student Assessment and Feedback (1/3)
1. Written quizzes or examinations: Written examinations are mostly objective, single-answer, multiple-choice questions that aim to test the cognitive abilities of the students
2. Oral examinations: Oral examinations are less commonly used than written examinations to test knowledge, application of knowledge, problem solving and clinical reasoning skills.
3. Practical Examinations: These assessments are used to demonstrate mastery of anatomical knowledge, histo-pathological and radiological skills.
4. Observed structured clinical examinations (OSCE’s)OSCE’s are used to test specific skills (clinical skills and reasoning, procedural skills, communication skills, professional conduct, ethical reasoning). They consist of multiple stations in which students are instructed to perform specific tasks (e.g. history taking, physical examination, communication with patient…), involving simulated or real patients.
Student Assessment and Feedback (2/3)
5. Direct observation of performance: Daily performance of students during the clinical rotations in years 3 and 4 or during case-based discussion sessions, TBL or laboratory work is assessed by their seniors & peers, through direct observation of performance and through examination of their written records. Mini clinical examinations (miniCEX) are special applications of this method in which a faculty member assesses the full clinical encounter between a student and a patient.
6. Essays: Short essays or papers, contributions to discussion forums, and similar approaches are used to assess students’ ethical and professional sensitivity and understanding, and their attitudes, personal development and reflective skills.
Student Assessment and Feedback (3/3)
7. E-portfolio and logbook: In most clinical clerkships, student must fill a logbook describing the patients/cases they have encountered and managed, and the procedures they have performed. E-portfolios consist of a repository of all the students’ learning experiences and reflections, arranged by the students to demonstrate achievement of the required learning objectives and competencies and development of scholarship.
8. Assessment of professionalism: Assessment of professionalism is a component of every course and clerkship, and consists of monitoring performance, fulfillment of duties, and overall attitudes and behavior using multisource feedback.
VI. Moodle
All the courses of Year 1 and 2 are uploaded on Moodle, as follows:
Material posted include: course schedule, learning objectives, lectures, grades, assignments…
Material posted is updated and modified on daily basis by coordinators and administrators of each course.
Students have access to view only information selected by administrators.
VII. EVALUATIONS
Evaluations are assigned and filled on-line on MyEvaluations.com, as follows:
Objective and subjective questions are designed, edited, and assigned depending on requirement and need of each clerkship, course, or session.
Students and faculty members submit evaluations online by an assigned deadline. These are included in grading of students and faculty promotion.
Students fill evaluations at end of each course or clerkship for course, faculty, peer, rotation, and self periodically as in TBL sessions or at end of course.
Faculty members evaluate students at end of course or encounter.
Students evaluate clerkship at end of each rotation.
Analysis of evaluations and comparisons are made at end of each block or clerkship and at the end of each year for improvement or implementing modifications if needed.
Student-Program EvaluationsObjective Questions: 1. The objectives of this course were clearly outlined.
2. Emphasis was on learning and using basic concepts and principles.3. The content and materials were appropriately organized to achieve the objectives.4. The teaching methods (case-based, problem-based, didactic lectures, etc.) used were effective in helping understand the information and concepts. 5. There was adequate presentation of scholarly research work which is at the basis of the concepts and facts6. The required course activities (assignments, etc.) were consistent with meeting course objectives.7. The required resource materials contributed to the learning experience:
- Textbooks8. The required resource materials contributed to the learning experience.
-Handouts /Web based Material9. The required resource materials contributed to the learning experience.
-Laboratory 10. Methods of assessment (examination, etc.) reflected the course objectives.11. The content of the course had clinical relevance.12. Repetition between this course and other courses was re-enforcing and needed. Statistical Analysis Based Q 1-12
on a Scale of 1-5
Average
SD
13. In the space below marked "Comments and/or Observations",
write down the best aspects of the course.
14. What improvements would you suggest for the course?
15. Overall Comments
Agreement Scale
0 - Unable to Assess
1 - Strongly Disagree
2 - Disagree
3 - Neither Agree nor Disagree
4 - Agree
5 - Strongly Agree
Student-Attending Evaluations
Objective Question:
1. The instructor was knowledgeable; he/she clearly explained difficult concepts and subject matter.2. The students were encouraged to participate and ask questions.
3. The instructor was accessible to students, and was ready to listen to their concerns/needs…4. The instructor stimulated critical thinking
5. The instructor showed enthusiasm for the subject matter.
6. The instructor was organized in presenting the material.
7. The instructor was punctual at various activities, and prompt in returning exams.
Statistical Analysis from Q1-7 Based on a Scale of 1-5
Mean SD
Names
8. What were the best attributes of this instructor?9. What improvements would you suggest for the overall teaching of this instructor?10. Overall Comments
Physicians Patients and Society-PPS courses (Ethics) Med 1 & 2
Question
1. The objectives of this course were clearly outlined.2. The content and materials were appropriately organized to achieve the objectives.
3. The teaching/learning methods and activities (discussion, forum, shadowing…)achieved the objectives of the course.4. The methods of assessment (essays, presentations, examination, etc.) reflected and achieved the course objectives and outcomes.5. The required resource materials contributed to the learning experience (e.g. texts, slides of paintings...)6. The content of the course had relevance to my growth and development as a physician and/or an individual7. The course provided a new perspective on the meaning and breadth of the medical profession8. The course provided knowledge, attitudes and skills that will be helpful and needed for physicians9. The course stimulated reflection and critical thinking10. Repetition between this course and other courses was re-enforcing and needed.
Research Design –Med 2
Question
1. This course increased my interest in research
2. In this course I have learned something that I consider valuable
3. The instructor gave students sufficient guidance for assigned work
4. Rate the overall instructor's teaching effectiveness
5. Rate the overall instructor's coordination effectiveness
6. The coordinator was accessible for feedback
7. Resources available were adequate (handouts, computer lab, documents on moodle,.etc.)8. IRB process was efficient
9. Assessment was appropriate to course content & learning outcomes
10. The instructor evaluated work using clear grading criteria
Instructor Research Design1. Encouraged the group to identify our research topic
2. Helped group develop capacity for theoretical reasoning
3. Helped group to be critical and objective concerning our own results and ideas
4. Provided constructive feedback on research proposal
5. Provided constructive feedback on our presentation and writing skills
6. Helped group deal with IRB issues7. Listened carefully to our concerns8. Provided timely feedback9. Was appropriately accessible to the group
10. Conveyed high ethical standards and concern for research subjects
11. Illustrated good mentoring skills12. Would recommend this mentor to future trainees
13. Overall, how satisfied were you with your mentor?
Clinical Skills-Med 1 & 2Question
1. The objectives of this course were clearly outlined.2. Emphasis was on learning and using basic concepts and skills
3. The content and materials were appropriately organized to achieve the objectives.4. The teaching methods (demonstrations, lectures, SP's, etc.) used were effective in helping me understand the information and concepts.
5. The required course activities (assignments, practical sessions, etc.) were consistent with meeting course objectives.
6. The required resource materials contributed to the learning experience:
- Textbooks (Bates)7. The required resource materials contributed to the learning experience.
- Handouts /Web based Material8. The required resource materials were adequate.
- Instruments, equipment…
9. The instructors were clear in their explanations/demonstration of skills
10. During the sessions, there was an opportunity to practice the skills learned.
11. The Instructors provided feedback to students on skills development.12. The methods of assessment reflected the course objectives.
-OSCE
13. The methods of assessment reflected the course objectives.-Written test
14. There was progressive development of skills during the course of the year15. There was good integration of this course with other courses.
Med I Clinical Anatomy
Subjective questions are added to the evaluations:
14. Please comment on the Clinical Discussion part of this course.
15. Please comment specifically on the Radiographic Anatomy part of this course (Strengths, Weaknesses, suggestions).
16. What improvements would you suggest for the course?
Learning Communities - Preceptor Assessment-Med 1 & 2:Attendings evaluate Students
Part 1:Communication
1. Communicates clearly
Speaks with clarity. Explains reasoning or difficult concepts very well. Logical / methodical in explanation.
2. Listens actively
Listens actively. Attempts to obtain information from group members. Does not interrupt. Encourages others to participate.
3. Promotes discussion
Promotes and participates actively in group discussions. Asks probing questions. Provides valuable input.
4. Provides feedback
Gives constructive feedback that is useful, easy to understand, and specific.
Professionalism
1. Comes prepared to sessions
2. Shares information
Shares information, resources, and thinking process.
3. Demonstrates respect to others
Respectful and civil to all. Acknowledges the efforts of others. Does not belittle others. Polite.
4. Is truthful and honest
Admits freely own mistakes and works to correct them. Acknowledges own weaknesses. Keeps commitments.
Part 2:Personal Development
1. Accepts feedback
Receptive to feedback from classmates and teachers - with postive attitude.
2. Recognizes limits
Assesses own knowledge and skills accurately. Asks for help when needed. Humble.
3. Exhibits leadership qualities
Takes initiative in the group. Motivates. Inspires. Resolves conflict in the group.
4. Seeks to understand other people's viewpoints
Sensitive to other people's viewpoints and actively seeks to understand them.
Cognitive Skills
1.Has depth and breadth of knowledge
Excellent level of knowledge for the topic being discussed or for other topics.
2. Identifies problems
Recognizes the important issues to be discussed. Identifies/delineates the problems.
3.Solves problems
Demonstrates critical thinking. Analyzes issues/problems and proposes solutions.
Frequency Scale
0 - No interation
1 - Never
2 - Infrequently
3 - Sometimes
4 - Most of the time
5 - Always
Years 3 and 4 clerkship evaluations
Question:
1. Were the objectives of the clerkships and the duties and competencies (skills and knowledge) required of you in this clerkship clearly explained to you?
2. Were the didactic sessions (lectures, conferences) instructive?
3. Were the attending rounds effective?
4. Were the resident rounds effective?
5. Did you have the opportunity to see a diverse mix of patients?
6. Were you given adequate opportunity to actually participate in patient care?
7. Were you supported and encouraged to offer your own differential diagnosis and treatment plan?
8. Did you feel you understood the diagnostic and therapeutic procedures employed on the patients you saw?
9. Were the standards for your expected level of performance (how you were to be evaluated) on this rotation made clear to you at the onset?
10. Did you receive timely feedback about development of your clinical skills (e.g. charting, physical exams, history taking, and DPR, etc.)?
11. Were the evaluation instruments used to evaluate your performance adequate?
12. Was there adequate integration of basic science content in this rotation?
13. Did the experience enable you to become more familiar with psychosocial and economic aspects of disease?
14. Did the supervising faculty on this service “model” physician-patient interactions on this service in ways you would like to emulate?
15. Were the issues of “Professionalism” and “Ethics” included as a point of discussion by faculty on this rotation?
16. Taking everything into account, did your experiences on this rotation stimulate your commitment to become a physician?
Frequency Scale0 - No interaction1 - Never2 - Infrequently3 - Sometimes4 - Most of the time5 - Always
Assessment of Student Performance in Third and Fourth Year MedicineAttending-Student
1. History taking
2. Physical Examination
3. Assessment of Findings – Clinical Reasoning Skills
4. Plan of Management
5. Presentation of Cases
6. Adequacy of record/note keeping
7. Medical Knowledge
8. Use of the medical literature
9. Command of language
10. Curiosity and motivation
11. Patient care
12. Professional attitude and behavior
13. Relation with Colleagues and supervisors
14. Ethical Principles and Sensitivity
15. Potential for professional and academic growth
Below expectations Borderline Meets Expectations Exceeds Expectations
Outstanding Performance
1 2 3 4 5 6
TBL: Peer and Self Assessment/Feedback FormCommunication
1. Communicates clearly.
Speaks with clarity. Explains reasoning or difficult concepts very well. Logical / methodical in explanation.
2. Listens actively.
Listens actively. Attempts to obtain information from group members. Does not interrupt. Encourages others to participate.
3. Promotes discussion.
Promotes and participates actively in group discussions. Asks probing questions. Provides valuable input.
4. Provides feedback.
Gives constructive feedback that is useful, easy to understand, and specific.
Professionalism
1. Comes prepared to sessions
2. Shares information.
Shares information, resources, and thinking process.
3. Demonstrates respect to others.
Respectful and civil to all. Acknowledges the efforts of others. Does not belittle others. Polite.
4. Is truthful and honest.
Admits freely own mistakes and works to correct them. Acknowledges own weaknesses. Keeps commitments.
Personal Development
1. Accepts feedback.
Receptive to feedback from classmates and teachers - with positive attitude.
2. Recognizes limits.
Assesses own knowledge and skills accurately. Asks for help when needed. Humble.
3. Exhibits leadership qualities.
Takes initiative in the group. Motivates. Inspires. Resolves conflict in the group.
4. Seeks to understand other people's viewpoints.
Sensitive to other people's viewpoints and actively seeks to understand them.
Frequency Scale0 - No interaction1 - Never2 - Infrequently3 - Sometimes4 - Most of the time5 - Always
