Improved classes based on student feedback

In response to both student and faculty feedback, the Course Management Team has improved and updated their course materials. The Course Management Team has revised eight small group sessions and re-recorded eleven lectures, including pulmonary physiology and pathology lectures. Virtual microscopy sessions have been embedded into small group materials. The team improved the audio on selected renal physiology lectures. We are continuing to have two exams during the physiology section of the course. Student performance improved from previous years compared to having a single exam over the three-week period. While this increases the number of exams in the course, it removes having a single high stakes exam over half of the course (physiology). New practice questions with answers and explanations have been added to all blocks of the course.

• We have updated a learning objective to address a gap in course content to go beyond explaining the basic principles of immunization: Explain the basic principles of immunization and discuss ways to support informed vaccine decision making.

• We have updated a learning objective to address a gap in course content to go beyond explaining the basic principles of immunization: Explain the basic principles of immunization and discuss ways to support informed vaccine decision making.

• To improve the structure and timing of both the autoimmunity (block 1) and immunodeficiencies (block 3) sessions, several changes have been made to the sessions:

  • Students will no longer give presentations during these sessions. Instead, after a brief pre-work video and introductory material, students will research key facts on each disease, focusing on disease mechanisms. The group will then review a series of brief cases to identify the diseases described.

  • To make the time more manageable, the set of diseases is now split between two sessions instead of covering all diseases on the first day and recapping on the second day.

  • To avoid overwhelming students with a lot of new material right before the exam, the autoimmunity session in week 2 has been moved up by one day. This change provides students with two full days free of in-class activities to study for exam 1.

• To give students more time to complete the SDL activity and prepare a good presentation, HIV day 1 has been moved up by one day, while day 2 remains in its original place. This adjustment gives students two days to work on the activity.

• All small group activities have been reviewed by a group of infectious disease physicians and updated accordingly.

• Links have been added for students to give feedback on each session in the course, rather than just the lectures.

Based on last year’s feedback, several modifications have been made to this year’s Neuroscience and Behavior (N&B) course, including:

• Pre-work lectures and prep materials greater than 30 minutes were moved to dedicated time in the N&B calendar.
• Updated small group lab materials to increase focus.
• Reviewed, revised and updated lecture recordings.
• Reviewed and updated small group sessions materials.
• Revision of some neurology sessions to reduce redundancies in clinical cases.
• Addition of TrueLearn formative quizzes for each N&B block.
• Revised unit exams based on question performance.

• Guidelines for AI use have been added to the course.
  
• A Learning Skills session has been integrated into the Growth Mastery session.
  
• Sessions have been examined for redundancy and materials have been adjusted to reduce redundancy.
  
• HEAL integration has been improved in individual sessions.
  
• Additional practice questions and quick checks have been added.
  
• Accessibility of course materials has been improved.
  
• Reviewed and/or updated all pre-recorded lectures based on feedback from students and faculty.

• Course schedule revisions:
  - Due to the change in the Labor Day holiday, we gained a day in Block 1. We therefore, moved Exam 1 to Thursday 9/3, which frees up the Friday before Labor Day for students to complete pre-recorded Block 2 lectures. This change will help to decompress the Block 2 content.
  - Embryology lectures have been scheduled after the related gross anatomy lectures as students provided feedback that it would be helpful to complete the gross anatomy lectures prior to the embryology lectures.
  - All required work is now listed on the schedule. In addition, students told us that the time allotted for gross anatomy lab sessions was too short, so it's been increased from 2 to 3 hours.
  
  
• Statewide pre-recorded lectures - All lectures were reviewed and/or revised based on student and faculty feedback and in accordance with MSE guidelines.
  - We revamped many of the lectures throughout the course as part of our annual improvement process and ensured that the PowerPoint files were ADA-compliant.
  - In Block 3, we added a cranial nerves overview lecture to address student feedback indicating that it would be helpful to have a single lecture covering all cranial nerves. Cranial nerves are also discussed throughout the head and neck lectures.
  - Presentation of surface anatomy has been enhanced in gross anatomy lectures to facilitate integration with physical exam skills taught in Foundations of Clinical Practice 1 course

• We revamped many of the lectures throughout the course as part of our annual improvement process and ensured that the PowerPoint files were ADA-compliant.

• Revamped histology lab practice PowerPoints — now better aligned with lecture content and streamlined the practice of identifying histology structures.

• Revised gross anatomy laboratory resources and guidance on use of resources — changed the 'structures to know' lists and dissection instructions for Block 2

  • Adopted Grant’s Dissector as the official dissection instructions for gross anatomy labs. Lab-associated chapters have been linked to the gross anatomy lab Canvas module pages and are also available as an eBook at the Lilly library
  • Prosection videos are provided as an overview of structures that will be dissected in lab. The videos are not intended to provide dissection instructions
  • Peer-teaching guides are provided to give students instructions on what should be covered during peer-teaching sessions
  • A document describing these resources and how best to use them to prepare for gross labs and enhance learning of gross anatomy is provided on the Introduction to Gross Anatomy Lab Canvas Module page.
• Revised Introduction to Anatomical Donors session — this was a new session last year that was very well received by students. We have made some revisions to enhance the session for its second iteration, including reducing the amount of out-of-class pre-work, streamlining the in-class discussions, and creating a new donor and donor family perspectives video.
• Dissection group assignments - Students provided feedback that certain labs were more labor intensive and that group B seemed to be assigned more of the labor-intensive labs. We, therefore, reassigned particular labs to better balance the dissection efforts of group A vs. B.
• HS Anki Deck - Student feedback indicated that the length and organization of the deck could be improved. In response to this feedback, we condensed the deck and improved tagging of the content.

• New Gross Anatomy and Embryology Q Bank with over 500 practice questions — this will allow students to practice applying gross anatomy and embryology content.

• Accessibility of course materials has been improved.

• Reviewed and streamlined didactic content with a focus on clinical relevance
• Continued quality improvement measures for small group sessions
- Added clinical correlation
- Clarified key points of the session
• Added AI Chat GPT Teaching Assistant
• Aligned SDL Assignment to Single Gene Disorder Presentations

• Spring OSCE grade will now be counted as an independent assessment outside of the total course grade. Students must receive a passing score of 75% or higher on the spring OSCE and have a total course percentage of 70% or greater to pass the course.
• Clinic visit debrief discussion will be included in small groups.
• PD Session wrap up quizzes will be replaced by in-session participation.
• Accessibility of course materials has been improved.
• The fall OSCE will include an assessment of the basic exam. We will have fall semester one-on-one facilitator meetings with video review of the fall OSCE.
• POCUS assessment
• Live, interactive feedback led by small group facilitators on H and P write-ups built into small group time
• The first SP practice has been redesigned to include a video review to enhance clinical skills development.
• Communication skills will be assessed using a validated tool known as the CARE measure during SP events.
• Clinic visit check-off list

• We have changed the SDL into two independent, time-limited projects focused on HSS domains
• We have created two ungraded practice exams with Step-1 style questions
• We added a number of example cases to focus on pragmatic knowledge in both large and small group sessions
• We have replaced 4 reflections with knowledge based quizzes
• Two zoom sessions have been converted to hybrid with an in-person component to improve participation
• Accessibility of course materials has been improved.
• Journal club assignments have more self-graded quizzes to improve consistency in feedback for students.
• Improvements to biostatistics; New short videos on high-yield biostatistics concepts; The interactive large group session on biostatistics is now required.
• Two small group sessions are supplemented with real world data from Indiana communities.

• Updated hematology and vascular pathology lectures
• Added new lectures focusing on cardiac physiology and pathology
• Restructured cardiology small groups to include clinical scenarios with NBME style questions
• Streamlined content in Block 2 to allow students more independent learning time
• Added transfusion medicine quiz to Block 1
• Added 12 new quizzes to Block 2
• Accessibility of course materials has been improved.
• Redesigned blood banking small group to an escape room format
• Modified session materials for easier viewing and downloading

• Moved GIN to a later slot in the academic calendar.
• Pathology small groups revised and updated.
• Reviewed and updated lectures, including re-recording multiple lectures to ensure high quality and accuracy.
• Structure changes in schedule to allow more flexibility in schedule and studying.
• Incorporation of more clinical scenarios in lectures, small groups, and block exams to align with NBME.
• New small groups to address clinically relevant topics.
• Improved self-study modules based on student feedback.
• New small groups to address clinically relevant topics
• Improved self-study modules based on student feedback

• PowerPoint slides and Canvas modules have been assessed for accessibility and most have been updated.
• PowerPoints and videos have been reviewed to ensure material is up to date.
• Hypertension small groups have been updated due to guideline changes.
• Diuretics lecture has been updated.
• Renal Grand Rounds have an updated format this year. Each session will have a 45-60 min video on the topic to be watched prior to the statewide panel sessions. This is to better prepare students for the topics prior to the panel discussions.
• All exam questions have been reviewed (Exam 1, Exam 2, and NBME) to ensure questions accurately represent material presented during the course.
• Pulmonary grand rounds under new direction. Dr. Seyffert has taken over running pulmonary grand rounds since Dr. Carlos has left IU School of Medicine.
• Changed the way the course calendar is laid out to put all sessions — including pre-work — onto the schedule so they are visible.
• More questions have been added to the TrueLearn block quizzes.

• Canvas site has been organized by topic for easier navigation.
• Many lectures and small groups have been updated.
• Dermatology block has been completely revamped to better integrate dermatology with dermatopathology. Lectures have been added and/or updated, and there is a new, integrated small group session that will utilize a digital pathology platform, Smart In Media, to integrate pathology slides into the clinical cases.

• This year we will be adding a breaking bad news communication session with standardized patients
• Updated grade distribution to better reflect student effort and clinical importance
• Addition of new Holistic Student Development (HSD) program
• Accessibility of course materials has been improved.

• Students on some campuses expressed concerns about scheduling. We worked with the course management team to minimize scheduling issues as much as possible.
• Students indicated that they want two attempts for the critical appraisal quizzes for journal clubs, so we will move back to that model.
• We have re-evaluated the SDL and removed the competency assignment to reduce the feel of busy work. Students also expressed interest in learning more about health insurance and payer models. These are great topics for students to investigate as part of self-directed learning assignments.
  - We will continue to link back to HSS 1 content in these areas to refresh students.
• Some students expressed interest in a final exam or harder biostats questions, so we are creating an optional quiz at the end of the course with some more challenging step style questions.
• A few students expressed interest in step style ethics questions. This information has been shared with our guest speaker.
• Accessibility of course materials has been improved.

• Improved didactics and focus on learning objectives
• NBME mid-rotation practice exams implemented for all clerkships
• Built in study day for all clerkships the day before an NBME exam
• Lecture content reviewed if more than two years old and re-recorded if the content is out-of-date
• Opportunity to retake one clerkship NBME exam at the end of the academic year to try to improve an overall grade for a clerkship

• To reduce the burden for students during the two-week rotation:
  • Reduced required assignment by one history and physical (H&P)
  • Reduced required assignment by one anesthetic plan
  • No longer utilizing QR code evaluations on H&P assignments
• Allowing students to request one additional evaluation from faculty or resident to provide additional information for assessment

Added:

• USPSTF recommendations to modules. 
• Preventive Health module.
• POCUS Soft Tissue to Professional Development module.

Combined:

• Knee Effusion and Wrist/Carpal Tunnel into one MSK POCUS module. 

Changed:

• Telemedicine from Dermatology to Health Inequities module. 
• NBME study sessions from a.m. to p.m.
• Non-Medical Drivers of Health — Social Needs Assignment to PBLI-type assignment
• Social Needs Assignment due date to allow for additional unencumbered final exam study time.

Removed:

• Family Medicine Case Files

• Mandatory didactics changed to 1-5 p.m. or 4-6:30 p.m.
• Quizzes and required chapters now assigned to help students keep up with reading and studying the materials
• The communication forms filled out by patients were previously required but are now optional

• To provide additional time for students to learn obstetrics and gynecology, the clerkship was re-structured to six weeks in duration (previously a four-week clerkship).
• Orientation is now two days with anesthesia to give more time for practicing procedures.

• To permit students adequate study time, dedicated assignment completion/study time has been added to both the inpatient and outpatient blocks.

• Increased outpatient experiences for students on inpatient sites
• Focus on NBME shelf exam preparation, including development of a psychiatry ANKI deck
• Increased exposure to child psychiatry for students with primary clinical sites with adults; Increased exposure to adult patients for students placed at primary clinical site for child patients.
• Increased education on substance use

• Added sessions for all students on scrubbing and sterile technique regardless of clerkship site or time of academic year
• Increased focus on expectations for daily involvement
• Added more advanced POCUS (FAST) skills
• Addition of Lines and Tubes lecture for all students
• Incorporation of TA into all rotations offering additional study opportunities and targeted help/feedback
• Didactic methods were updated to include a mixture of delivery methods including in-person, virtual, synchronous virtual and asynchronous sessions including:
  • Removal of foley catheterization
  • Addition of acute care surgery requirement in place of mandatory overnight call

• Grading scale shifted to Satisfactory/Fail for all Phase 3 clerkships, selectives and electives starting in the academic year 2023-2024
• Adapted sub-Internship RCEs to focus on skills related to preparation for residency
• i-Human simulation experience no longer used for the sub-Internships based on student feedback

Additional resources were created in the following content areas:

• Supplemental pediatric critical care didactics on Canvas: We have added optional didactics specific to pediatric critical care.
• Supplemental palliative care/end of life didactics on Canvas.

• Enhanced orientation by incorporating an updated simulation/procedures/airways day on the first day of the block (in most months), followed by a second day consisting of live online didactics and panel discussions.

• Included additional opportunities for RCEs, handoff and discharge through educational videos on Canvas.

• The patient handoff evaluation form has been reorganized and further streamlined based on feedback from both students and their supervising faculty and residents to better reflect the I-PASS framework.
• Our Transitions of Care pre-recorded lecture has been revised based on both student feedback as well as performance on this particular module; furthermore, the lecture has been split up into more easily accessible and digestible topics.

• Retired the i-Human simulation experience and focused on transitions and handoffs.

Students are now given the opportunity to spend three consecutive nights with an admitting pediatrics resident. The purpose of this experience is to ensure students gain exposure to the clinical setting in the evenings and overnight. Two of the nights focus on admissions and staffing patients while one night focuses on cross cover.

• The RCE has been changed to a group exercise to assure students have consistent, relevant cases for an enhanced learning opportunity.
• We added an extra session on the final day reviewing the course's essential concepts.

• Added technical skills workshop and assessment
• Added sub-I site guides

• Enhancing and tailoring course content and practical procedure training for the various specialty tracks.