imm viro course review - dartmouth college

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]


Assessment• Moreproblembasedquestionswillbeincorporatedintotheexamstoassess

higherlevelthinkingskillsandlearning.[Anewcoursedirectorwasappointedafterthisreviewandmanychangeswereimplemented.Inordertoassesstheeffectivenessofthenewteachingmethods,therewasadesiretokeepthequizzesandexamsrelativelystable,howevermoreofthesequestionswillbeaddedinthefuture]

• Allnegativeformatquestionswillberemovedfromallquizzes.[done]• Singlebestanswerformatwillbeusedforexamquestions.[done]

Courseoverlap• Thiscoursewillcoverfewerlaboratoryteststhatarecoveredasapartof

Pathologyinyear1.Thiscoursewillcontinuetocoverafewkeyimmunologicaltests.[done]

• Thiscoursewillnotcoverhistology/anatomyofimmunetissuesthatarecoveredinCTO.[done]


• 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.


• 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.


• 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.


• CC.8doesnotseemappropriate;couldmaptoCS.7andP.7.CC.8:Deliveroralpresentationsappropriatetothepatient'spresentationandclinicalcontext.

CS.7:Translatecomplexbiomedicalconceptsandadvancesintousefulinformationtoeducatepatients,families,peers,andothers.P.7:Demonstrateaccountabilityforallprofessionalresponsibilitiesandcommitments,andtakeresponsibilityforone’swordsandactions.


• 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- 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%)


• TheImmunologycoursereplacedtwohoursoflecturewithmoreactivesessions– aTBLsessionandaCasePresentation

• TheVirologycoursereplacedthreehoursoflecturewithnewsmallgroupconferences


• 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



ImmunologyAY13-14(88%)*



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



VirologyAY13-14(88%)*



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”


VirologyStrengths:• iBooks providedessentialbackgroundcontent

– “iBookexplanations[weremostly]easytounderstand.”– “Iappreciatedthatthelecturersrespondedtostudents'requestsandreleasedanoveralliBookthatconsolidatedallofthecoursematerial.”

• Viruseswereoftentaughtintheirclinicalcontext– “Thecoursedidagreatjobtryingtotieinclinicalcorrelations.”– Dr.Lahey’s lectureonHIVwasalsoveryclearandengaging.”– “Wetalkedabouthowcertainriskfactors(location,behaviors,genetics,etc.)couldmakeyoumoresusceptibletocertainviruses.”


ImmunologySuggestionsforImprovement:• Variablequalityandutilityoflecturenotes– “Ithoughtthenoteswereincrediblydenseandpoorlyorganizedforsomeofthelectures.”

• SectiononHumoralImmunitydifficulttounderstand– “Organizationofthehumoralimmunityunitwasdifficult…andhardtofollow.”

• Minimalguidanceonexpectationsforsmallgrouppresentations– “Thequalityofgroups’presentationswasheterogeneous.”


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%)

imm viro course review - dartmouth college

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