Foundations of the Profession (FOP) AY23-24

Human Blueprint and Architecture (HBA) AY2023-24

Plans for Further Course Development:

Leadership will continue to work with the genetics faculty regarding the density and presentation of materials and will look to see if any of the materials can be moved to other blocks or if additional time can be used for this subject.

Leadership will continue to work with the TBL team to update the pre-session materials and establish a better flow for the facilitation of sessions.

The faculty member who presented the signal transduction lectures will be replaced in the 2024-2025 iteration of HBA.

The positioning of the pharmacodynamics/pharmacokinetics lectures (which has never been a concern in previous iterations of HBA) will be reconsidered.

Leadership is working to rectify issues with the slide manager program and will look into the potential to recruit additional faculty or students as teachers for tissue biology laboratory sessions.

Leadership is working to move some of the more difficult sessions in the block to earlier in HBA to reduce the density in the end of the block.

Issues related to the conduct of one of the HBA faculty have been addressed.

Leadership will continue to refresh the CBL cases.

Plans for Further Course Development:

Block directors will add an introductory lecture to the virology section.

Block leadership will continue to trim excess detail.

Block leadership will review the NBME examination to ensure that it better aligns with the block materials.

Block directors will adjust lecture content accordingly.

Plans for Further Course Development:

The hematology coagulation lectures will likely be re-written and taught by core faculty.

Questions will continue to be sprinkled throughout lecture sessions using Poll Everywhere.

The new histopathology format will continue to be used.

Plans for Further Development:

More cases and review sessions will be provided for the students.

The course will repeat the success of including patients in the course.

The course will repeat the success of improved physiology.

Lecturers will continue to use real-time polling.

The course leaders will continue to build on their discussions of gender inclusion, racial biases, and environmental changes.

Plans for Further Course Development:

Leadership will change around lectures.

Plans to address areas for improvement:

The schedule for the block will remain the same with MSK intermixed with the first few weeks of neuroanatomy.

Content by new block directors will be reworked where appropriate.

TBL content will better reflect the level of material covered in lecture and what will be tested on the end-of-course exams.

Plans to address areas for improvement:

FPR: Patient Care will continue to offer multimodal learning opportunities with lectures, CELA standardized patient encounters, CST sessions, outpatient clinic home preceptor sessions, and small group learning sessions.

Effort continues to align content with that of the FMK science courses and to advise guest speakers regarding the level of detail necessary for first year students.

Course leadership has worked to recruit new preceptors, now called Clinical Skills Teachers, and to study the best format for student/CST pairings through a year-long research study.

The expectation continues to be that all CST sessions will be one hour in length. CSTs have been asked to engage in DIRECT OBSERVATION of their students during these hours.

FPR: Patient Care has taken on 102 outpatient clinics (formerly the CCX clinics), which are now called “Outpatient Clinic Home Preceptorship” (OCHP). These placements are providing a longitudinal and outpatient clinical experience in which students have the opportunity to reinforce their learning and practice skills, particularly skills of written communication through the clinic assignments. Course leadership is providing CSTs and OCHP with information about what students are learning in the course, so that they can focus on these skills during their sessions.

Course leadership has added the “Survey Physical Exam,” this year, which provides the students with an early and foundational introduction to a head-to-toe exam that they can use from the very first clinic session.

Plans to address areas for improvement:

Course directors plan to “Modernize” content and continue to update the readings/articles cited in TopHat.

Work with context speakers to articulate that some students come with significant knowledge while others do not.

Focus on ensuring all students have foundational knowledge.

Encourage a growth mindset by students even if they were exposed to topics previously.

Continue to encourage speakers to use clinic cases and link any theoretical discussions to cases or clinical context.

Revamp the small-group discussion questions for the “Empathy” session.

Combine the last two “Prep for FCC” sessions.

Move Structural Racism into Health Equity space.

Plans for Further Development:

Course leadership plans to do a better job of introducing students to the course on the first day.

Course leadership will proof the syllabus to make sure it is up to date.

Faculty who were new this past iteration will have a more advanced in understanding how the course works, what comes when, portraying expectations, etc.

Plans for Further Development:

FHD and other longitudinal components will transition to FPR in 2024-2025. This year’s course served to pilot several potential changes.

Changes will be made in the clinics, longitudinal days, and CBL case integration.

The advocacy project and windshield surveys will be dropped from the curriculum.

Course leadership will enhance the organization of course materials on the VSTAR platform, creating a centralized hub to streamline navigation for students.

Course leadership will increase the interactivity and engagement of seminars, incorporating more hands-on activities and opportunities for peer collaboration.

Course leadership plans to improve the feedback processes by ensuring students are aware of when they are expected to both give and receive feedback.

The successes that will be repeated when the course transitions to FPR include (1) maintaining the supportive learning environment created by our course directors and faculty, as well as (2) continuing to provide substantial/meaningful patient encounters and interprofessional collaboration opportunities.

Foundations of Clinical Care (FCC)

Medicine FCC AY2023-24

Plans for Further Course Development:

The course directors will no longer delegate the double checking of the schedule and will divide it between the CD and ACD to double check all schedules.  Additionally, will ask students to double check this on their schedules on day one of orientation to avoid this getting missed again.

All assignment due dates on VSTAR will be removed with the exception of one “summary schedule”.

Course directors will review the didactic schedule and try to streamline the sessions, particularly at the beginning of the course. All other lectures will still continue at noon, the same time the residents have lectures.

Course leadership will work on an improved process to ensure the ambulatory schedules are more equitable in the breadth of sub-specialties and general medicine. Students will be allowed to switch clinics amongst themselves, with permission from the CDs.

The Course Directors will schedule time with the EXCITE program to review the expectations for the resident chalk-talks and remind them of the menu of choices.

Will consider adding a “procedures day” to the ambulatory clinics.

Will evaluate the utility and value of all the clerkship assignments to reduce concern about “busy work”.

Plans for Further Course Development:

CD will continue to expand orientation to include clear expectations for students on each of the services, specifically the consult services.

CD will continue to work on expanding the variety of the didactics.

The Neurology clerkship will expand to include an opportunity to rotate on the VA consult service.

Plans for Further Course Development:

The development of an M4 “peer ambassador” for ob/gyn. Areas of focus for this ambassador could be to provide some clarity to residents on student expectations for each clinical environment and reduce student mistreatment/embarrassment concerns. (Consider clerkship leadership facilitate communications about this concern with ob/gyn residency leadership).

The consideration of added CELA time on “cervical size training”.

Providing additional instruction/practice for sterile gown and glove and suturing. A CELA session for all rising M2 students is planned for FCC Phase Launch week. Could consider adding additional time in Ob/gyn orientation.

Evaluating the feasibility and learning experience value of offering both benign gyn and gyn oncology experiences for all clerkship students.

Consider addition of an End-of clerkship in-person feedback session with CDs.

Plans for Further Course Development:

Course leadership is working on improving the organization of the VSTAR Learn course page.

Will continue faculty development work on lectures setting learning objectives and to provide lecture materials on VSTAR.

Will continue to work on faculty development in the outpatient clinics. The plan is to rewrite and resend a letter of expectations to each faculty preceptor. The hope is to decrease the variability in autonomy students have in clinic.

Plans for Further Course Development:

The course director will re-examine the lecture schedule to see if the lecture times can be shortened (will try for no more than a 3-hour block).

Will explore adding didactic sessions on medical causes of psychiatric presentations.

Will consider Shade Tree clinic as an option for a clinical experience.

Will continue to improve the structure and content of the lecture on race.

Will continue to encourage preceptors to provide students with autonomy seeing/interviewing patients in the outpatient clinics. This improved over the course of the year.

Plans for Further Course Development:

Re-evaluation/adjustments of the mentor-mentee model on all services.

Evaluate the surgical opportunities where students could be prioritized to scrub-in along with or in lieu of the PA.

Provide lecture materials to students.

Plans for Further Course Development:

The course director will re-evaluate the learning modules in Top Hat to makes sure the modules emphasize clinical applications and that any redundancy with FMK topics is purposeful.

Will continue faculty development when it comes to facilitating reflection pieces.

Plans for Further Course Development:

Although will not likely change this year, the course leadership will work to move the “Research Connections Event” to earlier in the AY next year.

Course directors and the course coordinator will work to update the mentor database.

Course directors will review and adjust the order of the didactic lectures to provide students with valuable information earlier.  (i.e. connecting with mentors, PLAN, writing IRB proposal, etc.)

The course directors will explore having the IRB session in person. This is challenging as most involved are working remotely.

Plans for Further Course Development:

This year we are allowing for more flexibility between the two longitudinal day topics so they can stand on their own slightly more (i.e. Climate Health).

We have also eliminated the Habits of a systems thinker post-session assignment structure. We may bring this back at some point for 1-2 sessions but my impression of the feedback was that the repetitive nature of the assignment wore on students and was no longer providing reflective value by the end.

As we move into a new phase with FPR2, application of concepts for patients on their current clerkships will be a focus of our team.

Plans for Further Course Development:

Integration into FRP. This course is changing in both scope and structure. This will provide a similar experience for all VUMS students.

Continuing to provide and further enhance faculty development resources in efforts to offer less variability site to site.

Immersion Phase

Plans for Further Course Development:

Continue to monitor medical student and graduate student experience in the course.
Development of a peer assessment for group presentations.
Evaluate the inclusion and assessment of the clinical experience essays.
Add questions from new lectures to the final exam.
Explore using clinical sites off the Main Campus

Plans for Further Course Development:

Review and revise learning objectives for clinical experiences.
Expand coverage of arrhythmias.
Message to clinical preceptors about observing all or part of an H&P.
Consider offering ACLS certification to students.
Explore additional options for clinical placements and continuity with preceptors.

Plans for Further Course Development:

Send course support the assignment and quiz due dates prior to the start of the course, so VSTAR Learn can be updated (ideally, 4 weeks prior to the course starts).
Review current lecture topics and consider additional topics such as AI and cybersecurity.
Develop tracks within the course for students who want to learn more (e.g., the addition of opportunities for coding).

Plans for Further Course Development:

Communicate expectations in clinic to students
Include additional foundational science in the course

Plans for Further Course Development:

Ensure that final grades align with the grading rubric.
Review VSTAR organization and materials, including PowerPoints.
Ensure that all students receive mid-course feedback.
Review final exam to ensure that test questions align with content covered.

Plans for Further Course Development:

Increase course activities to align number of course hours with other ISCs
Revise exam questions to focus on higher level knowledge
Ensure that final grades align with ISC final grade rubric
Develop and distribute document outlining provider and student clinic expectations

Plans for Further Course Development:

Limit event medicine experience to 1/section
Decrease group size for the scanning shift activity
Clarify expectations about the communication shift.
Communicate with peds ED faculty about patient care expectations of ISC students.
Restructure the ultrasound essay activity.

Plans for Further Course Development:

Review test statistics.
Review the ISC grading rubric when assigning grades.
Integration of mental health topics.

Plans for Further Course Development:

Send updated syllabus to course support with Course Objectives mapped to the MEPOs
Write objectives for the clinical experiences

Explore palliative care experiences
Consider expanding clinical experiences
Ask students to complete learning goals in VSTAR NEXT
Include in course description that last Friday of the course is required and cannot be missed.

Plans for Further Course Development:

Develop a rubric for assessing and providing feedback on students’ presentations.
Provide students with the objectives for the recorded lectures.
Request and utilize students’ personal learning goals in VSTAR NEXT.
Continue to search for additional lecturers to expand and advance content.
Explore additional clinical experiences.

Plans for Further Course Development:

Onboard non-course director faculty to teach in the course

Improve timeliness of feedback for diagnostic time outs and capstone proposals

Plans for Further Course Development:

Review assessment forms
Review CBL cases to highlight pharmacology
Review quiz questions to increase application rather than recall
Review course activities to add gamification for reinforcing foundational science knowledge

Plans for Further Course Development:

Decrease course offering to 2 sections in AY25-26
Encourage students to send Compass evaluation requests themselves

Plans for Further Course Development:

Review questions for quizzes and exams
Update lecture materials and review organization of materials on VSTAR
Revise rubrics for oral presentations and anatomy dissections
Provide midcourse feedback and complete midcourse feedback form
Review ISC grading rubric and ensure alignment of final grade with grading rubric

Plans for Further Course Development:

Review final grade alignment with ISC final grade rubric, quantitative assessments, and competency-based assessments with the Immersion Phase team.
Optimize timing of QuizTime question and answer release to students
Reinforce Q&A opportunities for recorded lectures

Opioid ISC AY2023-24

Plans for Further Course Development:

Align session-level objectives with course objectives
When possible, have another faculty member review assessment items to ensure the maintenance of high-quality questions
Ensure that the final grade aligns with the domain scores that are entered into VSTAR Grades
Assess higher order learning in future assessments
May include residents and Community Health ISC in classroom session
Consider CELA experience with H&Ps worked in for more practice

Plans for Further Course Development:

Work with course support on any needed changes to the course in VSTAR
Work with students to avoid content overlap of final presentations
Continue to monitor overlap with LGBTQ+ Health ISC
Ensure the accuracy of quiz items
Add additional lectures on topics recommended by students

Plans for Further Course Development:

Continue to message that students will get midcourse feedback in their portfolio after they complete unit 4 of Learning Communities.

Message to students about the objectives of the session on medical error.

Message to students about the reasoning for combining colleges.

Monitor student feedback on the burnout and priority setting session.

Implement mentor development sessions.

Plans for Further Course Development:

Will add qualitative research question to course quiz to highlight importance.

Continue faculty development and monitoring of student assessment.

Plans for Further Course Development:

Reorganize the course in VSTAR Learn so that materials are easier to find. Consider onboarding students as consultants.

Improve student assessment so that performance expectations and the grading process are more clear.

Review and revise the Wednesday sessions to make them more meaningful for students.

Review presentation exemplars and level-set expectations with students.

Revise course objectives in the syllabus to better align with MEPOs.

Patient Safety

CDs will monitor modifications to VSTAR to ensure improved student experience.
CDs will complete midcourse forms in VSTAR NEXT.
CDs will continue to compile list of available MMIs.