Evaluation in the First and Second Years
All examinations occur during the ninth week of each block. There are no mid-block exams or quizzes.
Each student receives a grade for BSci/PBL and a grade for IPC for each block. In addition, students must participate and receive grades for Ambulatory Clinical Experience (ACE) and Advanced Physical Diagnosis (APD).
First-year medical student performance is graded as either being "Satisfactory" (S) or "Unsatisfactory" (U) for both BSci/PBL and for IPC. When students advance to the second year, the grading system expands to include "Honors" (HN).
The grade for BSci/PBL is based on three components: performance in the PBL group, a knowledge-based examination and an assessment of clinical reasoning. In order to pass each block, a student must attain the level of performance deemed to be satisfactory on each of the three components:
Performance in the PBL group (Facilitator Evaluation)
Student performance in PBL groups is assessed throughout the block by the PBL facilitator. This is an observational assessment of each student's ability to analyze and organize information, apply information in discussion of cases, identify needed information, gather and critically analyze new information, present accurate information to peers in an organized and coherent manner and to contribute to the learning process of the group.
This examination may consist of multiple-choice questions similar to those on the USMLE Step 1 and Step 2 medical licensure exams, short answer questions, short essay-style questions, questions based on exhibits or slides, oral examination or other methods of determining knowledge levels. Most knowledge-based examination are a closed-book examination taken in a designated area(s).
This examination may consist of patient presentations and a series of questions requiring analysis and synthesis of information. Clinical reasoning examinations are typically "open-book" tests requiring library research but may take other formats..
BSci/PBL passing grades are as follows:
- Facilitator evaluation: No numeric values are awarded by the facilitator; "satisfactory" is the designated passing grade.
- Clinical-reasoning exam: 70% or higher
- Knowledge-based exam: 65% or higher
The grade for the IPC component of the curriculum is based on a variety of evaluations that take place during the ninth week. Evaluation for IPC may include written, knowledge-based examinations, simulations, objective structured clinical examinations (OSCE), papers, group projects, presentations, observations of skills performance, and faculty assessment of performance in small groups. Attendance and competence at specified learning experiences may also be required.
IPC passing grades are as follows:
IPC Knowledge-based exams: 70% or higher.
ICP facilitator evaluation: satisfactory
Performance of skills, attendance and other requirements: No numeric values are awarded; "satisfactory" is the designated passing grade.
M1/M2 Ambulatory Clinical Experience (ACE) and M2 Advanced Physical Diagnosis (APD)
Ambulatory Clinical Experience and Advanced Physical Diagnosis are graded curricular requirements. A satisfactory or unsatisfactory grade is assigned by the associated director. Evaluation is based upon observations by the preceptor and demonstrated professional behavior such as attendance, promptness, and interactions with and respect shown for the patients and the staff.
During the M-2 year, "Honors" (HN) is added to the grading scheme to recognize excellence. Consult the characteristics established by faculty for honors performance.
Honors in PBL Facilitator Evaluation/Bsci/PBL
Honor grades are as follows:
- Facilitator evaluation: No numeric values are awarded by the facilitator but facilitator may designate Honors.
- Clinical-reasoning exam: 90% or more correct responses
- Knowledge-based exam: 85% or higher
Honors in IPC
- Facilitator evaluation (where applicable): No numeric values are awarded by the facilitator but they may designate Honors.
- Examination: 90%
Any changes in these criterion levels will be announced at the beginning of the block.
Examination review provides the student with information that s/he needs to continuously enhance performance. Extensive analyses are performed on all examinations to ensure equitable and valid examinations. Examinations are not returned to students. Like the National Board of Medical Examiners, we are compiling a bank of test items, which have validity, predictability and reliability. The Office of Medical Education will announce the dates and times when students may review their examinations. All reviews must take place in the Office of Medical Education under the Honor Code.
The exam review process is bound to the same conditions of exam week and subject to the Honor Code. By signing in to review an exam, students acknowledge that they are subject to the Honor Code. Just as during exam week, students should work as individuals during exam review.
Students are not allowed to bring laptops or other electronic devices such as cell phones and/or digital cameras to the exam review site. No transcription of questions is allowed. Note taking is not permitted other than a) annotating the number of the question(s) for the Exam Question Request, and b) noting short phrases on the self-assessment form for clinical reasoning exams.
Request for Re-Evaluation
If during an examination review, a student finds something s/he believes deserves credit not received, he/she may bring it to the Block faculty's attention for consideration. Limits are placed on the number of requests for re-evaluation that a student may make. Students may request re-evaluation of any component of their grade except the facilitator evaluation. Questions concerning a grade must be submitted in writing and in compliance with the published schedule, and it must include both a clear statement of the perceived discrepancy and a request for faculty re-evaluation. A request to re-evaluate the test is considered part of the student assessment process and is therefore subject to the same Honor Code as when students complete tests during examination week. The deadline to request a re-evaluation will be announced for each block. When re-evaluation of a test occurs, the student's entire performance on the component in question will be reassessed. A re-evaluation will result in one of three possible outcomes:
- Partial points or more may be added to the student's score on that component of the evaluation.
- Partial points or more may be subtracted from the student's score when the entire component is re-evaluated.
- The component score may remain unchanged.
Each student has an opportunity to participate in the re-evaluation process and may only request reconsideration of only their own exams. Should additional credit be awarded as part of the re-examination process, it is awarded only to the student making the request..
Administrative review of a pre-clerkship grade
Students may question any component of the grade in a pre-clerkship course with the exception of the facilitator evaluation. Directions for requesting a re-evaluation of the grade are located on the student's portfolio and described above. When re-evaluation of an exam occurs, the student's entire performance on the component in question will be reviewed.
A re-evaluation shall not be used to question a rule, procedure, or policy established by an authorized faculty or administrative body. Rather, it shall be used as due process by a student who believes that a rule, procedure or policy has not been followed or has been applied in an inequitable manner.
Should the student be unsatisfied with the result of the faculty committee's request for re-evaluation of a pre-clerkship course the student may appeal to the Associate Dean for Learning Strategies (Kimberly Hoffman PhD, MA215, (573) 882-2923, firstname.lastname@example.org). Students request for an administrative review must be received in writing within four weeks of receipt of the original course grade. The Associate Dean may elect to charge a faculty panel to consider the student's request. The faculty panel will consist of basic science and clinical faculty with experience in the pre-clerkship curriculum, one clinical course director, and one faculty member drawn at random from the pool of participants. The pool of participants will be solicited annually from pre-clerkship and clinical course leaders. The list of volunteers will be maintained by the Offices of Medical Education. Names will be drawn randomly by the Associate Dean. If a person whose name is drawn is not able to participate because of prior commitments, another name will be drawn. The panel may gather evidence, review documentation, interview individuals and request further information from the involved parties. Within 30 calendar days of the receipt of the request for an administrative review, the panel will give a written copy of their recommendation to the Associate Dean for Learning Strategies. If the decision of the panel is not unanimous, the dissenting party may submit a written dissenting opinion at the same time. The Associate Dean will respond to the student in writing within five working days of receipt of the panel's recommendation.
The University Registrar provides guidelines for changes in grades. In accordance with the University Registrar's guidance:
- Neither the Associate Dean nor the faculty committee can substitute his or her judgment for that of the instructor concerning the quality of the student's work.
- Mathematical or mechanical errors in scoring examinations may be corrected.
- No grade shall be otherwise changed unless there is clear, convincing and unequivocal evidence that it was a direct result of arbitrary and capricious conduct by the instructor and or faculty evaluator.
Appeals to the Dean of the School of Medicine
Should the student be dissatisfied with the response of the administrative review he/she may, within ten (10) calendar days of receipt of such response, submit a written appeal to the Dean of the School of Medicine through the Senior Associate Dean for Education. Upon receipt of the written appeal, an ad hoc faculty panel will be formed by the Dean's Office. The ad hoc committee will review the process. As stated above no one, including faculty serving on the ad hoc review committee may substitute personal judgment for that of the instructor concerning the quality of the student's work. The Dean will review the faculty panel's information and may accept the recommendation, amend it, reverse it or refer it back to the panel for reconsideration. The decision of the Dean of the School of Medicine is the final decision within the Medical School. Should a student be dissatisfied with the decision of the Dean s/he may follow the grievance procedure of the University of Missouri-Columbia campus.