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m3-m4 Grading

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M3 and M4 Clerkship Grading

 

Authorizing Body:

Curriculum Committee

Author:

Lynda Misra, D.O., 

Revised by Cynthia Ledford, M.D.

Date Issued:

August 1, 2011

Last Update:

June 25, 2018

Rationale:

To provide a standard method of assessment for all clerkships.

Scope and Applicability:

All students enrolled in the School of Medicine.

Standard Practice Guideline:

Grading in clerkships is based on assessment in three separate areas; medical knowledge, clinical performance, and clinical skills.

Assessment of medical knowledge is measured by performance on the National Board of Medical Examiners (NBME) subject examination when such an examination is available and suitable for the content contained in that clerkship. In the instance when a NBME subject examination is not available, another internally- or externally-produced high stakes comprehensive examination may be substituted with the approval of the Associate Dean for Undergraduate Clinical Education.

The summary Clinical Performance Evaluation (CPE) is a narrative evaluation completed by the clerkship director characterizing a student's clinical performance. The clerkship director and/or designated clerkship assessment and grading committee assigns the ratings and completes this narrative evaluation of clinical performance based on feedback from faculty and residents that have had interaction with the student during the clerkship. Direct observations by supervising physicians and clinical faculty are collected via clinical performance assessments that are used to inform the summary CPE. The decision whether a student receives an “exceeds expectations”, "meets expectations" or "below expectations" on their Clinical Performance Evaluation is at the discretion of the clerkship director and/or designated clerkship assessment and grading committee.

The Objective Structured Clinical Examination (OSCE) is a performance-based measure of a student's clinical skills competence. During an OSCE, trainees are observed and evaluated as they rotate through stations with standardized patients or simulators to evaluate clinical skills. The decision whether a student "passes" or "fails" their OSCE is at the discretion of the clerkship director, based on evaluation of live or recorded data of the OSCE by the OUWB Clinical Skills and Training Center instructors, standardized patients and clerkship faculty.

The final grades for the clerkships are Honors, High Pass, Pass, Pass with Remediation, and Fail. These grades are awarded based on the following criteria:

HN (Honors) is a permanent grade, assigned by the faculty member(s) responsible for the clerkship, which denotes student performance exceeds expectations.

In order to earn a grade of Honors in a clerkship, a student must score above or equal to the 80th percentile on the NBME subject exam, earn a grade of “exceeds expectations” on the CPE, earn a grade of “pass” on the OSCE and complete all components of the clerkship. The above performance criteria must be achieved on all assessments on the first attempt in order to qualify for Honors.

HP (High Pass) is a permanent grade, assigned by the faculty member(s) responsible for the clerkship, which denotes student performance which qualifies for passing with distinction.

In order to earn a grade of High Pass in a clerkship, a student must “pass” the OSCE, score between the 40th and 79th percentile on the NBME subject exam and earn a grade of “exceeds expectations” on the CPE; or “pass” the OSCE, score above or equal to the 80th percentile on the NBME subject examination and earn a grade of “meets expectations” on the CPE. The above performance criteria must be achieved on all assessments on the first attempt in order to qualify for High Pass.

PA (Pass) is a permanent grade, assigned by the faculty member(s) responsible for the clerkship, which denotes student performance meets expectations.

Students who meet the minimum criteria for passing the clerkship, and have not scored at or above the 40th percentile on the NBME subject exam, will receive the grade of Pass. Therefore, the minimum criteria for passing the clerkship is an NBME subject exam score ranging from the 8th percentile to the 39th percentile, a grade of “pass” on the OSCE, and “meets expectations” on the CPE, on first attempts.

FL (Fail) is a permanent grade, assigned by the faculty member(s) responsible for the clerkship, which denotes student performance does not meet expectations.

Students who do not meet the minimum criteria for passing two or more clerkship assessment components (NBME subject exam, OSCE, or CPE) on the first attempt, or who have failed a single assessment component on the second attempt (remediating an Incomplete), will receive a final grade of Fail in the clerkship and will be required to repeat the clerkship to progress. Students who are assigned a grade of “Fail” for a required course will need to either retake the course or will be dismissed from the medical school.

PR (Pass with Remediation) is a permanent grade, assigned by the faculty member(s) responsible for the clerkship, in any clerkship in which performance meets expectations, after major remediation.

W (Withdraw) is a permanent grade, assigned by the faculty member(s) responsible for the clerkship, in any clerkship in which the student withdraws prior to completion of the clerkship.

The grade of Withdraw can be assigned at any time prior to the completion of a clerkship, and after the 100% refund period for the semester has expired (please see the tuition refund schedule). Students who are assigned a grade of “Withdraw” will be required to retake the clerkship.

Temporary Grades

I (Incomplete) is a temporary grade, assigned by the faculty member(s) responsible for the clerkship, which indicates work in the clerkship is incomplete.

Students may receive a grade of incomplete for one of two reasons: 1) excused absences resulting in incomplete assignments or assessments or 2) failure to meet the minimum criteria for any one of the clerkship assessment components (NBME subject exam, OSCE or CPE). Students will receive a grade of Incomplete until all clerkship requirements and assessments are satisfied.

Upon receipt of an Incomplete grade, the student must meet with the Clerkship Director or delegate to develop a timeline plan to complete the required coursework and pass any required assessments.  Whether the Incomplete is due to excused absences or need for additional coursework, assessments or remediation, the clerkship director, with consultation with the Associate Dean for Undergraduate Clinical Education and Clinical Optimization Specialist(s), will propose a list of remediation requirements with timeline plan, that are required in order for the student to receive a passing grade.  The remediation plan and timeline should be made in writing and forwarded to the Clinical Optimization Specialist and the student.  For students who receive a grade of Incomplete due to need for additional coursework, assessments or remediation, the clerkship director and/or assessment and grading committee will determine the core competency domains in which the student needs additional work, i.e. knowledge, patient care, communication skills, or professionalism. The clerkship director will also designate whether the remediation need is major or minor.

Examples of need for major remediation:

-  NBME subject exam failure

-  Additional clinical time needed to demonstrate minimum standards in patient care

-  Combination of deficiencies, e.g. failure of more than one assessment component

-  Major deficiencies identified on OSCE

Examples of minor remediation:

        -  Focused area of deficiency identified by OSCE failure

-  Focused areas of deficiency from CPE that does not require additional clinical assignment

Successful remediation of deficiencies that resulted in an Incomplete grade with major remediation requirements will result in the grade of Incomplete being replaced by a grade of PR (Pass with Remediation).

Successful remediation of deficiencies that resulted in an Incomplete grade with minor remediation requirements will result in the grade of Incomplete being replaces by a grade of Pass.

If the requirements are not satisfied or the assessment is not remediated, the grade of Incomplete will convert to a grade of Fail.  Removal of an Incomplete as a result of excused absences may be replaced by the earned grade assignments of Honors, High Pass, Pass, Pass with Remediation, or Fail following timeline plan completion.  Students are also subject to any additional guidance provided in clerkship syllabi pertaining to Incomplete grades following absences.

Grading Table for OUWB M3 Core Clerkships

Definitions:

Related Policies and Forms:

M1-M2 Grading and Longitudinal Course Grading

M3-M4 Clerkship Progress Guidelines

Satisfactory Academic Progress to Maintain Enrollment Eligibility

Appendix