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Welcome to the In the Loop newsletter, an initiative of the Wayne State University School of Medicine’s Office of Assessment, Accreditation and Continuous Quality Improvement. As a champion of continuous quality improvement, your medical school has benefited greatly from the feedback of students and other stakeholders the last several years. This feedback has been instrumental in driving positive change. In the Loop aims to keep you informed about these important updates and changes, and the successes we’ve achieved together. This month’s issue highlights recent and ongoing improvements to the clerkship and post-clerkship phases of the school’s M.D. curriculum. The Office of Undergraduate Medical Education and Curricular Affairs is committed to making continuous grading improvements, as proven over the last several years. The office, under the direction the Clerkship Directors Committee, has taken great efforts to make evaluations more precise and helpful in supporting students through the residency application process. Ensuring consistency across clinical sites The Office of Undergraduate Medical Education and Curricular Affairs monitors and reviews data consistently throughout the year for third- and fourth-year M.D. students. The office reviews clerkship grades monthly and annually to see that the threshold and criteria are comparable between sites, and that achieved grades are comparable across the student body. As we continue these reviews regularly, as part of accreditation and for our own review, we verify that grades are comparable between clinical campus sites. This information is also available to each clerkship grading committee and clerkship director to help them review criteria for pass, commendation and honors grades. Clerkship grades differ by necessity because each specialty has its own idiosyncrasies. To account for this, we ensure that Medical Student Performance Evaluation letters contain grade distribution charts for all rotations for the WSU class cohort. For example, residency program directors find it helpful to know that a student had a clinical commendation when most students had a satisfactory rating. Unlike many schools, the WSU School of Medicine’s grading curve rewards students who are top performers. Including this context in the MSPE letters gives residencies a graphic illustration of the fact that the grading curve is more severe at WSU. To help students assess their progress throughout their medical education, we have developed a dashboard that soon will be made available to junior and senior students. This information gives students the knowledge they need to help in their specialty selection, especially in competitive specialties. Enhancing our instruments of assessment In addition to ongoing monitoring and review of data across clinical sites, the Office of Undergraduate Medical Educationiton and Curricular Affairs also continuously finetunes assessment instruments. Our switch to New Innovations as a grading and evaluation platform in 2019 was a huge step forward in our ability to gather evaluations. We process 30,000 evaluation forms each year from several thousand faculty and residents. Using New Innovations also allows us to expand grading and course evaluations into the M4 courses. Our use of New Innovations also allows the school to examine and reward faculty effort in completing evaluations, even awarding teaching awards based solely on student feedback of teaching by preceptors. From 2022 onward, we rolled out student selection of preceptors for all courses. This allowed students to directly identify the residents and faculty with whom they had worked, resulting in more accurate evaluations of the students and of the preceptors as educators. In 2022-23, we had our first full year of mandatory evaluations of all M4 courses and electives, allowing feedback to hospitals, course directors and preceptors to allow for even more improvements. This was made possible by continuous changes in the culture of feedback and growth in skills. More to come … While much work has been done, we continue to focus on improvement every day. We know the future is now. With the discontinuation of the Step 2 Clinical Skills exam in 2020, the onus of competency assessment returned to medical schools. This is one reason our evaluation and assessment of competency has been updated to include Entrustable Professional Activities. We are in our second year of an EPA-based evaluation for the Acting Internship, in which students are judged on performance of EPAs. This has, and will continue, to lead to better feedback. The future will require “handovers” from medical schools to residencies, and the inclusion of the EPAs will put the WSU School of Medicine in prime position for this effort. In addition, WSU and medicine faculty at Corewell Dearborn have a grant from the American Medical Association to consider advanced tools for precision evaluation as part of the AMA’s precision education initiative. Recent graduates and students in the Class of 2025 have contributed greatly to the efforts under this grant. This year, the precision evaluation tool is being piloted at several sites, and we expect this will usher in a new era of clinical evaluation for students. We know that the Step 2 Clinical Knowledge exam has taken on far greater importance since Step 1 transitioned to pass/fail. Although shelf exams are stressful and do effect clerkship grades, their inclusion in the M3 curriculum has had many benefits, the most tangible being that Step 2 CK preparation is yearlong. Since 2022 we have required the Comprehensive Clinical Science Self-Assessment preparation exam for all students at the start of M4. Even though our CK scores are great, we continue to look for enhancements in the future. As part of our support for student residency applications, we have an enhanced Medical Student Performance Evaluation. Our New Innovations platform allows for the inclusion of all positive comments garnered from clerkship evaluations, in addition to putting all grades in context by including the grading graphs. We are unique in adding grades and comments from M4 electives through July of senior year. This allows each student to showcase performance in early rotations of M4 in their chosen fields, and because all students do great on these rotations, it makes a huge impression. This is not common at all medical schools and is an added benefit of our early calendar and grading platform, giving students another leg up in their residency applications, as evidenced by our consistently exceptional match rate. Thank you to our partners We could not do this without the thousands of clinical faculty and residents who complete the feedback and evaluations. We provide the faculty and resident with a guide to help them with grading expectations. We also have videos to help them with new evaluation systems, a dedicated webpage for their reference and a new guide for writing letters of recommendation for residency. The WSU School of Medicine continues efforts to tailor evaluation platforms to the changing landscape of medical education, leading the national effort at precision evaluation and supporting our students to take the next step in their training, while opening avenues of feedback that will eventually help our graduates provide outstanding health care. Let us know what you think We hope you enjoy this issue of In the Loop as well as the issues to come in the months ahead. You can have your voice heard by submitting questions or comments via the Warrior Med Suggestions Program. You are free to include your name and contact information or to remain anonymous. All issues of In the Loop can be found on the Office of Assessment, Accreditation and Continuous Quality Improvement website. Sincerely, Kanye Gardner |
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