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LEVEL 1 COMPETENCY EVALUATION


Competency I: Effective communication

Competency II: Basic clinical skills

Competency III: Using Science to Guide Diagnosis, Management, Therapeutics and Prevention

Competency IV - Lifelong Learning

Competency V: Self-awareness, self-care and personal growth

Competency VI: The social and community contexts of health care

Competency VII: Moral reasoning and ethical judgment

Competency VIII: Problem solving

Competency IX: Professionalism and role recognition


Competency I: Effective communication

MEDICAL SCHOOL YEAR 1

Biochemistry:

The student will be evaluated by his/her participation in problem-based learning sessions.

Gross Anatomy:

The students will be evaluated by short oral presentations during the semester. Effectiveness in written communication will be evaluated by the requirement of an autopsy report.

Histology:

The student will be evaluated on the basis of his/her questions/answers to the instructor, as well as by his/her communication of individual study needs.

Microbiology/Immunology:

The student will be evaluated on the basis of patient-centered unknown reports: Every year the students isolate 2 organisms from their own bodily normal flora and write a case vignette for each. The hypothetical case is accompanied by a summary of the techniques used for bacterial isolation and identification.

Neuroscience:

The students will be evaluated by short oral presentations throughout the semester.

Physiology:

Certification in effective communication will require demonstration of basic oral and written communication skills involving academic studies and interaction with colleagues. It will be tested in two ways:

1) The communication skills of each student will be observed during all activities throughout the whole semester in an informal way. It is expected that the student can express himself/herself in a clear, comprehensible way during class, laboratories and problem-based learning sessions. Further, interactions with faculty, staff and fellow students are expected to be conducted in a professional manner. Students with problems in communication and social skills will thus be identified early in the course. Remedial methods will then be discussed and applied. Each student will be evaluated in a pass/fail manner.

2) The second assessment consists of an oral presentation. Each student is required to perform an oral presentation during the semester about a medical topic related to the physiology course. Organized in three steps according to the triple jump idea, the student needs first to choose the topic, which can be a disease, a patient's case, a special diagnosis technique, therapy or drug and the student should discuss his/her choice with the instructor. Second, the student will collect information about the topic by using scientific and medical literature and by interviewing a local practitioner (see competency VI). In a third step, the student will give the presentation in a session open for the public. The seminar will be followed by a discussion, first about the topic and then about the personal performance of the presenter. The latter will include a discussion about the appropriate way of presenting the medical topic, the effective use of autodidactic equipment, the interaction with the audience, etc. The overall performance will be evaluated with the aid of a checklist and/or a Likert scale. Guest audience will be asked to fill out an evaluation sheet. Generally, the ability of all students to participate in the discussion session, to ask appropriate questions and to criticize the presenter in a fair way will be evaluated.

Students failing this competency will perform remedial during the following summer by preparing a second presentation and presenting to the THCME faculty.

 

MEDICAL SCHOOL YEAR 2

Introduction to Medicine II

First semester: History taking and the clinical interview.
Second semester: History and physical diagnosis (H & P)
Student will be expected to produce a complete written H&P by the end of the semester. They will also be expected to present clinical information to their physical diagnosis preceptors.

Pathology:

Clinical cases are presented to the students by using a history and minimal physical findings. The students are then required to communicate with the instructor as to what further testing is necessary, results of testing that they requested, and further physical findings. Then a discussion of the differential diagnoses follows with the students listing the differential diagnoses and explaining why each is a possibility. These clinical cases are introduced at the beginning of the year where at that time the instructor does most of the talking but by the end of the course the instructor does very little talking with the students carrying on 99% of the discussion.


Competency II: Basic clinical skills

 

MEDICAL SCHOOL YEAR 1

Gross Anatomy:

The students will be evaluated on their basic knowledge of imaging techniques (X-rays, CAT and MR scans) and their ability to derive data from these scans at an introductory level.

Microbiology/Immunology:

Introduction to Phlebotomy. The microbiology and immunology course has taken over the phlebotomy laboratory previously taught in biochemistry. Students perform venipuncture using lab partners as volunteers, then analyze the blood samples for hematocrit blood type and separate blood proteins using electrophoresis.

Neurobiology:

The students will be evaluated on their basic knowledge of imaging techniques (X-rays, CAT and MR scans) and their ability to derive data from these scans at an introductory level.

The students will also be evaluated on their ability to perform the Neurological Examination.

 

MEDICAL SCHOOL YEAR 2

Introduction to Medicine II

History and physical diagnosis (H&P) include both interview skills as well as examination skills. Over the course of the semester, students are expected to progress from simply collecting data to the process of synthesis where a problem list/assessment is constructed and a plan for intervention/diagnostic evaluation can be initiated.
Some of the H&P process will be moved into the first year, giving more exposure to student-patient interaction.
With time permitting (and available faculty), students will spend more contact time with an area physician in more of a mentoring (one-to-one) approach.
Student will also participate as intake evaluators in health clinics and perform simple clinical procedures.

Pathology:

Clinical cases are presented to the students with limited history, past medical history and physical findings. In order to develop a list of differential diagnoses, the student is required to ask further questions of the instructor to gain further knowledge of the case. This helps the students realize what questions are appropriate and how to better direct the discussion of the history. Laboratory testing, radiologic testing and other ancillary testing is then discussed with the final formulation of the diagnosis. This begins at the beginning of the year with the instructor demonstrating skills but by the end of the course the students develop the cases without much assistance.


Competency III: Using Science to Guide Diagnosis, Management, Therapeutics and Prevention.

 

All courses will participate in this competency:

 

To achieve level 1, students must:

Assessment tools within courses will be semester examinations and Subject Examinations purchased from the National Board of Medical Examiners or IUSOM statewide examinations.


Competency IV - Lifelong Learning

In the beginning of the first year, THCME students will be tested for their learning preferences (e.g., auditory, visual, expert needed, independent, peers important, etc.) using a Learning Preference Inventory. Results will be discussed individually with the students. In this exercise, students will gain an understanding of what learning activities (e.g., group problem-based learning or solitary reading) work best for them.

To develop one key habit of lifelong learners, namely that of "keeping current in one's field", first year THCME students will be registered for the e-mail notification service of either JAMA or NEJM. Students will receive on a weekly basis the table of contents and article summaries from one or both of these journals. At the end of the first semester, students will be tested on their general knowledge (not specific) of key, recent medical findings.

The Lifelong Learning Competency will also be assessed in two first-year courses at the Terre Haute Center for Medical Education:

Gross Anatomy:

The level 1 student will meet the criteria for lifelong learning by exhibiting the following skills within the structured setting of Gross Anatomy: framing a question, utilizing modern information searching modalities, organizing data, compiling and using the information. These skills will be assessed by relevant topics of clinical correlations in Gross Anatomy.

Furthermore, the level 1 student will be able to demonstrate the basic skills of self-assessment. These skills will include the ability to openly and critically evaluate verbally and in written form one's personal performance on the oral and written examinations as well as in dissection laboratories. The student should be able to recognize problems in his/her learning and seek assistance as necessary.

Histology and Cell Biology:

The level 1 student demonstrates his/her competency in lifelong learning by:

Introduction to Medicine II

Preparation of diagnostic treatment and plan as guided by the data collected during History and Physical diagnosis (H&P).

The following tasks also emphasize the concept that learning is necessary to function well as a physician rather than as a mean to pass a written test:

Neurobiology

The level 1 student will meet the criteria for lifelong learning by exhibiting the following skills within the structured setting of Medical Neurobiology: framing a question, utilizing modern information searching modalities, organizing data, compiling and using the information. These skills will be assessed by relevant topics of clinical correlations in Medical Neurobiology.


Competency V: Self-awareness, self-care and personal growth

Medical School Year 1

Biochemistry:

The student will be evaluated on the basis of his/her behavior and related during problem-based learning sessions.

 

Medical School Year 2

Introduction to Medicine II

Expectation of class attendance, personal appearance, interaction with peers and staff.

Pathology:

Clinical cases are presented in which several options for treatment could be chosen. Each student is encouraged to express their own beliefs and feelings and discuss how these beliefs and values may impact on their patient care.


Competency VI: The social and community contexts of health care

Medical School Year 1

Physiology

Each student will perform an oral presentation about a medical topic related to the physiology course (for details see competency I). To prepare for the presentation the student needs to visit or communicate with at least one physician in the community. This interaction will help the student to outline as part of the presentation the significance of the presented health problem in modern medicine.

In the case of failure to achieve the competency, other health practitioners will be approached and asked for their participation in remedial.

 

Medical School year 2

Introduction to Medicine II

Expectation of class attendance, personal appearance, interaction with peers and staff.

Pathology:

The human immunodeficiency virus is discussed early in the course very thoroughly to help the students prepare for their lectures to the high school students in the area


Competency VII: Moral reasoning and ethical judgment

Medical School Year 2

Pathology:

Clinical cases in which several options for therapy could be chosen are presented. The students are encouraged to develop these options and a discussion of the impact of each option on the patient care follows the clinical case. These cases include issues such as euthanasia, abortion, treatment of the indigent and HIV.

 

Pharmacology

Students will present clinical cases of hypothetical patients. In these cases several therapeutic options will be available and discussed by the students weighing the options in therapeutic efficacy, expense, formulary restrictions, and side effect profiles and how they relate to effective patient care. Cases will include such issues as HIV therapeutics, treatments for hypertension with formulary restrictions, and prescribing practices with scheduled drugs.


Competency VIII: Problem solving

Medical School Year 1

Biochemistry:

Students will be evaluated during their problem-based learning sessions.

Gross Anatomy:

The level 1 student will display competence in the basic problem solving skills necessary to acquire a passing grade in written and oral examination questions emphasizing clinical correlations for Gross Anatomy.

Histology:

The student is presented with clinically relevant problems on exams. The student demonstrates his/her competency in problem-solving by answering these questions correctly.

Microbiology/Immunology:

Patient-oriented problem-solving: The Upjohn POPS series and PBL paper cases are used in the laboratory portion of the Microbiology and Immunology course to promote medical problem-solving skills.

Internet-distributed patient cases: Bacteriology and parasitology cases are currently being developed for independent learning via computer-assisted instruction.

Neurobiology

The level 1 student will display competence in the basic problem solving skills necessary to acquire a passing grade in written and practical examination questions emphasizing clinical correlations for Medical Neurobiology.

At the end of medical school year 1, all students will be required to participate in the Objective Structured Clinical Examination / Triple Jump exam organized by the Indiana University School of Medicine. Problem solving will be evaluated by THCME faculty based on the written pages of the Triple Jump Exam.

 

Medical School Year 2

Introduction to Medicine II

This competency is ideally covered by History and Physical diagnosis (H&P): collect the data, identify the problems, review the literature (book/journal) to review the problems, form differential, plan the further evaluation and intervention for the patient, and be able to explain the reasoning.

Pathology:

Case-based questions as well as scientific questions are used to test the students at the end of each section in Pathology.

Pharmacology:

Students will discuss lecture concepts in a small group setting and get experience determining therapeutic regimens for model patients. Students will weigh pharmacokinetic considerations concerning dosing regimens and side effect profiles to determine effective therapeutic regimens for several classes of therapeutic agents.


Competency IX: Professionalism and role recognition

Medical School Year 1

Biochemistry:

The behavior exhibited in the problem-based learning sessions as well as during class indicate the level of professionalism.

 

Gross Anatomy:

The student will be responsible, reliable, dependable and demonstrate integrity, honesty, courtesy and self-discipline in the classroom.

 

Physiology:

Medical School Year 2

Introduction to Medicine II

Attendance at lectures and other meeting sessions.
Appropriate attire for meeting with patients.

Pathology:

Clinical studies are discussed and while formulating the diagnosis, standard operating procedures, the hospital policies, and legal issues as well as the standard of care are used to determine which testing methodologies and therapeutic treatments are necessary.

Pharmacology:

Clinical cases will be discussed emphasizing proper prescription writing, hospital procedures and policies, and legal issues governing the prescribing of medications.



Link to:

The Terre haute Center for Medical Education Home Page

Definitions of the Competencies Page