Curriculum Management, Evaluation, and Enhancement

Rationale

The Executive Curriculum Committee and its subcommittees are responsible for ongoing monitoring, review, and revision of all aspects of the curriculum to assure achievement of the institutional learning objectives.  The continuous quality improvement process uses internal and external data and national norms to identify opportunities for curricular enhancement and modification.  Programmatic level assessment is undertaken by the curriculum committees to evaluate the overall quality and outcomes of the curriculum to provide the best medical education program possible.  Curriculum review allows for identification of gaps or unwanted redundancy and coordination across the curriculum to resolve these issues.  The Brody School of Medicine uses a tiered approach for course and clerkship review as described below.  The ECC can request an in-depth review at any time.

Scope

Compliance with this policy is mandatory for Brody School of Medicine Office of Medical Education (OME), Curriculum Committees, course and clerkship directors and coordinators, and departmental faculty and chairs with courses and clerkships in the core curriculum for undergraduate medical students.

Definitions

Biennial Review/Preview

A biennial meeting, facilitated by the OME, of the course or clerkship director, course or clerkship coordinator, OME, and department chair in which the course is housed to review quantitative and qualitative data from the previous academic year and discuss planned changes for the upcoming two academic years.

 Programmatic Triennial Review

The curriculum will be reviewed as a whole over the course of 3 years: Foundational, Clinical, and In Toto (one per year on a rotating basis).  The Foundational Review will consist of M1 and M2 courses.  The Clinical Review will cover the M3 and M4 years.  The In Toto Review will provide an all-encompassing review of the total curriculum.  Each instance will provide an opportunity to review institutional learning objectives and address concerns (if any) from a total curriculum stance.  The ECC appoints ad-hoc committees to perform the phase and curriculum in toto reviews and generate reports with administrative support from the OME and ODAS. Results of the phase and curriculum reports will be reviewed and discussed at focused retreats. The subcommittee will generate a report summarizing its findings and recommendations based on review of internal and external data, national norming data, cross-course comparisons, student performance data, evaluations of the course/clerkship by students, and qualitative data.  The ECC will review the full report and recommendations for approval or modification.  The report and recommendations will be communicated to OME, the Senior Associate Dean of Academic Affairs, the Dean, and the Chairs of the relevant departments.  Progress toward the completion of recommendations will be tracked, and a follow-up report will be communicated periodically to the appropriate committees.

Continuous Quality Improvement: A systematic approach to the analysis of performance and efforts leading to improved educational quality and outcomes.

ECC: Executive Curriculum Committee

FCC: Foundational Curriculum Committee

CCC: Clinical Curriculum Committee

OME:  Office of Medical Education

CD: Course or Clerkship Director

Responsibilities and Procedures

Composition of Biennial Review Committee:

• Administrative support from OME (Associate Dean or designee)
• All course/clerkship directors from the relevant course/thread. A CD cannot serve as chair of a review pertaining to their own course.
• The clerkship review subcommittee will appoint an additional basic scientist; All foundational science courses will appoint an additional clinician
• At least one student representative to represent students and report results from a convened panel of students
• The director and coordinator of the courses/clerkships under review will serve as resources to the review committee

 Responsibilities of the Review Committee:

• Read course material prepared by Chair, CD, OME including the pre-report
• Read all student course/clerkship evaluations
• Read prior report and recommendations to ensure areas of prior concern have been addressed
• Meet with CD and coordinator
• Perform a SWOT analysis and make recommendations for quality improvement
• Generate a written report with the assistance of OME

 Report Distribution and Response:

• CD and department chair
• OME, Senior Associate Dean, Dean
• Appropriate curriculum committee and ECC
• Recommendations approved or amended by year and ECC as appropriate
• Response from Department Chair and CD – Any clarifications regarding report content must be requested in writing within 14 days and participate with annual follow-up reports and meetings on progress

See Appendix

1. Course/Clerkship Committee Process
2. Course/Clerkship Review Report Template
3. Review Process Checklist and Data Checklist

Related Policies

Course and Clerkship Director Responsibilities SOP
Curricular Changes Requiring Executive Curriculum Committee Approval SOP

Applicable Laws, Regulations & Standards

LCME 8.3

Appendix

Appendix A: Course/Clerkship Committee Process

Information provided and reviewed prior to committee meeting:
(distributed by OME to the committee at least 2 weeks prior to meeting

1. SWOT analysis from prior review
2. Report from Self-Study by the Clerkship Director and Department Chair
3. Learning Objectives
4. Current Syllabus
5. Internal and external data:

a. AAMC Graduation Questionnaire
b. NBME subject exam scores (as applicable)
c. USMLE performance data (Step 1 and Step 2 with specialization (if available))
d. Grade Distribution
e. OSCE performance by Clerkship
f. Curriculum map query of low-performing topics on NBME shelf exam
g. Compliance

i. Grade timeliness
ii. Required Clinical Experiences Completion Rate
iii. Mid-rotation feedback
iv. Direct observation of students in clinical setting (for clerkships)
v. Mistreatment
vi. CD participation and compliance with standard operating procedures

Self-Study from Clerkship Director and Chair of the Department:
(requested by OME 4 weeks before meeting; CD and chair have 2 weeks to submit report to OME, which then will be distributed to the committee 2 weeks before meeting)

1. Overall Description of the Course/Clerkship: (Provided by the CD)
2. Adequacy of resources/support-faculty, patients, space, financial, IT, administrative, other, including time for the CD to spend on related activities (Provided by CD and Chair)
3. Explanation if prior recommendations have not been addressed
4. Describe preparation of Residents as Teachers
5. Describe departmental distribution of objectives, required conditions, instructional sites, faculty affiliation agreements, and student policies to faculty, residents, graduate students, or pertinent staff
6. Describe assessments of students and assessor training, including formative, summative, and narrative components, if indicated.
7. Describe major successes and challenges
8. Describe how any problems identified by student feedback are being addressed

During the Review:

Charge to committee:

The goals of the review committee are fourfold: 1) to ensure educational quality, innovation, and a supportive learning environment in every course and clerkship, 2) to provide the course and clerkship directors, affiliated departmental chair(s), and Curriculum Committees information regarding themes of student feedback and the integration of clerkship content with other components of the curriculum, 3) to ensure compliance with LCME Educational Standards for accreditation, and 4) to ensure a process for continuous quality improvement of the BSOM curriculum.

The course and clerkship review is a constructive process that aims to stimulate productive discussion among course and clerkship directors, faculty, staff, students, and leadership to support the highest quality educational experience. The review encompasses multiple aspects of the clerkship, including organization, teaching, patient care, the learning environment, student input, and the analysis of the chair and director. The process identifies aspects of the course or clerkship that are particularly effective, which can then be disseminated for broader inclusion and make recommendations for course/clerkship improvement. Additionally, the process can be used to identify opportunities for improved organizational support.

Perform review of LMS course/clerkship site, including objectives, syllabus, content, and recommended reading/resources.

Summarize findings related to:
1. Recommendations from prior review
2. Annual Review (Review-Preview Form) from prior 3 years
3. Report from Clerkship Director and Chair
4. Objectives
5. Syllabus
6. Clerkship evaluation from prior 2 years
7. Internal and external data:

a. NBME subject exam scores
b. USMLE performance data
c. Grade Distribution
d. OSCE utilization and feedback
e. Curriculum map query of low performing topics on NBME shelf exam
f. Compliance

i. Grade timeliness
ii. Required Clinical Experiences Completion Rate
iii. Mid-rotation feedback
iv. Direct observation of students in clinical setting (for clerkships)
v. Mistreatment
vi. CD participation and compliance with standard operating procedures

Perform SWOT Analysis (identify strengths, weaknesses, opportunities, and threats)

After the Review:

Chair of the review committee, with administrative support from OME, will write a draft of the report and distribute it to the review committee for approval prior to presentation at the ECC and its subcommittees.

Any clarifications regarding report content must be requested by the Course Director or Department Chair in writing within 14 days of receipt of the final report.

Appendix B: Course/Clerkship Review Report Template

Course/Clerkship:
Course/Clerkship Directors:
Course/Clerkship Coordinator:
Chair (if applicable)
Review Committee Members:
Date:
Brief Description of the Course/Clerkship:
Summary of prior recommendations and progress:
Notable changes to the Course/Clerkship over the past three years:
Description of how objectives were derived and appropriateness of objectives:
Description of Resident as Teachers preparation (clerkships only):
Description of how objectives, required conditions, and policies are distributed to faculty, residents, graduate students or pertinent staff:
Internal and external data report:

1. NBME subject exam scores
2. USMLE performance data
3. Student evaluation (survey and narrative)
4. Grade distribution and how grade is calculated
5. OSCE utilization and feedback (clerkships and Doctoring only)
6. Curriculum map query (using low-performing topics on NBME shelf exam, if available)
7. Compliance

a. Grade timeliness (clerkships only)
b. Required Clinical Experiences Completion Rate (clerkships only)
c. Mid-rotation feedback (clerkships, Doctoring, and FoM)
d. Direct observation of students in clinical setting (clerkships only)
e. Mistreatment
f. CD participation and compliance with standard operating procedures

SWOT Analysis:

Strengths:
Weaknesses:
Opportunities:
Threats:

Final Recommendations:
Attachments:

1. Syllabus
2. Objectives linked to Institutional Learning Objectives
3. Review-Preview forms