imm viro course review - dartmouth college
TRANSCRIPT
ReviewofYear1Immunology/Virologycourse
• CourseoccursinthewintertermofYear1
• CourseDirectors– DavidMullins(Immunology),DavidBzik (Virology)
• Coursehas44curricularhours
• CoursewaslastreviewedinDec2013
• CourseobjectivesareclearlywrittenandcorrelatewellwithobjectivesintheStepIbrochure
• Somesessionobjectivesneedtoberewritten;sessionobjectivesneedtobeprovidedforeveryactivityinthecourse
• Theissueofredundancyregardingcommondiseasesshouldbeexploredbythecoursedirectorstoensurethattheredundancyisplanned
• Thecourseisheavilylecture-based;thecoursedirectorsneedtointroducemoreengaged/activeformsofpedagogyintothecourse
PriorReview:SummaryofRecommendations
• Assessmentquestionshavebeenimprovedsincethelastreviewofthecourse,howeverfurtherrevisionisneeded;studentscontinuetocitefrustrationwiththecontentonassessments(i.e.thematerialassesseddoesnotmatchwhatisemphasizedinthecourse)
• Expectationsregardingthecourseneedtobeclearlycommunicatedtostudents;someimprovementisneededintheclarityofcoursematerials
PriorReview:SummaryofRecommendations
Faculty• Facultythathavereceivedfeedbackwheresignificantstudent
dissatisfactionwasnotedwillconsultwithDCALandamemberoftheAcademyofFacultyMasterEducatorstoreviewpasttapedlecturestoimprovetheirabilitytocommunicatematerialeffectively[done].
• Thecoursedirectoranddepartmentchairmanwillattendsomelecturestoseethematerialpresented‘inaction’andobservestudent-professorinteractions.[done]
Notes• Noteswillappearinasimilarformatwithlearningobjectivesatthefront.
Theywillbeinshortparagraphformatandcoverkeyconcepts.[done]• Noteswillbewritteninthesameorderasthesessionmaterial.[done]• Thelearningobjectiveswillbethesameforthelecturesandstatewhat
theexpectationsarefromthestudentsforeachsession.[done]
PriorReview:ImmunologyActionPlan
Lectures• Objectivesforthesessionwillbestatedatthebeginningofeachsessionandwhat
specificallyshouldbelearnedwillbestated.[done]• Dr.Mullinswillusea2hourteambasedlearningproblemfortumorimmunology,
whichwillincreasetheactivelearningtime.[done]• Thecoursewillshortenthelecturetimeby3hours.[done]• Althoughalargegrouplectureformatwillbeusedinmanysessions,more
interactivelearningstyles(e.g.pairsharing,ARSquestions)willbeincorporated,althoughtherewillstillbetraditionallecturematerial.[somefacultydidthis,othersstillworkingonit]
SmallGroups• Thestudentpresentationgroupswillreceivefeedbackfromtheirfacultyfacilitator
fortheirpresentation.Theywillalsoreceiveresultsofasurveyfromallstudentsattendingtoprovidefeedbackonthepresentation/discussion.[done]
• Toprovidemoreflexibility,wewillallowtheuseofcomputeraidsandotherpresentationapproaches.However,thiswillbeprovisionaldependingonwhetherthesepromoteorinhibitstudentinteractionsandlearning.[done]
PriorReview:ImmunologyActionPlan
Assessment• Moreproblembasedquestionswillbeincorporatedintotheexamstoassess
higherlevelthinkingskillsandlearning.[Anewcoursedirectorwasappointedafterthisreviewandmanychangeswereimplemented.Inordertoassesstheeffectivenessofthenewteachingmethods,therewasadesiretokeepthequizzesandexamsrelativelystable,howevermoreofthesequestionswillbeaddedinthefuture]
• Allnegativeformatquestionswillberemovedfromallquizzes.[done]• Singlebestanswerformatwillbeusedforexamquestions.[done]
Courseoverlap• Thiscoursewillcoverfewerlaboratoryteststhatarecoveredasapartof
Pathologyinyear1.Thiscoursewillcontinuetocoverafewkeyimmunologicaltests.[done]
• Thiscoursewillnotcoverhistology/anatomyofimmunetissuesthatarecoveredinCTO.[done]
PriorReview:ImmunologyActionPlan
• Incorporatemoreactivemodesoflearning/newmethodsofpedagogyintothecourse(i.e.reduce%oflectures)[donetoasmalldegree]
• Rewrite/createlearningobjectivesforeachsessiontoclearlyarticulateexpectationstostudents[done]
• Facultydevelopmentisneededforsomefacultythatarenotmeetingexpectationswithregardtoteaching[oneissuewasrectified]
• Update/editnotes;ensurelecturecontentandnotesareinagreement[continualprocess;facultyhaveworkedonthis]
• Provideanopportunitywherebiologicdataareobserved,measuredandanalyzed[incorporatedanonlinelabforoneyear,butdecidedtodiscontinueasitwasnotdeemeduseful]
• Reviewoverlapofmaterialwithothercourses[done]• Identifyatriskstudentsearlyandprovidesupport[done;coursedirector
reachedouttothem]• Reviseassessmentquestions;verifythattheylinkbacktomajorcourse
objectives[continualprocess;facultyhaveworked/continuetoworkonthis]
PriorReview:VirologyActionPlan
CourseObjectives- Immunology
• AlsomapstoMS.3;suggestaddingthislinkMS.3:Useinterdisciplinarybasicscienceknowledgetoappraisenovelmechanismsofdisease,andproposeandassessdiagnosticstrategies,andtreatments
• AlsomapstoCC.4;suggestaddingthislinkCC.4:Evaluatetheappropriatenessofdiagnostictestsandstudiesforaparticularconditionandclinicalcontext.
CourseObjectives- Immunology
• CC.8doesnotseemappropriateforthisobjectivesincethereisno“patientpresentation”;suggestremovingthislink.CouldalsomaptoCS.7andPH.2.
CC.8:Deliveroralpresentationsappropriatetothepatient'spresentationandclinicalcontext.
CS.7:Translatecomplexbiomedicalconceptsandadvancesintousefulinformationtoeducatepatients,families,peers,andothers.PH.2:Assesstheimpactofsocial,environmental,behavioral,economic,cultural,andpersonalfactorsonthehealthofindividuals,andtheincidenceandburdenofdiseaseinpopulations.
CourseObjectives- Immunology
• CC.8andCC.1donotseemappropriate;couldmaptoPPLD.1,PPLD.7,P.2,CT.1,CT.2,CT.4,CT.5
CC.8:Deliveroralpresentationsappropriatetothepatient'spresentationandclinicalcontext.CC.1:Establishmutuallyrespectfulstudent-patient-familyrelationshipsbasedontrust.PPLD.1:Demonstratecriticalandaccurateself-assessment,reflection,andeffectivelearningstrategiestoengageinlifelonglearningandimproveone'sperformance.PPLD.7:Beapositiverolemodeltofellowstudentsinacademic,clinical,researchand/orservice-learningcontexts.P.2:Behaverespectfully,responsibly,andethicallytowardspatients,families,colleagues,membersofthehealthcareteam,andthecommunity.CT.1:Fosteraclimateofcollaboration,mutualrespect,integrity,trust,andtolerancetofacilitateoptimalteamperformance.CT.2:Demonstratetheabilitytoeffectivelyshareand/orallocateresponsibilitiesamongteammembers.CT.4:Developorganizational,timemanagement,andcommunicationskillstoserveefficientlyandproductivelyindifferentrolesonateam.CT.5:Manageconflictconstructively.
CourseObjectives- Immunology
• CC.8doesnotseemappropriate;couldmaptoCS.7andP.7.CC.8:Deliveroralpresentationsappropriatetothepatient'spresentationandclinicalcontext.
CS.7:Translatecomplexbiomedicalconceptsandadvancesintousefulinformationtoeducatepatients,families,peers,andothers.P.7:Demonstrateaccountabilityforallprofessionalresponsibilitiesandcommitments,andtakeresponsibilityforone’swordsandactions.
CourseObjectives- Immunology
• CC.8doesnotseemappropriate;couldmaptoCS.2,CS.7,PPLD.4,PPLD.6,PPLD.7,P.2,P.7.
CC.8:Deliveroralpresentationsappropriatetothepatient'spresentationandclinicalcontext.CS.2:Demonstrateempathyforindividuals'concerns,andberespectfulofothers'perspectivesandpersonal,cultural,andreligiousvalues.CS.7:Translatecomplexbiomedicalconceptsandadvancesintousefulinformationtoeducatepatients,families,peers,andothers.PPLD.4:Engageinactivediscussionanddebate,takingadvantageofdifferentperspectivestoadvanceknowledgeandunderstanding,andimprovedecision-making.PPLD.6:Identifyanddemonstratethequalities,knowledge,skills,andattitudestoleadeffectivelyatthelevelofone'sself,team,organization,andcommunity.PPLD.7:Beapositiverolemodeltofellowstudentsinacademic,clinical,researchand/orservice-learningcontextsP.2:Behaverespectfully,responsibly,andethicallytowardspatients,families,colleagues,membersofthehealthcareteam,andthecommunity.P.7:Demonstrateaccountabilityforallprofessionalresponsibilitiesandcommitments,andtakeresponsibilityforone’swordsandactions.
CourseObjectives- Immunology
CourseObjectives- Virology
• Thewordingoftheobjectiveisslightlyconfusingduetotheway“andclinicalsigns”wastackedonattheend;revisionisadvised.[duringthesubcommitteemeetingitwasconveyedthattheintentwastohavestudentsdescribeclinicalsignsofthediseasescausedbyviruses]
• ThisobjectivecouldalsomaptoMS.2.
MS.2:Applycorebiomedicalandsocialscienceknowledgetounderstandandmanagehumanhealthanddisease.
CourseObjectives- Virology
• ThecorrelationwiththeUSMLEBrochureforStepIisverygood;theimmunologycontentinthisbrochureiscoveredinbothyears1and2ofthecurriculum,whilethevirologycontentisprimarilydiscussedinyear1
Note:Dr.MullinswillbethecoursedirectorfortheVirologyportionofthecoursenextyear;wesuggestthattheStepIcontentoutlinemightbeusefultohimasheplansthecoursecontent
CorrelationwithUSMLEContent
• Courseobjectivesareprovidedinthesyllabus• Courseobjectivesarewritteninthecorrectformat• Sessionobjectivesare providedinthecoursematerials,howevertheyarelistedinthenotesratherthanonCanvassessionpagesasmostcoursesdo
• Mostsessionobjectivesare writteninthecorrectformat;someobjectivesinthesessionsbelowusethewords“know”or“understand”andneedtoberevised:MHC/antigen,T-cellrecognition,T-cellresponses,TransplantImmunology,Tumorviruses
• Virologysmallgroup#2ismissingsessionobjectives
FormatofCourse&SessionObjectives
• Numerouskeywordswereusedtosearchforredundancy(e.g.immunodeficiency,autoimmunity,hypersensitivity,Tcell,etc.)
• Ilios indicatesthatthereissignificantunplannedredundancywiththeY1Pathologycourse.Twoexamplesarebelowusingimmunodeficiencyandhypersensitivityasakeywords:
Immunologycourse:TodescribethedifferencebetweenaprimaryandasecondaryimmunodeficiencyPathologycourse:Definewhatismeantbyimmunodeficiencyandnamethetwocategoriesintowhichitisdivided.
Immunologycourse:TodescribeandcomparethefourtypesofhypersensitivityPathologycourse:Define,distinguishandexplainhypersensitivitydiseasestypesIthroughIV
IssuesofRedundancy
• TheremaybeslightunplannedredundancywiththeimmunesystemsessionintheY1CTOcourse.
• ThereisredundancywithsomesessionsintheSBMInfectiousDiseasesandPharmacologycoursesinY2,howeverthisseemsappropriate
IssuesofRedundancy
• Twoimmunologysessionsaddressethics,culturalawarenessandhealthequity– alargegrouponvaccinesandasmallgrouponTB
• AvirologysmallgroupsessiononhepatitisCaddressesethicsandhealthequity
• Manyvirologylecturesincludeinformationabouttheepidemiologyofspecificviruses/diseases
ExplorationofHealthandValues
• Overall,theobjectivesarewellwrittenandthecontentseemsappropriate
• SomeadjustmentscouldbemadeinthemappingofobjectivestothenewGeiselcompetencies
• Minorrevisionsneedtobemadetoasmallnumberofsessionobjectivestoincorporatemeasureableverbs
• TheremaybesomeunplannedredundancywiththeY1CTOandPathologycourses.Thecoursedirectorsshouldmeettoensureredundancyisplannedandcoordinated.
SummaryregardingObjectives
• ImmunologyLectures19hrs.(79%)• ImmunologyConferences3hrs.(13%)• ImmunologyCasePresentation1hr (4%)• ImmunologyTBL1hrs.(4%)Optionalreviewswereprovidedpriortoquizzesandexams
Datafrompriorreview:• Lecture21hrs.(88%)• Discussiongroups3hrs.(12%)
CourseLearningOpportunities
• VirologyLectures17hrs.(85%)• VirologyConferences3hrs.(15%)
Optionalreviewwasprovidedpriortofinalexams
Datafrompriorreview:• Lecture20hrs.(100%)
CourseLearningOpportunities
• TheImmunologycoursereplacedtwohoursoflecturewithmoreactivesessions– aTBLsessionandaCasePresentation
• TheVirologycoursereplacedthreehoursoflecturewithnewsmallgroupconferences
CourseLearningOpportunities
• Thesubcommitteewaspleasedtoseethatbothcoursesintroducednewpedagogytoreplaceseveralhoursoftraditionallecture
• Bothcoursesneedtoreducethenumberoflecturehours.ThecurrentpercentageoflecturesdoesnotmeettheGeiselpolicyonActiveLearning/LectureTimeorLCMErecommendations(targetis40-50%ofcontacthours).
Note:ThecoursedirectorfeltitwouldbeusefulfortheMECtodefineactivitiesthatmeettheGeiselcriteriaof“activelearning”toguidecourserevisionefforts;thesubcommitteeagreedthatthiswouldhelpmanycoursedirectors
SummaryregardingPedagogy
• WrittenQuizzes-2inImmunology,2inVirology(40%ofcoursegrade)
• FinalExam(50%ofcoursegrade)• Immunologyconferences (5%ofcoursegrade)• Virologyconferences(5%ofcoursegrade)
Assessment
• Objectives1-12,18-33coveraspectsofmedicalknowledge– assessedonquizzes/exams
• Objectives13-16relatetoskillssuchaspeerteaching,communication,givingapresentationandleadingadiscussion– facultyassessedtheseskillsinconferences usingarubricdevelopedbythecoursedirector,howeverthecoursedirectorfelttheycouldimproveongivingfeedback
– studentswereaskedtoevaluatetheirpeers,butthecoursedirectorfelttheexercisewasnotusefulsincemoststudentsjustcheckedthe“excellentjob”box
AssessmentofCourseObjectives
• Objective17relatestointerpretingdatafromexperiments– thereiscurrentlyonequestiononanexamthatassessestheseskills;thecoursedirectorplanstoincorporatemoreapplicationquestionsinthefuture
• Objectives34-35relatetoproblem-solvingskillsanddesigningexperimentsintheVirologycourse– theseobjectivesrelatedtothevirtuallabthatwasdevelopedandnowhasbeendiscontinued;thusthecoursedirectorfelttheyshouldbeeliminated
AssessmentofCourseObjectives
• Thereareavarietyofactivitiesinthecourse(conferences,quizzes,exams)thatcontributetotheoverallcoursegradeandthepercentageoftheseactivitiesseemsappropriate
• Withtheexceptionofobjectives34-35,allobjectivesinthecoursearebeingassessed.Thesubcommitteerecommendsthatobjectives34-35shouldbeeliminated.
SummaryregardingAssessment
TRADITIONALCOREDISCIPLINES2013* 2014* 2015* Means13-15
Biochemistry 0.20 0.22 0.03 0.15
Biostatistics/Epidemiology 0.40 N/A N/A N/A
Biostatistics 0.08 0.29 0.19
Genetics 0.18 0.28 0.09 0.18
Grossanatomy/Embryology 0.26 0.14 0.16 0.19
Histology/CellBiology 0.26 0.23 0.07 0.19
Microbiology/Immunology 0.47 0.39 0.02 0.29
Pathology 0.24 0.20 0.12 0.19
Pharmacology 0.22 0.12 -0.02 0.11
Physiology 0.35 0.25 0.11 0.24
MeasuresofQuality– StepI
*valuesreportedforcoredisciplinesareSDabovetheUS/CanmeanforGeiselmeanscores
Year1courses OverallQualityAY14-15 OverallQualityAY15-16
BiochemicalandGeneticBasisofMedicine 4.34 4.40
CTO 4.07 4.06
HumanAnatomyandEmbryologyI 4.35 4.04
Physiology-Cardiovascular 3.23 3.41
Physiology-Respiration 3.34 3.41
HumanAnatomyandEmbryologyII 4.57 4.43
Immunology 3.67 3.94
MetabolicBasisofDisease 4.35 4.48
Physiology-Renal 4.19 3.63
Physiology-Endocrine 3.76 3.52
Virology 3.77 3.83
Basic ScienceofMicrobialDisease 3.94
Neuroscience 3.59
Pathology 3.22
scale[1=poor;2=fair;3=good;4=verygood;5=excellent]
MeasuresofQuality– CourseEvaluation
scale[1=poor;2=fair;3=good;4=verygood;5=excellent]
MeasuresofQuality– CourseEvaluation
ImmunologyAY13-14(88%)*
ImmunologyAY14-15(93%)*
ImmunologyAY15-16(91%)*
Overallsatisfactionofcourse 2.35 3.67 3.94
Clarity oflearningobjectives 2.68 3.70 4.06
Organizationofthecourse 2.45 3.59 3.79
Howwellthecourseintroduced metothisdiscipline Not available 3.84 4.01
Congruence ofassessmentquestionstomaterialemphasizedincourse 2.01 3.61 3.84
*studentparticipationrateoncourseevaluation
scale[1=poor;2=fair;3=good;4=verygood;5=excellent]
MeasuresofQuality– CourseEvaluation
VirologyAY13-14(88%)*
VirologyAY14-15(93%)*
VirologyAY15-16(91%)*
Overallsatisfactionofcourse 3.71 3.77 3.83
Clarity oflearningobjectives 3.81 3.86 3.98
Organizationofthecourse 3.68 3.67 3.67
Howwellthecourseintroduced metothisdiscipline notavailable 3.94 4.01
Congruence ofassessmentquestionstomaterialemphasizedincourse 3.61 3.69 3.61
*studentparticipationrateoncourseevaluation
MeasuresofQuality– StudentComments
ImmunologyStrengths:• Ahostofgreatlecturers– “Mullins’lectureswereoutstanding.”
• Largebankofpracticequestionsforeachquiz– “HavingtheLevinsonquestionswasagreatwaytoself-test”
• Reviewsessionshelpedtointegratethematerial– “Thereviewsbeforequizzes[highlight]theimportantconcepts”
MeasuresofQuality– StudentComments
VirologyStrengths:• iBooks providedessentialbackgroundcontent
– “iBookexplanations[weremostly]easytounderstand.”– “Iappreciatedthatthelecturersrespondedtostudents'requestsandreleasedanoveralliBookthatconsolidatedallofthecoursematerial.”
• Viruseswereoftentaughtintheirclinicalcontext– “Thecoursedidagreatjobtryingtotieinclinicalcorrelations.”– Dr.Lahey’s lectureonHIVwasalsoveryclearandengaging.”– “Wetalkedabouthowcertainriskfactors(location,behaviors,genetics,etc.)couldmakeyoumoresusceptibletocertainviruses.”
MeasuresofQuality– StudentComments
ImmunologySuggestionsforImprovement:• Variablequalityandutilityoflecturenotes– “Ithoughtthenoteswereincrediblydenseandpoorlyorganizedforsomeofthelectures.”
• SectiononHumoralImmunitydifficulttounderstand– “Organizationofthehumoralimmunityunitwasdifficult…andhardtofollow.”
• Minimalguidanceonexpectationsforsmallgrouppresentations– “Thequalityofgroups’presentationswasheterogeneous.”
MeasuresofQuality– StudentComments
VirologySuggestionsforImprovement:• AIDSsmallgrouppresentationrelativelymoredifficult– “Ithinkthethirdsmallgrouptopicwasoverlyambitious[especially]whenstudentsaredistractedbytheupcomingfinalexam.”
• Rationalebehindorderofviruslecturesunclear– “Ithinkthecoursecanbetaughtinamoreorganizedway.”– “Thetaxonomyofviruseswasoftenratherconfusing”
• Presentationofvirusesinconsistentacrosslecturers– “Itwouldhavebeensohelpfulforeachvirustohavebeenclearlypresentedinthesameway....i.e.Classification,Pathogenesis,Epi,vaccines/treatment,etc.”
• TheratingsfortheimmunologyportionofthecoursehaverisensubstantiallysinceAY13-14andnumbersarecurrentlyinthe“good”to“verygood”range;wecommendthecoursedirectorforhisefforts
• Thevirologyportionofthecoursehasconsistentlybeenratedinthe“good”to“verygood”range;valuesforoverallsatisfactionandclarityoflearningobjectivesexhibitanupwardtrend
• Studentssuggestsomerevisionstosomesessions(e.g.Humoralimmunity)toimprovethecourse,andclarificationofsmallgroupexpectations/rationaleofcoursedesign
SummaryregardingMeasuresofQuality
RecommendationsSinceDr.MullinswillbeleadingtheentirecourseinAY16-17(bothimmunologyandvirology),thesubcommitteefeelsthisisanidealtimeforthecoursetobereimaginedand“polishedup”.WeunderstandthatDr.Mullinshasplanstofixmanyoftheissuesraisedbystudentsovertheyearsandweareconfidentinhisabilitiestoaddressthem.Basedonthecurrentreview,hereareourrecommendations:
• Thecourseshouldfixminorissueswithcourseandsessionobjectives
• PossibleunplannedredundancyinthePathologyandCTOcoursesshouldbeexplored(andremediedifnecessary)bythecoursedirector
Recommendations• Thecoursedirectorshouldcontinuetoexplorewaystoincorporateengaged/activelearningactivitiesintothecourseandgraduallyreplacetraditionallectureswithotherpedagogies
• Althoughallcourseobjectivesarecurrentlybeingassessed,thecoursedirectorshouldcontinuetoexperimentwithmethodstoprovidestudentswithverbalornarrativefeedback
• Thecoursedirectorshoulddirectimprovementeffortstowardssessionsthatstudentsidentifiedasproblematic;courseexpectationsshouldbeclarified
• Reviseandupdatethecourselayoutandcontent– UpdateCourseAims(anticipatedsummer‘16)– GreaterintegrationofImmunologyandVirologycontent– EnsurecorrespondencewithUSMLEBrochure– Reassignmentoflecturesfromunderperforminginstructors
• Reviseandupdatesessionobjectives– Ensurecorrectformatandconsistentpresentationofsessionobjectives
– Usesessionobjectivestoestablishexpectationsforlearningandassessmentacrossthecourse
ActionPlan
• Assesspotentialredundancy– CourseDirectortomeetwithpeersfromPathologytoidentifyandeliminateunplannedredundancy
– CourseDirectortoworkwithpeersfromCTO,SBM,andPharmacologytocoordinateplannedredundancy
• Improveassessmentandfeedback– Additionofhigherorder,problem-solvingtestitems– Improvefeedbackonsmallgrouppresentations,includingexpandedassessmentrubricandpeerfeedback
ActionPlan
• Decreasetraditional/didacticlectureinfavorofactivelearningcontentinimmunologyandvirology
Traditionallecturecontenthours(percentage):
– EngageDCALandGAMEforadditionalguidance
ActionPlan
Actuals Goals
AY14-15 AY15-16 AY16-17 AY17-18
Immunology 20/24(83%) 19/24(79%) 15/24(63%) 11/24(46%)
Virology 17/20(85%) 17/20(85%) 14/20(70%) 11/20(55%)
TOTAL 37/44(84%) 36/44(82%) 29/44(66%) 22/44(50%)