Phase 4- INTEGRATION INTO PRACTICE
MED 8720: Clinical Skills IV
Academic Year 2024-2025
Class of 2025

Assessment Plan

Description
Provides learners with opportunities to advance their procedural and clinical skills to promote patient safety and work effectively in team settings.

Course Objectives
The learning objectives and linked course goals are listed on C-Blue. They have been mapped to the following Entrustable Professional Activities for Phase 4:

EPA 1: Obtain a history and perform a physical examination adapted to the patient’s clinical situation.
EPA 2: Formulate and justify a prioritized differential diagnosis.
EPA 3: Formulate an initial plan of investigation based on the diagnostic hypotheses.
EPA 11: Perform general procedures of a physician.

Each EPA has been independently mapped to the Program (CanMEDS) Objectives.

Teaching and Learning Methods
The required content will be delivered to the learners through both lectures and small group sessions. Learners will also participate in an OSCE examination.

Attendance is required for the Clinical Skills IV course. Any absences must be requested and approved by the Undergraduate Medical Education (UGME) office.

Course Timing/Duration
This course will occur during the last 2 weeks of Phase 4.

Assessment
Summative assessment of the EPAs as described above will be delivered in the following ways:

EPA 1 -3:
Learners will complete an OSCE examination that will be based on Phase 4 clinical content.  This exam will be linked to the appropriate EPAs and assess all CanMEDS roles.  

EPA 11:
Learner proficiency in mandatory procedures will be assessed using checklists during the scheduled time in the simulation lab. Learners need to obtain a satisfactory rating for each procedure in order to pass this component without reassessment.

Standard setting for OSCE examination
The provisional pass mark for the OSCE examination is 80%. The borderline-regression method will be used to determine the pass marks for each station using the class exam results. The following criteria are used to determine the pass/reassessment outcome for the OSCE:

• Any learner (a) receiving an overall OSCE mark at or above the OSCE pass mark as determined by the borderline-regression method and (b) passing at least 6 out of 8 stations will receive a pass.
• Any learner receiving an overall OSCE mark below the OSCE pass mark as determined by the borderline-regression method will need to remediate.
• Any learner failing more than 3 out of 8 stations will need to remediate.

Reassessment
Any learner who does not receive a pass grade for the OSCE or satisfactory for any of the mandatory procedures will require reassessment. Remediation for the OSCE is individualized and developed by the Clinical Skills IV Lead and the Phase 4 Lead based on the deficits of the learner. Reassessment for mandatory procedures will occur with supervised direction and practice in the simulation lab.

Course Success Criteria

To pass the course, a learner must:

• Pass the OSCE examination or reassessment
• Pass the mandatory procedure simulation checklists or reassessment
• Attend all sessions as per the course requirements
• Have no outstanding concerns with professionalism

Learners will receive their grades from the Undergraduate Medical Education (UGME) office via One45.

Original work, completed wholly by the learner, is expected to be submitted in this course. The use of an artificial intelligence tool like chatGPT is not permitted.

As outlined in the MD program objectives, the Faculty of Medicine at Memorial University values professionalism as a core competency and a requirement of the MD program. Recognizing that medical learners are developing their professional identity, professionalism lapses will be remediated where possible and appropriate. Unsuccessful remediation will result in failure of the Phase.  Professionalism lapses may render a learner incompatible with continuation in the MD program (as outlined in the Memorial University Calendar Regulation 10.5 Promotion).

As outlined in Section 10.5.2 and 10.5.3 of the Regulations for the Degree of Doctor of Medicine in the University calendar, learners with a Fail grade in any course cannot be promoted to graduation. Even in the absence of any Fail grades, a learner for whom substantial concerns about performance have been expressed may either be required to repeat the Phase or required to withdraw conditionally or unconditionally.

 

Version date:  March 27, 2023
Reviewed by SAS: April 26, 2023
Approved by UGMS: May 17, 2023