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. 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)

• 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 N&B course, including:
• Prework 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

• Updated biostats sessions to ensure greater content alignment and scaffolding.
• Reviewed and/or updated all pre-recorded lectures based on feedback from students and faculty.
• Revised learning sessions to reduce content redundancy.
• Added additional Practice Quick check questions.

• Revised course schedule — 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.
• Revamped statewide pre-recorded lectures — all lectures were reviewed and/or revised based on student and faculty feedback and in accordance with MSE guidelines.
• Revamped histology lab practice PowerPoints — now better aligned with lecture content and streamlined the practice of identifying histology structures.
• Revised gross anatomy laboratory documents — changed the 'structures to know' lists and dissection instructions for Block 2.
• New Introduction to Cadaveric Donors session — students will have an opportunity during Transitions 1 to learn more about the Anatomical Education Program and donors and consider the emotional aspects of cadaveric dissection.
• New student-created, faculty/graduate student/medical student-curated, HS course-specific Anki Deck — we're excited to bring students this new customized HS-specific Anki deck!
• New Gross Anatomy and Embryology Q Bank with over 500 practice questions — this will allow students to practice applying gross anatomy and embryology content!

• Reorganization of content to evenly balance all three course blocks.
• All lectures were reviewed and updated as needed.
• Addition of precision medicine lecture.
• Optional statewide weekly review sessions have been scheduled during course time from 1-2 p.m. ET.
• Additional practice questions via Canvas quiz, statewide weekly reviews, and TrueLearn.

• Assignments including reflections and modules simplified, reducing overall number of assignments.
• Basic exam will be taught earlier to allow increased practice time for the physical exam. The fall OSCE will include an assessment of the basic exam.
• Live, interactive feedback led by small group facilitators on H and P write-ups built into small group time.
• Total number of PD sessions reduced but will remain required. Sessions will include time for in-person discussion with site leaders/local faculty. Opportunities for interaction with the speakers are built into the sessions using TopHat.
• 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.

• Journal club assignments will have more self-graded quizzes to improve consistency in feedback for students.
• Improvements to biostatistics.
• The interactive large group session on biostatistics is now required.
• New short videos on high-yield biostatistics concepts.
• Organization of the Canvas site has been improved with new blocks to align with current definitions of health systems science domains.
• All content has been redesigned to focus on health systems organization and function across three pillars of community, system, and evidence-based practice.
• Redesigned research project.
• Newly focused self-directed learning assignment to allow students to identify areas of interest and gaps in knowledge.
• Additional self-graded quizzes to reinforce course content.
• Reflection assignments have been decreased and revised to focus on health systems domains.

• Redesigned blood banking small group to an escape room format.
• Realigned schedule to allow better preparation for small group sessions.
• Added environmental impacts to cardiovascular diseases small group.
• Modified session materials for easier viewing and downloading.
• Re-recorded several lectures with improved audio for the 2024-2025 academic year.

• Moved GIN to a later slot in the academic calendar
• Pathology small groups revised and updated
• Multiple lectures re-recorded 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

• Changed the way the course calendar is laid out to put all sessions — including pre-work — onto the schedule so they are visible.
• Kept all pre-work videos to 30 minutes or fewer.
• Reviewed all sessions that weren't re-recorded last year and re-recorded those that needed updating or had quality issues that Adobe couldn't address to our satisfaction.
• Resolved the pronoun-mismatch issue with the Hypertension small group.
• Recorded some new primer videos for PGR by Dr. Carlos, as requested by students.
• Added an additional question to the SDL to help us assess the revised HEAL competency CLO in another way.
• Developing another formative quiz with questions more similar in style to the NBME questions (longer more complicated stems that integrate CVH, etc.). This will prepare students for them so they don't come as a shock. This is to address the comments that the NBME seems to be out of sync with the course and more difficult. 

• Moved ERMD to an earlier slot in the academic calendar.
• Rearranged blocks to better accommodate scheduling and allow sufficient time for all topics.
• Updated and rerecorded several lectures.

• Added an introduction to a telehealth visit.
• Created a three-week longitudinal case highlighting SOAP notes, electronic health records and discharge planning.

• Made journal club assignment improvements to increase health systems science topics.
• Provided wrap-ups for each journal club, which will be highlighted in course announcements after every campus has completed small group sessions.
• Worked to better align journal club content with other courses, such as FCP 2.
• Reduced the number of discussion boards to one.
• Incorporated more self-graded quizzes in journal club assignments to improve consistency in feedback for students.

• 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 2 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 AM to PM.
• SDOH Project to PBLI-type assignment
• SDOH assignment due date to allow for additional unencumbered final exam study time.

Removed:

• Family Medicine Case Files

• Mandatory didactics changed to 1-5 PM in the afternoon or 4-6:30 PM
• 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 6 weeks in duration (previously a 4-week clerkship).

• 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 an IUSM 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 & 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 & 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 SPA day (Simulation/Procedures/Airways) 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.