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Identification and support process for required clinical years courses that are underperforming or not meeting expectations

It is important to note that identification of a course as underperforming is considered a continuous quality improvement (CQI) opportunity.

Identification: An “underperforming” Course or Rotation is identified on IREA-generated cross-course evaluations. The cross-course report will be reviewed by the respective sub-committee annually in September. A course/rotation with any metric that is < 75% good + excellent or strongly agree + agree is considered to be “at risk.” Metrics include: Objectives clearly defined, Summative assessments reflected course objectives, I was treated with respect, overall course rating. That course will be considered “at risk” until the follow up review demonstrates improvement to above the 75%. Additionally, clerkships and acting internships with <85% “yes” for receiving mid rotation feedback will be considered at-risk. These metrics are triggers for further analysis of the course’s performance. A course or block will be considered underperforming until follow up review demonstrates improvement to above the threshold. Underperforming courses will need to re-analyze these metrics 6 months after underperformance has been identified. This information can be directly pulled from OASIS by the rotation director or requested from IREA. If a course continues to be below the threshold after two 6 month improvement cycles for continually enrolled courses (example clerkships, ECPS) and annually for non “continuously enrolled” courses (example ABTS, Acting Internships) it will be considered non-compliant. The Education Policy Committee (EPC) Chair & Co-Chair will review the determination of underperforming courses at the October Rules Committee Meeting with Subcommittee leadership and the Senior Associate Dean of Educational Affairs (SADEA). Other data sources that may lead to identifying a course as underperforming include:

  • high faculty turnover,
  • specific areas of deficiency identified during the annual review by the Senior Associate Dean to the EPC,
  • recurrent lower than average but above threshold metrics on the cross course reports or per the SADEA or EPC description

Support and Action Plan for Underperforming Courses or Rotations

For courses or rotations deemed to not be meeting expectations for the first time: A plan will be designed by the rotation director in consultation with the co-director or other course leadership team and presented to the subcommittee chair or to the subcommittee in the annual course report, dependent upon timing of that course report in the academic calendar. Underperforming courses will be prioritized

for early annual rotation/course reports to their subcommittee. This plan should be beyond the scope of a typical course review. Rotation leaders should review Course and Clerkship leader’s guide . The course leader is encouraged to meet with the assistant dean for undergraduate medical education. Other supports include the subcommittee chair, EPC officers, academic technology and the Center for Academic Achievement (CAA.)

If the course/rotation continues to not meet expectations in the following review (6 months from the annual report): A working group will be led by the course/rotation leader or designee, and may include representatives from Tan Chingfen Graduate School of Nursing, Morningside Graduate School of Biomedical Sciences, CAA, (Office of Student Affairs, if a learning environment issue is involved) , a student curriculum representative, a faculty at-large representative, an EPC officer, a course administrator from a different rotation, and the subcommittee chair. The working group final composition will be at the discretion of the subcommittee chair in consultation with the SADEA and the EPC leadership. This working group will review course data in comparison to other courses, the course report as well as other appropriate data and meet with the course leadership team who will respond to working group questions, and may also choose to conduct a student focus group. The action plan may include a faculty coach, if indicated. They will create an action and monitoring plan for the next 6 months.

If a course/rotation is still not meeting expectations 6 months after the working group develops their plan, the course will be considered non-compliant: The EPC will recommend to Office of Educational Affairs (OEA) that independent, outside consultation be sought for additional strategy.


The course or rotation leader should: lead this working group review process as requested, include identification of their course as underperforming during their course report to their respective subcommittee, carry out the plan approved by the subcommittee chair in the first phase, carry out the plan approved by the working group in the second phase (if applicable). The improvement plans should be discussed as part of the CQI portion of their course report.

The Subcommittee Chair should: identify underperforming courses in their annual report to the EPC, participate in the October EPC Rules meeting where underperforming courses are identified, facilitate the population of the working group in the second phase, participate on the working group, be available to the course leader for issues carrying out the improvement plan at both phases. The timeline for interventions/countermeasures will be set after discussion with the EPC leadership and will be based on course calendaring.

The EPC Chair should: ensure that underperforming courses are identified annually, conduct the October Rules meeting to identify underperforming courses and review cross course reports, set time expectations for the working group to deliver their recommendations and report underperforming courses to the SADEA. The timeline for interventions/countermeasures will be set after discussion with the subcommittee chair and will be based on course calendaring. The timeline for interventions/countermeasures will be set after discussion with the subcommittee chair and will be based on course calendaring.

As we transition to CR22 foundational courses will be absorbed into blocks and clinical courses reconfigured. The strategies that are part of the outlined improvement plans (at any phase) for a LInC course should be continued in the new curriculum and reported on during during the first annual block & rotation reports in the new curriculum to the respective subcommittees.. The blocks/rotations, themselves, will not be considered underperforming based on LInC status.

EPC | AY2020-2021