Assessment System: Grading Architecture

Rationale

The Brody School of Medicine (BSOM) assesses its learners using multiple methods across a wide variety of settings to ensure mastery of knowledge, skills and behaviors required for the practice of medicine. A comprehensive grading architecture has been implemented at BSOM to ensure standardized reporting of final grades throughout the curriculum.

Scope

This Standard Operating Procedure (SOP) applies to all courses offered within the medical school curriculum at BSOM. It defines the procedure that will be used for final grade reporting of all courses at BSOM.

Definitions

Foundational Phase: Encompassing the M1 and M2 years, this phase includes all courses leading up to the clinical clerkships. The foundational phase is arranged in a spiral architecture with planned, spaced repetition of topics designed to maximize both retention of facts and mastery of concepts, skills and behaviors.

Clinical Phase: The six core clerkships, a longitudinal radiology clerkship, and two electives each lasting two weeks. The Clinical Phase is traditionally considered the 3rd year of a medical program.

Differentiation Phase: The advanced core clerkships, additional advanced clinical training requirements, and elective opportunities. The Differentiation Phase allows learners to further explore learners’ career path. The differentiation phase also includes opportunities for interviewing and transitioning to residency.

Thread: A defined subset of the curriculum delineating disciplines or other components of medical education. Threads are used to track learner performance within and across semesters.

Course: A Defined block of material, typically lasting an entire semester. Courses may be comprised of multiple threads.

Clerkship: Full-immersion learning experience that focuses on learning in the clinical space.

Exam Block: A defined subset of the curriculum that includes all assessments during a period of time. This includes, but is not limited to, quizzes and exam(s) for that time period.

Resolution: Re-testing on the content of individual thread(s) within a course to demonstrate mastery of the topic.

Responsibilities

Office of Medical Education (OME)

Provides curriculum support to courses including developing syllabus templates that define the grading architecture appropriate for that course, course delivery and outcomes assessment.

The Executive Curriculum Committee (ECC)

The faculty group having ultimate control and responsibility for the curriculum. The ECC reviews and approves curricular changes and monitors overall learner performance outcomes. The ECC determines the grading architecture for all components of the curriculum.

Office of Student Affairs (OSA)

The administrative office that guides student progression through the curriculum. OSA calculates class rank, reported in quartiles, using final numerical course grades as weighted by the total credit hours per course.

Year Curriculum Committees

Assists the ECC. Theis includes the review of course-specific syllabi to ensure that the grading architecture complies with the ECC-approved grading architecture.

Course Directors

Faculty members who design, deliver and monitor courses using policies approved by the ECC. This includes understanding and following the Grading Architecture SOP as approved by the ECC.

Promotion and Review Committee

A faculty committee that reviews learner performance at regular intervals and implement procedures related to academic progression.

Procedures for Implementation and Review

The following procedures have been implemented to ensure standardized grade reporting across the curriculum. BSOM is committed to ensuring mastery of the medical curriculum competencies to ensure the best patient care while being mindful of learners’ wellbeing.

Grading Conventions

• Learners will be assessed on knowledge, skills, behaviors and/or other criteria as outlined in the relevant syllabi.
• Individual assessment grades will be available to the learners in the learning
  management system as they are finalized as a form of formative feedback.
• No academic bonuses may be given.
• Class rank will be calculated using final course numerical grades and weighted by credit hours for each course.

Foundational Phase Courses

• Final letter grades will be reported on the transcript as either “Pass” or “Fail.” (“P” or “F”)
• In addition to the Pass/Fail designation, all courses will report a final numeric grade out of 100 to the BSOM Registrar.
• The final numeric grade, rounded to whole numbers, along with the course credit hours, will be used by the Office of Student Affairs for class rank calculation and AOA eligibility.
• A passing threshold of 70 out of 100 has been established by the ECC for all courses.

Foundational Phase Resolution/Remediation

• For courses consisting of threads (eg M2 systems courses) learners achieving below a 70 on any thread, averaged across the relevant exam block, will be required to re-test on that thread during the designated resolution dates. Specifics can be found in these courses’ syllabi.
• The learner must achieve a 70 on this retest in order to demonstrate mastery and resolve the thread.
• The learners’ initial numerical score will be used for class rank and cannot be replaced by resolution.
• Specific remediation pathways are outlined in the respective syllabi of Foundational phase courses that do not have designated threads and are instead a standalone or longitudinal course.
• Limitations on resolution and remediation opportunities are outlined in the Promotion and Review SOP.

M1 Exam Reassessment Option

• Learners with an examination score below 70 in a course or a thread will have one optional attempt to resolve the failure by retaking an assessment on that material.
• The reassessment option will be offered for each examination in the M1 Fall Term and M1 Spring Term. Specific dates are listed in the curriculum calendar.
• The first score earned will be used for class rank.
• The higher of the two attempts will be used to calculate the course average for progression purposes. Remediation attempts receiving a score higher than 70 will be recorded as a 70 for promotion and advancement purposes.
• There will be no other opportunity to remediate examination performance.

Clinical Phase (M3)

• Final letter grades will be reported as “Honors (H)” “A” “B” “C” or “Fail (F)” for the six core clerkships (Internal Medicine, Family Medicine, Pediatrics, Obstetrics-Gynecology, Surgery, and Psychiatry).
• In addition to the letter grade designation, the six core clerkships will report a final numeric grade as a whole number out of 100 to the BSOM registrar.
• The final numeric grade will be used by the Office of Student Affairs for class rank calculation and AOA eligibility.
• Longitudinal clerkships (Radiology) and electives will be graded as P/F.

Differentiation Phase (M4)

• For required clerkships and rotations in this phase (Emergency Medicine, Acting Internships, Neurology/Physical Medicine and Rehabilitation, and Critical Care Medicine), grading will follow the clinical phase grading schema.  Away rotations will also follow this schema.
• For other rotations, courses, and electives, final grades will be P/F.
• Final numeric grades will be reported as a whole number out of 100.
• Final numeric grades earned in the Differentiation Phase will not be used in determining class rank as reported in the MSPE.

Related Policies

Academic Achievement Program SOP

Applicable Laws, Regulations & Standards

LCME Elements 8.1, 8.3, 9.4, and 9.6