Clinical Logbook Caseloads, SPC Intervention, and New Review Courses

Beginning in Term 2104, required logbook cases will depend upon the length of the rotation, the Student Progress Committee will meet weekly to more readily identify at-risk students, and students may enroll in review sessions focused on critical thinking, vocabulary building and other important skills in the context of the block they just completed.

“Each of these resolutions addresses an important aspect of a student’s academic journey,” says Vice Chancellor and Professor Dr. Randell Brown. “It is important for the University to continually assess the programs we have in place to see what may need updating, to ensure we are giving students every chance to be successful.”

Caseloads to vary by rotation

Last year, Clinical Logbook assessments became part of a student’s final grade, but the number of cases required remained the same regardless of the length of the rotation. Thanks to a suggestion by the OUMSA, a new resolution approved by the Academic Board last month has changed the caseloads as follows:

  • 12-week core clerkships (Internal Medicine and Surgery): six cases each
  • 8-week core clerkships (Family/Community Medicine, Obstetrics and Gynecology, Pediatrics): four cases each
  • 4-week core clerkships (Psychiatry and Emergency Medicine): three cases each
  • Clinical Electives with Patient Contact will require one case per two weeks of elective time:
    • 6-week elective: three cases
    • 4-week elective: two cases
    • 2-week elective: one case
    • Minimum of one case per elective, i.e., a 1-week elective will have one case.
  • Non-Patient Contact electives (online Radiology and Pathology: four cases each)

Early intervention for improved outcomes

If a student’s academic lack of progress is viewed as a chronic illness that needs constant monitoring, then the weekly quiz scores are like the blood work that indicates whether things are headed in the right direction. Every clinician understands the importance of early intervention. That is the goal of the newly revamped Student Progress Committee (SPC), which will now consist of three faculty members, the Director of Pre-Clinical Education and Faculty, Chief Academic Officer (Dr. Brown is retaining this part of his job), and the Associate Director of Student Advising, along with the Dean and Academic Advisor of the student under review.

“The idea is to check weekly and intervene immediately if necessary, not waiting until after a failure, or the end of the module, to try and avoid a problem,” says Dr. Paula Diamante, Director of Pre-Clinical Education and Faculty. Students who score below a 70 percent are flagged, and the Academic Advisor is expected to work with the student to address the situation. The SPC will get involved, as needed, especially if there are extenuating circumstances.

“At the end of a course, students determined to be at-risk receive a letter from the registrar regarding their academic status. Students we see heading in this direction are put in the SPC crosshairs before they reach the end of term and get that letter,” says Dr. Diamante. “Students whose final grades fall below 70 are much less likely to pass their country’s exams for licensure or registration and to win an internship or residency.”

She adds that it was necessary to expand the SPC from three members to five and to meet more than just monthly, because the student body has grown substantially since the Committee was created in 2014. The criteria formerly used to identify at-risk students, including the grading scale and the Academic Notice, Probation, and Suspension guidelines have been revised over time.

More than just a review

A series of optional review sessions are expected to help students retain the material presented in their previous block and present material beyond what was covered in the class.

“Retention of high volume, complex material over an extended period of time is challenging, and learning science has clearly shown that repetition and retrieval are essential,” says Dr. Scott Cunningham, Professor and OUM’s Director of Curriculum, who developed the content and will moderate the review sessions. “In addition, the review sessions are comprehensive and cover material that cannot be covered in class alone.”

The review sessions are optional and intended to supplement, not replace, the required activities in the curriculum. The various options allow the students to be grouped according to their stage in the program. In addition to concentrating on repetition and retrieval, the sessions include time-tested, necessary skills in the clinical profession, such as vocabulary-building, oral presentation, and critical thinking.

“Medicine does not always follow an algorithm. Exceptional clinicians learn to ask the right questions, make associations, and connect the dots. Critical thinking is an acquired skill that requires active rather than passive learning,” says Dr. Cunningham.

Optional review sessions are one-hour each on Zoom and will be offered on a weekly basis, as shown below. The day/time of the sessions is subject to change to accommodate student needs. All times are Eastern Time (New York City time).

  • The Basic Science Review (BSR) is open to all students who have completed the eFoundation 100 or 300 series. Currently offered on Saturday at 10:00 am ET (North America). The BSR consists of a student-led discussion of clinical vignettes with a focus on the major basic science disciplines, as well as a discussion of detailed learning objectives provided by the moderator.
  • The Systems Review (SR) is open to all students who have completed the system-based modules. Currently offered on Monday at 6:00 pm ET (North America). The SR consists of a student-led discussion of clinical vignettes with a focus on clinical cases integrated with the basic sciences.
  • The eFoundation Review (EFR) is open to all students currently enrolled in the eFoundation 100 series. Currently offered on Friday at 5:00 pm ET (North America.) The EFR consists of a student-led discussion of the weekly eFoundation 100 lecture topics, but in greater depth and breadth than covered in class. The moderator will present mini-lectures on complex concepts/student questions.
  • The Introduction to Medicine review is open to all students currently enrolled in the 12-week course. Students who score < 75% on the weekly quizzes will be encouraged, but not required, to attend. Currently offered on Friday at 9:00 pm ET (North America.) The review will reinforce concepts covered in the course that week. The moderator will present mini-lectures on complex concepts/student questions.
  • The Case of the Week live sessions are open to all students, with emphasis on students in their clinical clerkships. The hour-long live session is offered on Thursday at 6:00 pm ET (North America) and involves a case with incremental presentations of the data and a final diagnosis. A unique clinical case will be presented and discussed each week. The clinical cases will represent all specialties and will be used to integrate the basic and clinical sciences.

All these changes take effect July 2021, for Term 2104. The Academic Board meets bimonthly to consider policy changes for the University. Composed of academic and administrative leadership and student representatives from Australasia and North America, the Board considers resolutions that have been vetted by the OUM Steering Committee. Once approved by the Academic Board, the resolutions are ratified by the OUM Council.

(April 2021)