Assessment, Evaluations and Outcomes

• Centrally coordinated based on expected outcomes 
  • Clearly delineated graduation outcomes as well as milestones for progression  
  • Central oversite of all assessment in Office of Assessment, Evaluation, Outcomes 
• Emphasis is on assessment for learning with continuous and frequent assessment using multiple methods 
• Trustworthy methods for high-stakes decision-making 
  • Competency committee to review student progress on milestones 
  • Grading committees determine grades using criterion-based grading rather than norm referenced 
• Student assessment data informs program evaluation 

• Assessors – The emphasis will be on high quality feedback utilizing workplace-based assessment and our assessors will receive feedback on their assessment.  
• Learners – Assessment should promote self-regulated learning in the learner and the learner will be an active participant in assessment 
• Coaches – Help students process and understand assessment data and translate it into learning 

• Any single assessment point is flawed – Multiple different assessment methods will be used longitudinally to generate multiple data points about each student.  
  • All assessments will be connected to the Trek outcomes/milestones 
• The multitude of assessment data necessitates a means of displaying and visualizing data – Dashfolio 
  • Data must be granular enough to actually support learner growth (just exam scores is not enough)  
• Work-place based assessment, particularly direct observation is crucial in medical education 
  • Criterion referenced over norm referenced scales 
  • Qualitative data is just as important as quantitative  

The outcomes chosen for the Trek curriculum composed of Entrustable Professional Activities (EPAs) and competencies organized into the core competency domains of the ACGME.  The 13 Core EPA’s for Entering residency drafted by the AAMC are included (CEPAER).  However, rather than creating the cross walk with competencies we opted to simplify things and include additional outcomes that we believe are important at CUSOM and that we want to assess in and of themselves.  By highlighting these areas as outcomes, we hope that it will increase the emphasis on developing those specific skills even though many of them are necessary for entrustment of the core EPA’s.   

The milestones for the Trek curriculum are based on the premise that assessment is about making a claim/judgement about a learner.  Therefore, the milestones represent claims that we want to make about a student’s ability at a specific transition point when the student will obtain increased responsibility.  This model echoes the core EPA language of thinking about what a day 1 resident should be able to do without supervision.  The two key transitions that we have identified are the transition to the core clinical year (Foothills) and the transition to the advanced course work including acting internships (Alpine).   

• Demonstrate behaviors that convey compassion, empathy, respect and inclusion  
• Demonstrate professional behaviors that build trust 
• Apply ethical values to service of individual patients, communities and the public at large. 
• Develop an individualized identity as a physician built on the shared values of the profession. 
• Advocate for the well-being of patients, families, communities, and populations. 

• Graduates will be entrusted to perform the following activities without direct supervision: 
• Gather a comprehensive patient centered history  
• Perform a physical examination  
• Develop a prioritized differential diagnosis and select a working diagnosis following a patient encounter.  
• Recommend and interpret common diagnostic and screening tests.  
• Create and implement a management plan including entering and discussing patient orders/prescriptions and explaining the diagnosis and collaboratively discussing treatment plans.  
• Recognize a patient requiring urgent or emergent care, initiate evaluation and treatment and seek help 
• Perform general procedures for a physician  
•  Obtain informed consent for tests and/or procedures that the day 1 intern is expected to perform without supervision  
• Integrate individual, community, socio-ecological, and systems factors in service of patient and family well-being. 
• Organize and prioritize responsibilities to provide care that is safe, effective and efficient  

• Demonstrate effective verbal and nonverbal communication with patients, families, and health professionals of diverse backgrounds. 
• Provide written documentation of a clinical encounter  
• Provide an oral presentation/summary of a patient encounter  
• Effectively give or receive a patient handover to transition care responsibility to another health care provider  
• Participate as a contributing and integrated member of an interprofessional team  

• Demonstrate and apply knowledge of established and evolving biomedical, clinical, informatics, epidemiological, and social-behavioral sciences.  

Demonstrate an awareness of and responsiveness to the larger context and system of health care, as well as the ability to call effectively on other resources in the system to provide optimal health care. Leadership is defined as taking responsibility for productive change through collaboration with people, processes, institutions, and policy.  

• Adapt personal leadership skills to maximize the performance of self and others. 
• Recognize how healthcare system factors impact health and care delivery.  
• Identify personal and system level factors impacting patient safety and participate in improvement activities.  

• Demonstrate the ability to investigate and evaluate one’s care of patients, to appraise and assimilate scientific evidence, and to continuously improve patient care based on constant self-evaluation and life-long learning  
• Form clinical questions, retrieve and appraise evidence to advance patient care (or transform health)  
• Demonstrate the skills of a Master Adaptive Learner  
• Advance knowledge through structured scholarship