CourseReview

BasicScienceofMicrobialDisease

Coursereviewcommittee:TimLahey(chair),VirginiaLyons,EdUsherwood,ErinD’Agostino

Coursedirector:PaulaSundstrom

August2015

ReviewofYear1BasicScienceofMicrobialDisease

• CourseoccursintheSpringtermofYear1

• CourseDirector– PaulaSundstrom,PhD

• Coursehas61curricularhours– priorreviewithad59hours;2hourswereaddedtopilotaPBLexercise

• CoursewaslastreviewedinDecember2012

ActionPlanfromPriorReview– MajorIssues

• Issuesrelatedtoobjectives(rewritingone,placementinthesyllabus,syllabusobjectivestomatchthoseinIlios)completed

• Assessmentquestionsshouldcorrelatewithobjectivesandmajorcontentemphasizedinthecoursecompleted– studentratingimprovedfrom3.76to3.95

• Objectivesrelatingtostudentskillsinthelabneededtobeassessed– facultywillsignoffonproficiencycompleted;thecoursedecidednottoadoptaformal“signoff”butgiveverbalfeedback

ActionPlanfromPriorReview– MajorIssues

• Reducetimeintraditional lecturecompleted• Introducemoreactivelearningexercisesintolecturecompleted

• Movecontentfromlectureintolaboratorysessionscompleted

• Introducecase-basedlaboratorylearningexercisespilotedPBLforonelab;plantoincorporatea2nd

• Incorporatefewerrecallquestionsandmoreclinicalvignettesinassessments;eliminatequestionswithnegativestemscompleted

CourseObjectives1. Torecognize,identifyanddifferentiatetheinternalandexternalstructuresof

prokaryoticandeukaryoticmicrobialcells.2. Toexplainthefunctionofstructuresofbacterialandfungalcellsthatareimportant

forcausingdisease.3. Todescribethemorphologiesandgrowthformsoffungalpathogensinclinical

specimens,intheenvironmentandinlaboratorymedia.4. Toexplainthebasicstagesofmicrobialgrowthandtheirimportancetodisease.5. Toexplainthebasicfeaturesofmicrobialgenomesanddiscusstheroleofmicrobesin

elucidatingbasicgeneticmechanismssuchasmutation,recombinationandtransferofDNAbetweencells.

6. Todescribethebasicmetabolicpropertiesofmicrobialcells.7. Tolistpathogensthatgrowintracellularly withinhostcellsandexplaintheadvantages

ofintracellulargrowth.8. Todescribethecharacteristicsofmorphology,metabolismorantigenicstructurethat

aidinrecognitionofpathogensbytheclinicallaboratoryandexplainhowpathogensaredistinguishedfromnormalfloraandnon-pathogens.Explainalternativesforstainingandculturingthatareusedtoidentifythepresenceoforexposuretomicrobialpathogens.

CourseObjectives9. Torecognizetheessentialpropertiesofclinicalspecimensthatareimportantfor

pathogenidentificationandhazardsassociatedwithhandlinginfectedclinicalspecimens.

10. Todescribeandpracticemethodsforlaboratorycultureandstainingfordetectionofmicrobesinclinicalspecimens;explainlimitationsofstainingandculturingifapplicable.

11. Todescribeandpracticethebasicprinciplesofchemotherapyanddisinfectionthroughlaboratoryexercisesaccompaniedbycasestudies.

12. Todescribethemechanismsthatleadtomicrobialresistancetoantibiotics.13. Todescribethesymptomsandclinicalfeaturesofdiseasescausedbybacteriaand

fungi.14. Todescribethepostulatesusedtoestablishthatadiseaseiscausedbyaspecific

microbeaswellasKochs molecularpostulatestoestablishtheroleofaspecificstructureofgeneproductindisease.

15. Todescribefactorsimportantforvirulenceofeachmicrobialpathogenifknown.16. Todescribehowpathogenicmicrobesarespreadfrompersontopersonthroughthe

populationandmethodsofspreadintheenvironment.

CourseObjectives17. Toexplainhowspecificinfectionsarepreventedandtreated.18. Todescribeforthemostcommoninfectiousdiseaseswhetherthediseaseiscaused

primarilybytoxin(e.g.Tetanus),orbymicrobialgrowthandinvasionofthehost(e.g.Pneumococcalpneumonia).

19. Tolistmicrobialtoxinsthatcausehumandisease,describethemechanismofactionofeachtoxinandexplainifantitoxinsareusedintreatment.

20. Tospecifywhetheravaccineexiststopreventeachdiseasecausedbyamicrobeanddescribethemolecularbasisofthevaccinefunction.

21. Todescribepropertiesofmicrobialvaccinesintermsoflivevs.killed,subunitortoxoid.

22. Todescribeunderlyingriskfactorsinmammalianhoststhatincreasesusceptibilitytomicrobialpathogens.

23. Toapplyknowledgeofmethodsusedbyclinicallaboratoriestounderstandhowinfectionsarediagnosed;andtorecognizethepresenceofnormalfloraandtoexplainbeneficialrolesofnormalflora

24. Tobehaverespectfullyandresponsiblytowardscolleaguesandmembersofthehealthcareteamatalltimes

CourseObjectives25. Tosolveproblemseffectivelythroughcollaborationwithstudentcolleagues.26. Totakeresponsibilityforownworkandgaincompetenceinskillsassociatedwith

microbiology.27. Tomeetprofessionalresponsibilitiesfully,includingbeingpunctual,present,and

engagedinlaboratoryactivitiesactivities,andbeingreliableincommitmentstotasks.28. Topracticeutilizationofeffectiveproceduresfordisinfectionanddisposalof

biologicalhazardouswaste.29. Tointeractwithpersonnelfromtheclinicallaboratoryduringlaboratorysessionsand

developthepracticeofconsultingclinicallaboratoryspecialistsinthefuture.30. Tobenefitfromphysicianinputintoexercisesandcasesforstudentanalysis.31. Toprovideopportunitiestoenhancecommunicationbetweeninstructorsand

students.32. Todiscusstheconsequencesofdisregardingethicsrelatedtomedicalhuman

experimentation.

CourseObjectives– Comments

• Theobjectivesgiveanexcellentdescriptionofcoursecontent

• Theyareclearandgenerallyaddressonetopic• Courseobjectivesarenumerousanddetailed,andinsomecasesreadmorelikesessionobjectives• Ex:Tolistmicrobialtoxinsthatcausehumandisease,describethe

mechanismofactionofeachtoxinandexplainifantitoxinsareusedintreatment.

• Objectives11and28partiallyoverlap• Professionalism-relatedobjectives24-32areassessedinlabs

CourseObjectives– Comments

• SomeobjectivesaddressdetailedtopicsthatmaynotbenecessarytolearnasaY1medicalstudent:8.Todescribethecharacteristicsofmorphology,metabolismorantigenicstructurethataidinrecognitionofpathogensbytheclinicallaboratory…

10.Todescribeandpracticemethodsforlaboratorycultureandstainingfordetectionofmicrobesinclinicalspecimens;explainlimitationsofstainingandculturingifapplicable.

15.Todescribefactorsimportantforvirulenceofeachmicrobialpathogenifknown.

19.Tolistmicrobialtoxinsthatcausehumandisease,describethemechanismofactionofeachtoxinandexplainifantitoxinsareusedintreatment.

USMLEAlignmentisverygood

discussedinVirology

discussedinSBMID

FormatofCourse&SessionObjectives• Courseobjectivesareprovidedinthesyllabusandare

writteninthecorrectformat• Thereareinconsistencieswiththedistributionand

contentofsessionobjectives.Thecourseprovidesacompiledsetofnotesforallsessions,andobjectivesarepresentforallsessionsinthispacket.Some(butnotall)sessionobjectivesarealsolistedonCanvas(thepreferredmethodforY1courses).InmanycasesthesessionobjectivesinthenotesdonotmatchthesessionobjectivesonCanvas

• Sessionobjectivesforthe14laboratoriesareinthelabmanual

FormatofCourse&SessionObjectives• SessionobjectivesarenotprovidedonCanvasforthefollowingsessions:– AntibioticsIandII;AntibioticsIV(thereisonesetofsessionobjectives

forall4AntibioticsessionsandtheyarelistedonCanvasunderAntibioticsIII)

– SmallgrouponEnterics– ClostridiaII– Anaerobes– NormalFlora– StaphylococciI,StaphylococciII– Streptococci– Pneumococci,Listeria,Anthrax– Plague,Tularemia,Brucellosis

FormatofCourse&SessionObjectives• SessionobjectivesinthenotesdonotmatchthesessionobjectivesonCanvasforthefollowingsessions:– IntroductiontoPathogens– SalmonellaandShigella– Legionella,Mycoplasma,Diphtheria– Neisseria– ClostridiaIandII(combinedinnotes)– Mycoses:intro&cutaneous/mucosalinfections– SystemicMycoses– OpportunisticFungalPathogens

FormatofCourse&SessionObjectives• Sessionobjectivesthatarenot writteninthecorrectformat(theydonothaveameasurableverb):– objectives#2and#5intheBacterialMetabolismsessionobjective#4in

theIntroductiontoSpecificPathogenssession– objective#5intheSalmonella/Shigella session– objective#2intheEscherichiacolisession– objective#3intheClostridiaI– objective#3intheStreptococcuspneumoniae session– objective#3inthetuberculosissession– objectives#1-2inthenontuberculousmycobacteriasession– objective#5inthespirochetessession– objective#4inmycoses(Canvasversion)– objectives#2-5inSystemicMycoses(Canvasversion)

SessionObjectives– Comments

• Coursecoversalargeamountoffactualinformation,potentiallyattheexpenseofconceptualunderstanding.ManyofthesefactswerenotknownbyanIDspecialistonthereviewteam

• SomeinformationcoveredisbeyondthelevelofdetailthatY1students– oractuallyphysiciansingeneral–shouldknow.

Sampleclassnotesdemonstratefocusonfacts

Sampleclassnotesdemonstratefocusonfacts

IssuesofRedundancy

Thekeywordsusedtosearchforredundancywere:• bacteria• antibiotics• Salmonella• Escherichiacoli• Cholera• Staphylococcus

• Chlamydia• Streptococcus• Pneumococci• Tuberculosis• fungi

IssuesofRedundancy• Forthebroadterms“bacteria”,“antibiotics”and“fungi”,therewasoverlapwithtwocourses:SBMInfectiousDiseasesandOrganBasedPharmacology.Whilethisistobeexpected,theremaybeunplannedredundancyinsomeintroductorysessions.Coordinationhasoccurredbetweenmicroandpharmacologyandinmostcasesthisisplannedredundancybutweidentifiedpointswhereunplannedredundancycouldberemoved.

• Manyofthespecificbacteriadidnotrevealsignificantoverlapwithothercourses

IssuesofRedundancy• Staphylococcus,Streptococcus,Pneumococcusand

TuberculosisarediscussedintheInfectiousDiseaseunitofY1Pathologyandthereappearstobesomeredundancy,howeverwedetermineditwasnotdisadvantageous.

• Theterm“Tuberculosis”revealedthemostredundancyasitisdiscussedinthreeY1courses(Microbiology,Pathology,Immunology/Virology)andtwoY2courses(SBMNeurology,SBMInfectiousDiseases).Weevaluatedinourcoursereviewconversationwhetherthisrepresentedcomplementarycoverage.WeaskedElizabethTalbotwhoteachesinbothcoursestoclarifyifapproachesarecomplementary.

VIG:Ethics/Humanities• Onecourseobjectiverelatestoethics:– Todiscusstheconsequencesofdisregardingethicsrelatedtomedicalhumanexperimentation.

• Onesessionobjectiverelatestoethics:– TodiscusstheTuskegeeexperimentasanunethicalexampleofneglectingethicsrelatedtomedicalhumanexperimentation

– (Seestudentcommentsaboutsocialdeterminantsofhealth)

VIG:CulturallyCompetentCare• Courseevaluationindicatesthereisdiscussionoftheprevalenceofvariousdiseasesinparticulargroups,howeverthesubjectisnotfullyexploredandstudentswouldliketohearmoreaboutit[seestudentcommentsaboutSDOHlater]

SummaryregardingObjectives

• Clearcourseobjectivesdescribethecoursewell

• Numerousdetailedobjectivesmaycontributetocoursefocusonlotsofdetailedinformation

• Addressingminorunplannedredundancyissuesmightfreeupalittlemoretimeforconceptuallearning

• FrameSDOH-relatedtopicalcoveragewithmentionthatdiscussionaboutdriverswilloccurelsewhereinthecurriculum

CourseLearningOpportunities

• Lecture35hrs.(57.4%)– priorreviewthepercentagewas66%

• PBLSmallGroups2hrs.(3.3%)

• Laboratory24hrs.(39.3%)– priorreviewthepercentagewas34%

OptionalReviewSessionsareofferedpriortoeachquiz

CourseLearningOpportunities• Thecoursehasmadegoodprogressinreducingthenumberoftraditional lecturesfrom39hours(AY11-12)to35hours(AY14-15)andcontinuestomakesubstantialeffortsinthisdirection.

• Clickerquestionsareusedinnearlyalllecturestoincreasefaculty-studentinteractions

• ThecoursepilotedaPBLactivitythisyearthatwasverysuccessful(datawascollectedaftertheactivityviasurveys);thishasresultedinplanstoincorporatesixPBLsessionsinY1duringAY15-16includingasecondPBLinthemicrobiologycourse

SummaryregardingPedagogy

• Thecourseisworkingtowardsreducingthenumberoftraditionallecturestobelowtherecommendedpercentageof40-50%percourseonaverageandisencouragedtocontinueinthisdirection

• Facultyareincorporatingtoolstomakelecturesmoreinteractive

• ThecoursedirectoristobecommendedforherinitiativeinpilotingaPBLsession,andleadingthewayinincorporatingPBLintoYear1

Assessment

• WrittenQuizzes(33%ofcoursegrade)

• FinalExam(42%ofcoursegrade)

• LaboratoryReports(20%ofcoursegrade)

• ClassParticipation(5%ofcoursegrade)–determinedbyclickerresponsestoquestionsduringlectures[determinedbytheMECthispastspringtoconflictwiththeofficialattendancepolicy]

AssessmentQuestions• Aspromisedintheprioractionplan,questionswithnegativestemswereremovedandmoreclinicalvignetteswereincorporated;mostquizquestionsusedclinicalstems,howeveronly~35%offinalexamquestionsusedvignettes

• Commensuratewiththehighlevelofdetailincourseobjectives,manyexamquestionsassessedthestudents’abilitytomemorizefacts– Examples:whichbugsarecatalasepositive,whichclostridiahavespores,

whichorganismcanbeculturedonwhichmedium,whatalcoholsdoinbiofilms, etc.

• Laboratorysessionsusedlaboratoryspecimensandcasehistoriestoassessevaluativeandanalyticalskills;thiswasdoneverywell

AssessmentofCourseObjectives• Allexamandquizquestionsmaptocourseobjectives.

• Somecourseobjectives(4,15)arenotrepresentedonthefinalexam;aseditsoccurcorrespondencebetweenassessmentandobjectivesshouldremainstrong

• Courseobjectives24-31arenotrepresentedontheexam,butareassessedinlabexercises.Theexceptionisobjective30(Tobenefitfromphysicianinputintoexercisesandcasesforstudentanalysis.)whichtheteamthoughtmightbedifficulttoassess

SummaryregardingAssessment• Allquizandexamquestionsmaptoatleastonecourseobjective

• Thesubcommitteefeelsthatsomeassessmentquestionsfocusonrecallingdetailsthatarenotnecessaryforphysicianstoknow

• Mostquizquestionshadclinicalstems,howevermanyfinalexamquestionsdidnot;quizzesmaynotpreparestudentswellforthefinalexamformat[Note:thecommitteedoesnotexpectallquestions touseclinicalvignettes,howeverconsistencybetweenexamsisideal]

• Laboratorysessionsdoagoodjoboftestingevaluativeandanalyticalskills

Measuresof

Quality–AAMCGQ

Geiselmean2010

Geiselmean2011

Geiselmean2012

Geiselmean2013

Geiselmean2014

All schoolsmeans2014

Biochemistry 2.7 2.5 2.6 2.6 2.8 2.7

Biostatistics/Epidemiology 2.9 3.2 3.2 2.9 3.2 2.8

Genetics 2.9 2.8 2.8 2.6 2.8 2.9

Grossanatomy/Embryology 3.6 3.5 3.6 3.4 3.6 3.4

Immunology 2.9 3.0 3.1 2.7 2.7 3.1

IntrotoClinMed/OnDoc 3.5 3.4 3.5 3.0 3.3 3.5

Microanatomy/Histology 2.8 2.9 3.1 2.8 3.1 2.9

Microbiology 3.1 3.2 3.3 3.0 3.1 3.2

Neuroscience 3.2 3.0 3.0 3.0 3.2 3.2

Pathology 3.2 3.1 3.4 2.8 3.1 3.3

Pharmacology 3.4 3.1 3.1 2.6 3.1 3.1

Physiology 3.6 3.6 3.5 3.1 3.4 3.4

BehavioralScience 3.2 3.3 3.3 3.0 3.2 3.2

PathophysiologyofDisease 3.5 3.5 3.5 3.3 3.5 3.5

MeasuresofQuality– AAMCGQ“Indicatehowwellyouthinkthatinstruction inmicrobiology preparedyouforclinicalclerkshipsandelectives.”[1=poor;2=fair;3=good;4=excellent]

MeasuresofQuality– StepI

TRADITIONALCOREDISCIPLINES2012* 2013* 2014* Means12-14

Biochemistry 0.30 0.20 0.22 0.24

Biostatistics/Epidemiology 0.43 0.40 N/A N/A

Biostatistics 0.08 0.08

Genetics 0.28 0.18 0.28 0.25

Grossanatomy/Embryology 0.33 0.26 0.14 0.24

Histology/CellBiology 0.37 0.26 0.23 0.29

Microbiology/Immunology 0.31 0.47 0.39 0.39

Pathology 0.26 0.24 0.20 0.23

Pharmacology 0.22 0.22 0.12 0.19

Physiology 0.38 0.35 0.25 0.33

*valuesreportedforcoredisciplinesareSDabovetheUS/CanmeanforGeiselmeanscores

Year1courses OverallSatisfactionAY2014-2015

HumanAnatomyandEmbryologyII 4.57

HumanAnatomyandEmbryologyI 4.35

MetabolicBasisofDisease 4.35

BiochemicalandGeneticBasisofMedicine 4.34

Biostatistics andEpidemiology 4.23

Physiology-Renal 4.19

CTO 4.07

Basic ScienceofMicrobialDisease 3.94

Virology 3.77

Physiology-Endocrine 3.76

Immunology 3.67

Neuroscience 3.59

Physiology-Respiration 3.34

Physiology-Cardiovascular 3.23

Pathology 3.22

MeasuresofQuality– CourseEvaluation

scale[1=poor;2=fair;3=good;4=verygood;5=excellent]

scale[1=poor;2=fair;3=good;4=verygood;5=excellent]

MeasuresofQuality– CourseEvaluation

BSoMD2012(93%)*

BSoMD2013(68%)*

BSoMD2014(86%)*

Overallsatisfactionofcourse 4.04 3.78 3.94

Clarity oflearningobjectives N/A 3.91 4.01

Organizationofthecourse N/A 3.86 3.90

Howwellthecourseintroduced metothisdiscipline 4.20 N/A 4.12

Congruence ofassessmentquestions tomaterialemphasizedincourse 4.04 3.76 3.95

*studentparticipation rateoncourseevaluation

MeasuresofQuality– StudentComments

Strengths:• Manystudentsfelttheclasswaswellorganizedandthe

materialwasup-to-dateandrelevant:“Veryorganized.Materialpresentedclearlyandconsistently.”

• Studentsenjoyedthelabs:“Labwaslow-stressandapplicable.”

• Studentsappreciatedthatthenoteswereprovidedallatonceinonepacket:“Microcoursebookwithalltherelevantinformation- thisshouldbereplicatedinallourothercourses.”

• ThePBLsessionwasagreatadditiontothecourse:“ThePBLwasreallygreatinmyopinion.”

MeasuresofQuality– StudentComments

SuggestionsforImprovement:• Manystudentsfeltthattherewastoomuchclinically

irrelevantinformation– thatthecourseneededtoemphasizetheimportantinformationandnotfocussomuchonmemorizingdetails

• Additionally,theyfelttheexamsfocusedonthesedetails:“ExamquestionsDIDNOTalignwiththeimportantinformation- instead,itwouldsometimesspecificallylookforsomefactoidinalecturethatwasn'tinthecoursenotesandusethatasonequestionina20questionexamaka5%wasaboutafactoidnotrelevanttopracticingclinician.Sometimes,thereweremultipleofthesefactoidquestions…”

MeasuresofQuality– StudentComments• Somestudentswereconcernedabouthowpatientgroups

werediscussedwithvariousdiseases,i.e.socialdeterminantsofhealth:“Themicrobiologycoursemoreorlesspromotedstereotypinginmedicinetocometodiagnoses.”

• Therewerevariousminorsuggestionsaboutimprovingthecoursematerials.Additionallythestudentspreferbeing“paperless”(currentlyclassmaterialsareprintedandstudentsarechargedforthemwithouttheirpermission)

• AsalreadydiscussedattheMEC,thestudentswerenothappywithaportionofthegradebeingdeterminedbyclassparticipation:“5%participationrequirementwasinconsistentwithGeisel'smentalityofsupportingstudentsvaryinglearningstyles.”

MeasuresofQuality– StudentComments

OtherSuggestions:• Asignificantnumberofstudentsusedthe“SketchyMedical”

app,andfeltitwasinstrumentaltotheirsuccess.Somestudentsthoughtitwouldbeniceiftheinstructorsincorporatedvideosfromtheappintheirteaching;othershopedasitelicensecouldbepurchasedfortheclass

• Itwasmentionedthataflippedclassroomapproachmightbeadvantageousinthecourse:“Ithinkthematerialforthiscoursecouldbenefitfromflippedsessions- thecontentisrelativelystraightforwardandcouldreallybenefitfromahigherdegreeofstudentengagement.Rightnowthereislittledifferencebetweengoingtoclassandreadingnotesindependently.”

SummaryregardingMeasuresofQuality• Verygoodpreparationinmicrobiology,andfortheboards• PBLandotherinteractivesessionswellreceived• Facultyinvestmentvaluedbystudents• Heavyemphasisonfacttransferandmemorization• Studentswouldlikeaccesstolabmanual(coursedirectorawarebutneedsto

workthroughIPandbiosafetydetails)• Couldstopprintingcoursenotessostudentsarenotobligatedtohaveit

printedortopayafee• Summarytablesinnotescouldbepresentedinaconsistentformatacross

pathogensratherthanwithadifferentorganizationalschemeforeach• 5%attendancecreditapproachhasalreadybeenabolished• IsthereawayforGeiseltosupportstudentaccesstostudyaidslikeSketchy

Medical?• Insteadofcurrentparallelbetweenlecturesandsyllabuscoulduselecturesto

emphasizekeyconcepts&difficult-to-learnfactsinaninteractivefashion

Recommendations• Revisecourseobjectivestocoverbiggerpicturetopics;mostcourseshaveabout8-15courseobjectives[seesamplesintheappendix]

• Revisecoursematerialsandsessioncontenttofocusonconceptsnotfacts.Thiscouldbethroughredactionsorbyindicatingwhichinformationwillbetestedandwhichnot.[somesamplesareprovidedhereindropbox:]https://www.dropbox.com/s/ygwga1mvsuq019b/Basic%20Science%20of%20Microbial%20Disease%20TL.pdf?dl=0

• Addresssmallamountofunplannedcontentredundancye.g.reantibioticmechanismsofactionviacoordinationwithrelevantothercourses

Recommendations• Continuetoreducehoursinlecture&emphasizesuccessfulactivelearningapproacheslikePBLandflippedsessions

• Reduceemphasisonfact-basedquestionsinassessment;increaseproportionoffinalexamquestionsthatbeginwithaclinicalstem

• Notifystudentsthatsocialdeterminantsofriskofvariousinfectiousdiseaseswillbecoveredinotherpartsofthecurriculum

• Discontinuetheprintingofthecoursematerials

ActionPlanCourseObjectivesü Reducethenumberofobjectivesanddecreasetheamountof

detail.ü Eliminateoverlap.ü Removeobjectivesthatcannotbeassessed.ü Usetheexampleobjectivesduringrevision.Coursematerialsandsessionobjectivesü Reviewmaterialsandsessionobjectivestodecreasethe

amountofdetail.ü Revisecoursematerialstoclarifytestablecontent.ü Modifysessionobjectivesthatareintheincorrectformat.ü Establishasinglelocationforsessionobjectives(Canvas).ü Discontinueprintingcoursematerials.

ActionPlanRedundancy– antibioticsü Coordinationhasoccurredbetweenmicroandpharmacology

anditwasdeterminedthatthepresentationsofantibioticsinthetwocoursesarecomplementaryandthatanyredundancyisusefultostudents.

ü RedundancywithInfectiousDiseaseswillbeaddressedinameetingwithfacultyrepresentativesfrombothcourses.

ActionPlanCourseLearningOpportunitiesü ReducenumberofformallecturesbyincreasingPBLsessions

andtrimminglecturehours.ü Makelecturesinteractivethroughuseofpollingexercisesfor

extracreditandexploreflippingtheclassroom.ü OptionalReviewSessionswillnotbeofferedinthecoming

yearpercommunicationwithDr.Lyonson5/28/15.Inlieuofthesesessions,facultywillwriteanswerstostudentquestionsaboutthematerialandwillmakealltheanswersavailabletoallstudents.Thiswaspioneeredin2015andworkedwell.Peer-ledtutoringgroupshaverecentlybeenintroducedinY1andareveryeffective.(communicationwithDr.Lyons)

ActionPlanAssessmentü Increasetheproportionofclinicalvignettesinthefinalexam

tobeconsistentwithquizzes.ü Decreasethefocusonfacts.ü Mapexamquestionstorevisedsessionandcourseobjectives.

ActionPlanOtherSocialDeterminantsofHealthandCulturallyCompetentCareü FortopicsthatincludeSDOH-relatedcoverage,facultywill

informstudentsthatdiscussionaboutthedriversofSDOHwilloccurelsewhereinthecurriculum.

SketchyMedical• MedicalEducationDept willcheckaboutacopyforthe

library.LabManual• Placethelabmanualon-lineafterregisteringwiththeUS

copyrightofficeiftheMedicalEducationDept.willprocesstheapplication.

Appendix:ExamplecourseobjectivesUniversityofVirginia

Uponcompletionofthiscourse,studentsareexpectedtohaveacquiredthefollowingcompetencies:1)Todescribetheroleofmicrobialpathogensinimmuneresponses.2)Toidentifytheactionandregulationoforgans,cells,geneticsandmoleculesoftheimmunesystem.3)Tounderstandthemechanismsofallergy,inflammation,autoimmunedisease,tolerance,andtransplantimmunology.4)Tocategorizethemechanismsbywhichindividualsmountimmunitytotumors,bacteria,virusesandfungi.5)Toknowthestructure,physiology,growth,geneticexchangeanddrugresistanceofmicroorganisms.6)Tocorrelatepropertiesofviruses,bacteriaandfungiwiththediseasestheycause.7)Toidentifymostlikelycausativeagentsofdiseaseandtoappreciatedifferentialdiagnosesofinfectiousdiseasesbasedonsymptoms,epidemiologyandlaboratorytests.

Appendix:ExamplecourseobjectivesUniversityofVirginia

Uponcompletionofthiscourse,studentsareexpectedtohaveacquiredthefollowingcompetencies:1)Todescribetheroleofmicrobialpathogensinimmuneresponses.2)Toidentifytheactionandregulationoforgans,cells,geneticsandmoleculesoftheimmunesystem.3)Tounderstandthemechanismsofallergy,inflammation,autoimmunedisease,tolerance,andtransplantimmunology.4)Tocategorizethemechanismsbywhichindividualsmountimmunitytotumors,bacteria,virusesandfungi.5)Toknowthestructure,physiology,growth,geneticexchangeanddrugresistanceofmicroorganisms.6)Tocorrelatepropertiesofviruses,bacteriaandfungiwiththediseasestheycause.7)Toidentifymostlikelycausativeagentsofdiseaseandtoappreciatedifferentialdiagnosesofinfectiousdiseasesbasedonsymptoms,epidemiologyandlaboratorytests.

Appendix:ExamplecourseobjectivesTulane

Uponcompletionofthiscoursethestudentwillbeableto:1.Explainrelationshipsandapplyappropriateterminologyrelatingtothestructure,metabolism,genetics,andecologyofprokaryoticmicroorganisms,eukaryoticmicroorganisms,andviruses.2.Explaininteractionsbetweenopportunisticandpathogenicmicroorganismsandsusceptiblehosts incontactsthatresultininfectionand/ordiseaseandapplytheseinteractionstodiseasesymptoms.3.Explaininnateandadaptiveimmuneresponsesandapplythisunderstandingtothe infectiousdiseaseprocessaswellasthepreventionandcontrolofinfectiousdiseases.4.Explainprinciplesofphysicalandchemicalmethodsusedinthecontrolofmicroorganismsandapplythisunderstandingtothepreventionandcontrolofinfectiousdiseases.5.Demonstrateanappreciationandunderstandingofclinicallaboratoryskillsandtechniquesrelatedtotheisolation,staining,identification,assessmentofmetabolism,andcontrolofmicroorganisms.6.Interpretanddrawappropriateconclusionsfromlaboratoryresults.7.Analyzeanddistinguishtherapeutictreatmentsformicrobialinfections,anddistinguishwhenavaccine,antibiotic,orothertherapyislikelytobethemostappropriateresponse.8.Specifytheroleofecologyandevolutioninthespreadofinfectiousdiseases, comparingtheroleoftransmission,populationsizeandsusceptibility,andvirulenceinendemicdisease,epidemicdisease,emergingdiseases,andbioterrorism9.Developtheabilitytoworkbothindependentlyandwithothersinteamsandstudy groups.10.Developaninformationbaseformakingpersonalhealthdecisionsinregardtoinfectiousdiseases.