Exhibits

1. Principles of Educational Program Planning and Implementation (exhibit 1)
2. Educational Program and Curriculum Goals and Objectives (exhibit 2)
3. Competency Categories: Graduation Competencies for Medical School (exhibit 3)
4. Clinical Presentation List (exhibit 4)
5. The Faculty’s Vision of Exemplary Professionalism in Medicine (exhibit 5)
6. College of Medicine Evaluation Plan (exhibit 6)
7. Evaluating Student Performance in the UFCOM Competency-based Curriculum

Principles of Educational Program Planning and Implementation (exhibit 1)

The principles were developed with the expectation that they would: (1) serve as criteria for which to base standards of quality for curriculum development, instruction, and evaluation in order to achieve equivalency of approach within the institution and at off-campus sites; (2) serve as a guide to course and clerkship directors in planning and implementing instructional units; (3) be promulgated among students, faculty, and alumni, and serve as criteria for assessing compliance by courses and clerkships, and the curriculum as a whole, and (4) be reviewed periodically for affirmation or revision of the basic tenets of our educational program.

A set of eleven statements was developed and approved by the Curriculum Committee in January of 1994. This document was reviewed, revised, and, after a lively debate, unanimously approved in March of 1997. The principles are as follows:

1. The general professional education of the physician is the goal of the curriculum:

The General Professional Education is represented as a set of competencies to be acquired by the students as cognitive and psychomotor skills, and professional behaviors which all physicians must master regardless of specialty.

2. The educational program and evaluations are competency based:
   • ability to use basic science knowledge
   • ability to apply clinical knowledge and skills
   • clinical reasoning
   • professional behavior
   • Student evaluations must assess mastery of the stated competencies.

The general professional education must be defined in terms of specific competencies expected to be mastered by students. The competencies fall into the following categories:

3. A conceptual framework for defining knowledge promotes learning and effective utilization of that knowledge and serves as a basis for curriculum integration:

Each component of the curriculum should be integrated with the other components and the total as defined by the conceptual framework. The design of courses and clerkships must provide the optimal context for learning and use of resources.

4. The ability to learn independently is essential for the physician to provide quality health care:

The student must become an independent lifelong learner to be able to adapt to continuing, substantial and unpredictable changes due to scientific, technologic and socioeconomic developments, which will occur in health care.

5. Incorporation of the characteristics of outstanding physicians in the educational program is essential for complete professional development of students:

The faculty must identify these characteristics and the specific professional behaviors that reflect them.

These behaviors, which include interpersonal skills, ethical and legal competence, and a continuing effort to improve ones own performance and the profession of medicine, must be taught, modeled and evaluated.

6. Effective health care delivery requires the consideration of family and community contexts:

The student must have the opportunity to learn the socioeconomic and psychological conditions which define context and are important factors in the outcome of health care delivery.

7. Appropriate faculty and appropriate clinical settings are essential for students acquiring the mastery of the competencies:

The curriculum should be implemented by carefully assessing faculty resources and clinical care settings which provide the best match for competency achievement.

8. Informatics is essential for effective utilization of information by students:

Whenever appropriate, information technology should be applied to instruction, assessment, clinical decision making, and patient care.

9. The educational program must be responsive to emerging needs of society:

These needs and expectations must be taken into account when considering curricular content and design.

10. Discovery of new knowledge and solutions are part of the medical profession:

Students must be allowed and encouraged to pursue research interests in the basic, clinical or socioeconomic sciences. They should also attain an understanding of the processes underlying discovery in the context of health care. Students wanting to participate in this process should be provided adequate time, resources, and preceptorship to do so.

11. Health care delivery requires individual and team efforts:

The educational program should include exposure to settings which demonstrate the team approach to health care delivery.

We are convinced that the quality of an educational program can be strengthened by verbalization and documentation of the vision and values to which the faculty can adhere. Furthermore, the process of arriving at such documentation can help establish an institutional conscience and memory, helpful to both current and future generations of faculty and students.

12. Learning and professional development requires a humane environment which fosters respect, personal integrity, service orientation and a sense of personal well being:

Our students are being trained to become care givers. We must insure that the environment in which they train cares for them. Our program should be attentive to the student’s sense of well being and foster personal growth, which will engender successful human relationships which is the cornerstone of care giving.

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Educational Program and Curriculum Goals and Objectives (Exhibit 2)

Principle 1: The general professional education is the goal of the curriculum.

Goal: Provide a program that defines a core curriculum designed to provide the foundations of medical science and practice and prepares students for any residency of their choosing.

Principle 2: The educational program and evaluations are competency based.

Goal: Develop a competency based curriculum and evaluation system

Objectives:

• Develop comprehensive list of competencies
• Develop course learning objectives based on competency categories
• Ensure that the student evaluation process assesses student progress towards attainment of these competencies
• Implement recommendations of the evaluation subcommittee of the curriculum committee
• Develop an evaluation scheme that will specifically address the performance of our graduates during their residencies.

Principle 3: A conceptual framework for defining knowledge promotes learning and effective utilization of that knowledge and serves as a basis for curriculum integration.

Goal: Core material will be taught in the context of clinical relevance.

Objectives:

• Determine the degree to which pre-clinical material is taught in the context of clinical utility.
• Provide clinical support in the development of basic science course objectives.
• Develop clinically relevant basic science questions to be integrated with the performance-based evaluations in the Harrell Center. These questions are asked at computer interstations after a standardized patient encounter.
• Continue to develop the integrated course, “Essentials of Patient Care,” in the first two years of medical school with the ongoing goal of teaching the pre-clinical curriculum in the context of total professional development. The curriculum of this course will be coordinated with the learning of basic science concepts and emphasize human relationship building, communication, and ethical and professional behavior.

Principle 4: The ability to learn independently is essential for the physician to provide quality health care and promotes the development of life long learning habits.

Goal: Develop structure and learning methodologies that foster independent learning.

Objectives:

• Adopt a structure in the first two years that allows no more than _ day of contact hours for basic science courses
• Assure that scheduled faculty contact with students during the pre-clinical years does not exceed 25 hours per week.
• Develop independent study modalities such as computer assisted learning modules.

Principle 5: Incorporation of the characteristics of outstanding physicians in the educational program is essential for complete professional development of students.

Goal: Develop curriculum and programs to encourage the highest standards of professionalism

Objectives:

• Develop a faculty statement of exemplary professionalism
• Derive a list of professionalism competencies from the above statement
• Develop a curriculum addressing professionalism competencies

Principle 6: Effective health care delivery requires the consideration of family and community context.

Goal: Develop learning experiences to focus on the family and community context

Objectives:

• Provide an emphasis on the health needs of our community and society in general; this should take place early in the medical school and persist throughout the clinical years.
• Provide support for the Interdisciplinary Family Health course and other community-based programs.
• Maintain required clerkship in Family Medicine.
• Provide students with knowledge about community resources that complement the role of the physician in caring for patients.

Principle 7: Appropriate faculty and appropriate clinical settings are essential for students acquiring the mastery of competencies.

Goal: Utilize diverse clinical settings and utilize our best teaching faculty in those settings.

Objectives:

• Maintain appropriate balance of ambulatory versus inpatient training.
• Expand the use of the Jacksonville campus.
• Improve access to general pediatric clinical settings.
• Expand clinical facilities that offer opportunities to gain experiences in a multitude of health care settings, care for a wide spectrum of patient problems, and participate with other members of the health care team.
• Empower the Office of Generalist Education and Community programs to develop community clinical educational opportunities.
• Continue to work closely with the North Florida AHEC to enhance student exposure to the practice of medicine in rural settings.
• Have faculty serve as facilitators of learning, as well as sources of information, in order that students will learn to retrieve information, critically evaluate the literature, solve problems, apply the scientific method, and make appropriate clinical decisions.

Principle 8: Informatics is essential for effective acquisition and utilization of information by students.

Goal: Develop curriculum and services to develop student skills in informatics

Objectives:

• Implement the informatics curriculum plan adopted by the Curriculum Committee.
• Continue to develop online course exams and web based course materials .
• Encourage the use of information technology to monitor areas of rapid advancement in the care and treatment of patients.
• Have the Office of Information Technology continue helping faculty and students develop innovative learning methods and programs.
• Assist students to learn the practical utilization of information technology in the everyday care of their patients.
• Develop an Internet-based system to provide students and faculty access to secure information about their performance.

Principle 9: The educational program must be responsive to emerging needs of society.

Goal: Develop an educational program that is informed by and responsive to multiple constituencies involved in health care delivery

Objectives:

• Appoint community members to the curriculum committee.
• Charge the curriculum committee with refining and updating the competency list so that our curriculum remains up to date and responsive to society’s needs.
• Develop curriculum in contemporary health care issues such as managed care, health care financing and geriatrics.
• Maintain a balance of training settings as more care is shifted to an ambulatory base.
• Continue to work with AHEC to provide community based training opportunities that demonstrate the civic responsibility of the institution.
• Develop a flexible curriculum component, “Contemporary Issues in Medicine” which focuses on current community and national issues such as substance abuse, violence, AIDS, teenage pregnancy.
• Develop learning experiences in health care economics.
• Increase the number of opportunities for students to experience the practice of medicine in a managed care environment.

Principle 10: Discovery of new knowledge and solutions are part of the medical profession.

Goal: Develop a curriculum which emphasizes new knowledge and discovery

Objectives:

• Continue to develop the research project course in the first year.
• Encourage research activities by continuing to offer mini grants for educational research.
• Encourage and support medical student involvement in research efforts.
• Enhance the MD/PhD program.

Principle 11: Health care delivery requires individual and team efforts.

Goal: Develop a curriculum fostering an interdisciplinary and multi-professional approach to health care delivery

Objectives:

• Continue to develop the Interdisciplinary Generalist Clerkship.
• Provide consistent curricular time across Health Science Center colleges that will allow multicollege involvement.
• Provide ongoing support for the Interdisciplinary Family Health program and additional interdisciplinary community-based service-learning projects.
• Continue to identify and utilize sites with multi-professional services and foster team building in those sites.

Principle 12: Learning and professional development requires a humane environment, which fosters respect, personal integrity, service orientation and a sense of personal well being.

Goal: Develop an educational environment and sequence that fosters student well being and personal growth.

Objectives:

• Continue to refine the Essentials of Patient Care course as an early exposure to strong Faculty role models serving as mentors.
• Continue to support student on site counseling services.
• Continue to develop student career counseling services.
• Develop curriculum and student support groups to address the issues of death and dying.
• Clearly define a set of professional behavior, human relationship and communication competencies.

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Graduation Competencies – University of Florida College of Medicine (Exhibit 3)

1. Professionalism
   • Professional behavior
2. Patient care
   • Diagnostic
   • History
   • Physical Examination
   • Information management
   • Procedural
3. Medical knowledge
   • Core discipline
   • Problem solving
4. Practice-based learning
   • Physician scholar
5. Interpersonal and communication skills
   • Human relationships and communications
6. Systems-based practice
   • Health care management
   • Health service delivery
   • Health care team

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Clinical Presentation List (Exhibit 4)

GENERAL

• health promotion/disease prevention also know as “routine check-ups”
  • including newborn, child, adolescent, adult and elderly
  • including assessment of occupational health hazards
  • including injury prevention counseling
  • including routine “screening issues”
• substance abuse genetic counseling fatigue, malaise, lethargy fever and chills include fever in immunocompromised host edema counseling and care of the dying patient preoperative assessment.

MIND

• suicidal /dangerous behavior anxiety
  • include panic attacks
• psychosis
  • include delusions and hallucinations
• mood disorders
  • include depression and mania personality disorders
• sleep disorders
  • include insomnia

NERVOUS SYSTEM

• loss of consciousness, coma seizures acute confusion Dementia headache muscle weakness, include paresis, paralysis numbness and tingling gait disturbances, include falls dizziness and vertigo speech language disorders

CARDIOVASCULAR

• chest pain palpitations
  • include dysrhythmias
• murmur cardiac arrest shock include hypotension hypertension diminished or absent pulses bruits

RESPIRATORY

• cough shortness of breath noisy breathing, strider, choking
  • include wheezing
• cyanosis
  • include hypoxia hemoptysis

RENAL- URINARY

• dysuria acute urinary retention oliguria/anuria polyuria abnormal urinalysis
  • include proteinuria, hematuria
• management of renal failure
  • include acute and chronic
• scrotal mass scrotal pain

ABDOMINAL-GASTROINTESTINAL

• oral lesions swallowing difficulties
  • include dysphagia
• abdominal pain
  • include acute and chronic dyspepsia
• abdominal mass
  • include hepatomegaly, splenomegaly
• ascites hematemesis vomiting blood in stool jaundice
  • include abnormal liver enzymes
• constipation diarrhea
  • include acute and chronic
• pain on defecation hemorrhoid abdominal wall hernia

REPRODUCTIVE

• contraception pregnancy
  • include normal and complicated
  • management of obstetrical emergencies
• abnormal pap smear pelvic pain
  • include acute and chronic
• infertility abnormal menstrual cycle
  • include amenorrhea, dysfunctional bleeding, dysmenorrhea
• evaluation for sexually transmitted disease vaginal discharge sexual dysfunction
  • including impotence menopause

BLOOD

• anemia abnormal bleeding abnormal bruising abnormal clotting abnormal white blood cells

HEAD AND NECK

• facial pain acute sore throat rhinorrhea hoarseness neck pain neck mass

EAR

• ear pain tinnitus hearing loss

EYE

• visual impairment
  • include blurred vision
• eye pain
  • include eye injuries, eye redness and irritation
• childhood strabismus and amblyopia

MUSCULOSKELETAL/EXTREMITY

• Back pain extremity pain
  • include claudication, myalgia
• acute joint pain
  • include monoarticular and polyarticular
• chronic joint pain
  • include monoarticular, polyarticular
• muscle pain swollen extremity myalgia

METABOLIC

• abnormal serum electrolytes
  • sodium, potassium, calcium
• acid/base disturbance abnormalities of serum cholesterol and lipids management of diabetes poisoning and drug ingestion

NUTRITION

• obesity weight loss nutritional support

LYMPHATIC

• lymphadenopathy

SKIN

• hair and nail complaints skin infections
  • including acne, cellulitis
• skin rash skin tumors

GROWTH AND DEVELOPMENT

• abnormal growth
  • include failure to thrive
• abnormal sexual development
  • include virilization, hirsutism
• breast abnormalities
  • include lumps, pain, discharge

PEDIATRIC

• newborn assessment
  • include congenital malformations
• neonatal respiratory distress neonatal jaundice enuresis problem child
  • include learning disorders, behavior disorders
• communicable diseases of childhood

EVALUATION AFTER INJURY

• major trauma
  • initial assessment and management
  • evaluation and management of
    • head injury
    • spine injury
    • chest injury
    • abdominal injury
    • extremity injury
    • include fractures and dislocations
  • burns
  • include evaluation and stabilization of major burns
  • include management of minor burns
• minor trauma
  • including strains, sprains, lacerations
• bites and stings drowning sexual assault
  • include exposure to sexually transmitted disease
• hypothermia and exposure family violence
  • include child, spouse and elderly abuse

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The Faculty’s Vision of Exemplary Professionalism in Medicine (Exhibit 5)

It is the responsibility of the College’s faculty to define for the students the characteristics of exemplary behavior in the medical profession. This will ensure greater consistency of faculty role modeling for students in a variety of settings. It also serves as a basis for identifying specific measurable behaviors reflecting those characteristics for which the students will be held accountable. The faculty of the University of Florida College of Medicine believes the following elements define the highest standards of professionalism in medicine:

A commitment:

• to excellence in the practice of medicine
• to the generation and dissemination of new knowledge
• to serve the interests and welfare of patients
• to be responsive to the health needs of society
• to life long learning
• to uphold high professional standards

Elements of professionalism are further defined as:

• Altruism. Service to patients without self interest.
• Accountability. Accountable to patients to fulfill the implied physician/patient relationship. Accountable to society for addressing the health needs of the public. Accountable to the profession for adhering to medicine’s time honored ethical precepts.
• Excellence. Conscientious effort to exceed ordinary expectations.
• Duty. A commitment to service.
• Honor and integrity. Being honest and uncompromising in one’s pursuit of high quality patient care.
• Respect for others. Patients, their families, physicians and professional colleagues.

Adapted from Project Professionalism by the American Board of Internal Medicine, Philadelphia 1995, p.5.

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Curriculum Evaluation Plan (Exhibit 6)

Approved by the Curriculum Committee March 9, 1999

In 1997, the Evaluation Subcommittee was charged by the Curriculum Committee to design and implement a comprehensive evaluation system that included:

• a means to more effectively evaluate students’ competencies and for students to have frequent, specific feedback about their proficiency of mastering the knowledge, behavior and skills required for graduation.
• a means to evaluate courses and clerkships that provide the directors of courses/clerkships feedback as to strengths and concerns, and integration with the comprehensive curriculum plan.
• a means to evaluate the teaching and provide teaching faculty timely feedback about their teaching effectiveness
• a means to evaluate the overall medical curriculum

Accordingly, the evaluation subcommittee has crafted four respective evaluation formats to be implemented July 1, 1999. The formats are to evaluate:

• student achievement
• courses/clerkships
• faculty instruction
• the medical curriculum

The formats are based upon the concepts presented in the document, “University of Florida College of Medicine Curriculum Renewal Plan, B. An Evaluation System: Evaluation of Student Achievement, Faculty Instruction, Courses and Clerkships” approved by the Curriculum Committee in June 1997.

I. Student Evaluation

[Originally approved by the Curriculum Committee, June 30, 1998; Revised 1/27/99, 12/11/02]

The goals of addressing student evaluation are threefold:

• to measure a student’s academic achievement and competency development
• to promote timely and specific feedback to students so that they can evaluate their progress
• to identify students with academic problems in order to support and provide remediation as needed, to identify outstanding students and provide appropriate recognition.

These goals can be achieved successfully by accomplishing the following seven objectives. Such objectives are not totally new; some objectives were proposed in reports of past task forces of the curriculum committee. **

**Subcommittee on evaluation/competencies report, M. Duerson, chair, 9/7/94
Final report of the committee for review of student evaluation, O. Harris, chair, 4/87
Report of Task Force on Student Evaluation, M. Duerson, chair, 3/25/97
Revised Report of task force on student evaluation, M. Duerson, chair, 4/9/97
Subcommittee on competencies and evaluation, M. Duerson, chair, 10/1/93

Objective 1: Student evaluations must be based upon learning objectives that are competency-based and criterion-referenced when possible.

1. Measurable, learning course/clerkship objectives must be given to students at the outset of each course/clerkship, and must relate to graduation competencies. The objectives will serve as explicit criteria to measure mastery of student’s knowledge, behaviors and skills.
2. Faculty development will be provided selectively to assist faculty in writing measurable learning objectives and to encourage faculty to use innovative criterion-referenced methods of assessment.

Objective 2: Performanced-based assessment should be a component of all course and clerkship evaluation plans.

1. Examinations must be based upon measurable learning objectives.
2. The use of performance-based formats, other than multiple choice questions (MCQs) must be increased. Use of performance-based evaluations is strongly encouraged in all courses, but is required in all clerkships.
   1. observed performances, e.g., observations of patient interaction in the clinical setting or PBEs
   2. small group learning activities
   3. oral, practical or essay examinations
   4. student thesis
3. Faculty development will be provided selectively to faculty to use innovative methods in assessment.

Objective 3: Formative evaluations and feedback must be incorporated into the evaluation process.

1. Written competency-based formative feedback must be given to a student by course faculty at least once during the course or clerkship. Ideally this should be accomplished mid-way or earlier during accrues/clerkship.
2. The inclusion of student self-assessment is strongly encouraged during the formative feedback process.
3. Faculty development will be provided selectively to enhance the faculty’s ability to provide effective feedback.

Objective 4: Summative evaluations of students’ learning must be based upon competency-based objectives.

1. There will be two summative feedback systems utilized for evaluation of medical students:
   • Course and Clerkship Evaluations: Students level of competencies will be evaluated for each course and clerkship.
   • Performance-Based Examinations Series (PBE): Four PBEs (I-IV) will be administered during the four years of medical curriculum to assess the progress of students development.

   PBE 1	PBE 2	PBE 3A	PBE 3B
   Diagnostic Skills	Diagnostic Skills	Diagnostic Skills	Diagnostic Skills
   History	History	History	History
   Communication	Communication	Communication	Communication
   Professionalism	Professionalism	Professionalism	Professionalism
   		Problem-solving

   1. PBEs will be criterion-referenced for judging the standard of performance.
   2. Students not meeting standards will be required to remediate.
   3. PBE remediation will be competency specific and based on predetermined criteria.
   4. Students’ Competency Profiles will be maintained in the students’ academic records.
2. Faculty development will be provided selectively to faculty to use a variety of summative evaluation techniques.

Objective 5: Evaluation by individuals, other than teaching faculty [e.g., students (self and peer), patients, nurses], when possible, must be incorporated into the evaluation process.

1. Self-assessment: Students are encouraged to utilize a self-assessment in monitoring their progress. Student self-assessment should be encouraged by faculty teaching specific courses/clerkships. A journal may serve as a means for students to document their assessment of learning.
2. Peer assessment: Evaluation by peers should be included in the evaluation process when possible.
3. Patient assessment: Evaluations of students by patients (standardized or actual) should be incorporated in assessing students. The use of standardized patients will decrease variability and increase reliability. In some circumstances, standardized patients should be introduced into clinical settings without the students’ knowledge.
4. Other health care professionals assessment: Evaluations by individuals of the health care team should be considered in determining the competency of a student.

Objective 6: Assessment of professional behavior and human relationship competencies must be incorporated in the evaluation process for all clerkships, and is strongly encouraged in preclinical courses.

1. Evaluation of students’ professional behavior and human relationship competencies must be conducted during all clerkships, and is strongly encouraged for basic science courses.

Objective 7: A uniform competency-based evaluation system must be established.

1. A standard student evaluation will be created for all first and second year courses, required clerkships, and electives that have common performance criteria to assess student achievement of competencies.
2. Course and Clerkship Directors must identify levels of competency upon which formative and summative evaluations are based, and identify minimal standards for satisfactory performance.
3. The evaluation of competencies will be reported on a four-interval (descriptive scale)* evaluation system. This scale will provide formative and summative feedback and assessment on evaluation of clinical skills and application of scientific knowledge.
4. An electronic database will be created to track student competency development through all four years of the curriculum.

*The recommended descriptive labeling system is based upon the following select references:
1. Downing, S. Improving Measures of Student Performance, Acad Med 65(9):S57-58, 1990.
2. Magarian, GJ, Majur, DJ. A National Survey of Grading Systems Used in Medicine Clerkships, Acad Med 65:636-639, 1990.
3. McLeod, PJ. So Few Medical Schools, So Many Clerk Rating Systems! Can Med Assoc J 146(12):21612-2164, 1992.

II. Evaluation of Courses and Clerkships

Introduction

Mission-based budgeting seeks to allocate educational funds equitably, support desired educational outcomes, promote innovation, and reward outstanding teachers, courses and clerkships. To accomplish this, instruction must be evaluated by mission outcome, as well as by activity. Courses and clerkships are evaluated quantitatively through the Faculty Effort Reports you submit. The qualitative component is by evaluation of your annual report, composed of the syllabus and your written report, and numerical data from the College of Medicine education Center (COMEC). Course and clerkship evaluation is performed by the Evaluation Subcommittee of the Curriculum Committee chaired by Kyle E. Rarey, Ph.D. Recommendations of the committee are forwarded to the Curriculum Committee and to the Senior Associate Dean of Educational Affairs. Recommendations for providing resources to courses and clerkships are then forwarded to them by COMEC.
The annual report consists of three parts:
I. The course or clerkship syllabus given to the students
II. The written report prepared by the director with accompanying appendixes
III. Data supplied by the Office of Medical Education (OME)

In order to facilitate evaluation, course/clerkship directors should be sure to include all material requested in the exact form and organization requested. Each section of the syllabus and report should be clearly delineated and identified to correspond with these instructions.

Each section of the syllabus and report are evaluated longitudinally by members of the subcommittee. Four parameters are used to assess quality of a course or clerkship syllabus and four parameters to assess the written report. A reviewer will assess the same section in all reports, i.e. like an NIH grant evaluation. Therefore, each section should “stand alone.” For example: if a deficiency is identified in the section on student evaluation of instruction and a strategy for improvement implemented, the improvement should appear in that section in addition to the separate section on plans for improvement. Do not refer a reviewer to another section.

An example of an exemplary submission(course report/syllabus, clerkship report/syllabus) and the evaluation form used by the subcommittee is provided. It is strongly recommended that these documents be reviewed during preparation of materials.

I. COURSE/CLERKSHIP SYLLABUS

Given to the students. In order, it must contain:
A. Overview
This section should contain the four following elements at a minimum:

• 1. A brief description of the course/clerkship
• 2. The administrative structure
  a. Department chair with contact information
  b. Course/clerkship director with contact information
  c. Course/clerkship administrative assistant/secretary with contact information
• 3. An overview of the clerkship content
  a. Length, hours, units of study as appropriate
  b. Sites for instruction
  c. Schedule for a typical week
• 4. The educational philosophy
  a. Course/clerkship
  b. Department – if there is one

B. Learning Objectives
These must be in the specific format requested (see representative course and clerkship syllabus template)

• 1. The competency categories to be addressed
• 2. The measurable learning objectives for each competency category
• 3. The learning/instructional activity used to achieve each learning objective
• 4. The evaluation methods used to assess student achievement of each learning objective.

C. Student Performance Criteria

• 1. Identify the internal and external measures used to assess student’s knowledge and skills. Representative forms should be included.
• 2. Describe the system for giving formative feedback. Representative forms should included, but alone are not sufficient.
• 3. Describe the system for determining summative feedback. Representative forms should be included.

II. DIRECTOR’S WRITTEN REPORT
Representative course and clerkship written report templates.

A. Identification of the Teaching Faculty for the Course or Clerkship

• 1. Director(s): Total FTE
• 2. Administrative support: Total FTE
• 3. Departmental Teaching Faculty: Total FTE
• 4. Non-departmental Teaching Faculty/Staff/Students: Total FTE

B. Specific Changes in the Course or Clerkship

• 1. Compare to last year and the rationale or basis for any changes.
• 2. Address remediation of areas of weakness or deficiency cited in the previous report.

C. Evaluation of Student Performance

• 1. Identify types of evaluations used to assess student levels of knowledge and/or skills. Comment on the appropriateness of them.
• 2. Describe how students performed on internal or external (e.g., NBME subject examinations) instruments relative to the course/clerkship learning objectives.
• 3. Based upon the data from the Office of Medical Education, comment on the distribution of competency scoring and final grade distribution of student performances. Do you believe that the course evaluation system identified students who were truly exceptional and those that may need additional assistance?

D. Feedback to Students

• 1. Identify the student rating to the on-line course question about formative mid-course feedback.
• 2. Describe your interpretation of such scoring in reference to what is written in your course syllabus about formative feedback, and what actually occurs.
• 3. Discuss the legitimacy of student ratings.

E. Student Evaluation of the Course/Clerkship and Director

• 1. Provide a synopsis/summary of student on-line evaluations of the course/clerkship. This should include analysis and comment by the Director of strengths and areas needing improvement. Numerical data alone is not sufficient. Discuss the legitimacy of the student ratings.
• 2. Provide a synopsis/summary of the student debriefings. This should include analysis and comment by the director of student concerns. Minutes alone are not sufficient. Discuss the legitimacy of the student ratings.
• 3. Provide a synopsis/summary of student evaluation of the Director, and administrative support, if applicable. Discuss the legitimacy of the student ratings.

F. Evaluation of Instruction

• 1. Provide a synopsis/summary of student evaluation (on-line and debriefings) of the overall instruction by faculty, residents and staff, as applicable.
• 2. Critique the overall teaching performance of faculty, residents, and staff from the Director’s perspective. Identify and comment on strengths and areas needing improvement.
• 3. Identify any plans for faculty development.

G. Evaluation of Course/Clerkship

• 1. Discuss the timing and appropriateness of the course/clerkship to the curriculum’s general professional education program including content and instructional methods.
• 2. Discuss the strengths and weaknesses of the course/clerkship and describe plans for improvement. Include a description of present and/or future innovative programs.
• 3. Discuss the long-term plans for continued development and new directions for the course/clerkship.
• 4. Describe the resources needed from the Office of Medical Education to improve the course/clerkship.

III. COURSE/CLERKSHIP AND STUDENT NUMERICAL DATA SUPPLIED BY THE OFFICE OF MEDICAL EDUCATION (OME)
Note: Course and Clerkship directors are not required to submit data for section III in their annual reports.

A. Course/Clerkship Evaluation – Student year end evaluations
B. Course/Clerkship Instruction – Student year-end evaluations
C. Course/Clerkship Director – Student year-end evaluations
D. Student performance

1. NBME subject examinations
2. USMLE Steps 2 and Steps 2, if applicable.

III. Evaluation of Faculty Instruction

Evaluation of faculty instruction is based upon following premises:

• A. Effective teaching skills can be defined. Characteristics of good teaching that can be evaluated are reasonably consistent in the literature. These include:
  • 1. being well prepared for class
  • 2. motivating students
  • 3. effective communication skills
  • 4. demonstrating comprehensive knowledge
  • 5. treating students with respect
  • 6. organized presentation
• B. Sources to assess teaching effectiveness can be identified. The most commonly identified evaluators of teaching effectiveness are students, peers, self, and college administration, with each group having its unique role. Faculty self-evaluation, when used with student and peer evaluation, is helpful in faculty growth and development. This self assessment must be consistent with assignments and the goals and objectives for faculty development agreed upon with the departmental chair.
• C. Some, but not all, faculty evaluation systems change behavior. Faculty development and evaluation are related processes. The former aspires to improve faculty performance and the latter aims to make judgment regarding worth. The processes can be integrated,and can be a powerful technique in changing behavior. On the other hand, there is little evidence that faculty evaluation alone improves instruction. As with any feedback system, faculty evaluation conducted early in the course of instruction favored instructional improvement because it allows faculty members the time and opportunity to make modifications.

Over the past five years, there have evolved standard methods and forms for student and peer evaluation of the faculty through College- and University-Wide initiatives. All teaching units should conform with the standards and use the required forms. Compliance will allow course directors to perform their responsibilities more efficiently, department chairs to have more meaningful assessments of faculty achievement, and the administration to more accurately assess the effectiveness of the overall teaching programs.

For the Curriculum Committee to assess the quality of instruction by the teaching faculty within the courses/clerkships, course directors are responsible that the following objective is addressed.

Objective: Student Evaluation of Teaching Faculty

Standard forms for evaluating teaching faculty by students (Exhibits 2-5) should be used for student assessment (they are available in hard copy and online in Internet-based versions). The forms are available in four formats: Basic Science Teaching, Clinical Teaching, Graduate Medical Education, and a short form for Lectures/Discussion Groups. The latter form should be used only when a faculty member has a minor role in teaching activities. These data will be included in the annual course report.

FOOTNOTE*
1 In preparing this report, the recommendations of two subcommittees that prepared reports on Faculty Evaluation in 1997 were reviewed. A subcommittee chaired by Pat Alguire submitted their report on April 9, 1997. A second report, prepared by Patrick Duff, Jeaninne Webb, and Tim VanSusteren, was submitted to the Curriculum Committee on September 10, 1997. In general, we confirm and support the recommendations of the Alguire Subcommittee. The major recommendations of the other subcommittee dealt with modifying the questions and format of the evaluations forms used in the College of Medicine, as part of the SUS standardization of the evaluation of the faculty. Since the COM is required to conform to the SUS standards, it is not productive to propose such modification.

IV. Evaluation of the Medical Curriculum

The primary mission of the COM is to educate medical students in humanistic, scientific and practical principles of medicine in keeping with the emerging needs of society. Therefore, an effective, dynamic curriculum that serves its students and supports its teaching faculty must be continually reviewed to determine its quality and how students perform within it.

The following are the general goals of the curriculum evaluation system:

• 1. To ensure that the curriculum is “appropriate” for the education and development of competent physicians.
• 2. To assess whether the measurement tools are “appropriate” to gather data about the effectiveness of the programs.
• 3. To update deans, teaching faculty and students as to the effectiveness of the educational program.

Curriculum planning at the UF COM is guided by a set of principles, which were adopted by the Curriculum and Executive Committees. These 12 principles describe which characteristics that the overall curriculum design should possess. The principles, therefore, should be the yardsticks to measure the success of the overall program. A specific evaluation plan is designed to assess the degree of accomplishment of each principle.

These principles are listed below:

1. A general professional education is the goal of the curriculum.The curriculum is intended to provide a set of knowledge, skills and behaviors that encompass a broad overview of the practice of medicine and is relevant to becoming a competent caring physician regardless of subsequent specialty choice.

Evaluation Issue:

• Is there “appropriate” content in the curriculum for a general professional education?
• Determine whether the general professional education program is having the desired impact on students

Evaluation plan:

• Solicit opinions of graduates as to how well the curriculum prepared them for the general practice of medicine.
• Review periodically the college’s-adopted list of competencies to ensure a general professional education of each student.
• Annual survey of UFCOM students performance in residency programs.

2. The educational program and evaluations are competency based.The general professional education is defined by a set of competencies expected to be “mastered” by the students.

Evaluation Issues:

• Does the curriculum content and structure, and the student evaluation system, adequately include the use of competencies?

Evaluation Plan:

• Determine whether all competencies are addressed in the curriculum (i.e., that at least one course teaches it and evaluates students to be sure they are competent in the area).
• Review competency categories to determine where each objective fits into the curriculum.
• Course and clerkship reports should be analyzed for the extent to which education and evaluation is competency based.
• Review descriptors to be sure appropriate descriptors are being used for competencies.
• Assess competency list every 3-5 years to update/modify it.

3. A conceptual framework for defining knowledge promotes learning and effective utilization of that knowledge and serves as a basis for curriculum integration.The curriculum committee has adopted the clinical presentation model as the primary mechanism for integrating basic and clinical science content.

Evaluation plan:

• An annual narrative report should be provided by the evaluation subcommittee to describe progress in implementing the clinical presentation model.
• Course and clerkship reports should be analyzed for the extent to which they use the clinical presentation model.

4. The ability to learn independently is essential for the physician to provide quality health care.

Evaluation Issue:

• Does the curriculum require students to learn independently (and if so, specify where)?

Evaluation plan:

• Annually evaluate student’s perception of their academic environment as a promoter of independent learning. Specific items in the annual class survey should assess student independent learning.
• Course and clerkship reports should include information about activities to promote independent learning.

5. Incorporation of the characteristics of outstanding physicians in the educational program is essential for complete professional development of students.

Evaluation plan:

• Utilize student self and peer evaluation.

6. Effective health care delivery requires the attention to family and community context.

Evaluation plan:

• Assess how and where in the curriculum this topic is being formally addressed.

7. A balanced variety of clinical settings are essential for students acquiring the mastery of competencies.

Evaluation plan:

• Decide upon and monitor the amount of inpatient versus outpatient clinical training site.
• Decide upon and monitor the amount of primary care versus specialty care training.

8. Informatics is essential for effective acquisition and utilization of information by students.

Evaluation plan:

• Provide a narrative description of the progress made toward implementing the Informatics plan adopted by the curriculum committee.
• Evaluate students use of informatics.
• Determine what course and clerkships utilize formal informatics activities.
• Urban vs rural; underserved vs others

9. The evaluation program is competency-based.

• Is the competency system having the desired outcome in terms of student performance?
• Have (for each clinical rotation/basic science course) an additional test, besides the shelf exams, that includes questions designed to see if students are competent in OUR competency areas, e.g., domestic violence, etc.
• Using the data from the competency tracking system, each class should be annually assessed to ensure that the students as a group are making adequate progress in each of the competency categories.
• Using data from our Performance Based Exam Series, each class should be annually assessed to ensure that the students as a group are making adequate progress in the competency categories assessed by those exams.

10. Discovery of new knowledge and solutions are part of the medical profession.

Evaluation plan:

• Assess the level of student educational scholarship, e.g., medical student research and publications.

11. Health care delivery requires individual and team efforts.

Evaluation plan:

• Determine the quality of activities which span colleges, departments, specialties, and provider types.

12. Learning and professional development requires a humane environment, which fosters respect, personal integrity, service orientation and a sense of personal well being.

Evaluation plan:

• Insert items, addressing these issues, in the annual class surveys.
• Institute a critical incident report program

Updated: 3/29/04, 6/9/04

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Evaluating Student Performance in the UFCOM Competency-based Curriculum (Exhibit 7)

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