Course Number: Course Title:
269501011; 269501012; 26950220; 26950221 Learning Communities 101/102 & 201/202
Course Director: E-mail: Phone: Office:
M. Stephen Baxter, MD Stephen.baxter@uc.edu 513-558-8107 MSB 1501
Coordinator: E-mail: Phone: Office:
David Paulik, MA David.paulik@uc.edu 513-558-5580 MSB G453D
Course Overview/What Will I Learn from this Experience? First, the overall goal of the Learning Communities is to provide clinical education that will help integrate all aspects of the curriculum over the first two years of medical school. The cornerstone of the Learning Community activities is case discussion. Each week students are given patient cases, which provide clinical background and relevance for the basic sciences they are learning in the Organ Blocks. These case discussions will occur in small groups that are facilitated by a physician with clinical training. Students will develop clinical problem-solving and critical thinking skills from the beginning of medical school. To prepare for these case discussions, students need to seek out information from a variety of resources in order to answer probe questions about the case, prior to meeting to discuss the case. Development of these self-directed learning skills is very important to one’s success as a physician, so we work to develop these skills early in the curriculum. Your ability to perform these self-directed learning skills will be part of the assessment of your performance and you will be given feedback on this. Another benefit of the Learning Communities is the opportunity to work in small groups. Relationship building and teamwork is an important part of being a successful health care professional. No one person has all the answers or the exact same set of skills as another student, so working together to solve problems or complete a task is an everyday occurrence in medicine (e.g. the use of consultants.) In addition to clinical thinking skills, Learning Communities focuses on teaching the many aspects of the art of medicine that do not fall under a particular specialty or domain such as physiology or internal medicine. While much of this material is covered in Physician and Society, a small group format is the best way to address many of these topics and issues, which really boil down to how to effectively interact with patients and the health care system, and the potential hurdles one will face as a physician. Page 1 of 9
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In summary, the Learning Community experience helps students develop the thought processes and behaviors needed to be successful as a physician. While there is much factual knowledge needed to be a successful physician (and much testing to assess whether one is able to assimilate this knowledge), Learning Communities provides the major forum for students in the first two years of the curriculum to work on these other skills, and to receive feedback on their progress in developing these skills. This experience provides for a smoother transition to the clinical rotations that occur after the foundational sciences Student Learning Outcomes* Upon completion of the Learning Communities program, students will be able to: 1. Demonstrate clinical problem-solving and critical thinking skills. 2. Recognize and understand the importance of clinical signs and symptoms. 3. Form a differential diagnosis. 4. Demonstrate the attitude, behavior, and skills of a self-directed learner. 5. Apply scholarly literature to solve clinical problems. 6. Demonstrate the qualities of empathy and respect for people who come from different cultures and socio-economic backgrounds. 7. Demonstrate the ability to have a constructive interaction with others (including, but not limited to, patients and all health care professionals) when resolving a conflict of opinion. 8. Demonstrate the ability to appropriately consider ethical issues that arise in patient care. 9. Demonstrate the ability to be a reliable team member by being active in team projects and providing leadership when needed. 10. Demonstrate skills and strategies to teach your peers. 11. Identify what roles other health care professionals play in providing optimal patient care. 12. Deliver a well-organized patient presentation. *Please note that the outcomes are aligned with the Entrustable Professional Activities (EPA’s) as defined by AAMC. For more information, see https://members.aamc.org/eweb/upload/Core%20EPA%20Faculty%20and%20Learner%20Guide.pdf
How is this Course Structured? For the first hour, students are to work through the case and answer all of the probe questions for the case. These questions are to be completed in order. The students are to email their answers to the probe questions to their LC facilitator. LC facilitator email addresses will be given to students at the beginning of the year. Please note that during the year there will be a small number of cases that are done as “live cases.” This means that the case will not be posted on Leo prior to the session. The group will have access to the case on Leo when the Learning Community session starts, and the group will proceed to work through the case. The purpose of this is to foster the ability to “think on one’s feet,” mirroring an actual patient encounter, and also to promote discussion among the group on ideas that get presented about how to proceed with the patient case. For these “live case” sessions, students do not need to email case answers to their faculty facilitator. The second hour of LC will cover a wide variety of topics, and have a variety of activities to perform, depending upon the curriculum content being covered that week. If there are written reflections to be completed, students are to email their completed work to their LC facilitator as they do with their case probe question answers. 2
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A copy of the facilitator guide for the case will be posted later in the week, after all LCs have met. All students must email their probe question answers and any other materials/reflections/writings to their LC facilitator by Monday noon on the week that they meet. This holds for both Monday and Tuesday LC students. Course Resources •
LEO
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University of Cincinnati College of Medicine Student Handbook
Methods of Instruction Case Based Instruction/Learning Concept Mapping Discussion, Large Grp (>12) Independent Learning Lecture Patient Presentation – Learner Problem-Based Learning (PBL) Role Play/Dramatization Simulation Tutorial
Clinical Experience – Ambulatory Conference Discussion, Small Grp (<12) Journal Club Mentorship Peer Teaching Reflection Self-Directed Learning Team-Based Learning (TBL) Ward Rounds
Clinical Experience – Inpatient Demonstration Games Laboratory Patient Presentation – Faculty Preceptorship Research Service Learning Activity Team-Building Workshop
Evaluation Methods/Exams/Assignments As of the 2020-21 academic year, Learning Communities is an official course. This means that it will appear on students’ transcripts as a course and students will receive a grade for the course. The two-year experience is divided into four semester-long courses, Learning Communities 101, 102, 201, and 202. The courses are graded pass/fail, with no numerical grade calculated, so the courses will not contribute to the calculation of class rank. Students are evaluated in each of the following six areas: • Integration and Approach to Patient Care • Interpersonal and Communication Skills • Participation and Leadership • Practice-based Learning and Improvement • Preparation • Professionalism For each of the six evaluation areas, facilitators will assign an assessment of either: • Did not meet expectations • Met expectations Any student who receives a summative assessment of “did not meet expectations” in four or more of the six areas during that semester will fail that semester. If the course failed is LC 101 or 201, the student will be permitted to continue on in the curriculum, as long as they are otherwise eligible to continue. Remediation will occur in the summer between the academic year of failure and the next academic year. Remediation will consist of meeting regularly with the course director to go over cases and work on skills identified as not meeting expectations. Any student who receives an assessment of “did not meet expectations” in any area on either a formative or a summative assessment form will be considered for referral to the Office of Student Affairs for the purpose of coordination of assistance for the student. 3
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Each student will meet with their Learning Community facilitator at least once during the semester to receive formative feedback on their performance prior to completion of the summative assessment. As part of the formative feedback process, students will complete a self-assessment rubric and the facilitator will complete a formative assessment rubric that include feedback on the six areas of evaluation. This feedback also will contain written narrative describing student performance and opportunities for improvement. At the end of Learning Communities 202, a final written summative assessment will be completed by facilitators for each student, which will include both the final assessment of their performance in the six evaluation areas and a written narrative assessment of their overall performance in the Learning Communities courses. Course Grading Scale Grade
Percentage
Pass
Pass 3 or more of the six evaluation areas described above
Fail
Fail 4 or more of the six evaluation areas described above
Session Recording Policy •
Students are responsible for the material presented in all didactic activities. Every reasonable effort will be made to record all educational activities occurring in the lecture halls, and provide these recordings to students via the learning management system (LEO). There will be some sessions that are intentionally not recorded; in these cases, students will be given notice well in advance of such sessions that the only opportunity to view such activity will be to attend the live session.
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Despite our best efforts, students should realize that, due to unforeseen circumstances, the recording may not be sufficient to duplicate the events that occur in the lecture hall. For example, some demonstrations may take place that unexpectedly cannot be recorded due to the permanent location of the camera. In addition, some sessions that are intended to be recorded may not be recorded due to a technical glitch. In these cases, students are still responsible for the material presented in these sessions, i.e., material presented in these sessions can be tested/assessed.
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Please note that LC Sessions are NOT recorded.
Final Course Schedules and Mandatory Events • • • • •
Course schedules will be published in LEO four weeks prior to the start date of the course. All mandatory events listed in LEO will be indicated with the “mandatory event” icon. Mandatory events will not be added to the course schedule after the start of the course. In addition, the course syllabus will have a listing of all mandatory events. If it is necessary to move the time and date of a mandatory event due to a conflict with the availability of a presenter or a patient, the course director will communicate this change to the class via email. If a mandatory event is rescheduled and a student previously made plans to be away from school at that time, the student will not be penalized for missing the mandatory event. The student will submit the associated paperwork for an MSSF and the course director will work with the student to formulate an equitable make-up session for the missed mandatory activity. See Attendance and Absences Policy, Medical Student Handbook.
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Students Being Doubled Booked for Events •
The College of Medicine cannot require a student to take make-up exams, Epic training, get flu shots or any other activity during the time that didactic sessions are scheduled. If a student has to reschedule an educational activity (missed exams, Epic training, LPCC, etc.) they may elect to do so when didactic sessions are scheduled as long as they do not miss a mandatory course activity.
Attendance •
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Attendance is required at all learning sessions which involve team/small group based activities (e.g., team-based learning, pharmacology small group sessions, dissection laboratories, laboratories, peer teaching, Learning Communities) and all sessions related to the Interprofessional Experience, the Longitudinal Primary Care Course, Clinical Skills, and the Community Health and Service Learning modules of Physician & Society. Attendance is also required for any session that has a patient as a presenter or has a panel of presenters that have been assembled for the session. These sessions will be listed as required on the course schedule. These sessions will not be recorded. Material covered in the sessions will be testable. Laptops / iPads / tablets must be turned off during these sessions so that the focus is on the patients and guest presenters. Note-taking can be done on paper. Professional dress casual, without white coats, will be required for these sessions. Professional dress causal includes: e.g., men: khakis (no shorts), dress shirt, polo shirts (tie not required); e.g., women: dress, dress shirt/pants, skirt. An excused absence for medical reasons of more than one day needs written verification from a physician attached to the Medical Student Status Form (MSSF). An excused absence for nonmedical reasons must be approved via the MSSF in advance of the session to be missed. An unexcused absence will result in recording a professionalism lapse and a loss of credit for any graded activity. Students should first submit their request for a planned absence to the course/block director using the online MSSF and e-mail to the course director. All planned/excused absences for any reason should be documented on the MSSF). If a student experiences an unplanned absence from required activities, he/she must notify the Registrar of the COM either in person, by telephone, or by email PRIOR TO the start of the required activity. If the student is part of a team (team teaching, dissection, etc.) it is the student’s professional responsibility to also notify the team members. The course director should be contacted to schedule when missed assignments should be completed. Within 48 hours of return to coursework the student must contact the Office of Medical Education (OME) to schedule makeup examinations. Religious accommodations are preapproved by the Associate Dean for Student Affairs by the spring of the previous academic year. Students will be informed as to when requests are due to Student Affairs and what details are required to evaluate the request. Students will be informed of the determinations made prior to beginning the course. The following items are explained in detail in the Medical Student Handbook: o Excused/unexcused/unplanned absence, religious holidays, jury duty, and make-up work. See Attendance and Absences Policy – M1/2, Medical Student Handbook. (Course Specific Policy) Attendance at all LC sessions is mandatory. If for some reason a student is not able to attend an LC session, the student must complete an MSSF form, which is available on MedOneStop. If you have questions, the Student Affairs office can assist you. In addition, the student is to inform David Paulik about the inability to attend the session as soon as the student knows that they will be unable to attend.
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Late/Missed Assignments • • • •
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Course directors will post assignments, all associated materials, and assignment due dates in LEO and by the start of the course. This information will also be included in the course syllabus. Course assignments that are submitted late and are unexcused will receive a grade of zero. In the event of a missed assignment resulting from an MSSF documented issue, Dr. Steve Baxter will adjudicate whether the missed assignment is excused and can still be submitted for credit. It is the student’s responsibility to confirm submission of assignments uploaded to LEO/Blackboard.
In the event of IT issues affecting uploading of documents to LEO/Blackboard, course/Course directors will notify students of the issues and either extend deadlines for uploading and/or suggest other ways of submitting assignments
See Attendance and Absences Policy, Medical Student Handbook.
Policy for Determining the Final Course Grade and Policy for Remediation of Missed Mandatory Course Activities The minimum requirement for a grade of pass consists of the following: 1. 2. 3.
The average of all graded activities and assessments must be 70% or above – there is no rounding of grades. You must attend and participate in all activities indicated as “mandatory”. You must be awarded a “P” (pass) on any required pass/fail component.
It is important to note that even if your average of all graded activities and assessments is 70% or above but you do not fulfill your obligations concerning #2 or 3 above, you will receive an INCOMPLETE for the course until missed mandatory activities are remediated. An excused absence from a mandatory course activity does not eradicate the requirement to complete this activity before a final course grade can be assigned. The nature and scheduling of any remediation for missed mandatory course activity is at the discretion of the course director. See ‘Grading System Policy’ can be found in the Grading System Policy, Medical Student Handbook.
Transportation Expectation This course requires students to travel to either a respective preceptor’s office location, an interprofessional clinical site or community service-learning partner. Thus, all students must have a form of reliable transportation. Every effort is made to reduce the amount of driving for students, but some preceptors are located outside Hamilton County.
Inclement Weather Policy The College of Medicine does not follow the University policy for closure due to inclement weather. Cancellation of UCCOM events and activities will be guided in part, but not exclusively, by the emergency declarations by the Hamilton County Sheriff’s office. The final determination of weather-related cancellations will be made by the College of Medicine. See Inclement Weather Policy, Medical Student Handbook.
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Student Evaluation of the Course The Office of Medical Education requires that all medical students complete end of course evaluations. Providing constructive curricular program feedback is a student’s professional responsibility and is essential for continuous quality improvement of the medical school curriculum. Procedure: 1. Students will receive an e‐mail informing them that an evaluation is available and the date for completion. Students will have two weeks to complete the evaluation. One email reminder will be sent the day before the evaluation is due. 2. M1 and M2 end of course and lecture (pre-clinical faculty) evaluations are mandatory. 30% of the class will be randomly selected to complete each mandatory evaluation. Each student will complete no more than 20 mandatory evaluations per year. Please note students will only receive emails for those mandatory evaluations they have been selected to complete. 3. An M1/M2 student who fails to complete three mandatory evaluation will be placed on the appropriate PAC agenda for discussion. A student may receive a Formative Feedback Form from the PAC for not fulfilling these requirements. See Required Course Evaluation Policy, Medical Student Handbook.
Grade Appeal Should a student have cause to request a review of a final grade of ‘F’ (Failure) that appears on the transcript, the formal grade appeals procedure may be undertaken once final grades are issued. The formal request must be submitted by the student within five business days following the notification of the grade. The only exception to the 5-day rule is if a failing grade was received and the failing grade will lead to a mandatory Leave of Absence; in this case the appeal must occur within 48 hours of posting of the grade. A student cannot appeal a grade received for a remediation course. The procedures for formal and informal grade appeals can be found in the Grade Appeal Process, Medical Student Handbook.
Wellness/Self-Care Student Affairs and the Center for Integrative Health & Wellness offers a number of programs on stress reduction. See http://med.uc.edu/academicsupport and https://med.uc.edu/integrative/education/medicalstudents
Dress Code Professional dress casual, without white coats, will be required for Patient Presentation Sessions. Professional dress causal includes: e.g., men: khakis (no shorts), dress shirt, polo shirts (tie not required); e.g., women: dress, dress shirt/pants, skirt. (Course Specific Policy) -
Special Needs and Accommodations In compliance with the American with Disabilities Act and Section 504 of the Rehabilitation Act of 1973, the UCCOM grants reasonable and appropriate accommodations to medical students with documented disabilities. All reasonable requests will be considered. A request for academic accommodations eligibility is submitted to the Office of Accessibility Resources. The assistant dean in the Office of Student Affairs is the liaison for that office and can assist you in the process of applying. Documentation requirements, approval and notification processes are outlined in the Disabilities Policy, student handbook (Disabilities: Student Policies and Procedures, Medical 7
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Student Handbook). Step-by-step instructions for initiating a request can be found on MedOneStop, academic support tab, Support Services, Request for Accommodations-Disability. For more information, consult the Disabilities: Student Policies and Procedures, Medical Student Handbook
Professionalism As representatives of the healthcare team, our expectation is that you respect and uphold the professional behaviors expected of a physician in terms of how you conduct yourself with patients, peers, staff, and faculty. Professional commendations and lapses will be noted on the formative feedback form submitted to the Office of Student Affairs and the PAC. For more information, consult the Medical Student Honor Code, Medical Student Handbook.
Health Insurance Portability and Accessibility Act (HIPAA) COM holds patient confidentiality and privacy to the highest standards. If you have any questions about HIPAA, direct them to your Course Director. Remember: You are not permitted to check your personal medical record, a family member, friend, or someone for whom you are not directly involved in their care. EPIC Security audits user access and quarterly reports are sent to Dr. Philip Diller, Senior Associate Dean for Educational Affairs for follow-up.
Electronic Communications The University of Cincinnati issues an email account to all registered students at no cost. The UC email account is the official means of communication between students, faculty and administration and all COM activities should only be conducted using University or affiliate email accounts. The COM IT Policies can be found at http://www.uc.edu/infosec.html.
Mistreatment and Harassment Policy The UCCOM is committed to providing a positive learning environment that promotes the acquisition of the knowledge, skills, and attitudes commensurate with being an exemplary physician. In order to achieve this goal, the COM has established standards of behaviors that are based upon mutual respect of all individuals in the learning process. No form of student harassment or abuse is acceptable. For more information, consult the Mistreatment and Harassment Policy Medical Student Handbook.
For a full overview of all UCCOM policies, you can access the Medical Student Handbook at https://med2.uc.edu/med-ed/student-handbook
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