Table of Contents
- Assessment Framework
- Core Competencies and Program Level Objectives
- Programmatic Assessment Structure
- Assessment Level
- Primary Modalities
- Oversight Body
- Output/Decision
- Outline of Assessment Modalities
- Assessment Review, Challenge, and Appeal Process
- Professional Attributes and Professional Lapses/Incident Cards
- Clinical Campus Week
- Monitoring Student Development through the MD Program
- Student Learning Center
- Accommodations Support
- Grading
- Targeted Skills Development, Remediation, and Failure
- Student Evaluation, Promotions, and Awards Committee
- Programmatic Requirements
Assessment Framework
The Elson S. Floyd College of Medicine’s Assessment Framework is designed to promote learning, development and progression through criterion-referenced and competency-based approach. Assessments are integrated across the curriculum to create a programmatic approach that provides multiple data points on student performance and informs progression decisions. Assessments collected from across the program and courses are used to monitor and inform students’ development and progression through the yearly milestones. The milestones are level-specific, and developmental descriptors are grouped in the six Program-level Core Competency Domains listed below. We will monitor the students’ progression in each of the six Core Competency Domains. Assessment through criterion-referenced methodology means that progressing through the program is determined by independently meeting the expected specified criteria defined in the milestones for each of the six Core Competency Domains and receive a passing grade in each assessment modality on its own, unless otherwise stated.
This is intended to provide program or phase-level assessment expectations and structure. Individual course-level details are addressed in course specific assessment packages. The framework aims to ensure alignment of all courses and phases.
Core Competencies and Program Level Objectives
- Medical and Scientific Knowledge: Demonstrate knowledge of established and evolving biomedical, clinical, epidemiological, and social-behavioral concepts in caring for healthy, ill patients, and the community
- Patient Care and Health Promotion: Provide evidence-based care that is compassionate, culturally appropriate, and effective for illness prevention, health promotion, treatment of disease, and improvement in quality of life, including appropriate end-of-life care
- Professionalism and Self Awareness: Demonstrate commitment to professional services, adherence to ethical principles, and awareness of one’s own interests, personal biases, vulnerabilities, and limitation of knowledge
- Practice-Based and Life-Long Learning: Demonstrate the ability to appraise, assimilate, innovate, and incorporate scientific evidence to evaluate and improve patient care practices based on continuous self-evaluation and life-long learning
- Systems-Based and Inter-Professional Practice: Demonstrate awareness of and responsiveness to the larger context of health care and the ability to call on system resources, including other health care professionals, to provide optimal care
- Interpersonal and Communication Skills: Demonstrate effective information exchange and collaboration with patients, their families, peers, and other health professionals to enhance their care
Programmatic Assessment Structure
| Assessment Level | Primary Modalities | Oversight Body | Output/Decision |
|---|---|---|---|
| Pre-Clerkship | MKAs, Pin Tests, WBAs, OSCEs, Assignments | Skills Development Panel (SDP) | Course pass/fail, feedback on growth |
| Clerkship -Year 3 | CPAs, WBAs, IPATs, Logs, OSCEs, Assignments | Clinical Competence Panel (CCP) | On-track/off-track status, feedback on growth, Final course grades |
| Clerkship -Year 4 | CPAs, DECs, IPATs, OSCE, Assignments | Y4 Grading Panel | Final course grades |
| Programmatic Requirements (Cross-Phase) | Service Learning, Professional Development, Interprofessional Education, Professional Identity Formation Portfolio, Basic Life Support | Thread directors and Assessment Unit | Completion required for progression and graduation |
| Program-Level | Aggregated data across any phase | SEPAC | Promotion and graduation decisions |
Outline of Assessment Modalities
The assessment instruments, methods, and processes have been planned and coordinated to ensure students receive feedback about their learning early and often by including frequent formative assessments (required or optional assessments that inform learning but do not count towards end-of-course standing) and required summative assessments (that count towards end-of-course standing and/or inform progression decisions) in order to allow for the student to implement a corrective action. Each assessment modality may inform one or more of the six Core Competency Domains. All assessments are considered required unless otherwise noted and satisfactory completion may be required to progress in the program.
Assessment Modalities Across the Program
Workplace-based Assessments (formative or summative)
Workplace-based Assessments (WBAs) are direct observation tools that assess skills and behaviors in clinical and formal curricular settings, for example in small group learning or the clinical setting. In the pre-clerkship these are called WBAs. In the clerkship there are WBAs linked to individual entrustable professional activities (EPAs), clinical performance assessments (CPAs) looking at longer term performance patterns with professionalism and EPA-based clinical skills, and interprofessional attributes tools (IPATs) looking at professional behaviors from the lens of an interprofessional team member. The skills and behavior descriptors are developmental in nature, and complexity will increase as students progress through the curriculum. Each individual skill, attitude, or behavior included on the WBA is linked to the relevant yearly milestones. These tools include space for personalized narrative feedback. WBAs may inform multiple Competency Domains.
Objective Structured Clinical Examinations (low-stakes or high-stakes summative)
An Objective Structured Clinical Examination (OSCE) is a programmatic practical, performance-based examination used to assess problem solving skills, clinical reasoning, decision making, and/or communication skills. A standardized grading scheme specific for each case and level is developed. Learning objectives assessed in the OSCEs may come from any course within the MD program. OSCEs may inform multiple Competency Domains. The Year 4 OSCE is a high-stakes summative assessment that must be passed for graduation. All other OSCEs are low-stakes summative assessments where additional skills work may be required if a student is not meeting competency standards.
Assignments (formative or summative)
An assignment is a form of assessment (Concept map, illness script, essay, diagrams, exercises in comparison and contrast, reflections, clinical note, etc.) used when a multiple-choice question format is deemed inappropriate to assess a particular learning outcome. Assignments are blueprinted to individual session-level objective(s) in the pre-clerkship. Students will receive feedback on each assignment guided by a rubric which includes space for personalized written narrative to help identify the strengths and any areas for improvement. Performance on assignments may inform multiple Competency Domains and timely completion of assignments informs the Professionalism and Self-awareness Competency Domain.
Evaluation Surveys (course requirement)
Evaluation surveys are designed to collect information aimed at monitoring the quality of the different courses and MD program as a whole. All evaluations will be distributed ONLY to the students WSU email account and will come directly from medicine.evaluation@wsu.edu. Completion of each Evaluation Survey is a programmatic and/or course-specific requirement and informs the Professionalism and Self-awareness Domain.
Assessment Modalities in the Pre-clerkship
Written/Computer Based Exams
Weekly Knowledge Checks (formative)
Weekly Knowledge Checks are required learning activities designed to help students consolidate weekly content and assess mastery of key concepts. These may include multiple-choice questions, short answers, essays, illness scripts, diagrams, and concept maps. Each activity is blueprinted to specific session-level learning objectives, when applicable, and is “open-book.” Rationales are provided to guide learning. Completion is required prior to the next summative written/computer-based assessment.
Written/Computer Based Assessments (summative)
Mastery Knowledge Assessments (MKAs) are mandatory exams administered every 3–5 weeks, depending on course structure. They assess conceptual understanding, integration, application, and comprehension, and are blueprinted to session-level objectives appropriate for this modality. Each exam includes a mix of current and previously covered content (4–8 questions per exam) and may inform multiple Competency Domains. Students receive individual score reports, typically within 72 hours, to highlight strengths and gaps to support learning plan development.
Anatomy Practical Knowledge Assessments (Pin Tests) (summative)
Pin Tests are required exams administered throughout the pre-clerkship curriculum, depending on course structure. They assess conceptual understanding, integration, application, and comprehension of anatomy principles, and may inform multiple Competency Domains.
Progress Tests (summative)
College of Medicine utilizes the Comprehensive Basic Sciences Exam (CBSE) from the National Board of Medical Examiners (NBME) as the progress test in the pre-clerkship space. This exam is a comprehensive standardized test that assesses students’ medical and scientific knowledge acquisition and readiness to achieve a passing grade in the Step 1 USMLE board examinations. In addition, they build testing stamina in preparation for USMLE board examinations. Students will complete one Progress test during each term in the pre-clerkship curriculum starting in FMS503. Students are expected to achieve the designated cut score in each term.
| Term | Designated Cut Score |
|---|---|
| FMS 503 | 35 |
| FMS 511 | 45 |
| FMS 512 | 50 |
Assessment Modalities in the Clerkship
Written/Computer Based Exams – Knowledge Checks (formative), Knowledge Assessments (summative)
Formative knowledge checks are learning activities (typically exams) comprised of multiple-choice questions, short answer question(s), essay, illness scripts, diagrams, concept maps, etc. designed to help students consolidate their learning and assess the mastery of concepts learning during clerkship learning. These are often in the form of modules for care domain specific learning in the clerkship. Summative Knowledge assessments are exams that inform overall grades. These may be exams purchased through the National Board of Examiners (NBME) or exams generated internally. Students will receive an individual exam report following each exam to help identify areas of strength and specific knowledge gaps, as well as to support the development of a learning plan. Completion of Knowledge Assessments are a program requirement and may inform multiple Competency Domains.
Portfolios (formative, requirement)
The College of Medicine portfolio is an assessment modality that will inform individual professional development and monitor progression towards achieving the Program Level Objectives and program requirements. Portfolio work is considered a formal method of assessment but is purely formative (formative, but required). Portfolios prompt you to review and integrate feedback, discuss developing competence with a coach, discuss classroom and workplace challenges, and set goals. Students will be connected with a Clinical Portfolio Coach at the beginning of Year 3 and will remain with the coach until the end of Year 4. Clinical Portfolio Coaches will meet with students individually to review learner dashboards, discuss expectations and progress, review feedback and facilitate the exploration of “strengths”, knowledge and skills gaps, and potential “blind spots”. Coaches will also provide on-going support for goal setting and learning plan development, as well as targeted support for individual learning needs. Required components of this work include attending required coaching meetings, and completing informed self-assessments and learning plans.
Logs (formative, requirement)
The College of Medicine Patient/Procedure Logs monitors the completion of specific clinical experiences and patient encounters as approved by the Undergraduate Medical Education Committee (UMEC). All required courses contained required clinical experiences within those logs. Any student who does not have a required clinical experience will be required to complete an alternative learning experience to fill that gap. Individual student logs will be reviewed on an ongoing basis by Clinical Coaches, Clerkship Co-Directors, Course Directors, and grading panels. Completion of the logs may inform multiple Competency Domains.
Assessment Review, Challenge, and Appeal Process
The ability to challenge assessments should exist for a finite period of time following most assessments and the process should correspond in rigor to the impact of the grade and/or decision. The process for assessment review, challenge and/or appeals can be found within cohort assessment resources in E.Flo. Requests should be submitted via the Challenge or Appeal of Assessments Form. For any additional concerns that you feel are worthy of review, challenge, and/or appeal – you can send the request to medicine.assessment@wsu.edu for consideration.
Professional Attributes and Professional Lapses/Incident Cards
The WSU College of Medicine considers Medical Student Professionalism and Self-Awareness to be a core competency of the medical school. This competency is assessed throughout the curriculum at designated intervals through professional attributes assessments or incident card monitoring. Core skills include accountability (completing tasks on time), respectful communication with faculty, staff, colleagues, interprofessional team members and patients/families, being on time and prepared for all required activities, demonstrating an understanding of the roles of all interprofessional team members, etc. Students’ growth in these areas will be monitored through direct observations in the small group setting, direct observations in the Virtual Care Center (VCC) and with patients in the community, through timely completion of assignments, and through responsive communication with faculty and staff. Students with significant lapses in professionalism measured by core assessments or incident cards (detailed below) may be reported to SEPAC and recommended for targeted skills development, remediation, or disciplinary action.
Incident cards are utilized at collage to document and track issues or concerns related to professionalism that occur outside of formal assessment points or with members of the faculty or staff that are not the primary assessors within a course. They capture information or observations about a potential skills gap such as late or missed deadlines, unexcused absences from required sessions, issues associated with punctuality, or unprofessional behavior.
Incident cards may be submitted by faculty or staff at college if they observe a professionalism concern. Incident cards are tracked centrally by the Office of Assessment and reported to the PowerBI Dashboard to help students identify trends in their own learning and help the program support the identification of students who exhibit patterns in professionalism that may require support.
- Minor Professionalism Lapse: Include things like tardiness, turning in an assignment late, not responding to emails, or missed meetings with faculty or staff.
- Major or Egregious Concerns (Isolated events or patterns): Examples of this include, but are not limited to, not attending a required assessment activity, disrespectful interactions with faculty or staff, dishonesty, endangering patients (including standardized patients or during Clinical Campus Week), racist, sexist, or otherwise biased behavior, and/or a significant pattern of ongoing problems despite documented feedback on multiple occasions (including 3 or more incident cards for minor reasons).
Minor Professionalism Lapses will be evaluated by the Course Directors on a case-by-case basis.
Patterns of minor professionalism lapses or any non-minor lapses will be reviewed by a member of assessment, curriculum, and student affairs to address next steps. Professionalism is a part of course assessment and detailed in assessment packages. Professionalism is also a core competency of the program that may be addressed outside of an individual course. Major concerns may be escalated to SEPAC and may halt progression or result in disciplinary action.
Clinical Campus Week
Clinical campus week expectations will be outlined in the course-specific syllabus and assessment package. Clinical campus week is a core curricular experience of the program with assessment occurring primarily in the form of assignments that may inform multiple competency domains. Lack of participation in clinical campus week will be addressed on a case-by-case basis and may require make-up of some or all missed elements. Professionalism expectations are addressed elsewhere in this document and remain an expectation in all elements of the program.
Monitoring Student Development through the MD Program
Student progress will be monitored regularly by the course director(s) to review the progress towards meeting course and program requirements of the MD Program. This will include a holistic review of the student’s performance across that course or the program overall (for instance across multiple courses in the year). If the Course Director(s) or the Assessment and Curriculum faculty leadership identify a gap, or notes that a student is off-track, then they will work with the Assessment unit and may refer the student to the Student Learning Center (SLC).
Student Learning Center
The Student Learning Center (SLC) sits inside the Office of Student Experience. Recommendations may be made to the SLC by the Assessment Unit. The SLC serves to support students as they learn how to approach and learn new content, identify strategies for taking exams, and address both skills and knowledge gaps. The Assessment Unit may refer a student to the SLC if they feel the student would benefit from additional structure and support. The work done within the SLC after referral is at the discretion of the SLC based on the findings of the course team as per the assessments. Performance with the SLC, whether positive or negative, will not impact the requirements of re-assessment for the particular skill involved. Professionalism expectations are addressed elsewhere in this document and remain an expectation in all elements of the program.
Accommodations Support
Washington State University Elson S. Floyd College of Medicine is committed to providing equal access to learning opportunities to students with documented disabilities. To ensure access to your program, please contact Dr. Ranna Nash at ranna.nash@wsu.edu as the designated disability resource professional to engage in a confidential conversation about the process for requesting accommodations in the classroom and clinical settings.
Accommodation is not provided retroactively. Students are encouraged to register with the Disability Resource Professional in the Student Learning Center as soon as they begin their program. Washington State University College of Medicine encourages students to access all resources available through the Student Learning Center for consistent support and access to their programs. Find more information at Spokane Access Services, or by contacting the office at medicine.accommodations@wsu.edu.
Grading
Skills Development Panel
The Skills Development Panel (SDP) is composed of faculty members of the Elson S. Floyd College of Medicine. The SDP meets at the end of each term to review student performance in the course using a variety of assessment data, including written assessments (MKAs and progress tests), narrative feedback (WBAs), course assignments, and pin tests. Incident cards may also be reviewed. The SDP takes a holistic approach to evaluating student progression, providing feedback on strengths and areas for continued growth. The panel recommends a “Satisfactory” or “Fail” grade for the course which is presented to SEPAC by the Course Directors.
Clinical Competence Panel
The Clinical Competence Panel (CCP) is composed of faculty who serve in various educational roles across all four years of the MD program. The CCP reviews student performance across all competency domains by considering all available assessment data collected during the Longitudinal Integrated Clerkship (LIC). The panel meets at the end of each course within the LIC to monitor student growth and progression, providing formative feedback and assigning a status of “On-track,” “On-track with monitoring,” or “Off-track.” Clerkship Co-Directors review CCP feedback to ensure students receive appropriate support. At the conclusion of the LIC, the CCP recommends a final grade, including clinical performance levels for each Patient Care Domain. These recommendations are reviewed by the LIC Co-Directors and presented to SEPAC.
Y4 Grading Panel
The Year 4 Grading Panel is composed of course directors and other medical school faculty. The panel reviews student performance in honors-eligible 4-week rotations using assessment data that includes clinical evaluations, planning for future learning, exams or assignments, and professionalism. Based on holistic and criterion-referenced review, the panel determines a final rotation grade, which course directors approve. For 2-week courses and non-honors-eligible courses, course directors determine the final grade based on the same performance domains, as applicable. These recommendations are reviewed by the Assistant Deans of the Clerkship and presented to SEPAC.
Grading in Med Scholar and LMH
Grading in Med Scholar and LMH is completed by the Course Directors based on the individual assessment packages and framework for those courses. These grades are presented by the Course Directors to SEPAC.
Targeted Skills Development, Remediation, and Failure
Skills gaps may be identified through routine review of the learners’ dashboards, a standardized assessment (OSCE or written exam), communications from instructors, facilitators, preceptors and/or reviews by grading panels.
Students not meeting the criteria for any summative assessment or identified as being “off-track” for any Competency Domain, may be offered up to two attempts (outside of the attempt from the course) to address the identified knowledge, behavior, or skill gaps. TSD is designed to meet narrow gaps in competency domains and not all student performance will be amenable to TSD (e.g. multiple attempts at TSD may suggest a need for more intensive support, multiple failures may indicate a broader gap, and egregious lapses may lead to failure). Determination of what is appropriate for TSD or remediation occurs at the course level. Details are outlined in the course-specific assessment packages.
TSD itself is a 3-step process:
- The Assessment Unit and/or course faculty will identify the gap and develop an individualized learning plan. The targeted element of TSD identifies that the focus in TSD is individualized on the gap or gaps that exist for the individual student or students.
- Students will then engage with support from the Student Learning Center (SLC) and/or with individual faculty members to implement their individualized learning plan.
- The Assessment Unit and course faculty will work together to develop a re-assessment activity for the student to demonstrate that gap(s) have been addressed.
The TSD cycle is used to support any knowledge or skill gap(s) that may surface in the course and program (knowledge, communication, clinical skill, professional attribute, etc).
Students are required to engage in TSD and remediation at the times and locations established by the Assessment Unit. Any travel during these periods of time may have to be cancelled should the student require TSD and/or remediation.
The appendix contains TSD plan examples for the preclerkship and clerkship.
Student Evaluation, Promotions, and Awards Committee
The Student Evaluation, Promotions, and Awards Committee (SEPAC) is the MD Program Promotions Committee. The SEPAC is a faculty committee that meets at the end of each course to review student performance and approve promotion to the next course and/or phase of the program. It should be noted that the SEPAC will review all students each term. If a student has experienced some challenges (e.g. two or more failed exams, multiple incident cards, etc), the SEPAC may take actions that include, but are not limited to, Academic Warning, Academic Probation, requirement for Remediation, Repetition of the course or year, or Dismissal. Learn more on the Medical Student Promotion, Dismissal, and Graduation Policy.
Programmatic Requirements
Programmatic requirements below are not part of a particular course but are educational components of the MD Program which still require completion. These requirements are aligned with the core competencies, mission, and vision of the college and are designed to complete the course curriculum of the program. Students are required to engage with and complete program requirements by the due date as they progress through the MD Program. The due dates for all such requirements will be communicated to students during the specific phase of the MD Program when the requirement is scheduled.
Service Learning
Faculty Lead: Dr. Anne Grossman
The medical education program requires all students to complete a minimum of 12 hours of service-learning over a minimum of four sessions with one community-based organization or program. Students learn about the definition and meaning of service-learning and community service, as well as the activities themselves, in the first term, and their service learning will progress each term. The curriculum supports students’ preparation for service-learning and community service activities through the WSU Spokane Office of Community Engagement and Service Learning, the Population and Community Health Thread director, and by using a dedicated software platform.
In the pre-clinical phase, medical students have opportunities to participate in service-learning and/or community service during self-directed learning time and during their three clinical campus weeks in each academic year. Students who do not meet the required hours and complete programmatic requirements in the pre-clerkship will be required to complete additional work in the clinical years. Students may choose to continue their service-learning and/or community service activities based in their learning communities after meeting requirements.
The following assignments guide student learning as they engage with their chosen community partner. Notably, service learning is not a part of FMS but times below are provided in the timing of when FMS courses are delivered:
FMS 501
- Community Partner Form (formative)
FMS 502
- Finalize Community Partner Choice
- Community Partner Organizational Structure and Impact Analysis (formative)
- Log hours on the GivePulse platform
FMS 503
- Systemic Health Barriers Analysis (formative)
- Log hours on the GivePulse platform, minimum 4
FMS 511
- Single Interaction Reflection (formative)
- Log hours on GivePulse platform, minimum 8
FMS 512
- Final Reflective Presentation (summative)-in person, attendance required
Professional Development
Faculty Lead: Dr. Anne Grossman
Professional development is designed to engage students with CME-eligible learning opportunities that practicing physicians attend to further their education and maintain licensure beyond medical school. These activities may include grand rounds, tumor boards, conferences, webinars, and other events that qualify for Continuing Medical Education (CME).
Students must engage in a professional development opportunity of their choice (minimum one-hour in length) during each term of the pre-clerkship (six in total) and complete a reflection to be submitted on E.FloMD.
Students may find professional development opportunities via the Slack channel, opportunities that they learn about through mentors or Clinical Campus Week (CCW) preceptors, or by reaching out to the Population and Community Health Thread Director directly.
Interprofessional Education
Faculty Lead: Dr. Skye McKennon
The medical education program is designed to prepare students to collaborate effectively within interprofessional health care teams. These teams include practitioners and students from a variety of health disciplines, all working together to deliver coordinated, patient-centered care. Through required structured curricular experiences, medical students engage with peers and professionals from other health fields to develop the knowledge, skills, and attitudes necessary for high-functioning teamwork in clinical settings.
This curriculum is aligned with the Interprofessional Education Collaborative (IPEC) Core Competencies, which include:
- Values/Ethics for Interprofessional Practice: Cultivating mutual respect and shared values among team members.
- Roles/Responsibilities: Understanding one’s own role and the roles of other professions to appropriately assess and address patient needs.
- Interprofessional Communication: Communicating with patients, families, communities, and professionals in a responsive and responsible manner.
- Teams and Teamwork: Applying relationship-building values and principles to perform effectively in team-based care.
Interprofessional Education is assessed using various modalities including, but not limited to, Mastery Knowledge Assessment and Weekly Knowledge Check questions, deliverables (such as interprofessional patient care plans), reflections, and presentations.
Objective Structured Clinical Examinations (OSCE)
An OSCE is an assessment tool that uses multiple stations to assess communication skills, problem-solving skills, clinical reasoning, clinical decision-making, and general clinical skills. OSCEs in the COM Program of Assessment occur in Years 2, 3, and 4. The Assessment Unit and Clinical Skills Director develop standardized grading schemes specific to each case, and assessments are completed by clinicians with contributions by standardized patients. Students are required to participate in all OSCEs and achieve a pass in the final Year 4 summative OSCE. If student performance does not meet expectations in the low-stakes summative OSCEs (Year 2, Year 3), they will be provided support to complete targeted skills development, and additional coaching may be required. Skills assessed in the OSCEs are derived from the entrustable professional activities, curricular milestones and benchmarks, and learning objectives from all areas of the curriculum (Clinical skills, Art and Practice of Medicine, Med Scholar, Case-based Learning, clinical rotations, etc.).
Basic Life Support
Faculty Lead: Dr. Chris Martin
All students must complete Basic Life Support (BLS) certification prior to the first clinical campus week and must maintain certification through their entire time in the MD program. This is a two-step process where students have asynchronous sessions and then in-person verification in the Virtual Clinical Center (VCC). Details of BLS requirements are communicated by the VCC and should be completed in the outlined time frame. For any challenges meeting these requirements, communication should occur with that team or the assessment and curriculum teams. There is a three month overlap between students’ entry into the clerkship phase of the curriculum and their initial BLS certification’s expiration date. This was a deliberate design choice to ensure that all students maintain a valid BLS certification. Student BLS certifications are uploaded and maintained in an online records management system to ensure compliance with guidelines.
Failure to get and maintain BLS certification can result in an inability to complete clinical work which may impact progression in a given course or the program.
Professional Identity Formation Portfolio
Faculty Lead: Dr. Judi Marcin
The Professional Identity Formation (PIF) thread is designed to help students begin to see themselves as physicians, engage in the intentional work of developing their personal identities as a practitioners of medicine, and understand how this professional identity translates in professional behavior. Students will engage with the PIF thread director during each term of the pre-clerkship and complete assignments to help them in their PIF journey. More details about each term’s PIF assignments can be found in the term-specific assessment packages.
Appendix: TSD Examples
Pre-clerkship example of the TSD process associated with knowledge gaps identified through our written exam process (e.g. Mastery Knowledge Assessments):
Step 1: Knowledge gaps identified through MKAs (student does not meet the 70% competency line by not achieving a cumulative 70% across all three exams, having two exams below 70%, or one exam below 67%).
For any student not meeting the criteria to pass the MKAs, the Assessment Unit and relevant course faculty will review assessment information and identify the gap. The analysis will translate to the individualized learning plan that can then be discussed with the student.
Step 2: Student offered additional support prior to re-assessment.
Students will be connected with the SLC and possibly faculty (as needed/available) to discuss the learning plan and review the available resources. The support may come from the SLC itself and/or from an appropriate faculty member (e.g. Anatomy faculty are experts in both anatomy and learning anatomy and are therefore best positioned to support your learning in anatomy).
Step-3: Re-assessment activity that will allow you to demonstrate that you have addressed your learning/skills gap.
Students will have two additional attempts to demonstrate their knowledge. The first attempt is referred to as TSD, the second as Remediation. The method of assessment in TSD and remediation most often matches the method of the original assessment (i.e. a written exam assessment for a failed written exam). If an alternative method of assessment is used, it must meet assessment standards and cannot represent fundamental alterations from the standards of achievement or the faculty and assessment-identified needs of a re-assessment. Students must achieve a score of 70% on TSD or remediation to meet the requirement of TSD or remediation knowledge assessment. TSD and remediation exams are reviewed pre-and post-performance for question quality and validity. Given the number of examinees and the purpose of the exam, there is no standard setting or adjustment of scores.
Students scoring above 70% on the Remediation assessment will have successfully completed the TSD/Remediation process and receive a passing grade for the term. Neither TSD nor Remediation are reflected on student transcripts nor the MSPE. Students who are unsuccessful on the Remediation attempt will fail the course and be required to retake the course the following academic year.
All TSD and Remediation activities must be completed within six weeks after the end of the term in order to continue progression in the pre-clerkship program.
Clerkship example of the TSD process associated with clinical skills gaps as an example.
Step 1: Clinical skills gaps identified. Student is mid-way through the LIC and not yet meeting expectations on clinical performance assessments (CPA) in multiple entrustable professional activities (EPAs).
The CCP will identify that the student is off-track and recommend TSD. The course directors will work together with any relevant care domain leads to outline clinical skills gaps based on available assessments.
Step 2: Student offered additional support.
The course directors will meet with the SLC to determine how to best support the student. If the gap is isolated to a single care domain, a care domain expert (for instance the surgery vice chair) may also be recruited for support. A plan will be discussed to support skills gaps, for instance if the gaps were in oral presentations then the SLC will meet with the student to work on whether the gaps are related to history and physical exam, clinical reasoning, medical knowledge, organization of knowledge, etc – and do skills work to support the student. Given the complexity of clinical schedules, sometimes a student will engage in this support alongside their clinical experiences and at other times the clinical experiences will be de-escalated or paused until skills improvements are made.
Step-3: Re-assessment activity that will allow you to demonstrate that you have addressed your learning/skills gap.
Clinical skills gaps typically require re-assessment of improved performance in the clinical environment.