Blind Sky

9, 11 Day of Terror

by Dr. Pelham K. Mead III
My Educational Philosophy
By Dr. Pelham K. Mead III
Introduction
I have always believed in Dewey’s position on Education on “pragmatism” since I am a pragmatist. I believe in God and that he/she has a purpose for our lives. Of the idea of God, Dewey said, “it denotes the unity of all ideal ends arousing us to desire and actions.
I agree with Dewey that education and learning are social and interactive processes. Education or schooling is where a child spends 6 ½ hours a day. It becomes their social focus. Thus as Dewey has stated, the school itself is a social institution through which social reform can and should take place. It is also my firm belief that students do well in an environment in which they are allowed to experience things and interact with the curriculum. This is another tenet of Dewey, and still today we are striving to allow students to actively engage in their learning in lecture halls in colleges, and in classrooms in elementary and secondary education.
Being a pragmatic teacher I believe programs that arise in education can be worked out. I also believe in Existentialism in which students learn in their own way. I believe students to be unique and no set curriculum will work unless it allows for their individualism to exist. Dewey believed, as do I that a teacher needs to model the right way of doing things and to prepare a student not only for the subject being taught, but also for the future where their values will continue.
Today, I received an e-mail letter from a student I had in my physical education classes and my Boys Gymnastics team over 40 years ago, thanking me for all I did for him. When I first saw the name, I had to think, “Who was this student.” Then it occurred to me it was one of my smallest gymnasts that I always gave encouragement to, that one day he would grow taller and become stronger. He never forgot that modeling, and even though it took 40 years, he finally thanked me. Thanks were not need because I was doing my job and then some. I was being not just a teacher or a leader but and adult role model, something which had stuck with this student even though after he graduated from high school I never saw him again.
Satisfactions and Challenges of the Teaching Profession
The satisfactions of teaching are when like the student just mentioned come back or contacts me and says thanks. I use to always get excited when my students who had graduated from high school would come back and tell me how they were doing in college and how gymnastics or physical education in knowing me made a difference for them. I recruited a great deal of students to the profession of teaching even at the young ages of 14, 15, and 16. When I saw that special talent in working unselfishly with others I knew this student would one day make a great teacher. I gave them opportunities to teach by becoming what I called Junior Instructors and when they went off to high school from Junior High, I asked them to come back and help me after-school in the gymnastic practice sessions. Soon after a few years I had over 30 Junior Instructors helping my gigantic team of 110 students. Out of the 30 students 19 went on to become teachers, which is quite a record. Many became Gymnastic Captains at their College teams. Three such students became Captains of the Springfield College Gymnastic Team, my Alma Mata. These successes were very satisfying rewards for me in my career in teaching.
There are always cons in all professions, however despite the politics of my school where I taught for 31 years, I managed to survive. We had three major strike threats in which our Union tried to force the Board of Education to give us at least a 3% pay increase every four years that was below the cost of living.
Student diversity seems to be a key word in today’s education, however when I started teaching I saw no diversity in having as many black students on my gymnastic team as white students. I did not see the difference between special students and normal students. I remember going out of my way to encourage a tall black student who was considered a special education student to succeed in gymnastics when his friends all wanted him to play Basketball. My support of this student paid off because he actually became a NY State Gymnastic finalist. After high school graduation he attended the local community college and started a Gymnastic Club there. He went on to transfer after two years to SUNY Cortland University where he became a star male gymnast. Even though he was a special education student with a reading level of second grade in eighth grade and being a black American in a generally “white” sport, he achieved. My major philosophy in my Gymnastic Exhibition Team was that everyone that kept up their attendance and show motivation and effort would participate in some way in all of our traveling gymnastic shows at other elementary and secondary schools in our district and later on in other school districts. If they weren’t good at tumbling, I put them in the parachute event. If they are too weak for the parallel bars or uneven parallel bars I made them a vaulter so they could be a part of the “Elephant Vaulting” event. (Vaulting over parallel bars with a mat laid over the rails using a springboard or trampolette, with me on the other side catching many of them as they cleared the mat.)
It never occurred to me that there was diversity of religious backgrounds, or ethnic backgrounds until my school had an International Day and I noticed that all of my students came from 21 different countries and spoke 21 different languages at home. In the 1960’s and the 1970’s my school district was 60% Jewish students from Spring Valley, Monsey, Pomona, and Montebello, NY. Monsey itself was a self-sufficient Ultra-orthodox Jewish community where Jewish people owned all of the stores, and all the schools were Jewish Yeshivas. By the 1980’s the population changed and Haitian students became the next population to move into Spring Valley bringing the overall Haitian student population to almost 40% by the end of the decade. Much of the liberal and conservative Jewish population moved out of Spring Valley to New City. Out diversity increased more and more each decade with an influx of different nationalities moving out of New York City to the suburbs where the schools were better than the city and housing was available for a cheaper amount. By the 1990’s the Indian population and the Russian population had become larger along with Chinese families. Our diversity became out strength as we struggled to learn from one another and to identify with the ethnic cultures that had moved into our community over 30+ years. Diversity was the keyword then as it is now and it meant treating students equally and fairly with sensitivity for their religious and ethnic cultural values.
Scope of my Teaching Profession
My first teaching experience other than my field-teaching placement was as a Graduate Teaching Fellow in Biology, Botany, and Anatomy at Springfield College. In my senior year I was fortunate to get a part-time position as a Teaching Fellow in Botany when another Teaching Fellow left suddenly. Because of this opportunity I stayed on as a Graduate Teaching Fellow in Botany and Zoology the next year. I was in charge of four Biology labs a week and had to teach once a month using 35 mm slides to a lecture hall of 350 Freshman Students.
After a summer in Los Angeles as Assistant Director of the LA Board of Education “School Camp” experience at Point Fermin Park, I concluded my graduate field experience, and headed back to New York. I started teaching Physical Education and Health that fall of 1967 and Coach of Cross Country, Track and Field, and Assistant to the Wrestling coach. After one year of teaching Physical Education I realized the school was in the “ice age” when it came to Gymnastics. The Men’s Physical Education staff had no clue what gymnastics really was as a sport. They called rope climbing and obstacle course-gymnastics. I had to demonstrate everything and strive to up grade the equipment, which was 20 years out of date. After I developed an intramural gymnastics program for the boys that were too small to play basketball in the winter, I inherited the girls gymnastic program the second year of my job when the girl’s coach left for a college job. I knew nothing about Girls gymnastics since in the 1960’s and early 1970’s before the Federal Title 9 rule came into effect demanding equal programs and equipment for girls. I went to gymnastic clinics every year. I bought records for Floor Exercise, and read books on Girls Gymnastics. I later became a Nationally Certified USGF Safety Gymnastic Instructor and Coach. I went on to pass the Men’s USGF National Judging test and was certified as a Men’s Gymnastic Judge for ten years.
My teaching experience was diverse in public school with 31 years at a Physical Education Teacher, Health Education teacher, Darkroom Photography Teacher, and Dean of Students for grades 7,8, and 9, called Junior High in New York State. I coached practically every sport that existed including Girls Softball but no Field Hockey. I coached French Foil fencing on a club basis and Lacrosse that was a new and upcoming sport at the time. I was supposed to be the Swimming Coach but the pool in my building was turned down by public vote and we never got a swimming pool and instead had to rent a college pool for the team to practice.
As I was retiring in 1998 the junior high system of education was being replaced by a Middle School concept of grades 6,7, and 8, leaving the 9th grade in High school where it belonged. In the 1970’s Physical Education which used to teach separate gender classes. Getting my Doctoral degree in 1992 opened a future door for me since I knew that I could not be a Physical Education Teacher forever and keep the same stamina and energy I had when I was younger. When I retired in 1998, it was just the beginning of another wonderful career in higher education where my Doctoral degree opened the doors to college and university jobs. My Dewey and James philosophy had stayed with me all my career and always made me reach out to the underdog, the underserved, the small the large, the slow and the fast students that came across my career path.
Responsibilities and Requirements of Teaching
My legal responsibilities as a teacher were “en loco parente,” in Latin, in place of the parent. It was my responsibility to prepare my lesson plans in advance, both for Health Education and Physical Education and have it approved by the Department Chairman. It was my job as a teacher and leader to present a moral presence to my students and to show them by my actions that act of kindness, good sportsmanship, good ethical values and fairness in judgment mattered both in school and in society.
My skills as a gymnast in high school and college gave me an edge in teaching Physical Education since most Physical Education teachers were poorly educated in Gymnastics and other minor sports like Fencing, Lacrosse, and Judo. These specialty areas made the difference between an average Physical Education teacher and a great Physical Education teacher. I found that in my first ten years on the job, I not only had to introduce real gymnastics to my colleagues, but I had to also educate other Physical Education teachers at the two high schools, the other two Junior High schools and the 13 elementary Schools. This opportunity came around once a year when we started off the year with the first Day of the year with the Superintendent’s Conference. I contacted several Olympic Gymnasts and one National Trampoline Expert that were employed by the Nissen Corp. and American Gymnastic Equipment Corp. as field reps and good will ambassadors. They came and put on demonstrations and clinics on three different occasions that sparked a lot of interest on the elementary school level in proper gymnastic progressions.
In 1975 I was asked to serve on the District-wide Curriculum Committee for Physical Education. I had the opportunity to write the complete Gymnastic Curriculum from K-12 grade with the skills progressions that were appropriate for each age and skill level. Later on in 1982, I was again invited to join the combined Health and Physical Education Curriculum rewrite committee to meet State requirements that had changed in Health Education and Physical Education. Trampoline has been outlawed and dropped due to insurance rates and local Doctors lobbying to drop it. Health Education was fighting with the AIDS/HIV curriculum which little was known at the time and was changed each year beginning in 1985 until 1992. These curriculum writing experience would go on to help me later in my second career in higher education where I wrote curriculums for instructional technology in the classroom, and in software programs like Powerpoint, MS Publisher, Podcasting, Electronic Whiteboards, and Student Response clickers. Still to this day my concern for the social life of the student, their learning environment, and getting them to participate in their education as Dewey and James advocated so many decades ago.
Conclusion
In conclusion I have tried to demonstrate how my philosophy of life with the tenets of Dewey and James in mind, have helped me to be a good lifelong teacher. I have shown by example how I deal with diversity in students and how I have always attempted to treat every student equally and with sensitivity to their cultural and religious backgrounds. I have tried in my teaching career to model what a highly motivated person would be like. I have tried to demonstrate that I achieve above the norm and that I have always tried to do more than expected and more than anticipated by my peers and colleagues, as well as my students. Proudly I have always remembered my College’s motto “spirit, mind, and body.” Treat the whole person was the theme at Springfield College, former YMCA Training School and the college where Basketball and Volleyball were invented. In retrospect I have been fortunate to have had two teaching careers, one in the New York State Public school Secondary level for 31 years, and after retirement for 12 years of higher education experience at some of the best Universities in the Northeast; New York University, St. Johns University, the NY College of Osteopathic Medicine and the College of Mount Saint Vincent.
References
Alfred, A. (2010). Surviving the APA requirement. American Research Journal, 47 (2), 75-83.
Curz, M.J. & Smith, C.D. (2009). APA format for dummies. American Psychological
Association Journal, 58. Retrieved July 1, 2010, from Academic Search Premier.
Dewey, John, “My Pedagogic Creed” (1897), “The School and Society “(1900), “The Child and the Curriculum,” (1902), Democracy and Education, (1916) Experience and Education (1938).
Henniger, M.L. (2004). The teaching experience: An introduction to teaching. Upper Saddle
River, NJ: Pearson Education, Inc.
Henniger. M.L. (2008). Educational philosophies and you. (Rev. ed.). Athens, OH: Universal
Publications.
Longfield, J.A. (1997). A survival guide for f200 students. Retrieved July 1, 2010, from
http://www.iun.edu/~edujal/f200/survival.doc
James, William, “ Principles of Psychology (1890), “ Psychology: The Briefer Course,” (1892). A
by Dr. Pelham Mead III
A true story of a five year Title V federal grant at the College of Mount Saint Vincent, a small Catholic College in Riverdale, New York, 2001-2005.
Twenty years ago in May of 2001 I was hired as the Director of the Teacher Learning Center at the College of Mount Saint Vincent in Riverdale, New York, on the border of Westchester county and the Bronx on the Hudson River. The Associate Dean at the time interview me first and I was recommended by Sister Margaret who was the Department chairperson of the Education Department. Originally, the Fall before in 2000 I applied for a job as a Professor of Special Education and Sister Margaret passed my name along as a possible Director of the Title V, Hispanic Serving Institutions grant for 1.1 million dollars.
The Dean of Students previously wrote the Title V grant but when it was awarded she had taken a leave of absence to care for her son in Arizona who was in a car crash. She never returned, so the 160 page grant was never read by anyone in the College. President Richard Flynn was hired in January of 2001 and insisted that someone be hired to run the Title V grant project for five years. I was interviewed in April 2001 and after several interviews including a group interview of ten people and a final interview by the President. There was no Teacher Learning Center at the time and no office.
After I was hired there was no office for me to work in. I stayed a week in the Reading Center until they could find an office. A storage closet on the four floor of the Administration building was selected. At the time it was full of cabinets and had no desks or chairs.
My first job was to hire an office assistant. I was allowed to pick my own office assistant, so I chose a Cambodian woman who was in my Computer training class at BOCES of Nyack. Her name was Py Liv Sun. I selected her because she was a quick learner and hard worker. I needed someone I could trust and depend on to keep track of the purchase orders and financial records. Py Liv was a a perfect choice. She lived in Suffern, so she drove to my house in Nyack and left her car there and we drove in together to the College of Mount Saint Vincent for five years. Later on I hired a Teaching Assistant, Christine Servano, who was an outstanding student in my Adobe Photoshop course at BOCES.
My second big task was cleaning out the storage room so we could set up office for the new Teacher Learner Center. I called Facilities many times to remove the metal cabinets, but they never came. Py Liv and I moved the cabinets out ourselves leaving them in the hallway to be removed. Finally, Facilities removed them. Next we needed furniture, so we were told there was old furniture in the fifth floor attic we could take. There was only one elevator that went to the fifth floor attic. We found office chairs and several desks in the attic. I got a hand cart from the basement and Py Liv and I moved the tables and chairs down the elevator to our new office on the fourth floor.
The clean-up came next. The place was dusty and filthy. We had to scrub all the wall and the floor before we could sit in the office. Eventually, I got approval to hire someone to paint the walls to cover all the cracks and stains. The ceiling lights needed new bulbs and the windows needed caulking to fill the cracks. Finally, we settled in and I was able to order several computers to work with using Title V grant money. All expenses had to be approved by the College Provost before I could order anything. Our budget for the first year was $340,000 dollars. All of it had to be spent or our account would be red flagged. The grant called for five smart classrooms a year to be installed on the campus. I reached out to the VP of Finance and the Director of Facilities for help in finding classrooms to upgrade to Smart Classrooms, but I got no cooperation all summer of 2001. Every time I called the Director of Facilities he ducked out on me. For some reason he did not want to be involved in the Title V grant development.
I interviewed Professors that were still on campus in May and June of 2001 and found some supportive friends for technology. Professor Pat Grove in Biology was one of my biggest supporters and had previously pushed for technology at CMSV. Dean Bob Coleman in the Communications department was another great supporter. He told me the history of the College in relation to technology and the hiring of an outside agency to run the college computer and technology program at the cost of five million dollars. Sister Margaret was also a good friend in helping to get teachers to sign up for Instructional Technology tutoring with the Teacher Learner Center. Sue Apold was the Director of the Nursing Department at the time and she personally came down for instruction from me in the first year. I was able to help her Professors write two successful grants for the Nursing Department. Professor Kathy Flaherty won a Masters Degree plus certificate Nurse training program from the New York State Education department. I helped write all the technical specs for that program and helped teach Nurses with Master degrees who wanted a certificate to teach on the college level but did not want to take a Doctor degree to do so.
The second Nursing grant for $650,000. dollars was a technology Nursing grant from the Federal Office of Health. I had to install a MAC lab for that grant and train the teaching Professors how to use the MAC Computers. We converted two old unused classrooms into a computer lab. I helped file all the Assessment paperwork for the Nursing Professors and kept all their equipment up to date. They had to film or video tape lectures for future reference, so I filmed the lessons and showed the Professors how to use iMovie and Final Cut Pro edit the movies and see them to a server.
Back to the Teacher learner center. The Associate Dean who hired me ran the Reading center for students and was very popular, but not with the new President. He forced her to retire in a year and all of a sudden she was gone to Canada to retire. There were a lot of turnovers in the Administration especially at the VP of Finance and Comptroller positions. The VP of Finance had spent funds from the grant illegally and without permission of the new incoming President for a financial software program costing $60,000. I found about the expenditure when I did the first year Assessment report and realized that $60,000 was unaccounted for. With some research, Py Liv and I went through all the purchase orders prior to my being hired from the fall of 2000. Lo and behold we found monthly payments to a software program in Indiana and signed by the VP of Finance. I knew that being the new guy in administration I could not opposed the VP of Finance until I had more evidence. I was able to absorb the expense within the ten percent rule the first year, but eventually, I had to inform the President that the VP of Finance has spent $60,000 from the grant illegally before he or I were hired in the fall of 2000. The President confronted the VP of Finance with the copies of the purchase orders Py Liv and I found and he was fired. The Director of Facilities was also fired for refusin to cooperated with the Title V grant.
After a whole summer of planning and interviewing administrators and faculty I achieved no progress on constructing the five smart classrooms in the goals of the Title V grant, thanks to the lack of cooperation from the Director of Facilities. Finally, when all hope dimmed and the first year grant was about to expire on September 30, 2001, I went to the President and told him the Director of Facilities had blocked me all summer and prevented me from installing any smart classrooms as required by the Title V grant. I informed the President that if we did not install the smart classrooms and spent the money, we would lose the 1.1 million dollar grant from the US Department of Education. He was furious that the director was not cooperating. The President told me to do what ever it took to install the five smart classrooms that weekend before there grant expired. “Do whatever it takes,” he told me.So I hired a subcontractor that was a specialist in smart classroom installations for $25,000. Sister Mary Edward the administrator of the Biology building helped me renovate the Biology 90 seat lecture hall. We could not safely remove a giant ceiling projector without danger to the workers. Sister Mary Edward talked the college plumber, a devote Catholic, into climbing through the ceiling to reach the heavy projector and lower it down by rope to the floor. I was nervous he would get injured, but luckily all went well. Sister Mary Edward helped me plan the TV wall rack which had to be drilled through a brick wall to hold it up. We ran a LAN wire from the computer server closet for WAN access for computers. The chemistry counter was removed and an electronic giant movie screen was also installed. Sister Mary Edward got President Flynn to replace the broken plastic seats and new curtains for the faded and torn old curtains. It was a very successful smart classroom conversion thanks to her help and Professor Pat Grove.
Back in the administration building I chose rooms 410 and 412 and on the third floor 310 and 308 classrooms with fifteen foot ceilings. Room 410 had been started but never finished as a smart classroom previously. It had defective windows that were broken and cracked that had to be replaced. The LAN system was drilled through the floors to the server closet on the first floor. Later on as technology improved I installed portable wireless modems. Eventually, I copied the UCLA approach and had the wireless modems installed on the telephone poles in front of the Administration building. This saved thousands of dollars in not having to put a modem in every classroom.
I began installed year two smart classrooms the fall of 2002 to make sure we had plenty of time to do it right. Meanwhile, My first class of professors had started. The professors were too interested in what the other professors were doing than what they were learning. I had to scrap the classroom approach and switch to individual tutoring to custom design the instructional technology to each Professors needs and learning ability level. Each Professor got an hour a week for 14 weeks in which they received a stipend of $1600. This factor alone made the TLC program very popular. In addition I ordered Laptop computers to loan out to Professors to use for the semester. Most of the King brand desktop computers were broken and beyond repair in most Professor’s offices. The five million dollar fee for an outside company did not go very far. Being that I had access to funds and the Technology department did not, I was able to get their cooperation.
A third priority was to establish a TLC web site with online learning courses in Photoshop, MS Word, Powerpoint, and Access. I also taught podcasting and movie editing to advanced Professors. To keep the graduates of the TLC program active and involved, I offered monthly Grad dinners in which I brought homemade chili, Py liv brought Cambodian spring rolls and Christine brought Filipino Adobo Beef. The unique foreign meals were a big hit. I reported the TLC progress and offered lunch time catch up clinic in new programs.
Installing Blackboard was the next major priority. I had to learn the program from scratch and then teach it to all the faculty. It took help from Manhattan college to install the program. I then had to manually upload each professor’s classiest and teach them how to upload their syllabus and use the lockbox. I was the administrator for three years until Manhattan college hired a full time person.
The biggest and most difficult job was a costly installation of the Banner all-college system. Manhattan College again provided tech support. The cost of the modules was thousands o dollars and training was included for the student database, registrar, financial, admissions and accounting modules for staff. The installation was so expensive it had to be spread out over a couple of years. The Banner system completely replaced the previous Manhattan college and College of Mount Saint Vincent systems. It was a very complicated and expensive process.
Dressed up in my Columbia Doctor’s Robe for Graduation ceremonies at CMSV.
Year
The College of Mount Saint Vincent Biology Building 2002
The College of Mount Saint Vincent administrative building 2002.
My hard working assistant Mrs. Py Liv Sun at the CMSV Teacher Learning Center 2002-2005.
Professor Kathy Flannigan, Nursing Professor.
Dr. Mead and Kathy relaxing at the monthly TLC graduate dinner at the College of Mount Saint Vincent. Kathy was one of the first Professors to complete the TLC tutoring program.
Christine Servano, my TLC teaching Assistant
Christine the TLC teaching assistant working with a Business Professor.
Professor Arlene Moliterno teaching in a Smart Classroom 2002.
Smart Classroom with electronic movie screen, TV mounted on the wall, overhead projector and LAN access with portable Laptop computer.
Py Liv Sun and Professor of Sociology 2003.
Dr. Pelham Mead attending College ceremonies in the fall of 2001.
Professor Pat Grove, Biology in her Office 2002.
The Biology Classroom 2002.
Christine TLC teaching assistant helps Professor Moliterno.
Professor Barbara Cohen, Nursing Graduate Professor 2002.
TLC Assistant Py Liv Sun and Christine Servano working at their desks in the Teacher learning lab 2001.
Newly renovated smart classroom -Biology Lecture hall, With the help of Sister Mary Edward, Biology administrator we completed the upgrade in September 2001. The old projector was taken down and a new $5,000 projector was installed. LAN access was installed and the Chemistry counter was removed. An electronic movie screen was installed and a 37 inch TV mounted through a brick wall to the right.
Dedicated Biology Professor.
Biology Department Chairperson in 2001.
Professor Jim working with students in Biology.
Dr. Green, Provost in 2001.
Professors Kathy and ….
Three female Professors at CMSV graduation in 2001.
Professor Fran and Sister Pat talking during the line up for Graduation 2001.
Director of the TLC- Dr. Pelham Mead and Professor Kathy.
Professor Arlene Moliterno, Teaching Professor at CMSV graduation 2001.
Dean of Communications, Bob Coleman, 2001.
Professor John, College Organist and Music Professor, graduate of TLC program using a Smart Classroom 2002.
Professor teaching in a new Smart Classroom 2002.
Sister Pat teaching in a smart classroom for Communications department. Notice the TV mounted in the background.
The Nursing Annex Smart Classroom. Previously a snack room. The floor was black from years of dirt. I had it sanded and resurfaced. The walls were cracked and had to be repaired. The overhead movie projector can be seen in this photo which was installed. The entire room was repainted after repairs. Outside the room a roof leak was also repaired. This room was a major unmaking but successful in the end.
Bother, Professor of Communications 2001.
Fran, Department Chairperson for Communications 2001.
CMSV department TV studio 2001 before the new one was installed in 2003.
Christmas party of 2001. Sister Mary Edward celebrating in Santa outfit.
Professors Celebrate at Christmas CMSV party 2001.
President Flynn and others sing at the Christmas Party 2001.
Dean Bob Coleman relaxes during the Christmas Party of 2001.
CMSV administration building from parking lot view.
Statutes in front of the CMSV library 2001.
Chapel of CMSV from the rear of the administration building.
The Business building under construction 2004. Maryvale was upgraded to a Fine Arts labs and Communication labs and classrooms, partially with Title V funds.
Maryvale construction. Before demolition.
Maryvale construction 2004-2005.
Front porch of Administration building. Before the old porch fell down, the Sisters of Charity had a porch going from end to end of the front of the administration building.
Another view of the administration building.
Maryvale construction pipes.
Sisters of Charity cemetery at the top of the hill.
Another view of the cemetery. All Nuns that taught or lived on the grounds and Priests are buried here.
Winter view of the great lawn from the Administration building.
2002 Spring View of Castle on the College of Mount Saint Vincent campus.
Winter view of Campus with Hudson river in the background.
Finished Maryvale 2005.
Road into the College of Mount Saint Vincent. 2002.
Gazebo on the back lawn behind the castle on the CMSB campus 2002.
CMSV auditorium and gymnasium building 2002 , spring.
Biology Building 2002.
Road to St. Vincent’s Point on the other side of the RR tracks on the shores of the Hudson river. Used to be a train station here in the old days.
Blackboard menu. Blackboard was installed by Title V and administered by Dr. Pelham Mead for three years until Manhattan College took over with a full time administrator.
Angel statute on campus.
Outdoor angel in the CMSV garden
Children praying to the Mother Mary.
Angel statute on campus
CMSV college logo
Female students exercise class at CMSV
Female CMSV students working out.
Exercise room at CMSV.
Fall leaf
Castle view from the administration building.
CMSV bell in the tower
Top of the administration building over the chapel.
Castle view.
Hudson river view looking toward the Tappan Zee bridge from the tower.
View from inside the bell tower on top of the administration building.
View of the road from the bell tower.
Administration building roof.
View from the roof.
Graduation Tent for 2002 goes up.
Stages of graduation tent going up on the great lawn. CMSV 2002.
Graduation tent covers the entire great lawn.
John, College Organist and Music teacher, Py Liv Sun and Christine Servano 2003.
Dr. Pelham Mead, Py Liv Sun, Christine Servano and Professor John.
College of Mount Saint Vincent chapel organ 2002.
College organist, John plays on the organ.
Organ view in chapel.
College organist John.
President Richard Flynn 2002 graduation.
Sister Mary Edward.
Faculty procession 2002 graduation.
Faculty procession 2002, Graduation.
Faculty entering Administration building.
Faculty leads student procession.
Student process in 2002 graduation at the College of Mount Saint Vincent.
Graduation 2002
castle door on CMSV campus
Faculty ascend platform.
Construction sign 2005 graduation
Faculty gather before graduation. Fran from Communications in background sitting.
Faculty graduation 2002.
Fran, Sister Pat and Brother chat.
Here are the course projects and contents.
By Dr. Pelham Mead
If you country was invaded by a foreigner what would you do? Fight back of course. Supposing the invader had superior weapons and you had only bows and arrows? Such was the plight of the American Native Indians. Who were the good guys and the bad guys? That depends on who you think had the right to wipe out entire nations of American Natives. The white eyes lied to the American Indians time after time. No wonder there was no trust.
Was the Native American Indian worse than the white eyes. Taking scalps was a tradition for Native Americans, but what about hanging a person from a rope in public until their neck broke or they choked to death.
Who killed hundreds of thousands of Buffalo? Not the Native American Indians, it was the white eyes with guns that could shoot rapidly. Buffalo skins had a great market value as well as horns.
Who held the white eyes accountable for their crimes against the Native American Nations? No one did. Killing Native American Indians was like a fox hunt where the fox had no chance in hell of surviving with hunting dogs chasing them down and men on horseback armed with rifles shooting at them.
So, a Few hundred years later the Native American Indian is treated as a minority with little or no rights. Look at Brazil how they do not let the Amazon Indians own land and have no more rights than a teenager.
When there is talk about reparations for the black slaves of America, think first about the white men who stole the land away from the Native Americans to begin with before the slaves were brought to America.
The Native American Nations had wonderful cultures and practices that are fading into the air over time. What can we do? Perhaps renew their status in the American culture and give them more support to get educated and become part of this great American society. Always remember the place in History the Great Chiefs and their Nations played in our history and the Wild West.
Why are there no national holidays that celebrate Native American Holidays?
Think about the Washington Redskins football team. Is Redskin really an insult?
Do we have any teams called the white eyes or the yellow skins? Think about it.
Are there any Polish poppers, or Irish hacks, or British cavaliers, or French Frogs?
New York College of Osteopathic Medicine
Learning Outcomes Assessment 2009-2010
January 2009
Taskforce Members
John R. McCarthy, Ed.D.
Pelham Mead, Ed.D.
Mary Ann Achziger, M.S.
Felicia Bruno, M.A.
Claire Bryant, Ph.D.
Leonard Goldstein, DDS, PH.D.
Abraham Jeger, Ph.D.
Rodika Zaika, M.S.
Ron Portanova, Ph.D.
Pre-
Doctoral
Data
Post-Graduate Data
Career
data
Pre-Matriculation
Table of Contents
OVERVIEW 4
I. Introduction and Rationale 5
II. Purpose and Design 9
III. Specifics of the Plan 11
Mission of NYCOM 11
Learning Outcomes 11
Compiling the Data 17
Stakeholders 17
IV. Plan Implementation 18
Next Steps 18
V. Conclusion 20
A. OUTCOME INDICATORS – DETAIL 24
1. Pre-matriculation data 24
Forms 26
2. Academic (pre-clinical) course-work 47
Forms – LDB / DPC Track 49
Forms – Institute for Clinical Competence (ICC) 55
3. Clinical Clerkship Evaluations / NBOME Subject Exams 86
Forms 88
4. Student feedback (assessment) of courses/Clinical clerkship
PDA project 92
Forms 94
5. COMLEX USA Level I, Level II CE & PE,
Level III data (NBOME) 120
6. Residency match rates and overall placement rate 121
2
7. Feedback from (AACOM) Graduation Questionnaire 122
Forms 123
8. Completion rates (post-doctoral programs) 142
9. Specialty certification and licensure 143
10. Career choices and geographic practice location 144
11. Alumni Survey 145
Forms 146
B. BENCHMARKS 151
Bibliography 152
Appendices: 153
Chart 1 Proposed Curriculum and Faculty Assessment Timeline
Institute for Clinical Competence:
Neurological Exam – Student Version Parts I & II
Taskforce Members
List of Tables and Figures
Figure 1 Cycle of Assessment 9
Figure 2 Outcome Assessment along the Continuum 15
Figure 3 Data Collection Phases 22
Table 1 Assessment Plan Guide 23
3
New York College of Osteopathic Medicine
Learning Outcomes Assessment Plan
February 2009
Overview
This document was developed by the NYCOM Task Force on Learning Outcomes
Assessment and was accepted by the dean in January 2009. Although a few of the assessment
tools and processes described in the document are new, most have been employed at NYCOM
since its inception to inform curriculum design and implementation and to gauge progress and
success in meeting the institution’s mission, goals and objectives.
The Learning Outcomes Assessment Plan documents the processes and measures used by
the institution to gauge student achievement and program (curricular) effectiveness. The results
of these activities are used by faculty to devise ways to improve student learning and by
administrators and other stakeholder groups to assess institutional effectiveness and inform
planning, decision-making, and resource allocation.
Certain of the measures described in later sections of this document constitute key
performance indicators for the institution, for which numerical goals have been set. Performance
on these measures has a significant effect on institutional planning and decision-making
regarding areas of investment and growth, program improvement, and policy.
4
Key performance indicators and benchmarks are summarized below and also on 151
Indicator Benchmarks
Number of Applicants Maintain relative standing among Osteopathic Medical
Colleges
Admissions Profile Maintain or improve current admissions profile based
on academic criteria (MCAT, GPA, Colleges attended
Attrition 3% or less
Remediation rate
(preclinical)
2% reduction per year
COMLEX USA scores
(first-time pass rates,
mean scores)
Top quartile
Students entering
OGME
Maintain or improve OGME placement
Graduates entering
Primary Care careers
Maintain or improve Primary Care placement
Career characteristics Regarding Licensure, Board Certification, Geographic
Practice, and Scholarly achievements–TBD
I. Introduction and Rationale
At NYCOM we believe it is our societal responsibility to monitor our students’ quality of
education through continual assessment of educational outcomes. On-going program evaluation
mandates longitudinal study (repeated observations over time) and the utilization of empirical
data based on a scientific methodology.
At Thomas Jefferson University, an innovative study was implemented circa 1970, which
was ultimately titled “Jefferson Longitudinal Study of Medical Education”.1 As a result of
implementation of this longitudinal study plan, Thomas Jefferson University was praised by the
1 Center for Research in Medical Education and Health Care: Jefferson Longitudinal Study of Medical Education,
Thomas Jefferson University, 2005.
5
Accreditation Team for the Middle States Commission on Higher Education for “…..their
academic interest in outcome data, responsiveness to faculty and department needs and the clear
use of data to modify the curriculum and teaching environment….their use of this data has
impacted many components of the curriculum, the learning environment, individual student
development, and program planning…” (TJU, 2005).
The Jefferson Longitudinal Study of Medical Education has been the most productive
longitudinal study of medical students and graduates of a single medical school. This study has
resulted in 155 publications in peer review journals. Many were presented before national or
international professional meetings prior to their publication (TJU, 2005).
According to Hernon and Dugan (2004), the pressure on higher education institutions to
prove accountability has moved beyond the acceptance and reliance of self-reports and anecdotal
evidence compiled during the self-regulatory accreditation process. It now encompasses an
increasing demand from a variety of constituencies to demonstrate institutional effectiveness by
focusing on quality measures, such as educational quality, and cost efficiencies.
Accountability focuses on results as institutions quantify or provide evidence that they are
meeting their stated mission, goals, and objectives. Institutional effectiveness is concerned, in
part, with measuring (Hernon and Dugan, 2004):
Programmatic outcomes: such as applicant pool, retention rates, and graduation rates.
Such outcomes are institution-based and may be used to compare internal year-to-year
institutional performance and as comparative measures with other institutions.
Student learning outcomes: oftentimes referred to as educational quality and concerned
with attributes and abilities, both cognitive and affective, which reflect how student
experiences at the institution supported their development as individuals. Students are
expected to demonstrate acquisition of specific knowledge and skills.
6
At NYCOM, we recognize that our effectiveness as an institution must ultimately be
assessed and expressed by evaluating our success in achieving our Mission in relation to the
following Outcomes:
1. Student Learning / Program Effectiveness
2. Research and Scholarly Output
3. Clinical Services
The present document focuses on #1, above, viz., Student Learning / Program Effectiveness.
That is, it is intended only as a Learning Outcomes Assessment Plan. At the same time, we are
cognizant that Institutional Effectiveness/Outcomes derive from numerous inputs, or “means” to
these “ends,” including:
1. Finances
2. Faculty Resources
3. Administrative Resources
4. Student Support Services
5. Clinical Facilities and Resources
6. Characteristics of the Physical Plant
7. Information Technology Resources
8. Library Resources
We believe it is our obligation to continually assess the impact of any changes in the inputs,
processes, and outputs of this institution.
The evaluation approach in this Assessment Plan provides for on-going data collection
and analysis targeted specifically at assessing outcomes of student achievement and program
effectiveness (educational quality). Assessment of achievement and program effectiveness is
based on objective, quantifiable information (data).
As a result of the NYCOM Learning Outcome Assessment Plan’s continual assessment
cycle, the report is available, with scheduled updates, as a resource in the decision-making
process.
7
The report provides outcomes data, recommendations, and suggestions intended to inform key
policy makers and stakeholders2 of areas of growth and/or improvement, together with proposed
changes to policy that strengthen both overall assessment and data-driven efforts to improve
student learning.
2 NYCOM Administration, academic committees, faculty, potential researchers, and students.
8
II. Purpose and Design
Well-designed plans for assessing student learning outcomes link learning outcomes,
measures, data analysis, and action planning in a continuous cycle of improvement illustrated
below.
Figure 1 Cycle of Assessment
Ten principles guide the specifics of NYCOM’s Learning Outcomes Assessment Plan:
1. The plan provides formative and summative assessment of student learning.3
2. The primary purpose for assessing outcomes is to improve student learning.
3. Developing and revising an assessment plan is a long-term, dynamic, and collaborative
process.
4. Assessments use the most reliable and valid instruments available.
3 Examples of the former include post-course roundtable discussions, Institute for Clinical Competence (ICC)
seminars, and data from the Course/Faculty Assessment Program. Examples of the latter include the AACOM
Graduation Questionnaire, COMLEX scores, NBOME subject exam scores, and clerkship evaluations.
Define
intended
Learning
Outcomes
Identify
methods
of measuring
outcomes
Collect Data
Review results
and use to make
decisions
regarding program
improvement
Start
Here
9
5. Assessment priorities are grounded in NYCOM’s mission, goals, and learning outcomes.
6. The assessment involves a multi-method approach.
7. Assessment of student learning is separate from evaluation of faculty.
8. The primary benefit of assessment is the provision of evidence-based analysis to inform
decision-making concerning program revision and improvement and resource allocation.
9. The assessment plan must provide a substantive and sustainable mechanism for fulfilling
NYCOM’s responsibility to ensure the quality, rigor, and overall effectiveness of our
programs in educating competent and compassionate physicians.
10. The assessment plan yields valid measures of student outcomes that provide stakeholders
with relevant and timely data to make informed decisions on changes in curricular design,
implementation, program planning, and the overall learning environment.
Outcomes assessment is a continuous process of measuring institutional effectiveness
focusing on planning, determining, understanding, and improving student learning. At
NYCOM, we are mindful that an integral component of this assessment plan is to ensure that the
plan and the reporting process measures what it is intended to measure (student achievement and
program effectiveness).
10
III. Specifics of the Plan
The NYCOM assessment plan articulates eleven student learning outcomes, which are
linked to both the institutional mission and the osteopathic core competencies
Mission of NYCOM
The New York College of Osteopathic Medicine of the New York Institute of
Technology is committed to training osteopathic physicians for a lifetime of learning and
practice, based upon the integration of evidence-based knowledge, critical thinking and the tenets
of osteopathic principles and practice. The college is also committed to preparing osteopathic
physicians for careers in primary care, including health care in the inner city and rural
communities, as well as to the scholarly pursuit of new knowledge concerning health and
disease. NYCOM provides a continuum of educational experiences to its students, extending
through the clinical and post-graduate years of training. This continuum provides the future
osteopathic physician with the foundation necessary to maintain competence and compassion, as
well as the ability to better serve society through research, teaching, and leadership.
Learning Outcomes
The following eleven (11) Learning Outcomes that guide this plan stem from NYCOM’s mission
(above) and the osteopathic core competencies:
1. The Osteopathic Philosophy: Upon graduation, a student must possess the ability to
demonstrate the basic knowledge of Osteopathic philosophy and practice, as well as
Osteopathic Manipulative Treatment.
2. Medical Knowledge: A student must possess the ability to demonstrate medical
knowledge through passing of course tests, standardized tests of the NBOME, post-
11
course rotation tests, research activities, presentations, and participation in directed
reading programs and/or journal clubs, and/or other evidence-based medicine activities.
3. Practice-based learning and improvement: Students must demonstrate their ability to
critically evaluate their methods of clinical practice, integrate evidence-based medicine
into patient care, show an understanding of research methods, and improve patient care
practices
4. Professionalism: Students must demonstrate knowledge of professional, ethical, legal,
practice management, and public health issues applicable to medical practice.
5. Systems-based practice: Students must demonstrate an understanding of health care
delivery systems, provide effective patient care and practice cost-effective medicine
within the system.
6. Patient Care: Students must demonstrate the ability to effectively treat patients and
provide medical care which incorporates the osteopathic philosophy, empathy, preventive
medicine education, and health promotion.
7. Communication skills: Students must demonstrate interpersonal and communication
skills with patients and other healthcare professionals, which enable them to establish and
maintain professional relationships with patients, families, and other healthcare providers.
8. Primary Care: Students will be prepared for careers in primary care, including health care
in the inner city, as well as rural communities.
9. Scholarly/Research Activities: Students will be prepared for the scholarly pursuit of new
knowledge concerning health and disease. Students in NYCOM’s 5-year Academic
Medicine Scholars Program will be prepared as academic physicians in order to address
12
this nation’s projected health care provider shortage and the resulting expansion of
medical school training facilities.
10. Global Medicine and Health policy: Students will be prepared to engage in global health
practice, policy, and the development of solutions to the world’s vital health problems.
11. Cultural Competence: Students will be prepared to deliver the highest quality medical
care, with the highest degree of compassion, understanding, and empathy toward cultural
differences in our global society.
The NYCOM assessment plan provides for analysis of learning outcomes for two
curricular tracks and four categories of student
NYCOM has historically tracked student data across the curriculum, paying particular
attention to cohorts of students (see below), as well as NYCOM’s two curricular tracks:
a) Lecture-Based Discussion track: integrates the biomedical and clinical sciences along
continuous didactic ‘threads’ delivered according to a systems based approach;
b) Doctor Patient Continuum track: a problem-based curriculum, whose cornerstone is
small-group, case-based learning.
Current data gathering incorporates tracking outcomes associated with several subcategories of
student (important to the institution) within the 4-year pre-doctoral curriculum and the 5-year
pre-doctoral Academic Medicine Scholars curriculum. The pre-doctoral populations are defined
according to the following subcategories:
Traditional:4
BS/DO: The BS/DO program is a combined baccalaureate/doctor of osteopathic
medicine program requiring successful completion of a total of 7 years (undergraduate, 3
years; osteopathic medical school, 4 years).
MedPrep: A pre-matriculation program offering academic enrichment to facilitate the
acceptance of underrepresented minority and economically disadvantaged student
applicants.5
4 All other students not inclusive of BS/DO, MedPrep, and EPP defined cohorts.
5 The program is funded by the New York State Collegiate Science and Technology Entry Program and the
NYCOM Office of Equity and Opportunity Programs.
13
EPP (Émigré Physician Program): A 4-year program, offered by NYCOM, to educate
émigré physicians to become DOs to enable them to continue their professional careers in
the U.S.
The NYCOM assessment plan includes data from four phases of the medical education
continuum (as illustrated in Figure 2 and Figure 3): pre-matriculation, the four-year predoctoral
curriculum6, post-graduation data, and careers and practice data
Within the NYCOM Learning Outcome Assessment Plan, the Task Force has chosen the
following outcome indicators for assessment of program effectiveness at different points in the
medical education continuum:
Pre-matriculation data, including first-year student survey;
Academic (pre-clinical) course-work (scores on exams, etc.) – attrition rate;
Clinical Clerkship Evaluations (3rd/4th year) and NBOME Subject Exams;
Student feedback (assessment) of courses and 3rd and 4th year clinical clerkships and
PDA-based Patient and Educational Activity Tracking;
COMLEX USA Level I, Level II CE & PE, and Level III data, including:
o First-time and overall pass rates and mean scores;
o Comparison of NYCOM first time and overall pass rates and mean scores to
national rankings;
Residency match rate and placement rate (AOA / NRMP);
Feedback from AACOM Graduation Questionnaire;
Completion rates of Post-Doctoral programs;
Specialty certification and licensure;
Career choices (practice type–academic, research, etc.);
Geographic practice locations;
Alumni survey.
The Outcome Indicators—Detail sections of this plan ( 24 150) show the various
data sources and include copies of the forms or survey questionnaires utilized in the data
gathering process.
The NYCOM assessment plan identifies specific sources of data for each phase
Figure 2 illustrates which of the above measures are most relevant at each phase of the medical
education continuum.
6 And the five-year pre-doctoral Academic Medicine Scholars program
14
15
16
The NYCOM assessment plan describes the collection and reporting of data,
responsibilities for analysis and dissemination, and the linkage to continuous program
improvement and institutional planning
Compiling the Data
Discussions with departmental leaders and deans confirmed that data gathering occurs at
various levels throughout the institution. Development of a central repository (centralized
database) facilitates data gathering, data mining and overall efficiency as it relates to data
analysis, report generation, and report dissemination. This includes utilization of internal
databases (internal to NYCOM) as well as interfacing with external organizations’ databases,
including the AOA (American Osteopathic Association), AACOM (American Association of
Colleges of Osteopathic Medicine), AMA (American Medical Association), and the ABMS
(American Board of Medical Specialties).
Stakeholders
Information from the data collection serves to inform NYCOM administration, relevant
faculty, appropriate research and academic/administrative committees, including the following:
Curriculum Committee
Student Progress Committee
Admissions Committee
Deans and Chairs Committee
Clinical and Basic Science Chairs
Research Advisory Group
Academic Senate
The NYCOM assessment plan sets forth benchmarks, goals and standards of performance
The major elements of the plan are summarized in Table 1: Assessment Plan Guide:
Learning Outcomes/Metrics/Benchmarks found at the end of this chapter.
17
IV. Plan Implementation
As discussed earlier, most of the assessment tools and processes described in the
document have been employed at NYCOM since its inception to inform curriculum design and
implementation and to gauge progress and success in meeting the institution’s mission, goals and
objectives. Beginning in fall 2008, however, assessment efforts have been made more
systematic; policies, procedures, and accountabilities are now documented and more widely
disseminated.
The Office of Program Evaluation and Assessment (OPEA), reporting to the Associate
Dean for Academic Affairs is responsible for directing all aspects of plan refinement and
implementation.
Next steps
1. Develop a shared, central repository for pre-matriculation, pre-doctoral, and postgraduate
data (see Figure 3). Time Frame: Academic Year 2010-2011
Centralized database: Development of a (shared or central) repository
(database) utilized by internal departments of NYCOM. WEAVEonline is
a web-bases assessment system, utilized by numerous academic
institutions across the country, for assessment and planning purposes.
Utilizing this program facilitates centralization of data. The central
database is comprised of student data categorized as follows:
Pre-matriculation Data includes demographics, AACOM pre-matriculation survey, academic
data (GPA), and other admissions data (MCAT’s, etc.).
Data is categorized according to student cohort as previously written and
described (see item III. Specifics of the Plan on pages 13-14).
18
Pre-doctoral Data includes academic (pre-clinical) course work, course grades, end-ofyear
grade point averages, the newly implemented, innovative Course /
Faculty assessment program data (described in Section 4), ratings of
clinical clerkship performance, performance scores on COMLEX USA
Level I and Level II CE & PE, descriptors of changes in academic status
(attrition), and AACOM Graduation questionnaires.
Post-graduate/Career Data includes residency match rate, residency choice, hospitals of
residency, geographic location, chosen specialty, performance on
COMLEX Level III, geographic and specialty area(s) of practice
following graduation, licensure, board certification status, scholarly work,
professional activities/societies, faculty appointments, type(s) of practice
(academic, clinical, research).
This database supports and assimilates collaborative surveys utilized by
internal departments in order to capture requested data (see item III.
Specifics of the Plan on pages 13-14) essential for tracking students during
and after post-graduate training. Specific data (e.g., COMLEX Level III,
board certification, and licensure) is provided by external databases,
through periodic reporting means, or queries from NYCOM, therefore the
database provides for assimilation of this external data, in order to
incorporate into institutional reporting format.
2. Establish metrics. Time Frame: Academic Year 2010-2011
Benchmarks and Reporting: Conduct a retrospective data analysis in
order to establish baseline metrics (see Compiling the Data on page 17).
19
Following development of these metrics, institutional benchmarks are
established. Benchmarks align with Institutional Goals as written above.
Reporting of data analysis occurs on an annual basis. An annual
performance report is compiled from all survey data and external sources.
Timeframe for reporting is congruent with end of academic year. Updates
to report occur semi-annually, as additional (external) data is received.
Data reporting includes benchmarking against Institutional Goals
(mission), in order to provide projections around effectiveness of learning
environment, quality improvement indicators, long-range and strategic
planning processes, and cost analysis/budgetary considerations.
Report dissemination to key policy makers and stakeholders, as previously
identified (see Stakeholders on page 17) in addition to other staff, as
deemed appropriate for inclusion in the reporting of assessment analysis.
V. Conclusion
The impact on student learning of such things as changes in the demographics of medical school
applicants, admissions criteria, curricula, priorities, and methods of delivery of medical education
deserve careful discussion, planning, and analysis before, during, and after implementation. This
plan facilitates change management at three points:
o Planning, by providing evidence to support decision-making;
o Implementation, by establishing mechanisms for setting performance targets and
monitoring results, and
20
o Evaluation, by systematically measuring outcomes against goals and providing evidence
of whether the change has achieved its intended objectives.
At NYCOM, accountability is seen as both a requirement and a responsibility. As healthcare
delivery, pedagogy, and the science of medicine constantly change, monitoring the rigor and
effectiveness of the learning environment through assessment of student learning outcomes
throughout the medical education continuum becomes paramount.
21
Figure 3 Data Collection Phases
Pre-doctoral Data
Pre-matriculation
Data
Post-Graduate
Data
Career
Data
Assessment
Process
22
Learning Outcomes7 Data Collection Phases8 Assessment Methods Metrics9 Development of
benchmarks10
Students will:
Demonstrate basic knowledge of OPP
& OMT
Demonstrate medical knowledge
Demonstrate competency in practicebased
learning and improvement
Demonstrate professionalism and
ethical practice
Demonstrate an understanding of
health care delivery systems
Demonstrate the ability to effectively
treat patients
Demonstrate interpersonal and
communication skills
Be prepared for careers in primary
care
Be prepared for the scholarly pursuit
of new knowledge
Be prepared to engage in global
health practice, policy, and solutions
to world health problems
Be prepared to effectively interact
with people of diverse cultures and
deliver the highest quality of medical
care
• Pre-matriculation
• Pre-doctoral
• Post-graduate
• Career
• Didactic Academic
Performance
• LDB Curriculum
• DPC Curriculum
• Formative / Summative
Experiences: Patient
Simulations (SP’s /
Robotic)
• Student-driven Course,
Clerkship, and Faculty
Assessment
• Clinical Clerkship
Performance
• PDA-Based Patient and
Education Tracking
• Surveys
• Standardized Tests
• Alumni Feedback
Vis a Vis:
• Admissions Data
(Applicant Pool
demographics)
• Course Exams
• End-of-year pass rates
• Coursework
• Analysis of Residency
Trends Data
• Standardized Tests
Subject Exams
• COMLEX 1 & II Scores
• Analysis of Specialty
Choice
• Analysis of geographic
practice area
• Academic Attrition
rates
• Remediation rates
• Graduation and postgraduate
data
• External surveys
• Applicant Pool
• Admissions Profile
• Academic Attrition
rates
• Remediation rates
(pre-clinical years)
• COMLEX USA
Scores I & II (1st
time pass rate /
mean score)
• Number of
graduates entering
OGME programs
• Graduates entering
Primary Care (PC)11
• Career Data:
Licensure (within
3 years);
Board
Certification;
Geographic
Practice Area;
Scholarly
achievements
7 Complete detail of Learning Outcomes found in III., pages 11-13.
8 See Figure 3, page 22.
9 List of Metrics is not all-inclusive.
10 See complete detail of benchmarks—pages 5 & 151.
11 Primary Care: Family Medicine, Internal Medicine, and Pediatrics.
Table 1 – Assessment Plan Guide: Learning Outcomes / Data Sources / Metrics
23
Outcome Indicators – Detail
1. Pre-matriculation data
Data gathered prior to students entering NYCOM, and broken down by student
cohort, which includes the following:
Traditional, MedPrep, and BS/DO students
AACOM pre-matriculation survey given to students;
Total MCAT scores;
Collegiate GPA (total GPA-including undergraduate/graduate);
Science GPA;
College(s) attended;
Undergraduate degree (and graduate degree, if applicable;
Gender,;
Age;
Ethnicity;
State of residence;
Pre-admission interview score.
Additional data is gathered on the MedPrep student cohort and incorporates the
following:
Pre-matriculation lecture based exam and quiz scores;
Pre-matriculation DPC (Doctor Patient Continuum) based facilitator assessment
scores and content exam scores;
24
ICC (Institute for Clinical Competence) Professional Assessment Rating (PARS)
Scores.
Émigré Physician Program students
TOEFL (Test of English as a Foreign Language) score;
EPP Pre-Matriculation Examination score;
Medical school attended;
Date of MD degree;
Age;
Ethnicity;
Country of Origin.
25
Specific forms/questionnaires utilized to capture the above-detailed information include the
following:
MedPrep 2008 Program Assessment
MedPrep Grade Table
NYCOM Admissions Interview Evaluation Form
Application for Émigré Physicians Program (EPP)
AACOM Pre-matriculation survey (first-year students)
NYCOM Interview Evaluation Form – Émigré Physicians Program
Samples of the forms/questionnaires follow
26
MedPrep 2008 Program Assessment
Successful completion of the MedPrep Pre-Matriculation Program takes into consideration the
following 3 assessment components:
1. Lecture-Discussion Based (LDB)
2. DPC (Doctor Patient Continuum)
3. ICC (Institute for Clinical Competence)
A successful candidate must achieve a passing score for all 3 components. Strength in one
area will not compensate for weakness in another.
1. The first component assesses the Lecture-Discussion Based portion of the MedPrep Pre-
Matriculation Program. It is comprised of 3 multiple choice quizzes and 1 multiple choice exam.
Histology
Biochemistry
Physiology
Genetics
Physiology
OMM
Pharmacology
Pathology
Microbiology
Clinical Reasoning Skills
Each of the three quizzes constitutes 10% of an individuals overall LDB score and the final exam
(to be conducted on June 27) constitutes 70% of an individuals overall LDB score (comprising
100%) in the Lecture-Discussion portion of the program.
2. The second is based upon your performance in the DPC portion of the MedPrep Pre-
Matriculation Program. There will be a facilitator assessment (to be conducted on June 26),
which will comprise 30% of an individual’s grade and a final written assessment which will be
70% of an individual’s overall DPC score.
** Note – Both the Lecture-Discussion Based and DPC passing scores are calculated as
per NYCOM practice:
Average (mean) minus one standard deviation
Not to be lower than 65%
Not to be higher than 70%
27
3. The third component is the ICC encounter designed to assess your Doctor Patient
Interpersonal skills. This assessment is evaluated on the PARS scale described to you in the
Doctor Patient Interpersonal Skills session on June 12, by Dr. Errichetti.
After the program ends, on June 27th, all three components of the assessment will be compiled
and reviewed by the MedPrep Committee. The director of admissions, who is a member of the
committee, will prepare notification letters that will be mailed to you within two weeks.
Please note:
The written communication you will receive ONLY contains acceptance information. NO
grades will be distributed. Exams or other assessments (with the exception of the Lecture-
Discussion Based quizzes, which have already been returned) will not be shared or returned.
Please DO NOT contact anyone at NYCOM requesting the status of your candidacy. No
information will be given on the phone or to students on campus.
Thank you for your participation in the MedPrep Pre-Marticulation Program. The faculty
and staff have been delighted to meet and work with you. We wish you success!
Sincerely,
Bonnie Granat
28
Last Name, First Name
Quiz #1
Score
(10% of
Overall
LDB
Score)
Quiz #2
Score
(10% of
Overall
LDB Score)
Quiz #3
Score
(10% of
Overall
LDB
Score)
LDB Final
Exam
Score
(70% of
Overall LDB
Score)
Overall LBD
Score
(Exam and
Quizzes
Combined)
Overall
DPC
Score
Overall
ICC
Score
29
NEW YORK COLLEGE OF OSTEOPAHTIC MEDICINE
ADMISSIONS INTERVIEW EVALUATION FORM
Applicant______________________________________________________ Date____/_____/____
CATEGORY
CRITERIA
VALUE
RATING
I. PERSONAL PRESENTATION
MATURITY
LIFE EXPERIENCE /TRAVEL
EXTRA CURRICULAR ACTIVITIES/HOBBIES
COMMUNICATION SKILLS
SELF ASSESSMENT (STRENGTHS/WEAKNESSES)
AACOMAS & SUPPLEMENTAL STATEMENT
50
II. OSTEOPATHIC MOTIVATION
KNOWLEDGE OF THE PROFESSION
TALKED TO A DO/LETTER FROM A DO
15
III. PRIMARY CARE MOTIVATION
INTEREST IN PRIMARY CARE
15
IV. OVERALL IMPRESSION
EXPOSURE TO MEDICINE
– VOLUNTEER EXPERIENCE
– EMPLOYMENT EXPERIENCE
– UNIQUE ACADEMIC EXPERIENCES
– RESEARCH
20
TOTAL RATING
100
OTHER COMMENTS: PLEASE USE OTHER SIDE
(REQUIRED)
INTERVIEWER:
Name______________________________
Signed__________________________________________
30
Comments on Applicant _____________________________________________________
COMMENTS:
Interviewer_______________________________________
31
32
14. List all Colleges attended (Undergraduate, Graduate, Professional – US and Home Country) List in chronological order
Institution Name Location Dates of Major
Attendance Subject
Degree granted
or expected (Date)
Medical Specialty (if any) ___________________ No. of years in practice _________
15. Have you had any U.S. military experience ? Yes ( ) No ( )
If yes, was your discharge honorable? Yes ( ) No ( )
16. List employment in chronological order, beginning with your current position:
Title or Description Where Dates Level of Responsibility
17. Work/daytime telephone number________________________
area code phone
18. How do you plan to finance your NYCOM education? Personal funds ________ Loans
19. Were you ever the recipient of any action for unacceptable academic performance or conduct
violations (e.g. probation, dismissal, suspension, disqualification, etc.) by any
college or school? Yes ( ) No
If yes, were you ever denied readmission? Yes ( ) No
20. Have you ever been convicted of a misdemeanor or felony (excluding parking violations)? Yes ( ) No(
If your answer to #19 or #20 is yes, please explain fully:
21. Evaluation Service used: Globe Language Services ______ Joseph Silny & Assocs. ______
World Education Services ______ IERF _____
*22. TOEFL Score(s): ________________________________
*ALL CANDIDATES MUST TAKE TOEFL / TOEFL
Scores Cannot Be Older Than 2 YEARS
If you plan to take or retake the TOEFL, enter date: _____/_____/ mo.
yr.
(NYCOM’s TOEFL Code is #2486; copies cannot be accepted)
( )
( )
)
33
USMLE WILL NOT BE ACCEPTED IN LIEU OF TOEFL
All evaluations must be received directly from the evaluation service and are subject to approval by the New York
College of Osteopathic Medicine.
Personal Comments: Please discuss your reasons for applying to the EPP program.
Selection of candidates is competitive; achieving a minimum, passing TOEFL Score
does not automatically guarantee an interview.
I certify that all information submitted in support of my application is complete and correct to the best of my knowledge.
Date: Signature: ______________________________________
PLEASE MAIL APPLICATION AND FEE ($60.00 CHECK OR MONEY ORDER ONLY, PAYABLE TO NYCOM) TO:
New York College of Osteopathic Medicine
Of New York Institute of Technology
Office of Admissions/ Serota Academic Center Room 203
Northern Blvd.
Old Westbury, NY 11568-8000
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37
38
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NEW YORK COLLEGE OF OSTEOPATHIC MEDICINE
INTERVIEW EVALUATION FORM – É MIGRE PHYSICIANS PROGRAM
Applicant:___________________________________ Date:________________
State:___________________________
CATEGORY
CRITERIA TO BE
ADDRESSED VALUE RATING
1. Oral Comprehension
Ability to understand questions, content
30
2. Personal Presentation
Appropriate response, ability to relate to
interviewers
30
3. Verbal Expression
Clarity, articulation, use of
grammar
30
4. Overall Impression
Unique experiences, employment ,
research
10
OVERALL
RATING
100
INTERVIEWER RECOMMENDATION:
Accept_____________
Reject_____________
COMMENTS:______________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
NAME:_____________________________
SIGNED:____________________________
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2. Academic (pre-clinical) course-work
Data captured during NYCOM’s pre-clinical 4-year pre-doctoral program and 5-year
Academic Medicine Scholars program which includes the following:
Curricular Tracks: Lecture Based-Discussion / Doctor Patient Continuum
Pre-clinical course pass/failure rate as determined by class year (year 1 and year
2) and overall at end of year 2 (tracking each class and in aggregate for two
years);
Failure rates of (components) Nervous System course or Behavior course;
Course grades (H/P/F);
Exam scores;
Scores (pass/fail rate) on Core Clinical Competency OSCE exams;
Professionalism Assessment Rating Scale (PARS)
Students determined as pre-clinical course dismissals (and remediated);
Students determined double course failure (and remediated);
Failure rates due to cognitive and/or OMM lab portions of course
Repeat students (aligned with Learning Specialist intervention)
Changes in academic status (attrition-as identified above);
End-of-year class rankings.
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Specific forms/questionnaires utilized to capture the above-detailed information include the
following:
Introduction to Osteopathic Medicine / Lecture-Based Discussion
Doctor-Patient Continuum (DPC) – Biopsychosocial Sciences I
Grading and Evaluation Policy
DPC – Clinical Sciences II – Grading Policy
Assessing the AOA Core Competencies at NYCOM
Institute for Clinical Competence (ICC) Professionalism Assessment
Rating Scale (PARS)
SimCom-T(eam) Holistic Scoring Guide
Case A – Dizziness, Acute (scoring guides)
Samples of the forms/questionnaires follow
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Introduction to Osteopathic Medicine / Lecture-Based Discussion
Grading and Evaluation
1. At the conclusion of this course, students will receive a final cognitive score and a final OMM laboratory
score.
2. Both a student’s final cognitive score and a student’s final OMM laboratory score must be at a
passing level in order to pass this course.
3. Cognitive Score
a. A student’s cognitive score is comprised of the following two components:
i. Written Examinations and Quizzes pertaining to course lectures and corresponding
required readings, cases, course notes, and PowerPoint presentations
ii. Anatomy Laboratory Examinations and Quizzes
b. The weighting of the two components of the final cognitive score is as follows:
Summary of Cognitive Score Breakdown
Cognitive Score Component % of Final Cognitive Score
Written Examinations and Quizzes 75%
Anatomy Laboratory Examinations and
Quizzes
25%
Total Cognitive Score 100%
c. Written Examinations and Quizzes
i. There will be three written examinations and four written quizzes in this course.
ii. The written examinations and quizzes will consist of material from all three threads
(Cellular and Molecular Basis of Medicine, Structural and Functional Basis of Medicine,
Practice of Medicine).
iii. Up to 25% of the written exam and quiz material will come from directed readings.
iv. For the purpose of determining passing for this course, the written examinations will be
worth 90% of the final written score and the quizzes will be worth 10% (2.5% each) of the
final written score. This weighting is illustrated in the following table:
Summary of Written Exam/Quiz Score Breakdown
Written Exam/Quiz # % of Final Written Score
Written Exam #1 25%
Written Exam #2 30%
Written Exam #3 35%
Total Written Exam Score 90%
Written Quiz #1 2.5%
Written Quiz #2 2.5%
Written Quiz #3 2.5%
Written Quiz #4 2.5%
Total Written Quiz Score 10%
Total Written Score 100%
d. Anatomy Laboratory Examinations and Quizzes
i. There will be two Anatomy laboratory examinations in this course
ii. There will be Anatomy laboratory quizzes in this course, conducted during Anatomy
laboratory sessions.
iii. For the purpose of determining passing for this course, each Anatomy lab examination
49
will be worth 45% of students’ final Anatomy lab score and all Anatomy lab quizzes
combined will be worth 10% of students’ final Anatomy lab score. This weighting is
illustrated in the following table:
Summary of Anatomy Lab Exam/Quiz Score Breakdown
Anatomy Lab Exam/Quiz # % of Final Anatomy Score
Anatomy Lab Exam #1 45%
Anatomy Lab Exam #2 45%
Anatomy Lab Quizzes 10%
Total Anatomy Lab Exam/Quiz Score 100%
4. OMM Laboratory Score
a. A student’s OMM laboratory score in this course is comprised of an OMM laboratory examination
and laboratory quizzes, as follows:
i. There will be one OMM laboratory practical examination in this course
ii. There will be two OMM laboratory practical quizzes in this course conducted during OMM
laboratory sessions
iii. There will be a series of OMM laboratory written quizzes in this course conducted during
OMM laboratory sessions.
b. The weighting of the components of the OMM laboratory final score is as follows: For the purpose
of determining passing for this course, the OMM laboratory practical examination will be worth 70%
of the final OMM laboratory score, the OMM laboratory practical quizzes will be worth 20% (10%
each) of the final OMM laboratory score, and the OMM laboratory written quizzes will be worth 10%
(all OMM lab written quizzes combined) of the OMM laboratory score. This weighting is illustrated
in the following table:
Summary of OMM Laboratory Exam/Quiz Score Breakdown
OMM Laboratory Exam/Quiz % of Final OMM Laboratory Score
OMM Laboratory Practical Exam 70%
OMM Laboratory Practical Quiz #1 10%
OMM Laboratory Practical Quiz #2 10%
OMM Laboratory Written Quizzes (all quizzes
combined)
10%
Total OMM Laboratory Score 100%
5. Examinations and quizzes may be cumulative.
6. Honors Determination
a. For the purpose of determining who will be eligible to receive a course grade of Honors (“H”), the
final cognitive score and final OMM laboratory score will be combined in a 75%/25% ratio,
respectively.
b. Using the formula noted above, students scoring in the top 10% (and who have not taken a makeup
exam within the course or remediated the course) will receive a course grade of Honors.
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DOCTOR PATIENT CONTINUUM(DPC) – BIOPSYCHOSOCIAL
SCIENCES I
Grading and Evaluation Policy:
The examinations and evaluations are weighed as follows:
Evaluation Criteria: Percent of Grade
Content Examination 55%
Component Examinations 25%
Facilitator Assessment 20%
Content Examination: There will a mid-term exam and an end of the term exam, each weighted equally. The
examinations will cover the learning issues submitted by the case-study groups. Questions will be based on the
common learning issues (covered by all groups) and learning issues specific to individual groups (unique issues).
Component Exams: Distribution of the component exams will be as follows:
Exams based on Anatomy lectures and labs = 20%
Graded assignments offered by problem set instructors, which might include quizzes, position papers,
and/or other exercises = 5%
Facilitator Assessment: Facilitators will meet individually with students twice during the term to evaluate their
performance. The first evaluation will be ‘formative’ only, i.e., to advise students of their progress and will not be
recorded for grade. The end of the term evaluation will be used to assess the student’s progress/participation in the
group and other class related activities. Students will also complete Self-Assessment Forms to supplement the
evaluation process.
The grading of this course is on a “PASS/FAIL/HONORS” basis.
1) Students will be evaluated each Term using the multiple components as described above.
2) Each year at the end of the 1st Term:
a) All students will be assigned an interim grade of I (Incomplete);
b) Each student will be informed of his/her final average, a record of which will be maintained in the office of
the DPC Academic Coordinator and the Director of the DPC program.
3) Students who earn less than a 1st-Term average of 70%, or a content exam score of <65%, will be officially
informed that their performance was deficient for the 1st Term. The student, in consultation with the Course
Coordinator, will present a plan designed to resolve the deficiency. This information will also be forwarded to
the Associate Dean of Academic Affairs for tracking purposes.
4) Students with a 1st-Term average <70%, or a content exam score of <65%, will be allowed to continue with the
class. However, in order to pass the year the student must achieve a final yearly average (1st- and 2ndterm)
of 70% or greater with a content exam average (for the two Terms) of 65% or greater.
5) All students who meet the requirements for passing the year (see 4) will then be awarded the grade of P (Pass)
or H (Honors) for each of the two Terms.
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6) Students who fail the year (see 4) will be awarded a grade of I (Incomplete) and will be permitted (with
approval of the Associate Dean for Academic Affairs) to sit for a comprehensive reassessment-examination.
The reassessment exam will be constructed by the course faculty and administered by the Course Coordinator.
The exam may include both written and oral components. Successful completion of the reassessment
examination will result in the awarding of a grade of P for the two Terms. Failure of the comprehensive
reassessment exam will result in the awarding of a grade of F (Fail) for the two terms, and a recommendation to
the Associate Dean of Academic Affairs that the student be dismissed from the College.
7) Students whose failure of the year (i.e. overall yearly average <70%) can be attributed to low facilitator
assessment scores present a special concern. The student has been determined, by his/her facilitators, to be
deficient in the skills necessary to effectively interact with patients and colleagues. This deficiency may not be
resolvable by examination. Such failures will be evaluated by the Director of the DPC program, the Associate
Dean of Academic Affairs and/or the Committee on Student Progress (CSP) to determine possible remediation
programs or to consider other options including dismissal.
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DOCTOR PATIENT CONTINUUM(DPC) – CLINICAL SCIENCES II
Grading Policy:
1. The grading of this course is on a “PASS/FAIL/HONORS” basis. Grades will be determined by performance
in the three components of the course, OMM, Clinical Skills, and Clinical Practicum, as follows:
Evaluation Criteria: Percent of Grade
OMM 40%
Clinical Skills 40%
Clinical Practicum 20%
In both the OMM and Clinical Skills components of the course, student evaluations will encompass written
and practical examinations. In order to pass the course, both the written and practical examinations in OMM
AND Clinical Skills must be passed. Students who fail to achieve a passing score in either Clinical Skills or
OMM will be issued a grade of “I” (Incomplete). Such students will be offered the opportunity to remediate
the appropriate portion of the course. Re-evaluation will be conducted under the supervision of the DPC
faculty. Successful completion of the re-evaluation examination, both written and practical, will result in the
awarding of a grade of P (Pass). Failure of the comprehensive reassessment exam will result in the
awarding of a grade of U (Unsatisfactory) for this course.
2. Grading of the OMM component will be evaluated according to the following criteria:
Evaluation Criteria: Percent of Grade
OMM written (weighted) 50%
OMM practical (average) 50%
3. Grading of the Clinical Practicum component will be evaluated according to the following criteria:
Evaluation Criteria: Percent of Grade
Attendance and Participation 15%
Case Presentation 35%
Clinical Mentor Evaluation 50%
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4. Grading of the Clinical Skills component will be evaluated according to the following criteria:
Evaluation Criteria: Percent of Grade
Class participation/assignments 5%
ICC participation/assignments 10%
Timed examination #1
– Practical portion 20%
– Written portion 5%
Timed examination #2
– Practical portion 20%
– Written portion 5%
Timed Comprehensive examination
– Practical portion 25%
– Written portion 10%
Pre-clinical Years: Years I and II DPC Track
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Assessing the American Osteopathic Association (AOA) Core Competencies at
New York College of Osteopathic Medicine (NYCOM)
A. Background
In recent years, there has been a trend toward defining, teaching and assessing a number
of core competencies physicians must demonstrate. The Federation of State medical Boards
sponsored two Competency-Accountability Summits in which a “theoretical textbook” on good
medical practice was drafted to guide the development of a competency-based curriculum. The
competencies include: medical knowledge, patient care, professionalism, interpersonal
communication, practice-based learning, and system-based practice. The AOA supports the
concepts of core competency assessment and added an additional competency: osteopathic
philosophy and osteopathic clinical medicine.
Arguably it is desirable to begin the process of core competency training and assessment
during the pre-clinical year. Patient simulations, i.e. using standardized patients and robotic
simulator, allow for such training and assessment under controlled conditions. Such a pre-clinical
program provides basic clinical skills acquisition in a patient-safe environment. NYCOM has
responded to this challenge by creating a two-year “Core Clinical Competencies” seminar that
requires students to learn and practice skills through various patient simulations in the Institute
For Clinical Competence (ICC). In this seminar the ICC assesses a sub-set of the above
competencies taught in the lecture-based and discussion-based clinical education tracks.
The following is a list of the competencies assessed during the pre-clinical years at
NYCOM, and reassessed during the third year (osteopathic medicine objective structured
clinical examination) and fourth year (voluntary Clinical Skills Capstone Program). It should be
noted that there is a fair amount of skills overlap between the competencies, for example, the
issue of proper communication can be manifested in a number of competencies.
B. Core Clinical Competencies
1. Patient Care: Provide compassionate, appropriate effective treatment, health promotion
Skills:
Data-gathering: history-taking, physical examination (assessed with clinical skills
checklists)
Develop differential diagnosis
Interpret lab results, studies
Procedural skills, e.g. intubation, central line placement, suturing, catheterization
Provide therapy
2. Interpersonal and communication skills: Effective exchange of information and collaboration
with patients, their families, and health professionals.
Skills:
Communication with patients and their families across a spectrum of multicultural
backgrounds (assessed with the Professionalism Assessment Rating Scale)
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Health team communication
Written communication (SOAP note, progress note)
3. Professionalism: Commitment to carrying out professional responsibilities and ethical
committments
Skills:
Compassion, respect, integrity for others
Responsiveness to patient needs
Respect for privacy, autonomy
Communication and collaboration with other professionals
Demonstrating appropriate ethical consideration
Sensitivity and responsiveness to a diverse patient population including e.g. gender,
age, religion, culture, disabilities, sexual orientation.
4. Osteopathic Philosophy and Osteopathic Clinical Medicine: Demonstrate, apply knowledge
of osteopathic manipulative treatment (OMT); integrate osteopathic concepts and OMT into
medical care; treating the person, and not just the symptoms
Skills:
Utilize caring, compassionate behavior with patients
Demonstrate the treatment of people rather than the symptoms
Demonstrate understanding of somato-visceral relationships and the role of the
musculoskeletal disease
Demonstrate listening skills in interaction with patients
Assessing disease (pathology) and illness (patient’s response to disease)
Eliciting psychosocial information
C. Assessment of Core Competencies
The ICC utilizes formative assessment to evaluate learner skills and the effectiveness of
NYCOM’s clinical training programs. Data on student performance in the ICC is tracked from
the first through the fourth year. The ICC satellite at St. Barnabas assesses students during their
clerkship years as well as interns and residents in a number of clinical services. It uses a variety
of methods to assess competencies:
1. Written evaluations
Analytic assessment – skills checklists that document data-gathering ability
Global-holistic rating scales to assess doctor-patient communication (Professionalism
Assessment Rating Scale) and health team communication (SimCom-T)
SOAP note and progress note assessment
2. Debriefing / feedback – a verbal review of learner actions following a patient simulation
program provided by standardized patients and instructors as appropriate.
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Core Clinical Competencies 590 (MS 1)
Core Clinical Competencies 690 (MS 2)
The courses provide a horizontal integration between clinical courses provided by the LDB and
DPC programs (small group discussion and demonstration) and the OMM department. It
provides practice with simulated patients (some variation in this aspect as noted below),
formative assessment, end-of-year summative assessment and remediation.
1. SP PROGRAM, METRICS AND HOURS
MS 1 Program – SP Different program, same standardized examination
LDB
SP program: training with formative assessment (see next bullet for formative assessment
metrics)
End of year OSCE assessing history-taking (checklists designed for each SP case), PE (see
attached physical examination criteria) and interpersonal communication (see attached
program in doctor-patient communication “Professionalism Assessment Rating Scale)
Hours: 13.5 / year (including OSCE)
DPC
Clinic visits to substitute for SP encounters
End of year OSCE (same as LDB)
Hours: Should be equivalent to the number of SP hours in the LDB program
NOTE: The purpose of the OSCE is to assess the clinical training of both the LDB and DPC
programs. It is assumed the LDB and DPC faculty will work on this OSCE together with the
OMM department.
MS 1 Program – Patient Simulation Program
LDB and DPC
Same program in basic procedures for both LDB and DPC students as outlined in the
syllabus distributed during the curriculum committee
Hours: 5 hours / year
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MS 2 Program – SP
LDB and DPC – same program, different approaches, same standardized exam
SP program: training with formative assessment (see next bullet for formative assessment
metrics)
End of year OSCE assessing history-taking (checklists designed for each SP case), PE (see
attached physical examination criteria) and interpersonal communication (see attached
program in doctor-patient communication “Professionalism Assessment Rating Scale)
Hours: 13.5 hours / year (including OSCE)
NOTE: It is assumed that the LDB and DPC program schedules will vary but that the
content will be equivalent
MS 2 Program – Patient Simulation Program
LDB and DPC – same program, same standardized exam
Students work in the same group throughout the year
End of year OSCE assessing medical team communication using the SimCom-T rating scale
(attached)
Group grade assigned for the OSCE (reflecting the spirit of the SimCom-T rating scale)
Hours: 11 / year (including OSCE)
2. Attendance
All activities and exams are mandatory.
Make ups are done at the discretion of the ICC
NOTE: Make ups will be done as close to an activity as possible because delaying them, e.g. to
the end of the year, will incur additional training expenses (e.g. re-training a SP for a case played
months earlier) for the ICC.
3. Grading and remediation
Pass / fail
Grading is based upon:
o Attendance
o Participation
o End-of-year OSCE (standards to be set)
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ICC Hours
MS1
Clinical Practice OSCE Total
Hours
LDB 8 SP exercises @1.5 hours each
12 hours per student
5 patient simulation program exercises @ 1 hours
each
5 hours per student
End-of-year SP OSCE
1.5 hours per student
(approximately 6.25 days)
13.5 hours
(SP)
5 hours
(Pat Sim)
Total = 18.5
DPC Clinic experience to substitute for SP exercises
Students will receive information re:
communication and PE competencies
5 patient simulation program exercises @ 1 hours
each
5 hours per student
0 hours
(SP)
5 hours
Pat Sim
Total = 5
MS2
Clinical Practice OSCE Total
Hours
LDB
DPC
8 SP exercises @1.5 hours each
12 hours per student
6 patient simulation program exercises, plus ACLS
10 hours per student
End-of-year SP OSCE
1.5 hours per student
(approximately 6.25 days)
End-of-year Pat Sim OSCE
1 hour per student
(approximately 5 days)
13.5 hours
(SP)
11 hours
(Pat Sim)
Total = 24.5
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© 2007 NYCOM Do not reproduce or distribute without permission 9/4/07
Institute For Clinical Competence (ICC)
Professionalism Assessment Rating Scale (PARS)
Dear Students:
As part of your professional development, standardized patients (SPs) in the ICC will be
evaluating your interpersonal communication with them using the Professionalism Assessment
Rating Scale (PARS).
This scale evaluates two types of interpersonal communication, both important to quality health
care:
Patient Relationship Quality – Rapport, empathy, confidence and body language.
Patient Examination Quality – Questioning, listening, information exchanging and careful and
thorough physical examination.
Arguably patients (real or simulated) are in the best position to assess your interpersonal
communication with them because you are directly relating to them during an intimate, face-toface,
hands-on encounter. They are in the best position, literally, to observe your eye contact,
demeanor and body language because they are in the room with you. We would recommend you
take their feedback seriously, but perhaps “with a grain of salt.”
The term standardized patient is to some degree a misnomer – SPs can be standardized to
present the same challenge and the same medical symptoms to each student, but they cannot be
standardized to feel the same way about you and your work with them compared to other
students. This is true in life as well as clinical work – some people will like you better than others,
and patients are people! You may communicate with one patient the way you do with the next,
but receive slightly different ratings. This is to be expected. Unlike the analytic checklists we use
to document if you asked particular questions or performed certain exams correctly, there are no
dichotomous / “right or wrong” communication ratings. Patients are people who may tune into
different things during an encounter. We think this slight variation in observation is an asset that
will help you understand that patients are individuals who must be approached as individuals.
Another word about the ratings you will receive – the ratings are not absolute numbers that
constitute an unconditional assessment of your communication skills. Some days you may be
better than other days. We use the ratings numbers (1-8 holistic scale) to chart progress over
time. We do see improvements during the first two years of the typical student’s training but the
ratings are used to track your progress as much as to structure a conversation with the SP, or
faculty member, during debriefing. We would recommend you take responsibility during SP
debriefing and ask them questions about the work you just did.
The holistic 1 – 8 scale is broken down into two parts: Ratings of 1 – 4 are considered “lower
quality” communication, i.e. what might be considered acceptable at a novice or trainee level, but
less acceptable for an experienced professional. Ratings of 5 – 8 are considered “higher quality”
communication, i.e. more professional-quality communication regardless of the training or
experience level.
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© 2007 NYCOM DO NOT DISCLOSE, DISTRIBUTE OR REPRODUCE WITHOUT PERMISSION 3/18/07
Professionalism Assessment Rating Scale (PARS)
Standardized patients will rate “to what degree” you demonstrated relationship quality and
examination quality on the following nine factors:
RELATIONSHIP QUALITY
To what degree did the student …
Lower Higher
Quality Quality
1 Establish and maintain rapport 1 2 3 4 5 6 7 8
2 Demonstrate empathy 1 2 3 4 5 6 7 8
3 Instill confidence 1 2 3 4 5 6 7 8
4 Use appropriate body language 1 2 3 4 5 6 7 8
EXAMINATION QUALITY
To what degree did the student …
Lower Higher
Quality Quality
5 Elicit information clearly, effectively 1 2 3 4 5 6 7 8
6 Actively listen 1 2 3 4 5 6 7 8
7 Provide timely feedback / information / counseling 1 2 3 4
5 6 7 8
8 Perform a thorough, careful physical exam or
treatment
1 2 3 4 5 6 7
8
Less experienced, More
or unprofessional professional
The following pages are a guide to the PARS, giving examples of “lower quality” and
“higher quality” communication.
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© 2007 NYCOM DO NOT DISCLOSE, DISTRIBUTE OR REPRODUCE WITHOUT PERMISSION 3/18/07
1 Establish and maintain rapport
Establish and maintain a positive, respectful collaborative working relationship with the patient.
Lower Quality
1 2 3 4
Higher Quality
5 6 7 8
Overly familiar.
“Hi Bill, I’m John. How are you doing
today.”
Appropriate address, e.g.
“Hi Mr. Jones, I’m Student-doctor Smith. Is it
OK if I call you Bill?”
No agenda set. Set agenda, e.g.
No collaboration with the patient, i.e. carries
out the exam without patient consent or
agreement.
“We have ___ minutes for this exam. I’ll take a
history, examine you…..etc.”
Collaborative mindset
“Let’s figure out what’s going on.”
“We’re going to work out this problem together.”
Took notes excessively, i.e. spent more time
taking notes than interacting.
Spent more time interacting with the patient than
taking notes.
Began physically examining patient without
“warming” patient up, asking consent, etc.
Asked consent for obtaining a physical
examination, e.g.
“Is it OK for me to do a physical exam?”
Did not protect patient’s modesty, e.g.
Did not use a drape sheet
Respected patient’s modesty at all times e.g.
Used a drape sheet when appropriate
Did not direct patient to get dressed after
exam
Letting patient cover up follow an examination.
Left door open when examining patient.
Talked “down” to patient, did not seem to
respect patient’s intelligence.
Seemed to assume patient is intelligent.
Rude, crabby or overtly disrespectful. Never rude, crabby; always respectful.
Dress, hygiene problems:
Wore distracting perfume/cologne.
Dressed professionally, i.e. in a clean white coat,
clean clothes, etc.
Poor hygiene, e.g. uncleanly, dirty nails,
body odor, did not wash hands, etc.
Touched hair continually
Unprofessional dress, e.g. wore jeans,
facial jewelry (e.g. tongue or nose studs),
overly suggestive or revealing garments
Seemed angry with the patient.
Seemed to like the patient.
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© 2007 NYCOM DO NOT DISCLOSE, DISTRIBUTE OR REPRODUCE WITHOUT PERMISSION 3/18/07
2 Demonstrate empathy
Demonstrate both empathy (compassion, understanding, concern, support) and inquisitiveness
(curiosity, interest) in the patient’s medical problem and life situation.
Lower Quality Higher Quality
1 2 3 4 5 6 7 8
EMPATHY
No expressions of concern about patient’s
condition or situation.
Expressed concern about patient’s condition or
situation, e.g.
“That must be painful.”
“I’m here to try to help you.”
Failed to acknowledge positive behavior /
lifestyle changes the patient has made.
Reinforced behavior/lifestyle changes the patient
has made, e.g. “That’s great you quit smoking.”
Failed to acknowledge suggested behavior /
lifestyle changes might be difficult.
Acknowledged that suggested behavior/lifestyle
changes might be difficult.
Empathic expression seemed insincere,
superficial.
Empathic expressions seemed genuine.
Detached, aloof, overly “business-like,” robotic in
demeanor.
Compassionate and caring, “warm.”
Seeming lack of compassion, caring.
Accused patient of being a non-compliant, e.g.
“Why don’t you take better care of yourself?”
“You should have come in sooner.”
Positive reinforcement of things patient is doing
well, e.g.
“That’s great that you stopped smoking.”
“I’m glad you are taking your medication on a
regular basis.
INQUISITIVENESS – An aspect of empathy is inquisitiveness, the ability to attempt to
understand the patient, both medically and personally.
Focused on symptoms, but not the patient, i.e.
did not explore how the medical problem /
symptoms affect the patient’s life.
Tried to understand how the medical problem /
symptoms affect the patient’s life, or vice versa.
“How is this affecting your life?”
“Tell me about yourself.”
Failed to explore activities of daily living. “Describe a typical day in your life.”
“Tell me about your stress.”
Failed to explore patient’s response to diagnosis
and / or treatment.
Inquires as to patient’s response to diagnosis and
/ or treatment
Failed to explore barriers to behavior / lifestyle
change.
Explored barriers to behavior / lifestyle change.
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© 2007 NYCOM DO NOT DISCLOSE, DISTRIBUTE OR REPRODUCE WITHOUT PERMISSION 3/18/07
3 Instill confidence
Instilling confidence that the medical student or doctor is able to help and treat the patient.
Lower Quality
1 2 3 4
Higher Quality
5 6 7 8
Conveyed his / her anxiety, e.g. Conveyed an appropriately confident demeanor,
e.g.
Made eye contact
By avoiding eye contact
Laughing or smiling nervously
Sweaty hand shake
Made statement such as:
“This is making me nervous.”
“This is the first time I’ve ever done this.”
“I don’t know what I’m doing.”
Apologized inappropriately to the patient. E.g.
“I’m sorry, but I have to examine you.”
Shook hands firmly, etc.
Overly confident, cocky.
Never cocky, appropriately humble without
undermining the patient’s confidence.
When making suggestions, used tentative
language, e.g.
“Maybe you should try…”
“I’m not sure but …”
When making suggestions, used authoritative
language, e.g.
“What I suggest you do is…”
Made excuses for his/her lack of skill or
preparation by making statements such as:
Offered to help the patient or get information if he
/ she could not provide it by saying, e.g.
“I’m just a medical student.”
“Let me ask the attending physician”
“They didn’t explain this to me.”
“Do you know what I’m supposed to do next?”
“I don’t know but let me find out for you.”
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© 2007 NYCOM DO NOT DISCLOSE, DISTRIBUTE OR REPRODUCE WITHOUT PERMISSION 3/18/07
4 Use appropriate body language
The ability to use appropriate gestures, signs and body cues.
Lower Quality Higher Quality
1 2 3 4 5 6 7 8
Overly casual posture, e.g. leaning against
the wall or putting feet up on a stool when
interviewing the patient.
Professional posture, i.e. carried himself / herself
like an experienced, competent physician.
Awkward posture, e.g.
• Stood stiffly when taking a history
• Stood as if he / she was unsure what to do
with his / her body.
Natural, poised posture.
Uncomfortable or inappropriate eye contact
e.g. stared at the patient too long and / or
never looked at the patient.
Used appropriate eye contact.
Avoided eye contact when listening.
Made eye contact when listening, whether eye
level of not.
Stood or sat too close or too distant from the
patient.
Maintained an appropriate “personal closeness”
and “personal distance.”
Turned away from the patient when listening.
Maintained appropriate body language when
listening to the patient.
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5 Elicit information clearly, effectively
Effectively ask questions in an articulate, understandable, straightforward manner.
Lower Quality Higher Quality
1 2 3 4 5 6 7 8
Used closed-ended, yes / no questions
exclusively, e.g.
Used open-ended questions to begin an inquiry,
and closed-ended questions to clarify, e.g.
“How many days have you “Tell me about the problem.”
been sick?” “What do you do in a typical day?”
“Ever had surgery?” “How is your health in general?”
“Any cancer in your family?”
Used open-ended questions / non-clarifying
questions exclusively.
Used open-ended questions to begin an inquiry,
and closed-ended questions to clarify.
Student’s questions were inarticulate, e.g.
mumbled, spoke too fast, foreign accent
problems, stuttered*, etc.
* NOTE: Consider stuttering a form of inarticulation for
rating purposes, i.e. do not make allowances for
stuttering
Student was articulate, asked questions in an
intelligible manner.
Asked confusing, multi-part or overly complex
questions, e.g.
“Tell me about your past medical
conditions, surgeries and allergies.”
Asked one question at a time, in a straight-forward
manner.
“Tell me about your allergies.”
Asked direct questions, e.g.
Asked leading questions, e.g.
“No cancer in your family, right?”
“No surgeries?” “Do you have any cancer in your family?
“You only have sex with your wife, right?” “Any surgeries?”
“Are you monogamous?”
Jumped from topic to topic Organized interview.
in a “manic,” disjointed or
disorganized way.
Stayed focused, asked follow up questions before
moving to another topic.
Asked questions in a robotic way, Asked questions in a conversational way, i.e.
listened to the response, and then asked another
question.
i.e. as if reading from a prepared
checklist.
Constantly cut off patient, i.e. did
not let patient finish sentences.
Allowed patient to finish sentences and thoughts
before asking the next question.
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6 Actively listen
Both listen and respond appropriately to the patients’ statements and questions.
Lower Quality Higher Quality
1 2 3 4 5 6 7 8
Asked questions without listening to the
patient’s response.
Asked questions and listened to patient’s
response.
No overt statements made indicating he / she
was listening.
Said, e.g. “I’m listening.”
Turned away from the patient when listening.
Maintained appropriate body language when
listening to the patient.
Kept asking the same question(s) because
the physician didn’t seem to remember what
he / she asks.
If necessary, asked the same questions to obtain
clarification, e.g.
“Can you tell me again how much you smoke?”
“I know you told me this, but when was the last
time you saw your doctor?”
Wrote notes without indicating he / she was
listening.
When writing indicated he / she is listening, e.g.
“I have to write down a few things down when
we talk, OK?”
Did not seem to be listening, seemed
distracted.
Attentive to the patient.
Kept talking, asking questions, etc. if the
patient was discussing a personal issue, a
health concern, fear, etc.
Was silent when necessary, e.g. if the patient was
discussing a personal issue, a health concern,
fear, etc.
67
7 Provide timely feedback / information / counseling
Explain, summarize information (e.g. results of physical exams, provides patient education
activities, etc.), or provide counseling in a clear and timely manner.
Lower Quality Higher Quality
1 2 3 4 5 6 7 8
Did not explain examination procedures, e.g.
just started examining the patient without
explaining what he / she was doing.
Explained procedures, e.g.
“I’m going to check your legs for edema.”
“I’m going to listen to your heart.”
Did not provide feedback at all, or provided
minimal feedback
Periodically provided feedback regarding what he /
she heard the patient saying.
“It sounds like your work schedule makes it
difficult for you to exercise.”
“I hear in your voice that your family situation is
causing you a lot of stress.”
Did not summarize information at all. Periodically summarized information.
“You had this cough for 3 weeks, it’s getting
worse and now you’ve got a fever. No one is
sick at home and you haven’t been around
anyone who is sick.”
Provided empty feedback or unprofessional
feedback, e.g.
Feedback was meaningful, useful and timely.
“OK…..OK…..OK…..OK…”
“Gotcha..gotcha…gotcha,..”
“Great ” “Awesome” “Cool”
Examined the patient without providing
feedback about the results of the exam.
Provided feedback about results of the physical
exam.
“Your blood pressure seems fine.”
Refused to give the patient information he /
she requested, e.g.
“You don’t need to know that.”
“That’s not important.”
Give information to the patient when requested, or
offered to get it if he / she couldn’t answer the
patient’s questions.
Used medical jargon without explanation, e.g. Explained medical terms.
“What you experienced was a myocardial
infarction.”
“What you experienced is a myocardial
infarction, meaning a heart attack.”
Ended the exam abruptly.
Let the patient know what the next step was,
provided closure.
No closure, no information about the next
steps
“Let’s review the exam and your health…”
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8 Conduct a thorough, careful physical exam or treatment
Conduct physical exams and / or treatment in a thorough, careful manner vs. a tentative or
superficial manner.
Lower Quality Higher Quality
1 2 3 4 5 6 7 8
Conducted a superficial examination, e.g. Conducted a careful examination, e.g.
Avoided touching the patient Examined on skin when appropriate
Touched patient with great tentativeness
Hurried through the exam. Used the full amount of time allotted to examine
the patient.
Avoided inspecting (looking at) the patient’s
body / affected area.
Thoroughly inspected (looked at) the affected
area e.g. with gown open.
Consistently palpated, auscultated and / or
percussed over the exam gown.
Consistently palpated, auscultated and / or
percussed on skin.
Exam not bi-lateral (when appropriate). Bi-lateral exam (when appropriate).
Rough exam, e.g. Conducted a smooth exam from beginning to
Started, stopped, re-started the exam. end.
Fumbled with instruments
Did not look to see what patient’s expressions
were during an examination in order to assess
pain.
Looked for facial expressions to assess pain.
Did not thoroughly examine the site of the
chief complaint, e.g.
Thoroughly examined the site of the chief
complaint.
Did not examine heart and / or lungs if
chief complaint was a breathing problem
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9 Conduct the examination in an organized manner
Overall conduct the exam in an organized, systematic way vs. a disorganized or unsystematic
way.
Lower Quality Higher Quality
1 2 3 4 5 6 7 8
No clear opening, e.g. Clear opening, e.g.
Did not set an agenda Set an agenda and followed it
Abruptly began the exam Began the exam after a proper introduction
Medical interview not organized – history
jumped from topic to topic
Organize the medical interview vs. jumping from
topic to topic
No clear closure, e.g. Clear closure, e.g.
Did not summarize information gathered
during the history and physical
examination
Summarized information gathered during the
history and physical examination
Did not ask patient “Any more questions?” Asked patient “Any more questions?”
Did not clarify next steps Clarified next steps
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SimCom-T(eam) Holistic Scoring Guide
The SimCom-T is a holistic health care team communication training program and rating scale. The nine-factor scale of SimCom-T
rates team members’ performance as a unit, i.e. individual team member performance should be considered a reflection upon the
entire team.
Rate each factor individually.
Ratings should be global, i.e. reflect the most characteristic performance of the team vs. individual incidents.
The following pages are a guide to SimCom-T, providing behavioral examples representative of each score for the SimCom-T
competencies.
Score Performance Level Description – The team…
1 Limited ….consistently demonstrates novice and / or dysfunctional team attributes
2 Basic ….inconsistently operates at a functional level
3 Progressing ….demonstrates basic and average attributes
4 Proficient ….proficient and consistent in performance
5 Advanced ….experienced and performing at a significant expert level
CNE Not applicable ….A factor could not be evaluated for some reason
Competency Lower
Quality
Higher
Quality
1 Leadership establishment and maintenance 1 2 3 4 5 CNE
2 Global awareness 1 2 3 4 5 CNE
3 Recognition of critical events 1 2 3 4 5 CNE
4 Information exchange 1 2 3 4 5 CNE
5 Team support 1 2 3 4 5 CNE
6 External team support 1 2 3 4 5 CNE
7 Patient support 1 2 3 4 5 CNE
8 Mutual trust and respect 1 2 3 4 5 CNE
9 Flexibility 1 2 3 4 5 CNE
10 Overall Team Performance 1 2 3 4 5 CNE
71
1. Leadership Establishment and Maintenance
Team members both establish leadership and maintain leadership throughout.
Lower Quality Higher Quality
Score 1 2 3 4 5 CNE
Level Limited Basic Progressing Proficient Advanced
Description ▪ Leader not
established
▪ Roles not assigned
▪ No discussion
regarding role
assignment
▪ Unable to identify
leader
▪ Many leaders
▪ No clear role
definition
▪ Leadership not
explicit throughout
event
▪ Leadership not
maintained
throughout the event
▪ Role switching
without leader
involvement
▪ Leader explicitly
identified
▪ Roles defined
▪ Leadership explicitly
identified and
maintained
▪ Roles defined and
maintained
▪ Leader delegates
responsibility
Examples ▪ Team operating
dysfunctionally
without a leader
▪ Team members
taking on similar roles
and role switching
consistently
▪ Team members
unsure of who is
responsible for
different tasks
▪ Leader timid and
does not take charge
▪ Team member roles
unclear and/or
inconsistent
▪ A team member asks,
“Who is running the
code?” and another
says, “I am,” but does
not take communicate
leadership
responsibilities.
▪ Team members are
assigned roles but do
not take on the
assignment
▪ Team members
select a leader
▪ A team member
volunteers to handle
the situation
▪ Roles clearly defined
by team members
and/or leader
▪ Leadership and roles
are established very
early in the event and
is maintained
throughout the event
▪ Clarity of leadership
and roles is evident
throughout the event
and with the team
members
72
2. Global Awareness
Team members monitor and appropriately respond to the total situation, i.e. the work environmental and the patient’s condition.
Lower Quality Higher Quality
Score 1 2 3 4 5 CNE
Level Limited Basic Progressing Proficient Advanced
Description ▪ Does not monitor the
environment and
patient
▪ Does not respond to
changes in the
environment and
patient
▪ Monitoring and
response to changes
in the environment
and patient rarely
occur
▪ Fixation errors
▪ Monitoring and
response to the
environment and
patient are not evident
throughout the event
▪ Monitors the
environment and
patient
▪ Respond to changes
in the environment
and patient
▪ Consistently monitors
the environment and
patient
▪ Consistently respond
to changes in the
environment and
patient
Examples ▪ There is no summary
of procedures, labs
ordered, or results of
labs
▪ Team is task oriented
and does not
communicate about
the event
▪ Event manager loses
focus and becomes
task oriented
▪ There is no clear
review of the lab
results and/or
summary of
procedures.
▪ Leader says, “Team,
lets review our
differential diagnosis
and labs,” and team
does not respond to
the leader.
▪ Some of the team
members discuss
among themselves
results and possible
problems.
▪ Leader says, “Team,
lets review our
differential diagnosis
and labs,” and team
reviews the situation.
▪
▪ Event manager
remains at the foot of
the bed keeping a
global assessment of
the situation
▪ Leader announces
plan of action for the
event.
73
3. Recognition of Critical Events
Team promptly notes and responds to critical changes in the patient’s status and / or environment.
Lower Quality Higher Quality
Score 1 2 3 4 5 CNE
Level Limited Basic Progressing Proficient Advanced
Description ▪ Does not monitor or
respond to critical
deviations from steady
state
▪ Fails to recognize or
acknowledge crisis
▪ “Tunnel Vision”
▪ Fixation errors are
consistently apparent
▪
▪ Team reactive rather
than proactive
▪ Critical deviations
from steady state are
not announced for
other members
▪ Monitors and
responds to critical
deviations from steady
state
▪ Recognizes need for
action
▪ All team members
consistently monitors
and responds to
critical deviations from
steady state
▪ Anticipates potential
problems
▪ Practices a proactive
approach and attitude
▪ Recognizes need for
action
▪ “Big Picture”
Examples ▪ Patient stops
breathing, and team
does not recognize
the situation
throughout the event
▪ Patient is pulseless,
and no CPR is started
throughout the event
▪ Patient stops
breathing, and team
does not recognize
this situation for a
critical time period
▪ Patient is pulseless,
and no CPR is started
for a critical time
period
▪ ▪ Leader says, “Team,
lets review our
differential diagnosis,
are there any
additional tests that
we should request?”
▪ “John, the sats are
dropping, please be
ready, we might have
to intubate.”
▪ “Melissa, the blood
pressure is dropping.
Get ready to start the
2nd IV and order a
type and cross.”
74
4. Information Exchange
Patient and procedural information is exchanged clearly.
Lower Quality Higher Quality
Score 1 2 3 4 5 CNE
Level Limited Basic Progressing Proficient Advanced
Description ▪ Communication
between team
members is not
noticeable
▪ Requests by others
are not acknowledged
▪ No feedback loop
▪ No orders given
▪ Vague
communication
between team
members
▪ Not acknowledging
requests by others
▪ Feedback loop left
opened
▪ Orders not clearly
given
▪ Communication
between team and
response to requests
by others inconsistent
▪ Feedback loops open
and closed
▪ Orders not directed to
a specific team
member
▪ Team communicates
and acknowledges
requests throughout
the event
▪ Feedback loops
closed
▪ Explicit
communication
consistently
throughout the event
▪ Team acknowledges
communication
▪ Closed loop
communication
throughout event
Examples ▪ No summary of
events.
▪ No additional
information sought
from the team
members.
▪ Event manager says,
“I need a defibrillator,
we might have to
shock this patient,”
and no team member
acknowledges the
order. The request
was not given
explicitly to a team
member.
▪
▪ One team member
says to another in a
low voice, “We need
to place a chest tube,”
but the event
manager does not
hear the
communication.
▪ Event manager
requests a
defibrillator, but not
explicitly to a
particular team
member; several
team members
attempt to get the
defibrillator
▪ Jonathan says to
event manager, “We
need to place a chest
tube.” Event manager
responds, “OK, get
ready for it.”
▪ Leader says, “Team,
lets summarizes what
has been done so
far.”
▪ Leader says, “Mary
please start an IV.”
Mary responds,
“Sorry, I do not know
how, please ask
someone else to do
it.”
▪ Event manager
summarizes events.
▪ Event manager seeks
additional information
from all team
members
▪ Event manager says,
“Peter, I want you to
get the defibrillator,
we might have to
shock this patient.”
Peter responds, “Yes,
I know where it is and
I’ll get it.”
75
5. Team Support
The team works as a unit, asking for or offering assistance when needed vs. team members “going it alone.”
Lower Quality Higher Quality
Score 1 2 3 4 5 CNE
Level Limited Basic Progressing Proficient Advanced
Description ▪ No assistance or help
asked for or offered
▪ Team members act
unilaterally
▪ No recognition of
mistakes
▪ Team members
watching and not
participating
▪ Team members take
over when not
needed
▪ Mistakes not
addressed to the
team
▪ Negative feedback
▪ Assistance is offered
when needed only
after multiple requests
▪ Team recognizes
mistakes and
constructively
addresses them
▪ Team member(s)
ask(s) for help when
needed
▪ Assistance provided
to team member(s)
who need(s) it
Examples ▪ During a shoulder
dystocia event, the
critical situation is
recognized, but no
help is requested or
attempts to resolve
situation on their own
▪ Wrong blood type
delivered and
administered, an no
backup behaviors to
correct the mistake
▪ Team member
administers
medication without
consulting the event
manager
▪ Charles knows that
the patient is a
Jehovah Witness and
does not let the team
know when a T&C is
ordered.
▪ Team does not
communicate that
he/she doesn’t know
how to use a
defibrillator and
attempts to do it
anyways and fails.
▪ ▪ ▪ During a shoulder
dystocia event, the
critical situation is
recognized, and event
manager calls for help
▪ Wrong blood type
delivered, attempt
made by team
member to administer
the blood but another
team member
recognizes the
mistake and stops the
transfusion before it
starts
▪ Team member
consults with the
event manager before
administering
medication
76
6. External Team Support
Work team provides “external team” (family members and / or other health care professionals) with information and support as
needed
Lower Quality Higher Quality
Score 1 2 3 4 5 CNE
Level Limited Basic Progressing Proficient Advanced
Description ▪ Team fails to
recognize or interact
with other significant
people who are
present during the
encounter
▪ Team recognizes
other significant
people who are
present during the
encounter but
ignores to interact
with them
▪ Team inconsistently
interacts with other
significant people who
are present during the
encounter
▪ Team interacts with
other significant
people who are
present during the
encounter
▪ Team effectively
interacts with other
significant people who
are present during the
encounter
Examples ▪ Team fails to interact
with a distraught
family member and/or
para-professional
▪ Team fails to interact
appropriately with a
distraught family
member
▪ Team does not
cooperate with a
para-professional
▪ ▪ ▪
77
7. Patient Support
Work team provides the patient and significant others with information and emotional support as needed.
Lower Quality Higher Quality
Score 1 2 3 4 5 CNE
Level Limited Basic Progressing Proficient Advanced
Description ▪ Team fails to interact
with patient if
conscious
▪ Team fails to show
empathy or respect
for a patient
(conscious or
unconscious)
▪ Team fails to provide
appropriate
information when
requested to do so
▪ Teams interaction
with patient is
minimal and when
done so is lacking in
respect or empathy
▪ Team inconsistently
shows empathy or
respect for a patient
(conscious or
unconscious)
▪ Team inconsistently
provides information
when requested to do
so
▪ Team shows empathy
toward patient
▪ Team provides
appropriate
information when
requested to do so
▪ Team demonstrates
consistent and
significant respect
and empathy for
patient
▪ Appropriate
information is
provided consistently
Examples ▪ Team deals with an
unconscious patient
with a lack of respect,
e.g. by joking about
his / her condition
▪ Charles knows that
the patient is a
Jehovah Witness and
does not let the team
know when a T&C is
ordered.
▪ ▪ ▪ Charles lets the
leader know that the
patient is a Jehovah
Witness and that she
refused blood
products.
▪
78
8. Mutual Trust and Respect
The team demonstrates civility, courtesy and trust in collective judgment.
Lower Quality Higher Quality
Score 1 2 3 4 5 CNE
Level Limited Basic Progressing Proficient Advanced
Description ▪ Team exhibits e.g.
rudeness, overt
distrust/mistrust,
anger or overt doubt
or suspicion toward
each other
▪ Few team members
exhibit rudeness,
overt distrust, anger
or suspicion toward
each other
▪ Team inconsistently
demonstrates respect,
rudeness, distrust or
anger toward each
other
▪ Team exhibits e.g.
civility, courtesy, and
trust in collective
judgment
▪ Team is significantly
respectful of each
other
▪ Praise when
appropriate
Examples ▪ Angry, stressed event
manager says to team
member, “I can’t
believe you can’t
intubate the patient.
What’s the matter with
you?”
▪ Team member says
to another, “You don’t
know what you’re
doing-let me do it for
you.”
▪ Event manager
recognizes a chest
tube is needed, and
barks, “Michelle, I
want you to put in a
chest tube, I want you
to do it now, and I
want you to do it right
on your first attempt.”
▪ Leader overbearing
and intimidating
▪ ▪ Stressed but
composed leader
recognizes a team
member cannot
intubate the patient
and offers assistance
▪ Team member says
to another, “Are you
OK? Let me know if I
can help you.”
▪ Event manager
recognizes a chest
tube is needed and
says, “Michelle, this
patient needs a chest
tube-can you put it in
now?”
▪ Leader is clear, direct,
and calm.
▪ Team members will
thank each other
when appropriate.
79
9. Flexibility
The team adapts to challenges, multitasks effectively, reallocates functions, and uses resources effectively; team self correction.
Lower Quality Higher Quality
Score 1 2 3 4 5 CNE
Level Limited Basic Progressing Proficient Advanced
Description ▪ Team rigidly adheres
to individual team
roles
▪ Inefficient resource
allocation / use
▪ Minimal adaptability
and/or hesitation to
changing situations
▪ Team can adapt to
certain situations, but
not all
▪ Generally very flexible
▪ Multi-tasks effectively
▪ Reallocates functions
▪ Uses resources
effectively
▪ Team adapts to
challenges
consistently
▪ Engages selfcorrection
Examples ▪ Ambu-bag not
working, and no
reallocation of
resources established
▪ Team members stay
in individual roles,
failing to support each
other e.g. by failing to
recognize fatigue of
those giving CPR
▪ Patient’s hysterical
family member
disrupts the team and
team continues
providing care,
ignoring disruptive
relative
▪ ▪ ▪ Ambu-bag not
working, and an
airway team member
gives mouth-to-mouth
with a mask and
event manager asks
another team member
to retrieve a working
ambu-bag
▪ Team members
alternate giving CPR,
recognizing fatigue of
those giving CPR
▪ Patient’s hysterical
family member
disrupts the team and
a team manages the
situation, e.g.
removes, counsels, or
reassures the family
member
▪
80
10. Overall Team Performance
Lower Quality Higher Quality
Score 1 2 3 4 5 CNE
Level Limited Basic Progressing Proficient Advanced
Description ▪ Consistently
operating at a novice
training level
▪ Demonstrates
inconsistent efforts to
operate at a
functional level
▪ Inconsistently
demonstrates below
and average
attributes
▪ Demonstrates
significant
cohesiveness as a
team unit;
▪ Performs proficiently
▪ Consistently operates
at an experienced
and professional
level; performs as
experts
Training
Level
▪ Team requires
training at all levels;
unable to function
independently
▪ Team needs training
at multiple levels to
function
independently
▪ Team needs focused
training to function
independently
▪ Team can function
independently with
supervision
▪ Team functions
independently
81
Case A – Dizziness, Acute
Student ___________________________ Student ID _________ SP ID _________
History Scoring: Give students credit (Yes) if they ask any of the following questions and / or SPs
give the following responses. If question(s) not asked or response(s) not give, give no credit (No).
HISTORY CHECKLIST Yes No
1 ONSET, e.g. “When did dizziness start?”
• “The dizziness started last night when I was cleaning up after dinner.”
2 PAST MEDICAL HISTORY OF PROBLEM, e.g. “Ever had this problem
before?”
“I almost passed out once in restaurant a few months ago. The EMT
truck came and checked me out and they thought I was dehydrated
from exercising. I had just come from the gym.”
3 QUALITY, e.g. “Describe the dizziness.”
• “Every few minutes or so I get the feeling the room is spinning and I
feel a little nauseous, then it goes away and I feel OK. Then it starts all
over again.”
4 AGGRAVATING, e.g. “What makes the dizziness worse?”
“Standing up with my eyes open makes me feel dizzy.”
5 PALLIATIVE, e.g. “What makes the dizziness better?”
“Closing my eyes and laying down makes the dizziness better.”
6 HEAD INJURIES, e.g. “Have you bumped or injured your head?”
• “No head injuries.”
7 PAST MEDICAL HISTORY, e.g. “How is your health in general?”
“In general I’ve been very healthy.”
8 MEDICATIONS, e.g. “Are you taking any medications for this problem or
anything else?”
“I’m not taking anything. I thought of taking Dramamine but I wasn’t
sure it would help.”
9 DIET, e.g. “What do you eat in a typical day?”
“A regular diet, toast and coffee in the morning, usually take out for
lunch, Chinese, a pizza or sub, something like that, and a regular meal
at night.”
10 TOBACCO USE, e.g. “Do you smoke?”
• “I used to smoke ó a pack a day, but now I’m down to 4 or 5,
sometimes a couple more if I’m stressed.”
11 ADLs, e.g. “How is this affecting your life?”
“I couldn’t go to work today.”
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Case A – Dizziness, Acute
PE SCORING:
COLUMN 1: NO CREDIT: If any box is checked, exam was done “incorrectly” or
“incompletely.” Checked “Incorrect Details” box records reason(s) why.
COLUMN 2: FULL CREDIT: If “Correct” box is checked, exam was done “Correctly /
Completely.”
COLUMN 3: NO CREDIT: If “Not Done” box is checked, exam was not attempted at all.
Physical Examination Checklist 1
Incorrect
Details
2
Correct
3
Not
Done
12 Perform fundoscopic examination
Did not ask the patient to fix their gaze at point in
front of them.
Exam room not darkened.
Otoscope used instead of ophthalmoscope
“Left eye-left hand-left eye” or “right eye-right
hand -right eye rule” not followed.
Exam not bilateral.
□
□
□
□
□
□
□
13 Assess Cranial Nerve II – Optic – Assess Visual
Fields by Confrontation
Examiner not at approximate eye-level with
patient, and / or no eye contact.
Examiner’s hands not placed outside of patient’s
field of vision.
Did not ask “Tell me when you see my fingers.”
Did not test both upper and lower fields, and / or
bilaterally.
□
□
□
□
□
□
14 Assess Cranial Nerves II and III – Optic and
Oculomotor: Assess direct and consensual
reactions
Did not shine a light obliquely into each pupil
twice to check both the direct reaction and
consensual reaction.
Did not assess bilaterally.
□
□
□
□
15 Assess Cranial Nerves II and III – Optic and
Oculomotor: Assess near reaction and near
response
Did not test in normal room light.
Finger, pencil, etc. placed too close or too far
from the patient’s eye.
Did not ask the patient to look alternately at the
finger or pencil and into the distance.
□
□
□
□
□
83
Case A – Dizziness, Acute
PE SCORING:
COLUMN 1: NO CREDIT: If any box is checked, exam was done “incorrectly” or
“incompletely.” Checked “Incorrect Details” box records reason(s) why.
COLUMN 2: FULL CREDIT: If “Correct” box is checked, exam was done “Correctly /
Completely.”
COLUMN 3: NO CREDIT: If “Not Done” box is checked, exam was not attempted at all.
1
Incorrect
Details
2
Correct
3
Not
Done
16 Assess Cranial Nerve III – Oculomotor: Assess
convergence
Did not ask the patient to follow his / her finger or
pencil as he / she moves it in toward the bridge of
the nose.
□
□
□
17 Assess Cranial Nerve III, IV and VI – Oculomotor,
trochlear and abducens: Assessing extraocular
muscle movement
Examiner did not assess extra-ocular muscle
movements in at least 6 positions of gaze using,
for example, the “H” pattern.
Did not instruct patient to not move the head
during the exam.
□
□
□
□
18 Assess Cranial Nerve VIII – Acoustic / Weber test
Did not produce a sound from tuning fork, e.g. by
not holding the fork at the base
Did not place the base of the tuning fork firmly on
top middle of the patient’s head.
Did not ask the patient where the sound appears
to be coming from.
□
□
□
□
□
19 Assess Cranial Nerve VIII – Acoustic / Rinne test
Did not produce a sound from tuning fork, e.g. by
not holding the fork at the base
Did not place the base of the tuning fork against
the mastoid bone behind the ear.
Did not ask patient to say when he / she no longer
hears the sound, hold the end of the fork near the
patient’s ear and ask if he / she can hear the
vibration.
Did not tap again for the second ear.
Did not assess bilaterally.
□
□
□
□
□
□
□
20 Assess Gait
Did not ask patient to walk, turn and come back to
look for imbalance, postural, asymmetry and type
of gait (e.g. shuffling, walking on toes, etc.)
□
□
□
21 Perform Romberg Test
Did not direct patient to stand with feet together,
eyes closed, for at least 20 seconds without
support.
Did not stand in a supportive position, e.g. behind
patient or with hand behind patient.
□
□
□
□
84
Case A – Dizziness, Acute
RELATIONSHIP QUALITY
To what degree did the student …
Lower Higher
Quality Quality
1 Establish and maintain rapport 1 2 3 4 5 6 7 8
2 Demonstrate empathy 1 2 3 4 5 6 7 8
3 Instill confidence 1 2 3 4 5 6 7 8
4 Use appropriate body language 1 2 3 4 5 6 7 8
EXAMINATION QUALITY
To what degree did the student …
Lower Higher
Quality Quality
5 Elicit information clearly, effectively 1 2 3 4 5 6 7 8
6 Actively listen 1 2 3 4 5 6 7 8
7 Provide timely feedback / information / counseling 1 2 3 4 5 6 7 8
8 Perform a thorough, careful physical exam or
treatment
1 2 3 4 5 6 7 8
85
3. Clinical Clerkship Evaluations / NBOME Subject Exams
Data compiled from 3rd/4th year clerkships includes:
Student Performance Evaluations from specific hospitals (attending/supervising
physicians, and/or residents) based upon the 7 core Osteopathic Competencies.
Data is broken down further by student cohort: traditional, BS/DO, and Émigré
and is quantified according to curricular track (Lecture Discussion-Based and
Doctor Patient Continuum);
NBOME Subject Exam scores for each of the (6) core clerkships and OMM.
Core clerkships include:
a) Family Medicine
b) Medicine
c) OB-GYN
d) Pediatrics
e) Psychiatry
f) Surgery
NBOME Subject Exam statistics are shared with 3rd year students as a frame of
reference to determine their performance relative to their NYCOM peers. These
data also serve as a general guide for COMLEX II CE preparation and
performance;
Students provide feedback on their clinical experiences during their clerkships,
via the “PDA project”:
a) The PDA is a tool utilized for monitoring clerkship activities. The
DEALS (Daily Educational Activities Logs Submission) focuses on
educational activities, while the LOG portion focuses on all major
student-patient encounters. A rich data set is available for comparing
patient encounters and educational activities across all sites for all
clerkships.
86
b) PDA data is used as a multimodal quality assessment tool for curricular
exposure as well as OMM integration across all hospitals (including
“outside” clerkships) for Patient Encounters and Educational Activities.
Reports from student focus groups—these reports are based upon in-person group
interviews by a full-time NYCOM Medical Educator and feedback is analyzed in
order to ensure consistency in clerkship education and experiences, as well as for
program improvement indicators.
87
Specific forms/questionnaires utilized to capture the above-detailed information include the
following:
Clinical Clerkship Student Performance Evaluation
Samples of the forms/questionnaires follow
88
NEW YORK COLLEGE OF OSTEOPATHIC MEDICINE
OFFICE OF CLINICAL EDUCATION
Northern Boulevard -– Old Westbury, NY 11568-8000
Tel.: 516-686-3718 – Fax: 516-686-3833
(*) Only ONE form, with COMPOSITE GRADE & COMMENTS should be sent to the Hospital’s Office of
Medical Education
for the DME SIGNATURE .
COURSE # _______________________________(For NYCOM Purpose
ONLY)
STUDENT: _____________________,_______________Class Year:
______HOSPITAL:_______________________
Last First
ROTATION(Specialty)_____________________________ROTATION DATES:
____/____/____ ____/____/____
From
To
EVALUATOR: _________________________________________ TITLE:
_______________________________________
(Attending Physician / Faculty Preceptor)
A. Student logs by PDA REVIEWED (at least 10 patients) NOT REVIEWED
B. Student’s unique “STRENGTHS” (Very Important –To be incorporated into the
College’s Dean’s Letter)
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
____________
C. Student’s LIMITATIONS (areas requiring special attention for future professional growth)
______________________________________________________________________________
______________________________________________________________________________
____________________________________
89
D. For items below CIRCLE the most appropriate number corresponding to the
following rating scale:
Exceptional=5 Very Good = 4 Average = 3 Marginal = 2 1 = FAILURE N/A OR no opportunity to observe
CORE COMPETENCY (See definitions on reverse side) RATING
Patient Care 5 4 3 2 1 N/A
Medical Knowledge 5 4 3 2 1 N/A
Practice-Based Learning & Improvement 5 4 3 2 1 N/A
Professionalism 5 4 3 2 1 N/A
System-Based Practice 5 4 3 2 1 N/A
Interpersonal and Communication Skills 5 4 3 2 1 N/A
Osteopathic Manipulative Medicine 5 4 3 2 1 N/A
OVERALL GRADE 5 4 3 2 1(FAILURE
Evaluator Signature:____________________________________________________ Date:
_______/________/_______
Student Signature: ____________________________________________________ Date:
_______/________/_______
(Ideally at Exit Conference)
(*) DME Signature: _________________________________________________ Date:
_______/________/_______
Please Return to: Hospital’s Office of Medical Education
OVER
The Seven Osteopathic Medical Competencies
Physician Competency is a measurable demonstration of suitable or sufficient
knowledge, skill sets, experience, values, and behaviors, that meet established
professional standards, supported by the best available medical evidence, that are in
the best interest of the well-being and health of the patient.
Patient Care: Osteopathic patient care is the ability to effectively determine and
monitor the nature of a patient’s concern or problem; to develop, maintain, and to
bring to closure the therapeutic physician-patient relationship; to appropriately
incorporate osteopathic principles, practices and manipulative treatment; and to
implement effective diagnostic and treatment plans, including appropriate patient
education and follow-up, that are based on best medical evidence.
90
Medical Knowledge: Medical Knowledge is the understanding and
application of biomedical, clinical, epidemiological, biomechanical, and social and
behavioral sciences in the context of patient-centered care.
Practice-Based Learning & Improvement: Practice-Based learning
and improvement is the continuous evaluation of clinical practice utilizing evidence-based
medicine approaches to develop best practices that will result in optimal patient care
outcomes.
Professionalism: Medical professionalism is a duty to consistently demonstrate
behaviors that uphold the highest moral and ethical standards of the osteopathic profession.
This includes a commitment to continuous learning and the exhibition of personal and social
accountability. Medical professionalism extends to those normative behaviors ordinarily
expected in the conduct of medical education, training, research, and practice.
System-Based Practice: System-based practice is an awareness of and
responsiveness to the larger context and system of health care, and the ability to effectively
identify and integrate system resources to provide care that is of optimal value to individuals
and society at large.
Interpersonal & Communication Skills: Interpersonal and
communication skills are written, verbal, and non-verbal behaviors that facilitate
understanding the patient’s perspective. These skills include building the physician-patient
relationship, opening the discussion, gathering information, empathy, listening, sharing
information, reaching agreement on problems and plans, and providing closure. These skills
extend to communication with patients, families, and members of the health care team.
Osteopathic Manipulative Medicine: Osteopathic philosophy is a holistic
approach that encompasses the psychosocial, biomedical, and biomechanical aspects of both
health and disease, and stresses the relationship between structure and function, with
particular regard to the musculoskeletal system.
Definitions Provided by the National Board of Osteopathic Medical Examiners
(NBOME)
91
4. Student feedback (assessment) of courses / Clinical clerkship / PDA project
Data received on courses and faculty through the newly implemented, innovative
Course / Faculty Assessment program (see below-NYCOM Student Guide for
Curriculum and Faculty Assessment). Students (randomly) assigned (by teams)
to evaluate one course (and associated faculty) during 2-year pre-clinical
curriculum. Outcome of student-team assessment is presented to Curriculum
Committee, in the form of a one-page Comprehensive Report;
Clerkship Feedback (quantitative and “open-ended” feedback) provided through
“Matchstix” (web-based feedback program): this information is shared with
NYCOM Deans and Clinical Chairs, Hospital Director’s of Medical Education
(DMEs), Hospital Department Chairs and Clerkship Supervisors. Also, the
information is posted on the “web” to assist and facilitate 2nd year students
choosing 3rd year Core Clerkship Sites (transparency). This data is also utilized
via two (2) year comparisons of quantitative data and student feedback shared
with NYCOM Deans & Chairs, as well as Hospital DMEs;
Clerkship Feedback via PDA: quantitative and open-ended (qualitative) feedback
on all clerkships is collected via student PDA submission. The information is
utilized as a catalyst for clerkship quality enhancement. This data-set is used as a
multimodal quality assessment tool for curricular exposure as well as OMM
integration across all hospitals (including “outside” clerkships) for Patient
Encounters and Educational Activities;
92
Reports from student focus groups—these reports are based upon in-person group
interviews by a full-time NYCOM Medical Educator and feedback is analyzed in
order to ensure consistency in clerkship education and experiences, as well as for
program improvement indicators;
93
Specific forms/questionnaires utilized to capture the above-detailed information include the
following:
NYCOM Student Guide for Curriculum and Faculty Assessment
Clerkship (site) feedback from Clerkship students
Clinical Clerkship Focus Group Form
4th Year PDA Feedback Questionnaire
Student End-of-Semester Program Evaluations (DPC)
DPC Program Assessment Plan
Osteopathic Manipulative Medicine (OMM) Assessment Forms
Samples of the forms/questionnaires follow
94
95
Site Feedback
Rotation: Surgery
Site: (*) MAIMONIDES MEDICAL CENTER
This is an anonymous feedback form. No student identification data is transmitted.
Questions marked with * are mandatory.
Section I. Please respond to each statement in this section according to the following
scale.
STRONGLY DISAGREE <-> STRONGLY AGREE
1* There were adequate learning opportunities (teaching patients, diversity of pathology and
diagnostic procedures)
Strongly Disagree Disagree Neutral Agree Strongly Agree
2* There were opportunities to practice osteopathic diagnosis and therapy
Strongly Disagree Disagree Neutral Agree Strongly Agree
3* There was adequate supervision and feedback (e.g., reviews of my H&P, progress notes and
clinical skills)
Strongly Disagree Disagree Neutral Agree Strongly Agree
4* I had the opportunity to perform procedures relevant for my level of training
Strongly Disagree Disagree Neutral Agree Strongly Agree
5* I was evaluated fairly for my level of knowledge and skills
Strongly Disagree Disagree Neutral Agree Strongly Agree
6* Attending physicians and/or house staff were committed to teaching
Strongly Disagree Disagree Neutral Agree Strongly Agree
7* Overall, I felt meaningfully engaged and well integrated with the clinical teams (e.g., given
sufficient patient care responsibilities)
Strongly Disagree Disagree Neutral Agree Strongly Agree
96
8* The DME and/or clerkship director was responsive to my needs as a student
Strongly Disagree Disagree Neutral Agree Strongly Agree
9* There were adequate library resources at this facility
Strongly Disagree Disagree Neutral Agree Strongly Agree
10* A structured program of directed readings and/or journal club was a component of this
rotation.
Strongly Disagree Disagree Neutral Agree Strongly Agree
11* The lectures were appropriate for this rotation (e.g., quality, quantity and relevance of
topics)
Strongly Disagree Disagree Neutral Agree Strongly Agree
12* Educationally useful teaching rounds were conducted on a regular basis.
Strongly Disagree Disagree Neutral Agree Strongly Agree
13* This rotation reflected a proper balance of service and education
Strongly Disagree Disagree Neutral Agree Strongly Agree
14* This rotation incorporated a psychosocial component in patient care
Strongly Disagree Disagree Neutral Agree Strongly Agree
15* Overall, I would recommend this rotation to others
Strongly Disagree Disagree Neutral Agree Strongly Agree
Section II. Psychomotor skills
Indicate the number you performed on an average week during this rotation for each of
the following:
16* History and Physicals
97
17* Osteopathic structural examinations
18* Osteopathic Manipulative Treatments
19* Starting IVs
20* Venipunctures
21* Administering injections
22* Recording notes on medical records
23* Reviewing X-Rays
24* Reviewing EKGs
25* Urinary catherizations
26* Insertion and removal of sutures
27* Minor surgical procedures (assist)
28* Major surgical procedures (assist)
29* Care of dressings and drains
98
30* Sterile field maintenance
Section III
31* Comment on unique STRENGTHS and Positive Features of this rotation
32* Comment on the LIMITATIONS and Negative Features of this rotation
33* Comment on the extent in which the Learning Objectives for the rotation were met (e.g.,
specific topics/patient populations to which you were or not exposed)
Section IV. Please list your clinical instructors with whom you had substantial contact
on this rotation and provide a general rating of their effectiveness as Teachers using the
scale below.
5=EXCELLENT, 4=VERY GOOD, 3=AVERAGE, 2=BELOW AVERAGE,
1=POOR
For example – John Smith – 4
34* List clinical instructors and rating in the box below
To submit your feedback, enter your password below and then click on Submit Feedback button
Submit Feedback
Cancel
99
Focus Groups on Clinical Clerkships
NAME OF HOSPITAL:
LOCATION:
DATE OF SITE VISIT:
The student’s comments on the clinical rotations are as follows:
(Name of Clerkship)
STRENGHTS:
WEAKNESSES:
100
4th Year PDA Feedback Questionnaire
1. Clinic Site
2. Rotation
3. Date
4. There were adequate learning opportunities
5. There were opportunities to practice Osteopathic diagnosis & therapy
6. I was evaluated fairly for my level of knowledge and skills
7. Attending physicians and/or house staff were committed to teaching
8. Overall, I felt meaningfully engaged and well integrated with the clinical teams
9. The DME and/or clerkship director was responsive to my needs as a student
10. This rotation reflected a proper balance of service and education
11. Overall, I would recommend this clerkship to others
12. Comments
13. Strengths/Positive Features of Rotation
14. Limitations/Negative Features of Rotation
15. List and Rate Clinical Instructors
101
Student End-of-Semester Program Evaluations
The DPC Student End-of-Semester Program Evaluation is an assessment of
each course that occurred during the semester and the corresponding faculty
members.
DPC END OF SEMESTER EVALUATION
Directions:
1. Please write in your year of graduation here: .
2. Enclosed you will find a blank scantron sheet.
3. Please make sure that you are using a #2 pencil to fill in your answers.
4. Please fill in the following Test Form information on the Scantron Sheet:
DPC Class 2011 – Bubble in Test Form A
DPC Class 2012 – Bubble in Test Form B
5. No other identifying information is necessary.
6. Please complete each of the following numbered sentences throughout
this evaluation using the following responses:
A. Excellent – couldn’t be better
B. Good – only slight improvement possible
C. Satisfactory – about average
D. Fair – some improvement needed
E. Poor – considerable improvement needed
7. There are spaces after each section in which you can write comments.
(When making comments, please know that your responses will be shared with DPC faculty,
Dept. chairs, and deans, as part of ongoing program evaluation.)
BIOPSYCHOSOCIAL SCIENCES COURSE EVALUATION:
102
I. CASE STUDIES COMPONENT
Excellent Good Satisfactory
Fair Poor
1. This course, overall is A B C D E
2. My effort in this course, overall is A B C D E
3. The case studies used in small
group are A B C D E
4. My preparation for each group
session was A B C D E
5. Other available resources for use in
small group are A B C D E
6. Facilitator assessments are A B C D E
7. Self assessments are A B C D E
8. Content Exams – midterm and final
are A B C D E
9. The group process in my group can
be described as A B C D E
10. The wrap-ups in my group were A B C D E
11. The quality of the learning issues
developed by my group was A B C D E
Overall comments on Case Studies
II. STUDENT HOUR COMPONENT:
Excellent Good Satisfactory
Fair Poor
12. The monthly student hours are A B C D E
Overall Comments On The Student Hour
103
III. FACILITATOR RATINGS
Please circle your group number/the name of your group facilitator(s).
Group Facilitators
A Dr. _____________________ and Dr. _______ ______________
B Dr. _____________________ and Dr. ________ ______________
C Dr. _____________________ and Dr. ______________________
D Dr. _____________________ and Dr. _______________________
Please bubble in your response to each of the following items:
Strongly
Agree Agree Disagree Strongly
Disagree
13. Maintained appropriate directiveness 5 (A) 4 (B) 2 (C) 1 (D)
14. Supported appropriate group process 5 (A) 4 (B) 2 (C) 1 (D)
15. Supported student-directed learning 5 (A) 4 (B) 2 (C) 1 (D)
16. Gave appropriate feedback to group 5 (A) 4 (B) 2 (C) 1 (D)
17. Ensured that learning issues were
Appropriate 5 (A) 4 (B) 2 (C) 1 (D)
18. Overall, these facilitators were
effective 5 (A) 4 (B) 2 (C) 1 (D)
Overall Facilitator Comments
(Comments on individual facilitators are welcome)
104
IV. PROBLEM SETS/DISCUSSION SESSIONS COMPONENT
A. Course Evaluation:
Excellent Good Satisfactory
Fair Poor
19. These sessions, overall were A B C D E
20. My effort in these sessions, overall
was A B C D E
21. The organization of these sessions
was A B C D E
22. Handouts in general were A B C D E
Problem Sets/Discussion Sessions Comments
(Please comment as to whether problem sets were too many, too few, too involved.)
105
V. PROBLEM SETS/DISCUSSION SESSIONS COMPONENT
B. Presenter Evaluation:
Excellent Good Satisfactory
Fair Poor
23. The Problem Set topic on
was A B C D E
24. The instructor,
, for the problem set named
in #23 was
A B C D E
25. The Problem Set topic on
was A B C D E
26. The instructor,
, for the problem set named
in #25 was
A B C D E
27. The Problem Set topic on
was A B C D E
28. The instructor,
, for the problem set named
in #27 was
A B C D E
29. The Problem Set topic on
was A B C D E
30. The instructor,
, for the problem set named
in #29 was
A B C D E
31. The Problem Set topic on
was A B C D E
32. The instructor,
, for the problem set named
in #31 was
A B C D E
Problem Sets/Discussion Sessions Comments
(Comments on individual instructors are welcome)
106
VI. ANATOMY COMPONENT
A. Course Evaluation:
Excellent Good Satisfactory
Fair Poor
33. This component, overall was A B C D E
34. My effort in this component was A B C D E
35. My preparation for each lab session
was A B C D E
36. Organization of the component was A B C D E
37. Quizzes were A B C D E
38. Resource Hour / Reviews were A B C D E
Anatomy Component Comments
107
VII. ANATOMY COMPONENT
B. Teaching Evaluation:
Please bubble in your response to each of the following items:
Strongly
Agree Agree Disagree Strongly
Disagree
39. The faculty were available to answer
questions in the lab 5 (A) 4 (B) 2 (C) 1 (D)
40. The faculty Initiated student
discussion 5 (A) 4 (B) 2 (C) 1 (D)
41. The faculty were prepared for each
lab session 5 (A) 4 (B) 2 (C) 1 (D)
42. The faculty gave me feedback on how
I was doing 5 (A) 4 (B) 2 (C) 1 (D)
43. The faculty were enthusiastic about
the course 5 (A) 4 (B) 2 (C) 1 (D)
44. Overall, the instructors were effective 5 (A) 4 (B) 2 (C) 1 (D)
Anatomy Component Comments
(Comments on individual instructors are welcome)
108
CLINICAL SCIENCES COURSE
I. CLINICAL SKILLS LAB COMPONENT
A. Course Evaluation:
Excellent Good Satisfactory
Fair Poor
45. This component, overall was A B C D E
46. My effort in this component was A B C D E
47. My preparation for each lab session
was A B C D E
48. Organization of the component was A B C D E
49. Examinations were A B C D E
50. Handouts/PowerPoints were A B C D E
51. I would rate my physical exam and
history taking skills at this time to
be
A B C D E
Overall Comments on Clinical Skills Component / Individual Labs
(Comments on individual instructors are welcome)
109
I. CLINICAL SKILLS LAB COMPONENT
B. Teaching Evaluation:
Please bubble in your response to each of the following items:
Strongly
Agree Agree Disagree Strongly
Disagree
52. The faculty were available to answer
questions in the lab 5 (A) 4 (B) 2 (C) 1 (D)
53. The faculty initiated student
discussion 5 (A) 4 (B) 2 (C) 1 (D)
54. The faculty were prepared for each
lab session 5 (A) 4 (B) 2 (C) 1 (D)
55. The faculty Gave me feedback on
how I was doing 5 (A) 4 (B) 2 (C) 1 (D)
56. The faculty were enthusiastic about
the course 5 (A) 4 (B) 2 (C) 1 (D)
57. Overall, the instructors were effective 5 (A) 4 (B) 2 (C) 1 (D)
Overall Comments on Clinical Skills Component / Individual Labs
(Comments on individual instructors are welcome)
110
II. OMM COMPONENT
A. Course Evaluation:
Excellent Good Satisfactory
Fair Poor
58. This component, overall was A B C D E
59. My effort in this component was A B C D E
60. My preparation for each lab session
was A B C D E
61. Organization of the component was A B C D E
62. Presentations / Lectures were A B C D E
63. Handouts were A B C D E
64. Quizzes were A B C D E
65. Practical exams were A B C D E
66. Resource Hour / Reviews were A B C D E
Overall Comments on OMM Component / Individual Labs
(Comments on individual instructors are welcome)
111
II. OMM COMPONENT
B. Teaching Evaluation
Please bubble in your response to each of the following items:
Strongly
Agree Agree Disagree Strongly
Disagree
67. The faculty were available to answer
questions in the lab 5 (A) 4 (B) 2 (C) 1 (D)
68. The faculty Initiated student
discussion 5 (A) 4 (B) 2 (C) 1 (D)
69. The faculty were prepared for each
lab session 5 (A) 4 (B) 2 (C) 1 (D)
70. The faculty gave me feedback on how
I was doing 5 (A) 4 (B) 2 (C) 1 (D)
71. The faculty were enthusiastic about
the course 5 (A) 4 (B) 2 (C) 1 (D)
72. Overall, the instructors were effective 5 (A) 4 (B) 2 (C) 1 (D)
Overall Comments on OMM Component / Individual Labs
(Comments on individual instructors are welcome)
112
III. ICC COMPONENT
A. Course Evaluation:
Excellent Good Satisfactory
Fair Poor
73. This component, overall was A B C D E
74. My effort in this component was A B C D E
75. My preparation for each lab session
was A B C D E
76. Organization of this component was A B C D E
77. The helpfulness/usefulness of the
ICC standardized patient
encounters was
A B C D E
78. The helpfulness/usefulness of the
ICC robotic patient encounters was A B C D E
79. Are Clinical Skills laboratory
exercises appropriate for the ICC?
[A] YES [B] NO
A YES B NO – – –
Overall Comments on the ICC Component
(Comments on individual instructors are welcome)
113
IV. CLINICAL PRACTICUM COMPONENT
80. I participated in Clinical Practicum this semester: [A] YES [B] NO
If you answered NO to this question, you have finished this evaluation, if you answered YES,
please continue this questionnaire until the end. Thank you.
A. Course Evaluation
Excellent Good Satisfactory
Fair Poor
81. This component, overall was A B C D E
82. My effort in this component was A B C D E
83. My preparation for each lab session
was A B C D E
84. Organization of this component was A B C D E
85. The helpfulness/usefulness of the
Clinical Practicum was A B C D E
86. The organization of the case
presentations was A B C D E
87. Are Clinical Skills laboratory
exercises appropriate for the
Clinical Practicum?
A YES B NO – – –
Please bubble in your response to each of the following items:
Strongly
Agree
Agree Disagree Strongly
Disagree
88. The case presentation exercise was a
valuable learning experience 5 (A) 4 (B) 2 (C) 1 (D)
Overall Comments on Clinical Practicum Course
114
IV. CLINICAL PRACTICUM COMPONENT
B. Mentor Evaluation:
Please bubble in your response to each of the following items:
Strongly
Agree Agree Disagree Strongly
Disagree
89. The preceptor was available to
answer my questions 5 (A) 4 (B) 2 (C) 1 (D)
90. I was supported in my interaction
with patients 5 (A) 4 (B) 2 (C) 1 (D)
91. Student-directed learning was
supported 5 (A) 4 (B) 2 (C) 1 (D)
92. I had appropriate feedback 5 (A) 4 (B) 2 (C) 1 (D)
93. Overall, this preceptor/site was
effective 5 (A) 4 (B) 2 (C) 1 (D)
Preceptor Name _______________________
Overall Comments on Clinical Practicum Mentor
(Comments on individual instructors are welcome)
115
DPC: Program Assessment Plan
I. Pre matriculated Evaluation – What determines that an applicant will pick the DPC
program?
Comparison of the students who chose the LDB program vs. the DPC program with
regard to the following outcome measures:
GPA scores (overall, science)
MCAT scores
Gender
Age
Race
College size
College Geographic location
Prior PBL exposure
OMM understanding
Research Background
Volunteer Work
Employment Experience
Graduate Degree
Scholarships/Awards
II. Years at NYCOM – How do we evaluate if the DPC program is accomplishing its goals
while the students are at NYCOM?
Comparison of Facilitator Assessments for each term, to monitor student growth
Comparison of Clinical Practicum Mentor Evaluations from Term 2 and Term 3, to
evaluate the student’s clinical experience progress
Comparison of Content exam scores from terms 1 through 4.
Comparison of entrance questionnaire (administered during first week of medical
school) responses to corresponding exit questionnaire administered at the end of year
4
Evaluation of the Student DPC End-of-Term Evaluations
Comparison of the following measures to those outcomes achieved by the students in
the LDB program:
OMM scores
116
DPC: Program Assessment Plan
Anatomy scores
ICC PARS scores
ICC OSCE scores
Summer research
Summer Volunteerism
Research effort (publications, abstracts, posters, presentations)
Shelf-exams
COMLEX I, II, III scores and pass rate
Fellowships (Academic, Research)
III. Post Graduate Training Practice – What happens to the DPC student once they leave
NYCOM? How to they compare to those students who matriculated through the LDB
program?
Comparison of the following measures to those outcomes achieved by the students in
the LDB program:
Internships
Residencies
Fellowships
Specialty (medicine)
Specialty board certifications
AOA membership
AMA membership
Publications
Research
Teaching
117
OMM Assessment Forms
118
119
5. COMLEX USA Level I, Level II CE & PE, and Level III data (NBOME)
a) First-time and overall pass rates and mean scores;
b) Comparison to national averages;
c) Comparison to college (NYCOM) national ranking.
Report provided by Associate Dean for Academic Affairs
120
6. Residency match rates and overall placement rate
Data compiled as received from the American Osteopathic Association (AOA) and
the National Residency Match Program (NRMP).
Report provided by Associate Dean for Clinical Education
121
7. Feedback from (AACOM) Graduation Questionnaire
Annual survey report received from AACOM comparing NYCOM graduates
responses to numerous questions/categories (including demographics, specialty
choice, overall perception of pre-doctoral training, indebtedness, and more) to nationwide
osteopathic medical school graduating class responses.
122
Specific forms/questionnaires utilized to capture the above-detailed information include the
following:
AACOM Survey of Graduating Seniors
Samples of the forms/questionnaires follow
123
124
125
126
127
128
129
130
131
132
133
134
135
136
137
138
139
140
141
8. Completion rates (post-doctoral programs)
Percent of NYCOM graduates completing internship/residency training programs.
Report provided by Office of Program Evaluation and Assessment
142
9. Specialty certification and licensure
Data compiled from state licensure boards and other specialty certification
organization (board certification) on NYCOM graduates.
Report provided by Office of Program Evaluation and Assessment
143
10. Career choices and geographic practice location
Data includes practice type (academic, research, clinical, and so on) and practice
location. Data obtained from licensure boards, as well as NYCOM Alumni survey.
Report provided by Office of Program Evaluation and Assessment
144
11. Alumni Survey
Follow up survey periodically sent to alumni requesting information on topics
such as practice location, specialty, residency training, board certification and
so on.
145
Specific forms/questionnaires utilized to capture the above-detailed information include the
following:
Alumni Survey
Samples of the forms/questionnaires follow
146
ALUMNI SURVEY
NAME
LAST FIRST NYCOM CLASS YEAR
HOME ADDRESS
PRACTICE ADDRESS
HOME PHONE ( ) OFFICE PHONE ( )
E-MAIL ADDRESS
________________________________ _______________________________ _______________________
INTERNSHIP HOSPITAL RESIDENCY HOSPITAL FIELD OF STUDY
FELLOWSHIPS COMPLETED:
CERTIFICATIONS YOU HOLD:
IF SPOUSE IS ALSO A NYCOM ALUMNUS, PLEASE INDICATE SPOUSE’S NAME AND CLASS YEAR:
EXCLUDING INTERNSHIP, RESIDENCY AND FELLOWSHIP, HAVE YOU EARNED ANY ADDITIONAL ACADEMIC DEGREES OR CERTIFICATES BEYOND
YOUR MEDICAL DEGREE (I.E., MPH, MBA, MHA, PHD, MS)? (PLEASE LIST)
CURRENT PRACTICE STATUS: FULL-TIME PRACTICE___ PART-TIME PRACTICE _____ INTERN/RESIDENCY _____ RETIRED/NOT PRACTICING _____
147
What specialty do you practice most
frequently? (Choose one)
Allergy and Immunology
Anesthesiology
Cardiology
Colorectal Surgery
Dermatology
Emergency Medicine
Endocrinology
Family Practice
Gastroenterology
Geriatrics
Hematology
Infectious Diseases
Internal Medicine
Neruology
Neonatology
Nephrology
Neurology
Nuclear Medicine
Obstetrics & Gynecology
Occupational Medicine
Ophthalmology
Oncology
Otolaryngology
Orthopedic Surgery
Psychiatry
Pediatrics
Plastic/Recon. Surgery
Physical Medicine/Rehab
Pathology
Pulmonary Medicine
Radiology
Rheumatology
Surgery (general)
Thoracic Surgery
Radiation Therapy
Urology
Other (Please specify)
____________________
Current military status (if applicable):
Active Duty
Inactive reserve
Active Reserve
What is the population of the
geographic area of your practice?
(Choose one)
5,000,000 +
1,000,000 – 4,999,999
500,000 – 999,999
250,000 – 499,999
100,000 – 249,999
50,000 – 99,999
25,000 – 49,999
10,000 – 24,999
5,000 – 9,999
Less than 5,000
How would you describe this
geographic area? (Choose one)
Inner City
Urban
Suburban
Small Town – Rural
Small town – industrial
Other ______________________
What functions do you perform in
your practice? (check all that apply)
Preventive care/patient education
Acute care
Routine/non-acute care
Consulting
Supervisory/managerial responsibilities
Research
Teaching
Hospital Rounds
What best describes the setting in
which you spend the most time ?
Intensive Care Unit of Hospital
Inpatient Unit of Hospital (not ICU/CCU)
Outpatient Unit of Hospital
Hospital Emergency Room
Hospital Operating Room
Freestanding Urgent Care Center
Freestanding Surgical Facility
Nursing Home or LTC Facility
Solo practice physician office
Single Specialty Group practice physician
office
Multiple Specialty Group practice physician
office
University Student Health facility
School-based Health center
HMO facility
Rural Health Clinic
Inner-city Health Center
Other Community Health Center
Other Freestanding Outpatient facility
Correctional facility
Industrial facility
Mobile Health Unit
Other (Please specify)
__________________________________
Do you access medical information
via the internet ?
Never
Sometimes
Often
What percent of your time is spent in primary
care? (family medicine or gen. internal medicine)
0%
1 – 25%
25 – 50%
50 – 75%
75 – 100%
What percent of your practice is outpatient?
0%
1 – 25%
25 – 50%
50 – 75%
75 – 100%
148
Do you engage in any of the following
activities? (check all that apply)
Professional organization
leadership position
Volunteer services in the
community
School or team physician
Free medical care
Leadership in church,
congregation
Local government
Speaking on medical
topics to community
groups
How many CME programs or other
professional training sessions did you
attend last year?
none
1-5
5-10
10-15
more than 15
Have you ever done any
of the following?
Author or co-author
a professional paper
Contribute to an article
Direct a research project
Participate in clinical
research
Present a lecture at a
professional meeting or
CME program
Serve on a panel
discussion at a
professional meeting
How often do you read
medical literature regarding
new research findings?
Rarely
Several times a year
Monthly
Weekly
Daily
How frequently do you apply
osteopathic concepts into
patient care?
Never
Rarely
Often
Always
In your practice do you employ any of
the following?
(check all that apply)
Structural examination or
musculoskeletal
considerations in
diagnosis
Indirect OMT techniques
High Velocity OMT
Myofascial OMT
Cranial OMT
Palpatory diagnosis
Please indicate how important each of the following skills
has been in your success as a physician, and how well
NYCOM prepared you in that skill.
Biomedical science knowledge base
Clinical skills
Patient educator skills
Empathy and compassion for patients
Understanding of cultural differences
Osteopathic philosophy
Clinical decision making
Foundation of ethical standards
Ability to communicate with other health care providers
Ability to communicate with patients and families
Knowing how to access community resources
Ability to understand and apply new medical information
Understanding of the payor/reimbursement system
How important to my practice
Strong Moderate Weak
Strong Moderate Weak
Strong Moderate Weak
Strong Moderate Weak
Strong Moderate Weak
Strong Moderate Weak
Strong Moderate Weak
Strong Moderate Weak
Strong Moderate Weak
Strong Moderate Weak
Strong Moderate Weak
Strong Moderate Weak
Strong Moderate Weak
How well NYCOM prepared me
Strong Moderate Weak
Strong Moderate Weak
Strong Moderate Weak
Strong Moderate Weak
Strong Moderate Weak
Strong Moderate Weak
Strong Moderate Weak
Strong Moderate Weak
Strong Moderate Weak
Strong Moderate Weak
Strong Moderate Weak
Strong Moderate Weak
Strong Moderate Weak
149
Ability to search and retrieve needed information
Manipulative treatment skill
Ability to use medical technology
Diagnostic skill
Skill in preventive care
Understanding of public health issues & the public health
system
Professionalism
Strong Moderate Weak
Strong Moderate Weak
Strong Moderate Weak
Strong Moderate Weak
Strong Moderate Weak
Strong Moderate Weak
Strong Moderate Weak
Strong Moderate Weak
Strong Moderate Weak
Strong Moderate Weak
Strong Moderate Weak
Strong Moderate Weak
Strong Moderate Weak
Strong Moderate Weak
Please return to:
NYCOM of NYIT, Office of Alumni Affairs
Northern Boulevard, Serota Bldg., Room 218
Old Westbury, New York 11568
or
fax to (516) 686-3891 or (516) 686-3822
as soon as possible.
Thank you for your cooperation!
150
NYCOM Benchmarks
1-Applicant Pool
Benchmark: To maintain relative standing among Osteopathic Medical Colleges based on
the number of applicants.
2-Admissions Profile
Benchmark: Maintain or improve current admissions profile based on academic criteria such
as MCAT, GPA, or Colleges attended.
3-Academic Attrition Rates
Benchmark: To maintain or improve our current 3% Academic Attrition rate
4-Remediation rates (pre-clinical years)
Benchmark: A 2% a year reduction in the students remediating in pre-clinical years.
5-COMLEX USA Scores
Benchmark: Top quartile in the National Ranking of 1st time pass rate and Mean Score.
6-Students entering Osteopathic Graduate Medical Education (OGME)
Benchmark: Maintain or improve the current OGME placement.
7-Graduates entering Primary Care (PC) 12
Benchmark: Maintain or improve the current Primary Care placement.
8-Career Data -Licensure (within 3 years, post-graduate), Board Certification , Geographic
Practice, and Scholarly achievements.
Benchmark: TBD
12 Family Medicine, Internal Medicine, and Pediatrics
151
BIBLIOGRAPHY
Gonnella, J.S., Hojat, M., & Veloski, J.J. Jefferson Longitudinal Study of Medical Education.
Retrieved December 17, 2008, from http://jdc.jefferson.edu/jlsme/1
Hernon, P. & Dugan, R.E. (2004). Outcomes Assessment in Higher Education. Libraries
Unlimited: Westport, CT
152
APPENDICES
153
NEUROLOGICAL EXAMINATION
©2009 New York College of Osteopathic Medicine 011509
1 Assess Cranial Nerve I
– Olfactory
Examiner checks for
patient’s sense of smell by,
e.g. coffee, soap,
peppermint, orange peels,
etc.
2 Assess Cranial Nerve II
– Optic: Assessing Visual
Fields by Confrontation
Examiner stands at
approximate eye-level
with patient, making eye
contact.
Patient is then asked to
return examiner’s gaze
e.g. by saying “Look at
me.”
Examiner starts by
placing his / her hands
outside the patient’s field
of vision, lateral to head.
With fingers wiggling (so
patient can easily see
them) the examiner
brings his / her fingers
into the patient’s field of
vision.
Hands diagonal
Or, hands horizontal
Examiner must ask the patient “Tell me when you see my
fingers.”
Assess upper, middle and lower fields, bilaterally.
154
NEUROLOGICAL EXAMINATION
©2009 New York College of Osteopathic Medicine 011509
3 Assess Cranial Nerve II –
Optic: Accessing Visual
Acuity
For ICC purposes,
handheld Rosenbaum
Pocket Screener (eye
chart)
NOTE: Use handheld
Snellen eye chart if
patient stand 20’ from
the chart
Ask patient to cover one
eye while testing the
other eye
Rosenbaum eye chart
is held in good light
approximately 14” from
eye
Determine the smallest
line of print from which
patient can read more
than half the letters
The patient’s visual
acuity score is recorded
as two numbers, e.g.
“20/30” where the top
number is the distance
the patient is from the
chart and the bottom
number is the distance
the normal eye can
read that line.
Repeat with the other
eye
155
NEUROLOGICAL EXAMINATION
©2009 New York College of Osteopathic Medicine 011509
4 Assessing Cranial Nerves II and III
– Optic and Oculomotor:
Assessing direct and Consensual
Reactions
Examiner asks the patient to look into the
distance, then shines a light obliquely into
each pupil twice to check both the direct
reaction (pupillary constriction in the same
eye) and consensual reaction (pupillary
constriction in the opposite eye).
Must be assessed bilaterally.
5 Assessing Cranial Nerves II and III – Optic
and Oculomotor: Assessing Near Reaction
and Near Response
Assessed in normal room light, testing one
eye at a time.
Examiner holds a finger, pencil, etc. about
10 cm. from the patient’s eye.
Asks the patient to look alternately at the
finger or pencil and then into the distance.
Note pupillary constriction with near focus.
Close focus
Distant focus
156
NEUROLOGICAL EXAMINATION
©2009 New York College of Osteopathic Medicine 011509
6 Assessing Cranial Nerve III
– Oculomotor: Assessing Convergence
Examiner asks the patient to follow his / her
finger or pencil as he / she moves it in
toward the bridge of the nose to within about
5 to 8 centimeters.
Converging eyes normally follow the object
to within 5 – 8 cm. of the nose.
7 Assessing Cranial Nerve III, IV and VI
– Oculomotor, Trochlear And Abducens:
Assessing Extra Ocular Muscle Movement
Examiner assesses muscle movements in at
least 6 positions of gaze by tracing, for
example, an “H pattern” with the hand and
asking the patient to follow the hand with
their eyes without turning the head.
157
NEUROLOGICAL EXAMINATION
©2009 New York College of Osteopathic Medicine 011509
8 Assessing Cranial Nerve V
– Trigeminal (Sensory) Ophthalmic Maxillary
Examiner assesses sensation in 3
sites:
Ophthalmic
Maxillary
Mandibular
Examiner may use fingers,
cotton, etc. for the
assessment.
Assess bilaterally.
Mandibular
9 Assessing Cranial Nerve V
– Trigeminal (Motor)
Examiner asks the patient to
move jaw his or her jaw from
side to side
OR
Examiner palpates the
masseter muscles and asks
patient to clinch his / her teeth.
Note strength of muscle
contractions.
OR
158
NEUROLOGICAL EXAMINATION
©2009 New York College of Osteopathic Medicine 011509
10 Assessing Cranial
Nerve VII – Facial:
Motor Testing
Examiner asks patient to
perform any 4 of the
following 6 exams:
Raise both eyebrows
Close eyes tightly,
then try to open
against examiner’s
resistance
Frown
Smile
Show upper and lower
teeth
Puff out cheeks
Note any weakness or
asymmetry.
Raise eyebrows Opening eyes against resistance
Frown Smile
Show teeth Puff cheeks
159
NEUROLOGICAL EXAMINATION
©2009 New York College of Osteopathic Medicine 011509
11
Assess Cranial Nerve VIII
– Acoustic
Weber test – for
lateralization
Use a 512 Hz or 1024
Hz turning fork.
Examiner starts the fork
vibrating e.g. by tapping
it on the opposite hand,
leg, etc.
Base of the tuning fork
placed firmly on top of
the patient’s head.
Patient asked “Where
does the sound appear
to be coming from?”
(normally it will be
sensed in the midline).
160
NEUROLOGICAL EXAMINATION
©2009 New York College of Osteopathic Medicine 011509
12 Assessing Cranial Nerve
VIII – Acoustic
Rinne test – to compare
air and bone conduction
Use a 512 Hz or 1024
Hz turning fork.
Examiner starts the fork
vibrating, e.g. by
tapping it on the
opposite hand, leg, etc.
Base of fork placed
against the mastoid
bone behind the ear.
Patient asked to say
when he / she no longer
hears the sound
Mastoid Bone
When sound no longer
heard, examiner moves
the tuning fork (without
re-striking it) and holds
it near the patient’s ear
and ask if he / she can
hear the vibration.
Examiner must vibrate
the tuning fork again for
the second ear.
Bilateral exam.
NOTE: (AC>BC): Air
conduction greater than
bone conduction.
Ear
161
NEUROLOGICAL EXAMINATION
©2009 New York College of Osteopathic Medicine 011509
13 Assessing Cranial Nerve VIII –
– Gross Auditory Acuity
Examiner asks patient to
occlude (cover) one ear.
Examiner then whispers
words or numbers into nonoccluded
ear from
approximately 2 feet away.
Asks patient to repeat
whispered words or
numbers.
Compare bilaterally.
OR
Examiner asks patient to
occlude (cover) one ear.
Examiner rubs thumb and
forefinger together next to
patient’s non-occluded ear
and asks the patient if the
sound is heard.
Compare bilaterally.
162
NEUROLOGICAL EXAMINATION
©2009 New York College of Osteopathic Medicine 011509
14 Assessing Cranial Nerve IX
and X – Glossopharyngeal
and Vagus: Motor Testing
First, examiner asks the
patient to swallow.
Swallowing
Next, patient asked to say
‘aah’ and examiner
observes for symmetrical
movement of the soft
palate or a deviation of the
uvula.
OPTIONAL: Use a light
source to help visualize
palate and uvula.
NOTE: sensory component of
cranial nerves IX and X is
testing for the “gag reflex”
Saying “Aah”
163
NEUROLOGICAL EXAMINATION
©2009 New York College of Osteopathic Medicine 011509
15 Assessing Cranial Nerve XI
– Spinal Accessory:
Motor Testing
Examiner asks the patient to
shrug his / her shoulders up
against the examiner’s
hands. Apply resistance.
Note strength and
contraction of trapezius
muscles.
Next, patient asked to turn
his or her head against
examiner’s hand. Apply
resistance.
Observe the contraction of
the opposite sternocleidomastoid
muscle.
Assess bilaterally.
164
NEUROLOGICAL EXAMINATION
©2009 New York College of Osteopathic Medicine 011509
16 Assessing Cranial Nerve
XII – Hypoglossal:
Motor Testing
First, examiner inspects
patient’s tongue as it
lies on the floor of the
mouth.
Note any asymmetry,
atrophy or
fasciculations.
Next, patient asked to
protrude the tongue.
Note any asymmetry,
atrophy or deviations
from the midline.
Finally, patient asked to
move the tongue from
side to side.
Note any asymmetry of
the movement.
Inspect tongue Protruding Tongue
Side to Side Movement
165
NEUROLOGICAL EXAMINATION
©2009 New York College of Osteopathic Medicine 011509
17 Assessing Lower Extremities –
Motor Testing
With patient in supine position, test
bilaterally
Test flexion of the hip by placing
your hand on patient’s thigh, and
ask them to raise his / her leg
against resistance.
Test extension of the hip by
having patient push posterior
thigh against your hand
CONTINUED
166
NEUROLOGICAL EXAMINATION
©2009 New York College of Osteopathic Medicine 011509
18 Assessing Lower Extremities –
Motor Testing
With patient in seated position, test
bilaterally
Test adduction of the hip by
placing hands firmly between the
knees, and asking them to bring
the knees together
Test abduction of the hip by
placing hands firmly outside the
knees, and asking patient to
spread their legs against
resistance
167
NEUROLOGICAL EXAMINATION
©2009 New York College of Osteopathic Medicine 011509
19 Assessing Upper Extremities –
Motor Testing
Examiner asks patient to pull (flex)
and push (extend) the arms against
the examiner’s resistance.
Bilateral exam.
Flexion
Extension
20 Assessing Lower Extremities –
Motor Testing
Examiner asks the patient to pull
(flex) and push (extend) the legs
against the examiner’s resistance.
Bilateral exam.
Flexion
Extension
168
NEUROLOGICAL EXAMINATION
©2009 New York College of Osteopathic Medicine 011509
21 Assessing Lower Extremities –
Motor Testing
Examiner asks patient to dorsiflex
and plantarflex the ankle against
resistance
Compare bilaterally
169
NEUROLOGICAL EXAMINATION
©2009 New York College of Osteopathic Medicine 011509
22 Assessing the Biceps Reflex
Examiner partially flexes patient’s
arm.
Strike biceps tendon with reflex
hammer (pointed or flat end) with
enough force to elicit a reflex, but not
so much to cause patient discomfort.
OPTIONAL: Examiner places the thumb
or finger firmly on biceps tendon with the
pointed end of reflex hammer only.
Reflexes must be assessed
bilaterally.
Examiner must produce a reflex for
credit.
OR
23 Assessing the Triceps Reflex
Examiner flexes the patient’s arm at
the elbow, and then taps the triceps
tendon with reflex hammer.
Reflexes must be assessed
bilaterally.
Examiner must produce a reflex for
credit.
170
NEUROLOGICAL EXAMINATION
©2009 New York College of Osteopathic Medicine 011509
24 Assessing the Brachioradialis
Reflex
With the patient’s hand resting
in a relaxed position, e.g. on a
table, his / her lap or supported
by examiner’s arm, the
examiner strikes the radius
about 1 or 2 inches above the
wrist with the reflex hammer.
Reflexes must be assessed
bilaterally.
Examiner must produce a reflex
for credit.
171
NEUROLOGICAL EXAMINATION
©2009 New York College of Osteopathic Medicine 011509
25 Assessing the Patellar Tendon Reflex
First, patient asked to sit with their legs
dangling off the exam table.
Reflexes assessed by striking the
patient’s patellar tendon with a reflex
hammer on skin.
Reflexes must be assessed bilaterally.
Examiner must produce a reflex for
credit.
OPTIONS:
Examiner can place his / her hand on
the on patient’s quadriceps, but this is
optional.
Patient’s knees can be crossed.
172
NEUROLOGICAL EXAMINATION
©2009 New York College of Osteopathic Medicine 011509
25 Assessing the Achilles
Reflex
Examiner dorsiflexes the
patient’s foot at the ankle
Achilles tendon struck with
the reflex hammer on skin,
socks completely off
(removed at the direction
of the examiner).
Reflexes must be
assessed bilaterally.
Examiner must produce a
reflex for credit.
173
NEUROLOGICAL EXAMINATION
©2009 New York College of Osteopathic Medicine 011509
26 Assessing the Plantar, or Babinski,
Response
Examiner strokes the lateral aspect of
the sole from the heel to the ball of
the foot, curving medially across the
ball, with an object such as the end of
a reflex hammer.
On skin, socks completely off
(removed at the direction of the
examiner).
Assessment must be done bilaterally
Note movement of the toes (normally
toes would curl downward).
174
NEUROLOGICAL EXAMINATION
©2009 New York College of Osteopathic Medicine 011509
27 Assessing Rapid
Alternating Movements
Pronate Supinate
Examiner must do all three
assessments for credit:
Examiner directs the
patient to pronate and
supinate one hand
rapidly on the other.
Touching Thumbs Rapidly Patient directed to
touch his / her thumb
rapidly to each finger
on same hand,
bilaterally.
Slapping Thighs Rapidly
Patient directed to slap
his / her thigh rapidly
with the back side of
the hand, and then with
the palm side of the
hand, bilaterally.
175
NEUROLOGICAL EXAMINATION
©2009 New York College of Osteopathic Medicine 011509
29 Assessing Finger-to-Nose
Movements
Examiner directs the patient to touch
the examiner’s finger with his or her
finger, and then to place his or her
finger on their nose.
Examiner moves his / her finger
randomly during multiple movements.
176
NEUROLOGICAL EXAMINATION
©2009 New York College of Osteopathic Medicine 011509
30 Assessing Gait
Examiner asks patient to perform the
following:
Walk, turn and come back
Note imbalance, postural asymmetry,
type of gait (e.g. shuffling, walking on
toes, etc.), swinging of the arms, and
how patient negotiates turns.
Heel-to-toe (tandem walking)
Note an ataxia not previously obvious
Shallow knee bend
Note difficulties here suggest
proximal weakness (extensors of
hip), weakness of the quadriceps (the
extensor of the knee), or both.
177
NEUROLOGICAL EXAMINATION
©2009 New York College of Osteopathic Medicine 011509
31 Performing the Romberg Test
Examiner directs the patient to stand
with feet together, eyes closed for
at least 20 seconds without support.
During this test, examiner must stand
behind the patient to provide support
in case the patient loses his / her
balance.
32 Testing for Pronator Drift
Examiner directs the patient to stand
with eyes closed, simultaneously
extending both arms, with palms
turned upward, for at least 20
seconds.
During this test, examiner must stand
behind the patient to provide support
in case the patient loses his / her
balance.
178
NEUROLOGICAL EXAMINATION
©2009 New York College of Osteopathic Medicine 011509
SPECIAL TESTING
1 Sensory Testing
First, examiner
demonstrates what
sharp vs. dull means by
brushing the patient
with a soft object, e.g. a
cotton ball or smooth
end of tongue
depressor, and a semisharp
object, e.g.
broken end tongue
depressor.
Examiner performs this
test on arms and legs
bilaterally by randomly
brushing the patient’s
arms and legs with the
soft and semi-sharp
objects, e.g. a cotton
ball, semi-sharp object,
etc..
Patient directed to keep
his / her eyes closed
during the examination
as he or she identifies
sharp vs. dull on skin.
Bilateral exam, upper
and lower extremities.
179
TASKFORCE MEMBERS
John R. McCarthy, Ed.D. Associate Director, Clerkship Education
Pelham Mead, Ed.D. Director, Faculty Development
Mary Ann Achziger, M.S. Associate Dean, Student Affairs
Felicia Bruno, M.A. Assistant Dean, Student Administrative
Services/Alumni Affairs/Continuing Education
Claire Bryant, Ph.D. Assistant Dean, Preclinical Education
Leonard Goldstein, DDS, PH.D. Director, Clerkship Education
Abraham Jeger, Ph.D. Associate Dean, Clinical Education
Rodika Zaika, M.S. Director, Admissions
Ron Portanova, Ph.D. Associate Dean, Academic Affairs
180
Due to the coronavirus Education in College and other levels will never be the same. Protection against the coronavirus and future pandemic viruses will require Social Distancing and the wearing of face masks to prevent spreading of a virus from one student to another or to the teacher. I have a solution for Elementary, Secondary and College schools to still have classrooms with live students instead of complete online courses. The average Secondary school grades 7-12 usually has 32 student except in some States it may rise to 45 in a classroom to one teacher. To allow for social distancing in the future the number of students in a classroom is going to have to drop from 32 to half that amount or 16 students.
This change would impact the Teacher contracts and agreements with the teacher Unions. Instead of having 8 classes a day of which teachers teach five, the new norm will be twice that number or 16 short classes a day. Short classes would be twenty minutes long instead of the usual 50 minutes. Teachers will have to teach ten short classes a day. Department chairpersons who use to be excused for teaching several classes a day would have to return to a full teaching regiment of 16 classes a day.
Online in school classes can be made available to help make the new curriculum easier to apply. Music auditoriums are the largest room in most schools next to the gyms. In auditoriums student could sit every other seat for social distancing with their own laptop or iPad and log on to the online course they were assigned for that period.
Lunch or cafeteria would have to change to allow social distancing . Every other seating might not work, so chairs might have to be placed in hallways near the cafeteria. Schools in warm climates could have an expanded outdoor picnic area with plenty of extra permanent seating installed.
Online course can supplement in class courses with support and guidance after school at home.
In College money walks and money talks. College Presidents will be tempted to go the all class online route to save massive amounts of money, while at the same time charging tuition to students who log on from home. Dormitories could become problem as the students at UCSD have complained, “why should they pay for a dorm or apartment when they can log on from home? At the NY College of Osteopathic medicine where I worked as. Director of Faculty Development and Assessment they had streaming for all lectures. The lucky thing is that only had two lectures going on at the same time. If a University were to apply instant streaming of all lectures and classrooms the cost would be prohibited due to the need for massive computer server storage space. The down side of streaming other than cost is that the students did not come to the lectures and instead remained at home with a cup of coffee and a donut. The administration at the NY College of Osteopathic medicine could not figure out how to get the students to attend the lectures. The solution was simple. Stop streaming the lectures and handing out of lecture notes in advance. Online course can be bought from third party companies or developed over time with the existing faculty. The problem there is intellectual property rights. Does the Professor had full rights to the classes and curriculum they write and teach or does the University or College have the full property rights to the recorded video copies of the lectures? That depends on the employment contract the Professors sign when they are hired. If they agree to give the University or College full legal rights to replay a Professor’s lectures for eternity than the Professor has no rights. Online courses save Colleges and Universities millions of dollars by not having to provide classroom space or pay a live professor to teach the course.
Some Universities provide a Professor at the beginning of the course and at the end for the final exam and the rest of the course is online. Blackboard is an online administrative system that I was certified and trained in that makes online teaching easy with computer testing, online grading reporting, lock boxes to record when an assignment is handed in onetime and the full curriculum can be posted in advance. Some textbook companies will provide the full text of their books to be uploaded to Blackboard for students to read and not have to pay for an expensive textbook.
Obviously the human interaction between student and teacher is going to suffer. There might be a decline in Teachers due to the new non personal online teaching approach? One big glitch is what happens when the servers go down? No server, no internet, no classrooms broadcast. Hacking will be a major problem and colleges, schools and universities will have to learn how to protect their online systems.
E-mailing a professor is always going to be risky if the student can upload a virus or deliver a link or app that tracks a Professors keyboard. Protected institution e-mails are the only way to prevent this.
Will the online system come the fall of 2020 be good? Probably not because schools have not had the time to train their teachers how to teach online. Early Kindergarten and first grade students will need software that is good for their age level. Who is to pay for these iPads or laptops, the district or college or the student. Many students come from poor families that cannot afford an iPad. They will need financial assistance to secure an iPad and the training how to use one on cds or dvds.
The shorter class time is actually a plus for student with a short attention span. It makes teaching more concentrated. Teachers tend to blab a lot and this will teach them to be concise. Online projects must be completed in 20 minutes.
Physical Education is more essential than ever as an outlet from being cooped up all day and for character development. Online instruction is not a good venue for character development. Good sportsmanship carries over into adult life and provides guidelines for interaction with others in sports. Learning to lose as well as win and profit from losses to eventually win says a lot about Physical Education. We live in an age of overeating students who are so obese they cannot do many things like run or hike. They run out of breath when walking or riding a bike. They are made fun of by their peers. Physical Education will teach students what they cannot learn on a computer. Live body practice is a great way to teach a person’s muscles how to coordinate a skill or sport. Just watching on a computer is not the same. Muscles have memory and the more you repeat a skill, the better you become using that skill.
This is only the beginning of the discussion. Next time the mathematics of setting up a school master schedule with 20 minute classes and 16 sections a day.
Dr. Pelham Mead, June 2020
In 2008, I was directed to research and rewrite the Assessment Outcomes for the College of Osteopathic Medicine since he was cited by the COCA national accrediting agency for having an insufficient Assessment system both for the students and the college. I asked Clinical Director John McCarthy to join with me on this project and my boss, Dr. Ron Portnova, Academic Dean of the College approved. John and I worked tirelessly and finally got all the College Deans to meet at 8:00 before the working day in meetings to resolve the problems in the assessment. Basically their old assessment system had no bench marks to work toward. They had the College Mission, Philosophy, Goals, and objectives but not real bench marks regarding the Real graduation rate, the Real application number of candidates and other critical information. In the process I discovered the Director of Institutional Research had not files the Federal Annual report in three years at the time. When I revealed this to my boss Dr. Portnova, all hell broke loose and the Dean of Students came to the Director’s defense because they all came from the same college in graduation. The Clinical Stats never allowed for medical leave, family leave, dropouts, failures, unreported absences in their numbers. They estimated 10% when in face 24% per year did not finish or graduate. By February 2009, John and I had finished the 160 page report and submitted it to Dr. Portnova who in turn gave it to the President of the NY Technology University, the Dean of NYCOM, the VP of Health and Medicine and they all approved of the report and it was made official and sent to COCA who accepted the new Plan.
Submitted by Dr. Pelham Mead, Director of Faculty Development and Assessment, 2008-2010.
New York College of Osteopathic Medicine Learning Outcomes Assessment 2009-2010
January 2009
Taskforce Members
John R. McCarthy, Ed.D. Pelham Mead, Ed.D. Mary Ann Achziger, M.S. Felicia Bruno, M.A. Claire Bryant, Ph.D.
Leonard Goldstein, DDS, PH.D. Abraham Jeger, Ph.D.
Rodika Zaika, M.S. Ron Portanova, Ph.D.
Table of Contents
OVERVIEW 4
I. Introduction and Rationale 5
II. Purpose and Design 9
III. Specifics of the Plan 11
Mission of NYCOM 11
Learning Outcomes 11
Compiling the Data 17
Stakeholders 17
IV. Plan Implementation 18
Next Steps 18
V. Conclusion 20
A. OUTCOME INDICATORS – DETAIL 24
Bibliography 152
Appendices: 153
Chart 1 Proposed Curriculum and Faculty Assessment Timeline Institute for Clinical Competence:
Neurological Exam – Student Version Parts I & II Taskforce Members
List of Tables and Figures
Figure 1 Cycle of Assessment 9
Figure 2 Outcome Assessment along the Continuum 15
Figure 3 Data Collection Phases 22
Table 1 Assessment Plan Guide 23
New York College of Osteopathic Medicine
Learning Outcomes Assessment Plan February 2009
Overview
This document was developed by the NYCOM Task Force on Learning Outcomes Assessment and was accepted by the dean in January 2009. Although a few of the assessment tools and processes described in the document are new, most have been employed at NYCOM since its inception to inform curriculum design and implementation and to gauge progress and success in meeting the institution’s mission, goals and objectives.
The Learning Outcomes Assessment Plan documents the processes and measures used by the institution to gauge student achievement and program (curricular) effectiveness. The results of these activities are used by faculty to devise ways to improve student learning and by administrators and other stakeholder groups to assess institutional effectiveness and inform planning, decision-making, and resource allocation.
Certain of the measures described in later sections of this document constitute key performance indicators for the institution, for which numerical goals have been set. Performance on these measures has a significant effect on institutional planning and decision-making regarding areas of investment and growth, program improvement, and policy.
Key performance indicators and benchmarks are summarized below and also on page 151 of the plan.
Indicator Benchmarks
• Number of Applicants Maintain relative standing among Osteopathic Medical Colleges
• Admissions Profile Maintain or improve current admissions profile based on academic criteria (MCAT, GPA, Colleges attended
• Attrition 3% or less
• Remediation rate (preclinical)
2% reduction per year
• COMLEX USA scores (first-time pass rates, mean scores) Top quartile
• Students entering OGME Maintain or improve OGME placement
• Graduates entering Primary Care careers Maintain or improve Primary Care placement
• Career characteristics Regarding Licensure, Board Certification, Geographic Practice, and Scholarly achievements–TBD
I. Introduction and Rationale
At NYCOM we believe it is our societal responsibility to monitor our students’ quality of education through continual assessment of educational outcomes. On-going program evaluation mandates longitudinal study (repeated observations over time) and the utilization of empirical data based on a scientific methodology.
At Thomas Jefferson University, an innovative study was implemented circa 1970, which was ultimately titled “Jefferson Longitudinal Study of Medical Education”.1 As a result of implementation of this longitudinal study plan, Thomas Jefferson University was praised by the
1 Center for Research in Medical Education and Health Care: Jefferson Longitudinal Study of Medical Education, Thomas Jefferson University, 2005.
Accreditation Team for the Middle States Commission on Higher Education for “…..their academic interest in outcome data, responsiveness to faculty and department needs and the clear use of data to modify the curriculum and teaching environment….their use of this data has impacted many components of the curriculum, the learning environment, individual student development, and program planning…” (TJU, 2005).
The Jefferson Longitudinal Study of Medical Education has been the most productive longitudinal study of medical students and graduates of a single medical school. This study has resulted in 155 publications in peer review journals. Many were presented before national or international professional meetings prior to their publication (TJU, 2005).
According to Hernon and Dugan (2004), the pressure on higher education institutions to prove accountability has moved beyond the acceptance and reliance of self-reports and anecdotal evidence compiled during the self-regulatory accreditation process. It now encompasses an increasing demand from a variety of constituencies to demonstrate institutional effectiveness by focusing on quality measures, such as educational quality, and cost efficiencies.
Accountability focuses on results as institutions quantify or provide evidence that they are meeting their stated mission, goals, and objectives. Institutional effectiveness is concerned, in part, with measuring (Hernon and Dugan, 2004):
• Programmatic outcomes: such as applicant pool, retention rates, and graduation rates. Such outcomes are institution-based and may be used to compare internal year-to-year institutional performance and as comparative measures with other institutions.
• Student learning outcomes: oftentimes referred to as educational quality and concerned with attributes and abilities, both cognitive and affective, which reflect how student experiences at the institution supported their development as individuals. Students are expected to demonstrate acquisition of specific knowledge and skills.
At NYCOM, we recognize that our effectiveness as an institution must ultimately be assessed and expressed by evaluating our success in achieving our Mission in relation to the following Outcomes:
The present document focuses on #1, above, viz., Student Learning / Program Effectiveness. That is, it is intended only as a Learning Outcomes Assessment Plan. At the same time, we are cognizant that Institutional Effectiveness/Outcomes derive from numerous inputs, or “means” to these “ends,” including:
We believe it is our obligation to continually assess the impact of any changes in the inputs, processes, and outputs of this institution.
The evaluation approach in this Assessment Plan provides for on-going data collection and analysis targeted specifically at assessing outcomes of student achievement and program effectiveness (educational quality). Assessment of achievement and program effectiveness is based on objective, quantifiable information (data).
As a result of the NYCOM Learning Outcome Assessment Plan’s continual assessment cycle, the report is available, with scheduled updates, as a resource in the decision-making process.
The report provides outcomes data, recommendations, and suggestions intended to inform key policy makers and stakeholders2 of areas of growth and/or improvement, together with proposed changes to policy that strengthen both overall assessment and data-driven efforts to improve student learning.
2 NYCOM Administration, academic committees, faculty, potential researchers, and students.
II. Purpose and Design
Well-designed plans for assessing student learning outcomes link learning outcomes, measures, data analysis, and action planning in a continuous cycle of improvement illustrated below.
Figure 1 Cycle of Assessment
Ten principles guide the specifics of NYCOM’s Learning Outcomes Assessment Plan:
3 Examples of the former include post-course roundtable discussions, Institute for Clinical Competence (ICC) seminars, and data from the Course/Faculty Assessment Program. Examples of the latter include the AACOM Graduation Questionnaire, COMLEX scores, NBOME subject exam scores, and clerkship evaluations.
Outcomes assessment is a continuous process of measuring institutional effectiveness focusing on planning, determining, understanding, and improving student learning. At NYCOM, we are mindful that an integral component of this assessment plan is to ensure that the plan and the reporting process measures what it is intended to measure (student achievement and program effectiveness).
III. Specifics of the Plan
The NYCOM assessment plan articulates eleven student learning outcomes, which are linked to both the institutional mission and the osteopathic core competencies
Mission of NYCOM
The New York College of Osteopathic Medicine of the New York Institute of Technology is committed to training osteopathic physicians for a lifetime of learning and practice, based upon the integration of evidence-based knowledge, critical thinking and the tenets of osteopathic principles and practice. The college is also committed to preparing osteopathic physicians for careers in primary care, including health care in the inner city and rural communities, as well as to the scholarly pursuit of new knowledge concerning health and disease. NYCOM provides a continuum of educational experiences to its students, extending through the clinical and post-graduate years of training. This continuum provides the future osteopathic physician with the foundation necessary to maintain competence and compassion, as well as the ability to better serve society through research, teaching, and leadership.
Learning Outcomes
The following eleven (11) Learning Outcomes that guide this plan stem from NYCOM’s mission (above) and the osteopathic core competencies:
course rotation tests, research activities, presentations, and participation in directed reading programs and/or journal clubs, and/or other evidence-based medicine activities.
this nation’s projected health care provider shortage and the resulting expansion of medical school training facilities.
NYCOM has historically tracked student data across the curriculum, paying particular attention to cohorts of students (see below), as well as NYCOM’s two curricular tracks:
a) Lecture-Based Discussion track: integrates the biomedical and clinical sciences along continuous didactic ‘threads’ delivered according to a systems based approach;
b) Doctor Patient Continuum track: a problem-based curriculum, whose cornerstone is small-group, case-based learning.
Current data gathering incorporates tracking outcomes associated with several subcategories of student (important to the institution) within the 4-year pre-doctoral curriculum and the 5-year pre-doctoral Academic Medicine Scholars curriculum. The pre-doctoral populations are defined according to the following subcategories:
• Traditional:4
• BS/DO: The BS/DO program is a combined baccalaureate/doctor of osteopathic medicine program requiring successful completion of a total of 7 years (undergraduate, 3 years; osteopathic medical school, 4 years).
• MedPrep: A pre-matriculation program offering academic enrichment to facilitate the acceptance of underrepresented minority and economically disadvantaged student applicants.5
4 All other students not inclusive of BS/DO, MedPrep, and EPP defined cohorts.
5 The program is funded by the New York State Collegiate Science and Technology Entry Program and the NYCOM Office of Equity and Opportunity Programs.
• EPP (Émigré Physician Program): A 4-year program, offered by NYCOM, to educate émigré physicians to become DOs to enable them to continue their professional careers in the U.S.
The NYCOM assessment plan includes data from four phases of the medical education continuum (as illustrated in Figure 2 and Figure 3): pre-matriculation, the four-year pre- doctoral curriculum6, post-graduation data, and careers and practice data
Within the NYCOM Learning Outcome Assessment Plan, the Task Force has chosen the following outcome indicators for assessment of program effectiveness at different points in the medical education continuum:
• Pre-matriculation data, including first-year student survey;
• Academic (pre-clinical) course-work (scores on exams, etc.) – attrition rate;
• Clinical Clerkship Evaluations (3rd/4th year) and NBOME Subject Exams;
• Student feedback (assessment) of courses and 3rd and 4th year clinical clerkships and PDA-based Patient and Educational Activity Tracking;
• COMLEX USA Level I, Level II CE & PE, and Level III data, including:
o First-time and overall pass rates and mean scores;
o Comparison of NYCOM first time and overall pass rates and mean scores to national rankings;
• Residency match rate and placement rate (AOA / NRMP);
• Feedback from AACOM Graduation Questionnaire;
• Completion rates of Post-Doctoral programs;
• Specialty certification and licensure;
• Career choices (practice type–academic, research, etc.);
• Geographic practice locations;
• Alumni survey.
The Outcome Indicators—Detail sections of this plan (pages 24 through 150) show the various data sources and include copies of the forms or survey questionnaires utilized in the data gathering process.
The NYCOM assessment plan identifies specific sources of data for each phase
Figure 2 illustrates which of the above measures are most relevant at each phase of the medical education continuum.
6 And the five-year pre-doctoral Academic Medicine Scholars program
The NYCOM assessment plan describes the collection and reporting of data, responsibilities for analysis and dissemination, and the linkage to continuous program improvement and institutional planning
Compiling the Data
Discussions with departmental leaders and deans confirmed that data gathering occurs at various levels throughout the institution. Development of a central repository (centralized database) facilitates data gathering, data mining and overall efficiency as it relates to data analysis, report generation, and report dissemination. This includes utilization of internal databases (internal to NYCOM) as well as interfacing with external organizations’ databases, including the AOA (American Osteopathic Association), AACOM (American Association of Colleges of Osteopathic Medicine), AMA (American Medical Association), and the ABMS (American Board of Medical Specialties).
Stakeholders
Information from the data collection serves to inform NYCOM administration, relevant faculty, appropriate research and academic/administrative committees, including the following:
• Curriculum Committee
• Student Progress Committee
• Admissions Committee
• Deans and Chairs Committee
• Clinical and Basic Science Chairs
• Research Advisory Group
• Academic Senate
The NYCOM assessment plan sets forth benchmarks, goals and standards of performance
The major elements of the plan are summarized in Table 1: Assessment Plan Guide: Learning Outcomes/Metrics/Benchmarks found at the end of this chapter.
IV. Plan Implementation
As discussed earlier, most of the assessment tools and processes described in the document have been employed at NYCOM since its inception to inform curriculum design and implementation and to gauge progress and success in meeting the institution’s mission, goals and objectives. Beginning in fall 2008, however, assessment efforts have been made more systematic; policies, procedures, and accountabilities are now documented and more widely disseminated.
The Office of Program Evaluation and Assessment (OPEA), reporting to the Associate Dean for Academic Affairs is responsible for directing all aspects of plan refinement and implementation.
Next steps
Centralized database: Development of a (shared or central) repository (database) utilized by internal departments of NYCOM. WEAVEonline is a web-bases assessment system, utilized by numerous academic institutions across the country, for assessment and planning purposes.
Utilizing this program facilitates centralization of data. The central database is comprised of student data categorized as follows:
Pre-matriculation Data includes demographics, AACOM pre-matriculation survey, academic data (GPA), and other admissions data (MCAT’s, etc.).
Data is categorized according to student cohort as previously written and described (see item III. Specifics of the Plan on pages 13-14).
Pre-doctoral Data includes academic (pre-clinical) course work, course grades, end-of- year grade point averages, the newly implemented, innovative Course / Faculty assessment program data (described in Section 4), ratings of clinical clerkship performance, performance scores on COMLEX USA Level I and Level II CE & PE, descriptors of changes in academic status (attrition), and AACOM Graduation questionnaires.
Post-graduate/Career Data includes residency match rate, residency choice, hospitals of residency, geographic location, chosen specialty, performance on COMLEX Level III, geographic and specialty area(s) of practice following graduation, licensure, board certification status, scholarly work, professional activities/societies, faculty appointments, type(s) of practice (academic, clinical, research).
This database supports and assimilates collaborative surveys utilized by internal departments in order to capture requested data (see item III. Specifics of the Plan on pages 13-14) essential for tracking students during and after post-graduate training. Specific data (e.g., COMLEX Level III, board certification, and licensure) is provided by external databases, through periodic reporting means, or queries from NYCOM, therefore the database provides for assimilation of this external data, in order to incorporate into institutional reporting format.
Benchmarks and Reporting: Conduct a retrospective data analysis in order to establish baseline metrics (see Compiling the Data on page 17).
Following development of these metrics, institutional benchmarks are established. Benchmarks align with Institutional Goals as written above.
Reporting of data analysis occurs on an annual basis. An annual performance report is compiled from all survey data and external sources. Timeframe for reporting is congruent with end of academic year. Updates to report occur semi-annually, as additional (external) data is received.
Data reporting includes benchmarking against Institutional Goals (mission), in order to provide projections around effectiveness of learning environment, quality improvement indicators, long-range and strategic planning processes, and cost analysis/budgetary considerations.
Report dissemination to key policy makers and stakeholders, as previously identified (see Stakeholders on page 17) in addition to other staff, as deemed appropriate for inclusion in the reporting of assessment analysis.
V. Conclusion
The impact on student learning of such things as changes in the demographics of medical school applicants, admissions criteria, curricula, priorities, and methods of delivery of medical education deserve careful discussion, planning, and analysis before, during, and after implementation. This plan facilitates change management at three points:
o Planning, by providing evidence to support decision-making;
o Implementation, by establishing mechanisms for setting performance targets and monitoring results, and
o Evaluation, by systematically measuring outcomes against goals and providing evidence of whether the change has achieved its intended objectives.
At NYCOM, accountability is seen as both a requirement and a responsibility. As healthcare delivery, pedagogy, and the science of medicine constantly change, monitoring the rigor and effectiveness of the learning environment through assessment of student learning outcomes throughout the medical education continuum becomes paramount.
Figure 3 Data Collection Phases
Pre-matriculation Data
Pre-doctoral Data
Career Data
Assessment Process
Post-Graduate Data
Table 1 – Assessment Plan Guide: Learning Outcomes / Data Sources / Metrics
Learning Outcomes7 Data Collection Phases8 Assessment Methods Metrics9 Development of benchmarks10
Students will:
Demonstrate basic knowledge of OPP & OMT
• Pre-matriculation
• Pre-doctoral
• Post-graduate
• Career
• Didactic Academic Performance
• LDB Curriculum
• DPC Curriculum
• Formative / Summative Experiences: Patient Simulations (SP’s / Robotic)
• Student-driven Course, Clerkship, and Faculty Assessment
• Clinical Clerkship Performance
• PDA-Based Patient and Education Tracking
• Surveys
• Standardized Tests
• Alumni Feedback Vis a Vis:
• Admissions Data (Applicant Pool demographics)
• Course Exams
• End-of-year pass rates
• Coursework
• Analysis of Residency Trends Data
• Standardized Tests Subject Exams
• COMLEX 1 & II Scores
• Analysis of Specialty Choice
• Analysis of geographic practice area
• Academic Attrition rates
• Remediation rates
• Graduation and post- graduate data
• External surveys
• Applicant Pool
• Admissions Profile
• Academic Attrition rates
• Remediation rates (pre-clinical years)
• COMLEX USA Scores I & II (1st time pass rate / mean score)
• Number of graduates entering OGME programs
• Graduates entering Primary Care (PC)11
• Career Data:
Licensure (within 3 years);
Board Certification; Geographic Practice Area; Scholarly achievements
Demonstrate medical knowledge
Demonstrate competency in practice- based learning and improvement
Demonstrate professionalism and ethical practice
Demonstrate an understanding of health care delivery systems
Demonstrate the ability to effectively treat patients
Demonstrate interpersonal and communication skills
Be prepared for careers in primary care
Be prepared for the scholarly pursuit of new knowledge
Be prepared to engage in global health practice, policy, and solutions to world health problems
Be prepared to effectively interact with people of diverse cultures and deliver the highest quality of medical care
7 Complete detail of Learning Outcomes found in III., pages 11-13.
8 See Figure 3, page 22.
9 List of Metrics is not all-inclusive.
10 See complete detail of benchmarks—pages 5 & 151.
11 Primary Care: Family Medicine, Internal Medicine, and Pediatrics.
Outcome Indicators – Detail
AACOM pre-matriculation survey given to students;
Total MCAT scores;
Collegiate GPA (total GPA-including undergraduate/graduate);
Science GPA;
College(s) attended;
Undergraduate degree (and graduate degree, if applicable;
Gender,;
Age;
Ethnicity;
State of residence;
Pre-admission interview score.
Additional data is gathered on the MedPrep student cohort and incorporates the following:
Pre-matriculation lecture based exam and quiz scores;
Pre-matriculation DPC (Doctor Patient Continuum) based facilitator assessment scores and content exam scores;
ICC (Institute for Clinical Competence) Professional Assessment Rating (PARS) Scores.
Émigré Physician Program students
TOEFL (Test of English as a Foreign Language) score;
EPP Pre-Matriculation Examination score;
Medical school attended;
Date of MD degree;
Age;
Ethnicity;
Country of Origin.
Specific forms/questionnaires utilized to capture the above-detailed information include the following:
MedPrep 2008 Program Assessment
MedPrep Grade Table
NYCOM Admissions Interview Evaluation Form
Application for Émigré Physicians Program (EPP)
AACOM Pre-matriculation survey (first-year students)
NYCOM Interview Evaluation Form – Émigré Physicians Program Samples of the forms/questionnaires follow
MedPrep 2008 Program Assessment
Successful completion of the MedPrep Pre-Matriculation Program takes into consideration the following 3 assessment components:
A successful candidate must achieve a passing score for all 3 components. Strength in one area will not compensate for weakness in another.
Each of the three quizzes constitutes 10% of an individuals overall LDB score and the final exam (to be conducted on June 27) constitutes 70% of an individuals overall LDB score (comprising 100%) in the Lecture-Discussion portion of the program.
** Note – Both the Lecture-Discussion Based and DPC passing scores are calculated as per NYCOM practice:
Average (mean) minus one standard deviation
Not to be lower than 65%
Not to be higher than 70%
After the program ends, on June 27th, all three components of the assessment will be compiled and reviewed by the MedPrep Committee. The director of admissions, who is a member of the committee, will prepare notification letters that will be mailed to you within two weeks.
Please note:
The written communication you will receive ONLY contains acceptance information. NO grades will be distributed. Exams or other assessments (with the exception of the Lecture- Discussion Based quizzes, which have already been returned) will not be shared or returned.
Please DO NOT contact anyone at NYCOM requesting the status of your candidacy. No information will be given on the phone or to students on campus.
Thank you for your participation in the MedPrep Pre-Marticulation Program. The faculty and staff have been delighted to meet and work with you. We wish you success!
Sincerely,
Bonnie Granat
Quiz #1 Quiz #3 LDB Final
Score Quiz #2 Score Exam Overall LBD
(10% of Score (10% of Score Score
Overall (10% of Overall (70% of (Exam and Overall Overall
LDB Overall LDB Overall LDB Quizzes DPC ICC
Last Name, First Name Score) LDB Score) Score) Score) Combined) Score Score
NEW YORK COLLEGE OF OSTEOPAHTIC MEDICINE ADMISSIONS INTERVIEW EVALUATION FORM
Applicant Date / /
CATEGORY
CRITERIA
VALUE
RATING
I. PERSONAL PRESENTATION
MATURITY
LIFE EXPERIENCE /TRAVEL
EXTRA CURRICULAR ACTIVITIES/HOBBIES COMMUNICATION SKILLS
SELF ASSESSMENT (STRENGTHS/WEAKNESSES) AACOMAS & SUPPLEMENTAL STATEMENT
50
II. OSTEOPATHIC MOTIVATION
KNOWLEDGE OF THE PROFESSION TALKED TO A DO/LETTER FROM A DO
15
III. PRIMARY CARE MOTIVATION
INTEREST IN PRIMARY CARE
15
IV. OVERALL IMPRESSION
EXPOSURE TO MEDICINE
TOTAL RATING
100
OTHER COMMENTS: PLEASE USE OTHER SIDE
(REQUIRED)
Comments on Applicant
COMMENTS:
Interviewer
APPLICATION FOR EMIGRE PHYSICIANS PROGRAM (EPP)
Application Deadline: March 16, 2009
City State Zip code
Area code
Number
E-mail:
City State Zip code
Area code
Number
NOTE: Only U.S. Citizens or Permanent Residents** are eligible.
(Attach copy of citizenship papers/green card, front and back)
(** APPLICANTS MUST BE IN POSSESSION OF “GREEN CARD” AT TIME OF APPLICATION)
1 1 . Date of Birth: “”‘//”””/-‘-/ 11 a. Place of Birth (city, country) _ M DY
Mex. Amer/Chicano
_ Asian/Pac.Isl. —
White Other Hispanic _
Name, Relationship to you (e.g. spouse, child, etc.), Age
Institution Name Location Dates of Major Attendance Subject
Degree granted
or expected (Date)
Medical Specialty (if any) No. of years in practice
Title or Description Where Dates Level of Responsibility
Loans
Joseph Silny & Assocs. IERF
*22. TOEFL Score(s):
*ALL CANDIDATES MUST TAKE TOEFL / TOEFL
Scores Cannot Be Older Than 2 YEARS
If you plan to take or retake the TOEFL, enter date: / / mo.
yr .
(NYCOM’s TOEFL Code is #2486; copies cannot be accepted)
USMLE WILL NOT BE ACCEPTED IN LIEU OF TOEFL
All evaluations must be received directly from the evaluation service and are subject to approval by the New York College of Osteopathic Medicine.
Personal Comments: Please discuss your reasons for applying to the EPP program.
I certify that all information submitted in support of my application is complete and correct to the best of my knowledge. Date: Signature:
PLEASE MAIL APPLICATION AND FEE ($60.00 CHECK OR MONEY ORDER ONLY, PAYABLE TO NYCOM) TO:
2008-09 Academic Year Survey – First Year Students
TO THE STUDENTS: Your opinions and attitudes about your medical education, your plans for medical practice, and Information about your debt are very important as the colleges and the osteopathic profession develop and plan for the future of osteopathic medical education. Please take some time to complete the following questionnaire to help in planning the future of osteopathic medical education. The Information you provide in this survey will be reported only in aggregate or summary form; individually identifiable information will not be made available to the colleges or other organizations. The reason we ask for your identification is to allow for longitudinal studies linking your responses as first year students to your responses when this survey is readministered again in your fourth year.
Please print in Capital Letters:
Please fill in marks like this:
Last
Name Suffix
First Name
Osteopathic College
Middle Name
or Maiden Name if Married Woman U ing Husband’s Name
0 ATSU-SOMA 0 LECOM-Bradenton 0 OU-COM 0 TUNCOM
0 ATSU/KCOM 0 LECOM-PA 0 PCOM 0 UMDNJ-SOM
0 AZCOM 0 LMU-DCOM 0 PCSOM 0 UNECOM
0 CCOM 0 MSUCOM 0 PNWU-COM 0 UNTHSCffCOM
0 DMU-COM 0 NSU-COM 0 RVUCOM 0 VCOM
0 GA-PCOM 0 NYCOM 0 TOUROCOM 0 WestemU/COMP
0 KCUMB-COM 0 OSU-COM 0 TUCOM-CA 0 WVSOM
Part I: CAREER PLANS
Pl. Plans Upon Graduation: Please indicate what type of osteopathic internship you plan to do. (Choose only one.)
0 a. Traditional rotating
0 b. Special emphasis Indicate type: I. Anesthesiology 0 2. Diagnostic Radiology 0
3. Emergency Med. 0 4. Family Practice 0
5. General Surgery 0 6. Psychiatry 0
7. Pathology 0
0 C. Specialty track Indicate type: I. Internal Medicine 0 2. Internal Medicine/Peds. 0
3. Ob/Gyn 0 4. Otolaryn./Facial Plastic Surg. 0
5. Pediatrics 0 6. Urological Surgery 0
0
d. Pursue AOA/ACGME dual approved internship
0 e. Not planning osteopathic internship. Reason: I. Allopathic residency 0
2. Other 0
0 f. Undecided
Please specify
P2. a. Immediate Post-Internship Residency Plans: Select the one item that best describes your plans immediately after internship (or upon graduation if not planning an osteopathic internship).
0 I. Pursue osteopathic residency
0 2. Pursue a\lopathic residency (see Item P2b)
0 3. Pursue AONACGME dual approved residency (see Item P2b)
0 4. Enter governmental service (e.g.. military, NHS Corps, Indian Health Service, V.A., state/local health dept.) (see
Item P2b)
If you are not doing a residency, please indicate your post-internship plans.
0 5.
0 6.
0 7.
0 8.
0 9.
Practice in an HMO
Self-employed with or without a partner
Employed in group or other type of private practice (salary, commission, percentage) Other professional activity (e.g.. teaching, research, administration, fellowship) Undecided or indefinite post-graduation/internship plans
b. If you plan to pursue an allopathic or AOA/ACGME dual approved residency, please give all the reasons that apply to you.
0 I. Desire specialty training not available in osteopathic program
0 2. Believe better training and educational opportunities available
0 3. Located in more suitable geographic location(s)
0 4. Located in larger institutions
0 5. Better chance of being accepted in program
0 6. Allow ABMS Board certification
0 7. Opens more career opportunities
0 8. Military or government service obligation
0 9. Shorter training period
0 10. Higher pay
0 ll. Other, please specify
P3. Long-Range Plans: Select the one item that best describes your intended activity five years after internship and residency training.
0 I. Enter governmental service (e.g.. military, NHS Corps, Indian Health Service, V.A., state/local health dept.)
0 2. Practice in an HMO
0 3. Self-employed with or without a partner
0 4. Employed in group or other type of private practice (salary, commission, percentage)
0 5. Other professional activity (e.g., teaching, research, administration, fellowship)
0 6. Undecided or indefinite
P4. •a. Area of Interest: Select one specialty in which you are most likely to work or seek training.
0 I. Family Practice 0 17. Ob/Gyn including subspecialties
0 2. General Internal Medicine 0 18. Ophthalmology
0 3. Internal Medicine Subspecialty 0 19. Oto laryngo logy
0 4. Osteopathic Manip. Ther. & Neuromusculoskeletal Med. 0 20. Pathology including subspecialties
0 5. General Pediatrics 0 21. Physical Medicine & Rehabilitation Med.
0 6. Pediatrics Subspecialty 0 22. Preventive Medicine including subspec.
0 7. Allergy and Immunology 0 23. Proctology
0 8. Anesthesiology 0 24. Radiology (Diagnostic) including subspec.
0 9. Critical Care 0 25. Sports Medicine
0 10. Dennatology 0 26. General Surgery
0 11. Emergency Medicine 0 27. Orthopedic Surgery
0 12. Geriatrics 0 28. Surgery, subspecialty
0 13. Medical Genetics 0 29. Vascular Surgery
0 14. Neurology including subspecialties 0 30. Urology/Urological Surgery
0 15. Psychiatry including subspecialties 0 31. Undecided or Indefinite
0 16. Nuclear Medicine
P4b. Please select one item that best describes your plans for board certification.
0 I. AOA Boards (osteopathic)
0 2. ABMS Boards (allopathic) (see Item P4c)
0 3. Both boards (see Item P4c)
0 4.
0 5.
0 6.
Other, please specify
Not planning board certification Undecided or indefinite
c. If you selected ABMS or both boards in item P4b, please indicate all the reasons for your choice.
0 I. ABMS board certification is more widely recognized
0 2. ABMS board certification has more colleague acceptance
0 3. ABMS board certification carries more prestige
0 4. ABMS board certification provides more opportunities (career, residencies. etc.)
0 5. Personal desire for dual certification
0 6. Hospital privileges more readily obtained with ABMS board certification.
0 7. Licenses more readily obtained with ABMS board cer1i tication
0 8. Other. please specify
PS. Please indicate the importance of each of the following factors affecting your specialty choice decision. Use the scale below.
(/) Major Influence (2) Strong b,jluem:e (3) Moderate Influence (4) Minor lnjlue,ru (5) No Influence/NA
a. Intellectual content of the specialty (type of work. diagnostic programs, diversity) 0 0 0 0 0
b. Like dealing with people (type of person, type of patient) more than techniques 0 0 0 0 0
C. Prestige/income potential 0 0 0 0 0
d. Lifestyle (predictable working hours, sufficient time for family) 0 0 0 0 0
e. Like the emphasis on technical skills 0 0 0 0 0
f Role models (e.g., physicians in the specialty) 0 0 0 0 0
g. Peer influence (encouragement from practicing physicians, faculty. or other students) 0 0 0 0 0
h. Skills/abilities (possess the skills required for the specialty or its patient population) 0 0 0 0 0
I.
J. Debt level (level of debt, length of residency, high malpractice insurance premiums) Academic environment (courses, clerkships in the specialty area) 0
0 0
0 0
0 0
0 0
0
k. Opportunity for research/creativity 0 0 0 0 0
I. Desire for independence 0 0 0 0 0
m. Previous experience 0 0 0 0 0
P6. Answer only ONE item.
a. State (two-letter abbreviation) where you expect to
locate after completion of internship and residency?
b. Fill in ifnon-U.S. 0
c. Fill in if unknown/undecided 0
P7. a. What is the population of the city/town/area of legal residence where you plan to be employed or in practice after completion of internship or residency?
I. Major metropolitan area (1,000,001 or more) 0 7. Town under 2,500 0
b. Are you planning to practice in any underserved or shortage areas? Yes 0 No 0 Unsure 0
41
42
A6. Non-educational Debts You Will Incur While in
Medical School: Show the total amount of non- A7a. How many years do
you expect to take b. Do you anticipate
participating in a
educational school debt (such as car loans, credit cards, to repay the student loan con-
medical expenses, and living expenses) that you will indebtedness for solidation program
incur during medical school. Do not include your home
mortgage in this figure. If none, enter zero. your osteopathic
education? (Max for repayment?
Yrs. 30)
$ 0 Yes
0 © ® ® 0 0 0 © 0 No
0 0 0 0 0 0 0 0 0 Undecided
0 0 © 0 0 0 0 0
© © 0 0 0 © 0 0
0 0 0 0 0 0 0 0
© © 0 0 0 © 0 ©
© © 0 0 © © 0 0
0 0 0 0 0 0 0 0
© © © © © © © ©
0 © 0 © © © 0 ©
Part Ill: DEMOGRAPHIC DATA
This information is for classification purposes only and is considered confidential. Information will only be used by AACOM and affiliated organizations in totals or averages.
DI. Date of Birth I I D2. Sex: Male 0
Female 0
D3. Marital Status: Married/cohabiting 0
Single/other 0
D4. SSN
AACOM asks for your Social Security Number so that we can track data longitudinally-a similar survey is administered during graduation, and this number allows us to analyze changes in responses. AACOM provides reports to the COMs only in aggregate and does not include any individual identifiers.
DS. Dependents: Including yourself, how many dependents do you support financially? 2 3 4 5 or more
0 0 0 0 0
D6. Ethnic background: Indicate your ethnic identification from the categories below. Please mark all that apply.
0
er 0
on-Vietnamese) 0
0
0
D7. Citizenship Status: U.S.
Permanent Resident Other
0
0
0 Please specify
D8. State of Legal Residence: Use 2 letter postal abbreviation.
D9. Population of city/town/area of legal residence:
a. Major metropolitan area (1,000,001 or more) 0
b. Metropolitan area (500,001 – 1,000,000) 0
C. City (100,001 – 500,000) 0
d. City (50,001 – 100,000) 0
e. City or town (10,001 – 50,000) 0
f. City or town (2,50 I – I 0,000) 0
g. Town under 2,500 0
h. Other 0
Please specify
D10. a. Father’s Education: Select the highest level of education your father attained. Complete this item even ifhe is deceased.
I. Professional Degree (DO/MD, JD, DDS, etc.) 0
(See Item DIOb below)
b. If your father’s professional degree is in the Health Professions field, please select one of the following: DO/MD 0 Other 0
D11. a. Mother’s Education: Select the highest level of education your mother attained. Complete this item even if she is deceased.
I. Professional Degree (DO/MD, JD, DDS, etc.) 0
(See Item Dllb below)
b. If your mother’s professional degree is in the Health Professions field, please select one of the following:
DO/MD 0 Other 0
D12. Parents’ Income: Give your best estimate of your parents’ combined income before taxes for the prior year.
a. Less than $20,000 0 d. $50,000 – $74,999 0 g. $200,000 or more 0
b. $20,000 – $34,999 0 e. $75,000 – $99,999 0 h. Deceased/Unknown 0
c. $35,000 – $49,999 0 f. $100,000 – $199,999 0
D13. Financial Independence: Do you consider yourself financially independent from your parents? Yes 0
No 0
Thank you very much for your cooperation!
NEW YORK COLLEGE OF OSTEOPATHIC MEDICINE INTERVIEW EVALUATION FORM – ÉMIGRE PHYSICIANS PROGRAM
Applicant: Date:
State:
CATEGORY
CRITERIA TO BE ADDRESSED
VALUE
RATING
30
OVERALL RATING
100
INTERVIEWER RECOMMENDATION:
Accept
Reject
COMMENTS:
NAME:
SIGNED:
Pre-clinical course pass/failure rate as determined by class year (year 1 and year 2) and overall at end of year 2 (tracking each class and in aggregate for two years);
Failure rates of (components) Nervous System course or Behavior course;
Course grades (H/P/F);
Exam scores;
Scores (pass/fail rate) on Core Clinical Competency OSCE exams;
Professionalism Assessment Rating Scale (PARS)
Students determined as pre-clinical course dismissals (and remediated);
Students determined double course failure (and remediated);
Failure rates due to cognitive and/or OMM lab portions of course
Repeat students (aligned with Learning Specialist intervention)
Changes in academic status (attrition-as identified above);
End-of-year class rankings.
Specific forms/questionnaires utilized to capture the above-detailed information include the following:
Introduction to Osteopathic Medicine / Lecture-Based Discussion
Doctor-Patient Continuum (DPC) – Biopsychosocial Sciences I Grading and Evaluation Policy
DPC – Clinical Sciences II – Grading Policy
Assessing the AOA Core Competencies at NYCOM
Institute for Clinical Competence (ICC) Professionalism Assessment Rating Scale (PARS)
SimCom-T(eam) Holistic Scoring Guide
Case A – Dizziness, Acute (scoring guides) Samples of the forms/questionnaires follow
Introduction to Osteopathic Medicine / Lecture-Based Discussion
Grading and Evaluation
d. Anatomy Laboratory Examinations and Quizzes
i. There will be two Anatomy laboratory examinations in this course
ii. There will be Anatomy laboratory quizzes in this course, conducted during Anatomy laboratory sessions.
iii. For the purpose of determining passing for this course, each Anatomy lab examination
will be worth 45% of students’ final Anatomy lab score and all Anatomy lab quizzes combined will be worth 10% of students’ final Anatomy lab score. This weighting is illustrated in the following table:
Summary of Anatomy Lab Exam/Quiz Score Breakdown
Anatomy Lab Exam/Quiz # % of Final Anatomy Score
Anatomy Lab Exam #1 45%
Anatomy Lab Exam #2 45%
Anatomy Lab Quizzes 10%
Total Anatomy Lab Exam/Quiz Score 100%
DOCTOR PATIENT CONTINUUM(DPC) – BIOPSYCHOSOCIAL SCIENCES I
Grading and Evaluation Policy:
The examinations and evaluations are weighed as follows:
Evaluation Criteria: Percent of Grade
Content Examination 55%
Component Examinations 25%
Facilitator Assessment 20%
Content Examination: There will a mid-term exam and an end of the term exam, each weighted equally. The examinations will cover the learning issues submitted by the case-study groups. Questions will be based on the common learning issues (covered by all groups) and learning issues specific to individual groups (unique issues).
Component Exams: Distribution of the component exams will be as follows:
• Exams based on Anatomy lectures and labs = 20%
• Graded assignments offered by problem set instructors, which might include quizzes, position papers, and/or other exercises = 5%
Facilitator Assessment: Facilitators will meet individually with students twice during the term to evaluate their performance. The first evaluation will be ‘formative’ only, i.e., to advise students of their progress and will not be recorded for grade. The end of the term evaluation will be used to assess the student’s progress/participation in the group and other class related activities. Students will also complete Self-Assessment Forms to supplement the evaluation process.
The grading of this course is on a “PASS/FAIL/HONORS” basis.
1) Students will be evaluated each Term using the multiple components as described above.
2) Each year at the end of the 1st Term:
a) All students will be assigned an interim grade of I (Incomplete);
b) Each student will be informed of his/her final average, a record of which will be maintained in the office of the DPC Academic Coordinator and the Director of the DPC program.
3) Students who earn less than a 1st-Term average of 70%, or a content exam score of <65%, will be officially informed that their performance was deficient for the 1st Term. The student, in consultation with the Course Coordinator, will present a plan designed to resolve the deficiency. This information will also be forwarded to the Associate Dean of Academic Affairs for tracking purposes.
4) Students with a 1st-Term average <70%, or a content exam score of <65%, will be allowed to continue with the class. However, in order to pass the year the student must achieve a final yearly average (1st- and 2nd- term) of 70% or greater with a content exam average (for the two Terms) of 65% or greater.
5) All students who meet the requirements for passing the year (see 4) will then be awarded the grade of P (Pass) or H (Honors) for each of the two Terms.
6) Students who fail the year (see 4) will be awarded a grade of I (Incomplete) and will be permitted (with approval of the Associate Dean for Academic Affairs) to sit for a comprehensive reassessment-examination. The reassessment exam will be constructed by the course faculty and administered by the Course Coordinator. The exam may include both written and oral components. Successful completion of the reassessment examination will result in the awarding of a grade of P for the two Terms. Failure of the comprehensive reassessment exam will result in the awarding of a grade of F (Fail) for the two terms, and a recommendation to the Associate Dean of Academic Affairs that the student be dismissed from the College.
7) Students whose failure of the year (i.e. overall yearly average <70%) can be attributed to low facilitator assessment scores present a special concern. The student has been determined, by his/her facilitators, to be deficient in the skills necessary to effectively interact with patients and colleagues. This deficiency may not be resolvable by examination. Such failures will be evaluated by the Director of the DPC program, the Associate Dean of Academic Affairs and/or the Committee on Student Progress (CSP) to determine possible remediation programs or to consider other options including dismissal.
DOCTOR PATIENT CONTINUUM(DPC) – CLINICAL SCIENCES II
Grading Policy:
Evaluation Criteria: Percent of Grade
OMM 40%
Clinical Skills 40%
Clinical Practicum 20%
In both the OMM and Clinical Skills components of the course, student evaluations will encompass written and practical examinations. In order to pass the course, both the written and practical examinations in OMM AND Clinical Skills must be passed. Students who fail to achieve a passing score in either Clinical Skills or OMM will be issued a grade of “I” (Incomplete). Such students will be offered the opportunity to remediate the appropriate portion of the course. Re-evaluation will be conducted under the supervision of the DPC faculty. Successful completion of the re-evaluation examination, both written and practical, will result in the awarding of a grade of P (Pass). Failure of the comprehensive reassessment exam will result in the awarding of a grade of U (Unsatisfactory) for this course.
Evaluation Criteria: Percent of Grade
OMM written (weighted) 50%
OMM practical (average) 50%
Evaluation Criteria: Percent of Grade
Attendance and Participation 15%
Case Presentation 35%
Clinical Mentor Evaluation 50%
Evaluation Criteria: Percent of Grade
Class participation/assignments 5%
ICC participation/assignments 10%
Timed examination #1
– Practical portion 20%
– Written portion 5%
Timed examination #2
– Practical portion 20%
– Written portion 5%
Timed Comprehensive examination
– Practical portion 25%
– Written portion 10%
Pre-clinical Years: Years I and II DPC Track
Assessing the American Osteopathic Association (AOA) Core Competencies at New York College of Osteopathic Medicine (NYCOM)
A. Background
In recent years, there has been a trend toward defining, teaching and assessing a number of core competencies physicians must demonstrate. The Federation of State medical Boards sponsored two Competency-Accountability Summits in which a “theoretical textbook” on good medical practice was drafted to guide the development of a competency-based curriculum. The competencies include: medical knowledge, patient care, professionalism, interpersonal communication, practice-based learning, and system-based practice. The AOA supports the concepts of core competency assessment and added an additional competency: osteopathic philosophy and osteopathic clinical medicine.
Arguably it is desirable to begin the process of core competency training and assessment during the pre-clinical year. Patient simulations, i.e. using standardized patients and robotic simulator, allow for such training and assessment under controlled conditions. Such a pre-clinical program provides basic clinical skills acquisition in a patient-safe environment. NYCOM has responded to this challenge by creating a two-year “Core Clinical Competencies” seminar that requires students to learn and practice skills through various patient simulations in the Institute For Clinical Competence (ICC). In this seminar the ICC assesses a sub-set of the above competencies taught in the lecture-based and discussion-based clinical education tracks.
The following is a list of the competencies assessed during the pre-clinical years at NYCOM, and reassessed during the third year (osteopathic medicine objective structured clinical examination) and fourth year (voluntary Clinical Skills Capstone Program). It should be noted that there is a fair amount of skills overlap between the competencies, for example, the issue of proper communication can be manifested in a number of competencies.
B. Core Clinical Competencies
Skills:
• Data-gathering: history-taking, physical examination (assessed with clinical skills checklists)
• Develop differential diagnosis
• Interpret lab results, studies
• Procedural skills, e.g. intubation, central line placement, suturing, catheterization
• Provide therapy
Skills:
• Communication with patients and their families across a spectrum of multicultural backgrounds (assessed with the Professionalism Assessment Rating Scale)
• Health team communication
• Written communication (SOAP note, progress note)
Skills:
• Compassion, respect, integrity for others
• Responsiveness to patient needs
• Respect for privacy, autonomy
• Communication and collaboration with other professionals
• Demonstrating appropriate ethical consideration
• Sensitivity and responsiveness to a diverse patient population including e.g. gender, age, religion, culture, disabilities, sexual orientation.
Skills:
• Utilize caring, compassionate behavior with patients
• Demonstrate the treatment of people rather than the symptoms
• Demonstrate understanding of somato-visceral relationships and the role of the musculoskeletal disease
• Demonstrate listening skills in interaction with patients
• Assessing disease (pathology) and illness (patient’s response to disease)
• Eliciting psychosocial information C. Assessment of Core Competencies
The ICC utilizes formative assessment to evaluate learner skills and the effectiveness of NYCOM’s clinical training programs. Data on student performance in the ICC is tracked from the first through the fourth year. The ICC satellite at St. Barnabas assesses students during their clerkship years as well as interns and residents in a number of clinical services. It uses a variety of methods to assess competencies:
Core Clinical Competencies 590 (MS 1)
Core Clinical Competencies 690 (MS 2)
The courses provide a horizontal integration between clinical courses provided by the LDB and DPC programs (small group discussion and demonstration) and the OMM department. It provides practice with simulated patients (some variation in this aspect as noted below), formative assessment, end-of-year summative assessment and remediation.
DPC
Clinic visits to substitute for SP encounters
End of year OSCE (same as LDB)
Hours: Should be equivalent to the number of SP hours in the LDB program
NOTE: The purpose of the OSCE is to assess the clinical training of both the LDB and DPC programs. It is assumed the LDB and DPC faculty will work on this OSCE together with the OMM department.
MS 1 Program – Patient Simulation Program
LDB and DPC
Same program in basic procedures for both LDB and DPC students as outlined in the syllabus distributed during the curriculum committee
Hours: 5 hours / year
MS 2 Program – SP
LDB and DPC – same program, different approaches, same standardized exam
SP program: training with formative assessment (see next bullet for formative assessment metrics)
End of year OSCE assessing history-taking (checklists designed for each SP case), PE (see attached physical examination criteria) and interpersonal communication (see attached program in doctor-patient communication “Professionalism Assessment Rating Scale)
Hours: 13.5 hours / year (including OSCE)
NOTE: It is assumed that the LDB and DPC program schedules will vary but that the content will be equivalent
MS 2 Program – Patient Simulation Program
LDB and DPC – same program, same standardized exam
Students work in the same group throughout the year
End of year OSCE assessing medical team communication using the SimCom-T rating scale (attached)
Group grade assigned for the OSCE (reflecting the spirit of the SimCom-T rating scale)
Hours: 11 / year (including OSCE)
NOTE: Make ups will be done as close to an activity as possible because delaying them, e.g. to the end of the year, will incur additional training expenses (e.g. re-training a SP for a case played months earlier) for the ICC.
ICC Hours
MS1 Clinical Practice OSCE Total Hours
LDB 8 SP exercises @1.5 hours each 12 hours per student End-of-year SP OSCE
1.5 hours per student (approximately 6.25 days) 13.5 hours (SP)
5 patient simulation program exercises @ 1 hours each
5 hours per student
5 hours (Pat Sim)
Total = 18.5
DPC Clinic experience to substitute for SP exercises
Students will receive information re: communication and PE competencies 0 hours (SP)
5 patient simulation program exercises @ 1 hours each
5 hours per student
5 hours Pat Sim
Total = 5
MS2 Clinical Practice OSCE Total Hours
LDB DPC 8 SP exercises @1.5 hours each 12 hours per student End-of-year SP OSCE
1.5 hours per student (approximately 6.25 days) 13.5 hours (SP)
6 patient simulation program exercises, plus ACLS 10 hours per student
End-of-year Pat Sim OSCE 1 hour per student (approximately 5 days)
11 hours (Pat Sim)
Total = 24.5
Institute For Clinical Competence (ICC)
Professionalism Assessment Rating Scale (PARS)
Dear Students:
As part of your professional development, standardized patients (SPs) in the ICC will be evaluating your interpersonal communication with them using the Professionalism Assessment Rating Scale (PARS).
This scale evaluates two types of interpersonal communication, both important to quality health care:
■ Patient Relationship Quality – Rapport, empathy, confidence and body language.
■ Patient Examination Quality – Questioning, listening, information exchanging and careful and thorough physical examination.
Arguably patients (real or simulated) are in the best position to assess your interpersonal communication with them because you are directly relating to them during an intimate, face-to- face, hands-on encounter. They are in the best position, literally, to observe your eye contact, demeanor and body language because they are in the room with you. We would recommend you take their feedback seriously, but perhaps “with a grain of salt.”
The term standardized patient is to some degree a misnomer – SPs can be standardized to present the same challenge and the same medical symptoms to each student, but they cannot be standardized to feel the same way about you and your work with them compared to other students. This is true in life as well as clinical work – some people will like you better than others, and patients are people! You may communicate with one patient the way you do with the next, but receive slightly different ratings. This is to be expected. Unlike the analytic checklists we use to document if you asked particular questions or performed certain exams correctly, there are no dichotomous / “right or wrong” communication ratings. Patients are people who may tune into different things during an encounter. We think this slight variation in observation is an asset that will help you understand that patients are individuals who must be approached as individuals.
Another word about the ratings you will receive – the ratings are not absolute numbers that constitute an unconditional assessment of your communication skills. Some days you may be better than other days. We use the ratings numbers (1-8 holistic scale) to chart progress over time. We do see improvements during the first two years of the typical student’s training but the ratings are used to track your progress as much as to structure a conversation with the SP, or faculty member, during debriefing. We would recommend you take responsibility during SP debriefing and ask them questions about the work you just did.
The holistic 1 – 8 scale is broken down into two parts: Ratings of 1 – 4 are considered “lower quality” communication, i.e. what might be considered acceptable at a novice or trainee level, but less acceptable for an experienced professional. Ratings of 5 – 8 are considered “higher quality” communication, i.e. more professional-quality communication regardless of the training or experience level.
© 2007 NYCOM Do not reproduce or distribute without permission 9/4/07
Professionalism Assessment Rating Scale (PARS)
Standardized patients will rate “to what degree” you demonstrated relationship quality and
examination quality on the following nine factors:
RELATIONSHIP QUALITY Lower Higher
Quality Quality
To what degree did the student …
1 Establish and maintain rapport 1 2 3 4 5 6 7 8
2 Demonstrate empathy 1 2 3 4 5 6 7 8
3 Instill confidence 1 2 3 4 5 6 7 8
4 Use appropriate body language 1 2 3 4 5 6 7 8
EXAMINATION QUALITY
To what degree did the student … Lower Higher
Quality Quality
5 Elicit information clearly, effectively 1 2 3 4 5 6 7 8
6 Actively listen 1 2 3 4 5 6 7 8
7 Provide timely feedback / information / counseling 1 2 3 4 5 6 7 8
8 Perform a thorough, careful physical exam or
treatment 1 2 3 4 5 6 7 8
Less experienced, More
or unprofessional professional
The following pages are a guide to the PARS, giving examples of “lower quality” and “higher quality” communication.
1 Establish and maintain rapport
Establish and maintain a positive, respectful collaborative working relationship with the patient.
Lower Quality
1 2 3 4 Higher Quality
5 6 7 8
Overly familiar.
■ “Hi Bill, I’m John. How are you doing today.” Appropriate address, e.g.
■ “Hi Mr. Jones, I’m Student-doctor Smith. Is it OK if I call you Bill?”
No agenda set.
No collaboration with the patient, i.e. carries out the exam without patient consent or agreement. Set agenda, e.g.
■ “We have minutes for this exam. I’ll take a history, examine you…..etc.”
Collaborative mindset
■ “Let’s figure out what’s going on.”
■ “We’re going to work out this problem together.”
Took notes excessively, i.e. spent more time
taking notes than interacting. Spent more time interacting with the patient than
taking notes.
Began physically examining patient without
“warming” patient up, asking consent, etc. Asked consent for obtaining a physical
examination, e.g.
■ “Is it OK for me to do a physical exam?”
Did not protect patient’s modesty, e.g.
■ Did not use a drape sheet
■ Did not direct patient to get dressed after exam
■ Left door open when examining patient. Respected patient’s modesty at all times e.g.
■ Used a drape sheet when appropriate
■ Letting patient cover up follow an examination.
Talked “down” to patient, did not seem to
respect patient’s intelligence. Seemed to assume patient is intelligent.
Rude, crabby or overtly disrespectful. Never rude, crabby; always respectful.
Dress, hygiene problems:
■ Wore distracting perfume/cologne.
■ Poor hygiene, e.g. uncleanly, dirty nails, body odor, did not wash hands, etc.
■ Touched hair continually
■ Unprofessional dress, e.g. wore jeans, facial jewelry (e.g. tongue or nose studs), overly suggestive or revealing garments Dressed professionally, i.e. in a clean white coat,
clean clothes, etc.
Seemed angry with the patient. Seemed to like the patient.
2 Demonstrate empathy
Demonstrate both empathy (compassion, understanding, concern, support) and inquisitiveness (curiosity, interest) in the patient’s medical problem and life situation.
Lower Quality
1 2 3 4 Higher Quality
5 6 7 8
EMPATHY
No expressions of concern about patient’s
condition or situation. Expressed concern about patient’s condition or
situation, e.g.
■ “That must be painful.”
■ “I’m here to try to help you.”
Failed to acknowledge positive behavior /
lifestyle changes the patient has made. Reinforced behavior/lifestyle changes the patient
has made, e.g. “That’s great you quit smoking.”
Failed to acknowledge suggested behavior /
lifestyle changes might be difficult. Acknowledged that suggested behavior/lifestyle
changes might be difficult.
Empathic expression seemed insincere,
superficial. Empathic expressions seemed genuine.
Detached, aloof, overly “business-like,” robotic in
demeanor.
Seeming lack of compassion, caring. Compassionate and caring, “warm.”
Accused patient of being a non-compliant, e.g.
■ “Why don’t you take better care of yourself?”
■ “You should have come in sooner.” Positive reinforcement of things patient is doing
well, e.g.
■ “That’s great that you stopped smoking.”
■ “I’m glad you are taking your medication on a regular basis.
INQUISITIVENESS – An aspect of empathy is inquisitiveness, the ability to attempt to understand the patient, both medically and personally.
Focused on symptoms, but not the patient, i.e.
did not explore how the medical problem / symptoms affect the patient’s life.
Failed to explore activities of daily living. Tried to understand how the medical problem /
symptoms affect the patient’s life, or vice versa.
■ “How is this affecting your life?”
■ “Tell me about yourself.”
■ “Describe a typical day in your life.”
■ “Tell me about your stress.”
Failed to explore patient’s response to diagnosis
and / or treatment. Inquires as to patient’s response to diagnosis and
/ or treatment
Failed to explore barriers to behavior / lifestyle
change. Explored barriers to behavior / lifestyle change.
3 Instill confidence
Instilling confidence that the medical student or doctor is able to help and treat the patient.
Lower Quality
1 2 3 4 Higher Quality
5 6 7 8
Conveyed his / her anxiety, e.g.
■ By avoiding eye contact
■ Laughing or smiling nervously
■ Sweaty hand shake
Made statement such as:
■ “This is making me nervous.”
■ “This is the first time I’ve ever done this.”
■ “I don’t know what I’m doing.” Conveyed an appropriately confident demeanor,
e.g.
■ Made eye contact
■ Shook hands firmly, etc.
Apologized inappropriately to the patient. E.g.
■ “I’m sorry, but I have to examine you.”
Overly confident, cocky. Never cocky, appropriately humble without
undermining the patient’s confidence.
When making suggestions, used tentative
language, e.g.
■ “Maybe you should try…” When making suggestions, used authoritative
language, e.g.
■ “What I suggest you do is…”
■ “I’m not sure but …”
Made excuses for his/her lack of skill or
preparation by making statements such as:
■ “I’m just a medical student.” Offered to help the patient or get information if he
/ she could not provide it by saying, e.g.
■ “They didn’t explain this to me.”
■ “Do you know what I’m supposed to do next?” ■ “Let me ask the attending physician”
■ “I don’t know but let me find out for you.”
4 Use appropriate body language
The ability to use appropriate gestures, signs and body cues.
Lower Quality
1 2 3 4 Higher Quality
5 6 7 8
Overly casual posture, e.g. leaning against
the wall or putting feet up on a stool when interviewing the patient. Professional posture, i.e. carried himself / herself
like an experienced, competent physician.
Awkward posture, e.g.
• Stood stiffly when taking a history
• Stood as if he / she was unsure what to do with his / her body. Natural, poised posture.
Uncomfortable or inappropriate eye contact
e.g. stared at the patient too long and / or never looked at the patient. Used appropriate eye contact.
Avoided eye contact when listening. Made eye contact when listening, whether eye
level of not.
Stood or sat too close or too distant from the
patient. Maintained an appropriate “personal closeness”
and “personal distance.”
Turned away from the patient when listening. Maintained appropriate body language when
listening to the patient.
5 Elicit information clearly, effectively
Effectively ask questions in an articulate, understandable, straightforward manner.
Lower Quality
1 2 3 4 Higher Quality
5 6 7 8
Used closed-ended, yes / no questions
exclusively, e.g.
■ “How many days have you been sick?”
■ “Ever had surgery?”
■ “Any cancer in your family?” Used open-ended questions to begin an inquiry,
and closed-ended questions to clarify, e.g.
■ “Tell me about the problem.”
■ “What do you do in a typical day?”
■ “How is your health in general?”
Used open-ended questions / non-clarifying
questions exclusively. Used open-ended questions to begin an inquiry,
and closed-ended questions to clarify.
Student’s questions were inarticulate, e.g.
mumbled, spoke too fast, foreign accent problems, stuttered*, etc.
■ “Tell me about your past medical conditions, surgeries and allergies.” Asked one question at a time, in a straight-forward
manner.
■ “Tell me about your allergies.”
Asked leading questions, e.g.
■ “No cancer in your family, right?”
■ “No surgeries?”
■ “You only have sex with your wife, right?” Asked direct questions, e.g.
■ “Do you have any cancer in your family?
■ “Any surgeries?”
■ “Are you monogamous?”
Jumped from topic to topic
in a “manic,” disjointed or disorganized way. Organized interview.
Stayed focused, asked follow up questions before moving to another topic.
Asked questions in a robotic way,
i.e. as if reading from a prepared checklist. Asked questions in a conversational way, i.e.
listened to the response, and then asked another question.
Constantly cut off patient, i.e. did
not let patient finish sentences. Allowed patient to finish sentences and thoughts
before asking the next question.
6 Actively listen
Both listen and respond appropriately to the patients’ statements and questions.
Lower Quality
1 2 3 4 Higher Quality
5 6 7 8
Asked questions without listening to the
patient’s response. Asked questions and listened to patient’s
response.
No overt statements made indicating he / she
was listening. Said, e.g. “I’m listening.”
Turned away from the patient when listening. Maintained appropriate body language when
listening to the patient.
Kept asking the same question(s) because
the physician didn’t seem to remember what he / she asks. If necessary, asked the same questions to obtain
clarification, e.g.
■ “Can you tell me again how much you smoke?”
■ “I know you told me this, but when was the last time you saw your doctor?”
Wrote notes without indicating he / she was
listening. When writing indicated he / she is listening, e.g.
■ “I have to write down a few things down when we talk, OK?”
Did not seem to be listening, seemed
distracted. Attentive to the patient.
Kept talking, asking questions, etc. if the
patient was discussing a personal issue, a health concern, fear, etc. Was silent when necessary, e.g. if the patient was
discussing a personal issue, a health concern, fear, etc.
7 Provide timely feedback / information / counseling
Explain, summarize information (e.g. results of physical exams, provides patient education activities, etc.), or provide counseling in a clear and timely manner.
Lower Quality
1 2 3 4 Higher Quality
5 6 7 8
Did not explain examination procedures, e.g. just started examining the patient without explaining what he / she was doing.
Explained procedures, e.g.
■ “I’m going to check your legs for edema.”
■ “I’m going to listen to your heart.”
Did not provide feedback at all, or provided minimal feedback Periodically provided feedback regarding what he / she heard the patient saying.
■ “It sounds like your work schedule makes it difficult for you to exercise.”
■ “I hear in your voice that your family situation is causing you a lot of stress.”
Did not summarize information at all. Periodically summarized information.
■ “You had this cough for 3 weeks, it’s getting worse and now you’ve got a fever. No one is sick at home and you haven’t been around anyone who is sick.”
Provided empty feedback or unprofessional feedback, e.g. Feedback was meaningful, useful and timely.
■ “OK…..OK…..OK…..OK…”
■ “Gotcha..gotcha…gotcha,..”
■ “Great ” “Awesome” “Cool”
Examined the patient without providing feedback about the results of the exam. Provided feedback about results of the physical exam.
■ “Your blood pressure seems fine.”
Refused to give the patient information he / she requested, e.g.
“You don’t need to know that.” “That’s not important.” Give information to the patient when requested, or offered to get it if he / she couldn’t answer the patient’s questions.
Used medical jargon without explanation, e.g.
■ “What you experienced was a myocardial infarction.” Explained medical terms.
■ “What you experienced is a myocardial infarction, meaning a heart attack.”
Ended the exam abruptly.
No closure, no information about the next steps Let the patient know what the next step was, provided closure.
■ “Let’s review the exam and your health…”
8 Conduct a thorough, careful physical exam or treatment
Conduct physical exams and / or treatment in a thorough, careful manner vs. a tentative or superficial manner.
Lower Quality
1 2 3 4 Higher Quality
5 6 7 8
Conducted a superficial examination, e.g.
■ Avoided touching the patient
■ Touched patient with great tentativeness Conducted a careful examination, e.g.
■ Examined on skin when appropriate
Hurried through the exam. Used the full amount of time allotted to examine
the patient.
Avoided inspecting (looking at) the patient’s
body / affected area. Thoroughly inspected (looked at) the affected
area e.g. with gown open.
Consistently palpated, auscultated and / or
percussed over the exam gown. Consistently palpated, auscultated and / or
percussed on skin.
Exam not bi-lateral (when appropriate). Bi-lateral exam (when appropriate).
Rough exam, e.g.
■ Started, stopped, re-started the exam.
■ Fumbled with instruments Conducted a smooth exam from beginning to
end.
Did not look to see what patient’s expressions
were during an examination in order to assess pain. Looked for facial expressions to assess pain.
Did not thoroughly examine the site of the
chief complaint, e.g.
■ Did not examine heart and / or lungs if chief complaint was a breathing problem Thoroughly examined the site of the chief
complaint.
9 Conduct the examination in an organized manner
Overall conduct the exam in an organized, systematic way vs. a disorganized or unsystematic way.
Lower Quality
1 2 3 4 Higher Quality
5 6 7 8
No clear opening, e.g.
■ Did not set an agenda
■ Abruptly began the exam
Medical interview not organized – history jumped from topic to topic
No clear closure, e.g.
■ Did not summarize information gathered during the history and physical examination
■ Did not ask patient “Any more questions?”
■ Did not clarify next steps Clear opening, e.g.
■ Set an agenda and followed it
■ Began the exam after a proper introduction
Organize the medical interview vs. jumping from topic to topic
Clear closure, e.g.
■ Summarized information gathered during the history and physical examination
■ Asked patient “Any more questions?”
■ Clarified next steps
SimCom-T(eam) Holistic Scoring Guide
The SimCom-T is a holistic health care team communication training program and rating scale. The nine-factor scale of SimCom-T rates team members’ performance as a unit, i.e. individual team member performance should be considered a reflection upon the entire team.
Rate each factor individually.
Ratings should be global, i.e. reflect the most characteristic performance of the team vs. individual incidents.
Competency Lower Higher
Quality Quality
1 Leadership establishment and maintenance 1 2 3 4 5 CNE
2 Global awareness 1 2 3 4 5 CNE
3 Recognition of critical events 1 2 3 4 5 CNE
4 Information exchange 1 2 3 4 5 CNE
5 Team support 1 2 3 4 5 CNE
6 External team support 1 2 3 4 5 CNE
7 Patient support 1 2 3 4 5 CNE
8 Mutual trust and respect 1 2 3 4 5 CNE
9 Flexibility 1 2 3 4 5 CNE
10 Overall Team Performance 1 2 3 4 5 CNE
The following pages are a guide to SimCom-T, providing behavioral examples representative of each score for the SimCom-T competencies.
Score Performance Level Description – The team…
1 Limited ….consistently demonstrates novice and / or dysfunctional team attributes
2 Basic ….inconsistently operates at a functional level
3 Progressing ….demonstrates basic and average attributes
4 Proficient ….proficient and consistent in performance
5 Advanced ….experienced and performing at a significant expert level
CNE Not applicable ….A factor could not be evaluated for some reason
Team members both establish leadership and maintain leadership throughout.
Lower Quality Higher Quality
Score 1 2 3 4 5 CNE
Level Limited Basic Progressing Proficient Advanced
Description ▪ Leader not established
▪ Roles not assigned
▪ No discussion regarding role assignment ▪ Unable to identify leader
▪ Many leaders
▪ No clear role definition ▪ Leadership not explicit throughout event
▪ Leadership not maintained throughout the event
▪ Role switching without leader involvement ▪ Leader explicitly identified
▪ Roles defined ▪ Leadership explicitly identified and maintained
▪ Roles defined and maintained
▪ Leader delegates responsibility
Examples ▪ Team operating dysfunctionally without a leader
▪ Team members taking on similar roles and role switching consistently
▪ Team members unsure of who is responsible for different tasks ▪ Leader timid and does not take charge
▪ Team member roles unclear and/or inconsistent ▪ A team member asks, “Who is running the code?” and another says, “I am,” but does not take communicate leadership responsibilities.
▪ Team members are assigned roles but do not take on the assignment ▪ Team members select a leader
▪ A team member volunteers to handle the situation
▪ Roles clearly defined by team members and/or leader ▪ Leadership and roles are established very early in the event and is maintained throughout the event
▪ Clarity of leadership and roles is evident throughout the event and with the team members
Team members monitor and appropriately respond to the total situation, i.e. the work environmental and the patient’s condition.
Lower Quality Higher Quality
Score 1 2 3 4 5 CNE
Level Limited Basic Progressing Proficient Advanced
Description ▪ Does not monitor the environment and patient
▪ Does not respond to changes in the environment and
patient ▪ Monitoring and response to changes in the environment and patient rarely occur
▪ Fixation errors ▪ Monitoring and response to the environment and patient are not evident throughout the event ▪ Monitors the environment and patient
▪ Respond to changes in the environment and patient ▪ Consistently monitors the environment and patient
▪ Consistently respond to changes in the environment and
patient
Examples ▪ There is no summary of procedures, labs ordered, or results of labs
▪ Team is task oriented and does not communicate about the event ▪ Event manager loses focus and becomes task oriented
▪ There is no clear review of the lab results and/or summary of procedures. ▪ Leader says, “Team, lets review our differential diagnosis and labs,” and team does not respond to the leader.
▪ Some of the team members discuss among themselves results and possible problems. ▪ Leader says, “Team, lets review our differential diagnosis and labs,” and team reviews the situation.
▪ ▪ Event manager remains at the foot of the bed keeping a global assessment of the situation
▪ Leader announces plan of action for the event.
Team promptly notes and responds to critical changes in the patient’s status and / or environment.
Lower Quality Higher Quality
Score 1 2 3 4 5 CNE
Level Limited Basic Progressing Proficient Advanced
Description ▪ Does not monitor or respond to critical deviations from steady state
▪ Fails to recognize or acknowledge crisis
▪ “Tunnel Vision” ▪ Fixation errors are consistently apparent
▪ ▪ Team reactive rather than proactive
▪ Critical deviations from steady state are not announced for other members ▪ Monitors and responds to critical deviations from steady state
▪ Recognizes need for action ▪ All team members consistently monitors and responds to critical deviations from steady state
▪ Anticipates potential problems
▪ Practices a proactive approach and attitude
▪ Recognizes need for action
▪ “Big Picture”
Examples ▪ Patient stops breathing, and team does not recognize the situation throughout the event
▪ Patient is pulseless, and no CPR is started throughout the event ▪ Patient stops breathing, and team does not recognize this situation for a critical time period
▪ Patient is pulseless, and no CPR is started for a critical time period ▪ ▪ Leader says, “Team, lets review our differential diagnosis, are there any additional tests that we should request?” ▪ “John, the sats are dropping, please be ready, we might have to intubate.”
▪ “Melissa, the blood pressure is dropping. Get ready to start the 2nd IV and order a type and cross.”
Patient and procedural information is exchanged clearly.
Lower Quality Higher Quality
Score 1 2 3 4 5 CNE
Level Limited Basic Progressing Proficient Advanced
Description ▪ Communication between team members is not noticeable
▪ Requests by others are not acknowledged
▪ No feedback loop
▪ No orders given ▪ Vague communication between team members
▪ Not acknowledging requests by others
▪ Feedback loop left opened
▪ Orders not clearly given ▪ Communication between team and response to requests by others inconsistent
▪ Feedback loops open and closed
▪ Orders not directed to a specific team member ▪ Team communicates and acknowledges requests throughout the event
▪ Feedback loops closed ▪ Explicit communication consistently throughout the event
▪ Team acknowledges communication
▪ Closed loop communication throughout event
Examples ▪ No summary of events.
▪ No additional information sought from the team members. ▪ Event manager says, “I need a defibrillator, we might have to shock this patient,” and no team member acknowledges the order. The request was not given explicitly to a team member.
▪ ▪ One team member says to another in a low voice, “We need to place a chest tube,” but the event manager does not hear the communication.
▪ Event manager requests a defibrillator, but not explicitly to a particular team member; several team members
attempt to get the defibrillator ▪ Jonathan says to event manager, “We need to place a chest tube.” Event manager responds, “OK, get ready for it.”
▪ Leader says, “Team, lets summarizes what has been done so far.”
▪ Leader says, “Mary please start an IV.” Mary responds, “Sorry, I do not know how, please ask someone else to do
it.” ▪ Event manager summarizes events.
▪ Event manager seeks additional information from all team members
▪ Event manager says, “Peter, I want you to get the defibrillator, we might have to shock this patient.” Peter responds, “Yes, I know where it is and I’ll get it.”
The team works as a unit, asking for or offering assistance when needed vs. team members “going it alone.”
Lower Quality Higher Quality
Score 1 2 3 4 5 CNE
Level Limited Basic Progressing Proficient Advanced
Description ▪ No assistance or help asked for or offered
▪ Team members act unilaterally
▪ No recognition of mistakes
▪ Team members watching and not
participating ▪ Team members take over when not needed
▪ Mistakes not addressed to the team
▪ Negative feedback ▪ Assistance is offered when needed only after multiple requests ▪ Team recognizes mistakes and constructively addresses them ▪ Team member(s) ask(s) for help when needed
▪ Assistance provided to team member(s) who need(s) it
Examples ▪ During a shoulder dystocia event, the critical situation is recognized, but no help is requested or attempts to resolve situation on their own
▪ Wrong blood type delivered and administered, an no backup behaviors to correct the mistake
▪ Team member administers medication without consulting the event manager ▪ Charles knows that the patient is a Jehovah Witness and does not let the team know when a T&C is ordered.
▪ Team does not communicate that he/she doesn’t know how to use a defibrillator and attempts to do it anyways and fails. ▪ ▪ ▪ During a shoulder dystocia event, the critical situation is recognized, and event manager calls for help
▪ Wrong blood type delivered, attempt made by team member to administer the blood but another team member recognizes the mistake and stops the transfusion before it starts
▪ Team member consults with the event manager before administering
medication
Work team provides “external team” (family members and / or other health care professionals) with information and support as needed
Lower Quality Higher Quality
Score 1 2 3 4 5 CNE
Level Limited Basic Progressing Proficient Advanced
Description ▪ Team fails to recognize or interact with other significant people who are present during the encounter ▪ Team recognizes other significant people who are present during the encounter but ignores to interact
with them ▪ Team inconsistently interacts with other significant people who are present during the encounter ▪ Team interacts with other significant people who are present during the encounter ▪ Team effectively interacts with other significant people who are present during the encounter
Examples ▪ Team fails to interact with a distraught family member and/or para-professional ▪ Team fails to interact appropriately with a distraught family member
▪ Team does not cooperate with a para-professional ▪ ▪ ▪
Work team provides the patient and significant others with information and emotional support as needed.
Lower Quality Higher Quality
Score 1 2 3 4 5 CNE
Level Limited Basic Progressing Proficient Advanced
Description ▪ Team fails to interact with patient if conscious
▪ Team fails to show empathy or respect for a patient (conscious or unconscious)
▪ Team fails to provide appropriate information when requested to do so ▪ Teams interaction with patient is minimal and when done so is lacking in respect or empathy ▪ Team inconsistently shows empathy or respect for a patient (conscious or unconscious)
▪ Team inconsistently provides information when requested to do so ▪ Team shows empathy toward patient
▪ Team provides appropriate information when requested to do so ▪ Team demonstrates consistent and significant respect and empathy for patient
▪ Appropriate information is provided consistently
Examples ▪ Team deals with an unconscious patient with a lack of respect,
e.g. by joking about his / her condition
▪ Charles knows that the patient is a Jehovah Witness and does not let the team know when a T&C is
ordered. ▪ ▪ ▪ Charles lets the leader know that the patient is a Jehovah Witness and that she refused blood products. ▪
The team demonstrates civility, courtesy and trust in collective judgment.
Lower Quality Higher Quality
Score 1 2 3 4 5 CNE
Level Limited Basic Progressing Proficient Advanced
Description ▪ Team exhibits e.g. rudeness, overt distrust/mistrust, anger or overt doubt or suspicion toward
each other ▪ Few team members exhibit rudeness, overt distrust, anger or suspicion toward each other ▪ Team inconsistently demonstrates respect, rudeness, distrust or anger toward each other ▪ Team exhibits e.g. civility, courtesy, and trust in collective judgment ▪ Team is significantly respectful of each other
▪ Praise when appropriate
Examples ▪ Angry, stressed event manager says to team member, “I can’t believe you can’t intubate the patient. What’s the matter with you?”
▪ Team member says to another, “You don’t know what you’re doing-let me do it for you.”
▪ Event manager recognizes a chest tube is needed, and barks, “Michelle, I want you to put in a chest tube, I want you to do it now, and I want you to do it right on your first attempt.” ▪ Leader overbearing and intimidating ▪ ▪ Stressed but composed leader recognizes a team member cannot intubate the patient and offers assistance
▪ Team member says to another, “Are you OK? Let me know if I can help you.”
▪ Event manager recognizes a chest tube is needed and says, “Michelle, this patient needs a chest tube-can you put it in now?” ▪ Leader is clear, direct, and calm.
▪ Team members will thank each other when appropriate.
The team adapts to challenges, multitasks effectively, reallocates functions, and uses resources effectively; team self correction.
Lower Quality Higher Quality
Score 1 2 3 4 5 CNE
Level Limited Basic Progressing Proficient Advanced
Description ▪ Team rigidly adheres to individual team roles
▪ Inefficient resource allocation / use ▪ Minimal adaptability and/or hesitation to changing situations ▪ Team can adapt to certain situations, but not all ▪ Generally very flexible
▪ Multi-tasks effectively
▪ Reallocates functions
▪ Uses resources effectively ▪ Team adapts to challenges consistently
▪ Engages self- correction
Examples ▪ Ambu-bag not working, and no reallocation of resources established
▪ Team members stay in individual roles, failing to support each other e.g. by failing to recognize fatigue of those giving CPR
▪ Patient’s hysterical family member disrupts the team and team continues providing care, ignoring disruptive relative ▪ ▪ ▪ Ambu-bag not working, and an airway team member gives mouth-to-mouth with a mask and event manager asks another team member to retrieve a working ambu-bag
▪ Team members alternate giving CPR, recognizing fatigue of those giving CPR
▪ Patient’s hysterical family member disrupts the team and a team manages the situation, e.g. removes, counsels, or
reassures the family member ▪
Case A – Dizziness, Acute
Student
Student ID
SP ID
History Scoring: Give students credit (Yes) if they ask any of the following questions and / or SPs give the following responses. If question(s) not asked or response(s) not give, give no credit (No).
HISTORY CHECKLIST Yes No
1 ONSET, e.g. “When did dizziness start?”
• “The dizziness started last night when I was cleaning up after dinner.”
2 PAST MEDICAL HISTORY OF PROBLEM, e.g. “Ever had this problem before?”
■ “I almost passed out once in restaurant a few months ago. The EMT truck came and checked me out and they thought I was dehydrated from exercising. I had just come from the gym.”
3 QUALITY, e.g. “Describe the dizziness.”
• “Every few minutes or so I get the feeling the room is spinning and I feel a little nauseous, then it goes away and I feel OK. Then it starts all over again.”
4 AGGRAVATING, e.g. “What makes the dizziness worse?”
■ “Standing up with my eyes open makes me feel dizzy.”
5 PALLIATIVE, e.g. “What makes the dizziness better?”
■ “Closing my eyes and laying down makes the dizziness better.”
6 HEAD INJURIES, e.g. “Have you bumped or injured your head?”
• “No head injuries.”
7 PAST MEDICAL HISTORY, e.g. “How is your health in general?”
■ “In general I’ve been very healthy.”
8 MEDICATIONS, e.g. “Are you taking any medications for this problem or anything else?”
■ “I’m not taking anything. I thought of taking Dramamine but I wasn’t sure it would help.”
9 DIET, e.g. “What do you eat in a typical day?”
■ “A regular diet, toast and coffee in the morning, usually take out for
lunch, Chinese, a pizza or sub, something like that, and a regular meal at night.”
10 TOBACCO USE, e.g. “Do you smoke?”
• “I used to smoke ½ a pack a day, but now I’m down to 4 or 5, sometimes a couple more if I’m stressed.”
11 ADLs, e.g. “How is this affecting your life?”
■ “I couldn’t go to work today.”
Case A – Dizziness, Acute
PE SCORING:
■ COLUMN 1: NO CREDIT: If any box is checked, exam was done “incorrectly” or “incompletely.” Checked “Incorrect Details” box records reason(s) why.
■ COLUMN 2: FULL CREDIT: If “Correct” box is checked, exam was done “Correctly / Completely.”
■ COLUMN 3: NO CREDIT: If “Not Done” box is checked, exam was not attempted at all.
Physical Examination Checklist 1
Incorrect Details 2
Correct 3
Not Done
12 Perform fundoscopic examination
■ Did not ask the patient to fix their gaze at point in front of them.
■ Exam room not darkened.
■ Otoscope used instead of ophthalmoscope
■ “Left eye-left hand-left eye” or “right eye-right hand -right eye rule” not followed.
■ Exam not bilateral.
□
□
□
□
□
□
□
13 Assess Cranial Nerve II – Optic – Assess Visual Fields by Confrontation
■ Examiner not at approximate eye-level with patient, and / or no eye contact.
■ Examiner’s hands not placed outside of patient’s field of vision.
■ Did not ask “Tell me when you see my fingers.”
■ Did not test both upper and lower fields, and / or bilaterally.
□
□
□
□
□
□
14 Assess Cranial Nerves II and III – Optic and Oculomotor: Assess direct and consensual reactions
■ Did not shine a light obliquely into each pupil twice to check both the direct reaction and consensual reaction.
■ Did not assess bilaterally.
□
□
□
□
15 Assess Cranial Nerves II and III – Optic and Oculomotor: Assess near reaction and near response
■ Did not test in normal room light.
■ Finger, pencil, etc. placed too close or too far from the patient’s eye.
■ Did not ask the patient to look alternately at the finger or pencil and into the distance.
□
□
□
□
□
Case A – Dizziness, Acute
PE SCORING:
■ COLUMN 1: NO CREDIT: If any box is checked, exam was done “incorrectly” or “incompletely.” Checked “Incorrect Details” box records reason(s) why.
■ COLUMN 2: FULL CREDIT: If “Correct” box is checked, exam was done “Correctly / Completely.”
■ COLUMN 3: NO CREDIT: If “Not Done” box is checked, exam was not attempted at all.
1
Incorrect Details 2
Correct 3
Not Done
16 Assess Cranial Nerve III – Oculomotor: Assess convergence
■ Did not ask the patient to follow his / her finger or pencil as he / she moves it in toward the bridge of the nose.
□
□
□
17 Assess Cranial Nerve III, IV and VI – Oculomotor, trochlear and abducens: Assessing extraocular muscle movement
■ Examiner did not assess extra-ocular muscle movements in at least 6 positions of gaze using, for example, the “H” pattern.
■ Did not instruct patient to not move the head during the exam.
□
□
□
□
18 Assess Cranial Nerve VIII – Acoustic / Weber test
■ Did not produce a sound from tuning fork, e.g. by not holding the fork at the base
■ Did not place the base of the tuning fork firmly on top middle of the patient’s head.
■ Did not ask the patient where the sound appears to be coming from.
□
□
□
□
□
19 Assess Cranial Nerve VIII – Acoustic / Rinne test
■ Did not produce a sound from tuning fork, e.g. by not holding the fork at the base
■ Did not place the base of the tuning fork against the mastoid bone behind the ear.
■ Did not ask patient to say when he / she no longer hears the sound, hold the end of the fork near the patient’s ear and ask if he / she can hear the vibration.
■ Did not tap again for the second ear.
■ Did not assess bilaterally.
□
□
□
□
□
□
□
20 Assess Gait
■ Did not ask patient to walk, turn and come back to look for imbalance, postural, asymmetry and type of gait (e.g. shuffling, walking on toes, etc.)
□
□
□
21 Perform Romberg Test
■ Did not direct patient to stand with feet together, eyes closed, for at least 20 seconds without support.
■ Did not stand in a supportive position, e.g. behind patient or with hand behind patient.
□
□
□
□
Case A – Dizziness, Acute
RELATIONSHIP QUALITY
To what degree did the student …
Lower Higher
Quality Quality
1 Establish and maintain rapport 1 2 3 4 5 6 7 8
2 Demonstrate empathy 1 2 3 4 5 6 7 8
3 Instill confidence 1 2 3 4 5 6 7 8
4 Use appropriate body language 1 2 3 4 5 6 7 8
EXAMINATION QUALITY
To what degree did the student …
Lower Higher
Quality Quality
5 Elicit information clearly, effectively 1 2 3 4 5 6 7 8
6 Actively listen 1 2 3 4 5 6 7 8
7 Provide timely feedback / information / counseling 1 2 3 4 5 6 7 8
8 Perform a thorough, careful physical exam or treatment 1 2 3 4 5 6 7 8
Data compiled from 3rd/4th year clerkships includes:
Student Performance Evaluations from specific hospitals (attending/supervising physicians, and/or residents) based upon the 7 core Osteopathic Competencies. Data is broken down further by student cohort: traditional, BS/DO, and Émigré and is quantified according to curricular track (Lecture Discussion-Based and Doctor Patient Continuum);
NBOME Subject Exam scores for each of the (6) core clerkships and OMM. Core clerkships include:
a) Family Medicine
b) Medicine
c) OB-GYN
d) Pediatrics
e) Psychiatry
f) Surgery
NBOME Subject Exam statistics are shared with 3rd year students as a frame of reference to determine their performance relative to their NYCOM peers. These data also serve as a general guide for COMLEX II CE preparation and performance;
Students provide feedback on their clinical experiences during their clerkships, via the “PDA project”:
a) The PDA is a tool utilized for monitoring clerkship activities. The DEALS (Daily Educational Activities Logs Submission) focuses on educational activities, while the LOG portion focuses on all major student-patient encounters. A rich data set is available for comparing patient encounters and educational activities across all sites for all clerkships.
b) PDA data is used as a multimodal quality assessment tool for curricular exposure as well as OMM integration across all hospitals (including “outside” clerkships) for Patient Encounters and Educational Activities.
Reports from student focus groups—these reports are based upon in-person group interviews by a full-time NYCOM Medical Educator and feedback is analyzed in order to ensure consistency in clerkship education and experiences, as well as for program improvement indicators.
Specific forms/questionnaires utilized to capture the above-detailed information include the following:
Clinical Clerkship Student Performance Evaluation Samples of the forms/questionnaires follow
NEW YORK COLLEGE OF OSTEOPATHIC MEDICINE
OFFICE OF CLINICAL EDUCATION
Northern Boulevard -– Old Westbury, NY 11568-8000
Tel.: 516-686-3718 – Fax: 516-686-3833
(*) Only ONE form, with COMPOSITE GRADE & COMMENTS should be sent to the Hospital’s Office of Medical Education
for the DME SIGNATURE .
ONLY)
COURSE # (For NYCOM Purpose
STUDENT: , Class Year:
HOSPITAL:
Last First
ROTATION(Specialty) ROTATION DATES:
/ / / /
To
From
EVALUATOR: TITLE:
(Attending Physician / Faculty Preceptor)
A. Student logs by PDA REVIEWED (at least 10 patients) NOT REVIEWED
B. Student’s unique “STRENGTHS” (Very Important –To be incorporated into the College’s Dean’s Letter)
C. Student’s LIMITATIONS (areas requiring special attention for future professional growth)
D. For items below CIRCLE the most appropriate number corresponding to the following rating scale:
Exceptional=5 Very Good = 4 Average = 3 Marginal = 2 1 = FAILURE N/A OR no opportunity to observe
CORE COMPETENCY (See definitions on reverse side) RATING
Patient Care 5 4 3 2 1 N /A
Medical Knowledge 5 4 3 2 1 N /A
Practice-Based Learning & Improvement 5 4 3 2 1 N /A
Professionalism 5 4 3 2 1 N /A
System-Based Practice 5 4 3 2 1 N /A
Interpersonal and Communication Skills 5 4 3 2 1 N/A
Osteopathic Manipulative Medicine 5 4 3 2 1 N /A
OVERALL RADEG 5 4 3 2 1(FAILURE
Evaluator Signature:
/ /
Student Signature:
/ /
(Ideally at Exit Conference)
(*) DME Signature:
/ /
Please Return to: → Hospital’s Office of Medical Education OVER →
Date:
Date:
Date:
The Seven Osteopathic Medical Competencies
Physician Competency is a measurable demonstration of suitable or sufficient knowledge, skill sets, experience, values, and behaviors, that meet established professional standards, supported by the best available medical evidence, that are in the best interest of the well-being and health of the patient.
Patient Care: Osteopathic patient care is the ability to effectively determine and monitor the nature of a patient’s concern or problem; to develop, maintain, and to bring to closure the therapeutic physician-patient relationship; to appropriately incorporate osteopathic principles, practices and manipulative treatment; and to implement effective diagnostic and treatment plans, including appropriate patient education and follow-up, that are based on best medical evidence.
Medical Knowledge: Medical Knowledge is the understanding and application of biomedical, clinical, epidemiological, biomechanical, and social and behavioral sciences in the context of patient-centered care.
Practice-Based Learning & Improvement: Practice-Based learning and improvement is the continuous evaluation of clinical practice utilizing evidence-based medicine approaches to develop best practices that will result in optimal patient care outcomes.
Professionalism: Medical professionalism is a duty to consistently demonstrate behaviors that uphold the highest moral and ethical standards of the osteopathic profession. This includes a commitment to continuous learning and the exhibition of personal and social accountability. Medical professionalism extends to those normative behaviors ordinarily expected in the conduct of medical education, training, research, and practice.
System-Based Practice: System-based practice is an awareness of and responsiveness to the larger context and system of health care, and the ability to effectively identify and integrate system resources to provide care that is of optimal value to individuals and society at large.
Interpersonal & Communication Skills: Interpersonal and communication skills are written, verbal, and non-verbal behaviors that facilitate understanding the patient’s perspective. These skills include building the physician-patient relationship, opening the discussion, gathering information, empathy, listening, sharing information, reaching agreement on problems and plans, and providing closure. These skills extend to communication with patients, families, and members of the health care team.
Osteopathic Manipulative Medicine: Osteopathic philosophy is a holistic approach that encompasses the psychosocial, biomedical, and biomechanical aspects of both health and disease, and stresses the relationship between structure and function, with particular regard to the musculoskeletal system.
Definitions Provided by the National Board of Osteopathic Medical Examiners (NBOME)
Data received on courses and faculty through the newly implemented, innovative Course / Faculty Assessment program (see below-NYCOM Student Guide for Curriculum and Faculty Assessment). Students (randomly) assigned (by teams) to evaluate one course (and associated faculty) during 2-year pre-clinical curriculum. Outcome of student-team assessment is presented to Curriculum Committee, in the form of a one-page Comprehensive Report;
Clerkship Feedback (quantitative and “open-ended” feedback) provided through “Matchstix” (web-based feedback program): this information is shared with NYCOM Deans and Clinical Chairs, Hospital Director’s of Medical Education (DMEs), Hospital Department Chairs and Clerkship Supervisors. Also, the information is posted on the “web” to assist and facilitate 2nd year students choosing 3rd year Core Clerkship Sites (transparency). This data is also utilized via two (2) year comparisons of quantitative data and student feedback shared with NYCOM Deans & Chairs, as well as Hospital DMEs;
Clerkship Feedback via PDA: quantitative and open-ended (qualitative) feedback on all clerkships is collected via student PDA submission. The information is utilized as a catalyst for clerkship quality enhancement. This data-set is used as a multimodal quality assessment tool for curricular exposure as well as OMM integration across all hospitals (including “outside” clerkships) for Patient Encounters and Educational Activities;
Reports from student focus groups—these reports are based upon in-person group interviews by a full-time NYCOM Medical Educator and feedback is analyzed in order to ensure consistency in clerkship education and experiences, as well as for program improvement indicators;
Specific forms/questionnaires utilized to capture the above-detailed information include the following:
NYCOM Student Guide for Curriculum and Faculty Assessment
Clerkship (site) feedback from Clerkship students
Clinical Clerkship Focus Group Form
4th Year PDA Feedback Questionnaire
Student End-of-Semester Program Evaluations (DPC)
DPC Program Assessment Plan
Osteopathic Manipulative Medicine (OMM) Assessment Forms Samples of the forms/questionnaires follow
Rotation: Surgery
Site: (*) MAIMONIDES MEDICAL CENTER
This is an anonymous feedback form. No student identification data is transmitted.
Questions marked with * are mandatory.
Section I. Please respond to each statement in this section according to the following scale.
STRONGLY DISAGREE <-> STRONGLY AGREE
1* There were adequate learning opportunities (teaching patients, diversity of pathology and diagnostic procedures)
Strongly Disagree Disagree Neutral Agree Strongly Agree
2* There were opportunities to practice osteopathic diagnosis and therapy
Strongly Disagree Disagree Neutral Agree Strongly Agree
3* There was adequate supervision and feedback (e.g., reviews of my H&P, progress notes and clinical skills)
Strongly Disagree Disagree Neutral Agree Strongly Agree
4* I had the opportunity to perform procedures relevant for my level of training
Strongly Disagree Disagree Neutral Agree Strongly Agree
5* I was evaluated fairly for my level of knowledge and skills
Strongly Disagree Disagree Neutral Agree Strongly Agree
6* Attending physicians and/or house staff were committed to teaching
Strongly Disagree Disagree Neutral Agree Strongly Agree
7* Overall, I felt meaningfully engaged and well integrated with the clinical teams (e.g., given sufficient patient care responsibilities)
Strongly Disagree Disagree Neutral Agree Strongly Agree
8* The DME and/or clerkship director was responsive to my needs as a student
Strongly Disagree Disagree Neutral Agree Strongly Agree
9* There were adequate library resources at this facility
Strongly Disagree Disagree Neutral Agree Strongly Agree
10* A structured program of directed readings and/or journal club was a component of this rotation.
Strongly Disagree Disagree Neutral Agree Strongly Agree
11* The lectures were appropriate for this rotation (e.g., quality, quantity and relevance of topics)
Strongly Disagree Disagree Neutral Agree Strongly Agree
12* Educationally useful teaching rounds were conducted on a regular basis.
Strongly Disagree Disagree Neutral Agree Strongly Agree
13* This rotation reflected a proper balance of service and education
Strongly Disagree Disagree Neutral Agree Strongly Agree
14* This rotation incorporated a psychosocial component in patient care
Strongly Disagree Disagree Neutral Agree Strongly Agree
15* Overall, I would recommend this rotation to others
Strongly Disagree Disagree Neutral Agree Strongly Agree
Section II. Psychomotor skills
Indicate the number you performed on an average week during this rotation for each of the following:
16* History and Physicals
17* Osteopathic structural examinations
18* Osteopathic Manipulative Treatments
19* Starting IVs
20* Venipunctures
21*
Administering injections
22* Recording notes on medical records
23* Reviewing X-Rays
24* Reviewing EKGs
25* Urinary catherizations
26* Insertion and removal of sutures
27* Minor surgical procedures (assist)
28* Major surgical procedures (assist)
29* Care of dressings and drains
30* Sterile field maintenance
Section III
31* Comment on unique STRENGTHS and Positive Features of this rotation
32* Comment on the LIMITATIONS and Negative Features of this rotation
33* Comment on the extent in which the Learning Objectives for the rotation were met (e.g., specific topics/patient populations to which you were or not exposed)
Section IV. Please list your clinical instructors with whom you had substantial contact on this rotation and provide a general rating of their effectiveness as Teachers using the scale below.
5=EXCELLENT, 4=VERY GOOD, 3=AVERAGE, 2=BELOW AVERAGE,
1=POOR
For example – John Smith – 4
34* List clinical instructors and rating in the box below
To submit your feedback, enter your password below and then click on Submit Feedback button
Focus Groups on Clinical Clerkships
NAME OF HOSPITAL:
LOCATION:
DATE OF SITE VISIT:
The student’s comments on the clinical rotations are as follows:
(Name of Clerkship) STRENGHTS:
WEAKNESSES:
4th Year PDA Feedback Questionnaire
Student End-of-Semester Program Evaluations
The DPC Student End-of-Semester Program Evaluation is an assessment of each course that occurred during the semester and the corresponding faculty members.
DPC END OF SEMESTER EVALUATION
Directions:
A. Excellent – couldn’t be better
B. Good – only slight improvement possible
C. Satisfactory – about average
D. Fair – some improvement needed
E. Poor – considerable improvement needed
(When making comments, please know that your responses will be shared with DPC faculty, Dept. chairs, and deans, as part of ongoing program evaluation.)
BIOPSYCHOSOCIAL SCIENCES COURSE EVALUATION:
I. CASE STUDIES COMPONENT
Excellent Good Satis-
Fair Poor
Overall comments on Case Studies
II. STUDENT HOUR COMPONENT:
Excellent Good Satis-
Fair Poor
Overall Comments On The Student Hour
III. FACILITATOR RATINGS
Please circle your group number/the name of your group facilitator(s). Group Facilitators
A Dr. and Dr. B Dr. and Dr. C Dr. and Dr. D Dr. and Dr.
Please bubble in your response to each of the following items:
Strongly
Agree Disagree Strongly
Overall Facilitator Comments
(Comments on individual facilitators are welcome)
IV. PROBLEM SETS/DISCUSSION SESSIONS COMPONENT
A. Course Evaluation:
Excellent Good Satis-
Fair Poor
Problem Sets/Discussion Sessions Comments
(Please comment as to whether problem sets were too many, too few, too involved.)
V. PROBLEM SETS/DISCUSSION SESSIONS COMPONENT
B. Presenter Evaluation:
Problem Sets/Discussion Sessions Comments
(Comments on individual instructors are welcome)
VI. ANATOMY COMPONENT
A. Course Evaluation:
Excellent Good Satis-
Fair Poor
A B C D E
Anatomy Component Comments
VII. ANATOMY COMPONENT
B. Teaching Evaluation:
Please bubble in your response to each of the following items:
Strongly Agree
Agree Disagree Strongly
questions in the lab 5 (A) 4 (B) 2 (C) 1 (D)
Anatomy Component Comments
(Comments on individual instructors are welcome)
CLINICAL SCIENCES COURSE
I. CLINICAL SKILLS LAB COMPONENT
A. Course Evaluation:
Excellent Good Satis-
Fair Poor
A B C D E
Overall Comments on Clinical Skills Component / Individual Labs
(Comments on individual instructors are welcome)
I. CLINICAL SKILLS LAB COMPONENT
B. Teaching Evaluation:
Please bubble in your response to each of the following items:
Strongly Agree
Agree Disagree Strongly
questions in the lab 5 (A) 4 (B) 2 (C) 1 (D)
Overall Comments on Clinical Skills Component / Individual Labs
(Comments on individual instructors are welcome)
II. OMM COMPONENT
A. Course Evaluation:
Excellent Good Satis-
Fair Poor
A B C D E
Overall Comments on OMM Component / Individual Labs
(Comments on individual instructors are welcome)
II. OMM COMPONENT
B. Teaching Evaluation
Please bubble in your response to each of the following items:
Strongly Agree
Agree Disagree Strongly
questions in the lab 5 (A) 4 (B) 2 (C) 1 (D)
Overall Comments on OMM Component / Individual Labs
(Comments on individual instructors are welcome)
III. ICC COMPONENT
A. Course Evaluation:
Excellent Good Satis-
Fair Poor
Overall Comments on the ICC Component
(Comments on individual instructors are welcome)
IV. CLINICAL PRACTICUM COMPONENT
A. Course Evaluation
Excellent Good Satis-
Fair Poor
Please bubble in your response to each of the following items:
Strongly Agree
Agree Disagree Strongly
Disagree
5 (A) 4 (B) 2 (C) 1 (D)
Overall Comments on Clinical Practicum Course
IV. CLINICAL PRACTICUM COMPONENT
B. Mentor Evaluation:
Please bubble in your response to each of the following items:
Strongly
Agree Disagree Strongly
Preceptor Name
Overall Comments on Clinical Practicum Mentor
(Comments on individual instructors are welcome)
DPC: Program Assessment Plan
I. Pre matriculated Evaluation – What determines that an applicant will pick the DPC program?
• Comparison of the students who chose the LDB program vs. the DPC program with regard to the following outcome measures:
− GPA scores (overall, science)
− MCAT scores
− Gender
− Age
− Race
− College size
− College Geographic location
− Prior PBL exposure
− OMM understanding
− Research Background
− Volunteer Work
− Employment Experience
− Graduate Degree
− Scholarships/Awards
II. Years at NYCOM – How do we evaluate if the DPC program is accomplishing its goals while the students are at NYCOM?
• Comparison of Facilitator Assessments for each term, to monitor student growth
• Comparison of Clinical Practicum Mentor Evaluations from Term 2 and Term 3, to evaluate the student’s clinical experience progress
• Comparison of Content exam scores from terms 1 through 4.
• Comparison of entrance questionnaire (administered during first week of medical school) responses to corresponding exit questionnaire administered at the end of year 4
• Evaluation of the Student DPC End-of-Term Evaluations
• Comparison of the following measures to those outcomes achieved by the students in the LDB program:
− OMM scores
DPC: Program Assessment Plan
− Anatomy scores
− ICC PARS scores
− ICC OSCE scores
− Summer research
− Summer Volunteerism
− Research effort (publications, abstracts, posters, presentations)
− Shelf-exams
− COMLEX I, II, III scores and pass rate
− Fellowships (Academic, Research)
III. Post Graduate Training Practice – What happens to the DPC student once they leave NYCOM? How to they compare to those students who matriculated through the LDB program?
• Comparison of the following measures to those outcomes achieved by the students in the LDB program:
− Internships
− Residencies
− Fellowships
− Specialty (medicine)
− Specialty board certifications
− AOA membership
− AMA membership
− Publications
− Research
− Teaching
OMM Assessment Forms
a) First-time and overall pass rates and mean scores;
b) Comparison to national averages;
c) Comparison to college (NYCOM) national ranking.
Report provided by Associate Dean for Academic Affairs
Data compiled as received from the American Osteopathic Association (AOA) and the National Residency Match Program (NRMP).
Report provided by Associate Dean for Clinical Education
Annual survey report received from AACOM comparing NYCOM graduates responses to numerous questions/categories (including demographics, specialty choice, overall perception of pre-doctoral training, indebtedness, and more) to nation- wide osteopathic medical school graduating class responses.
Specific forms/questionnaires utilized to capture the above-detailed information include the following:
AACOM Survey of Graduating Seniors Samples of the forms/questionnaires follow
MERICAN
ASSOCIATION OF COLLEGES OF OSTEOPATHIC MEDICINE
2007-08 Academic Year Survey of Graduating Seniors
TO THE STUDENTS: Your opinions and attitudes.about your medical education, your plans for medical practice, and information about your debt are very important as the colleges and the osteopathic profession develop and plan for the future of osteopathic medical education. Please take some time to complete the following questionnaire to help in planning the future of osteopathic medical education. The information you provide In this survey will be reported only In aggregate or summary form; individually Identifiable information will not be made available to the colleges. The reason we ask for your Identification Is to allow for longitudinal studies linking your responses when you took a similar survey as a first-year medical student to your responses as a graduating medical student.
Please print in Capital Letters:
Please flll in marks like this: •
Last
Name Suffix
First Name
Osteopathic College
Middle Name
or Maiden Name if Married Woman Using Husband’s Name
0 ATSU-SOMA 0 LECOM-Bradenton 0 OU-COM 0 UMDNJ-SOM
0 ATSU/KCOM 0 LECOM-PA 0 PCOM 0 UNECOM
0 AZCOM 0 LMU-DCOM 0 PCSOM 0 UNTHSCffCOM
0 CCOM 0 MSUCOM 0 TOUROCOM 0 VCOM
0 DMU•COM 0 NSU-COM 0 TUCOM•CA 0 WesternU/COMP
0 GA·PCOM 0 NYCOM 0 TUNCOM 0 WVSOM
0 KCUMB·COM 0 OSU-COM
Part I: OPINIONS
a. Basic medical science 00® l. Cost•effective medical practice 00®
b. Behavioral science 00® m. Diagnostic skills 0©®
C. Biostatistics 00® n. Drug and alcohol abuse 00®
d. Bioterrorism 00® o. Family/domestic violence 00®
e. Care of ambulatory patients 00® p. Genetics 000
f. Care of elderly (geriatrics) 00® q. Health promotion & disease prevention 000
g. Care of hospitalized patients 000 r. Human sexuality 000
h. Care of patients with HIV/AIDS 00® s. Independent teaming & self-evaluation 000
i. Clinical decision•making 000 t. Infection control/health care setting 000
J. Clinical pharmacology 000 u. Infectious disease prevention 00®
k. Clinical science 00® V. Integrative medicine 000
(I) Appropriate (2) Inadequate (3) Excessive
w. Legal medicine 000
II. Physician-patient relationship 000
x. Literature analysis skill 000 jj. Practice management 000
y. Medical care cost control 000 kk. Primary care 000
z. Medical ethics 000 II. Public health & community medicine 000
aa. Medical record-keeping 000 mm. Rehabilitation 000
bb. Medical socioeconomics 000 nn. Research techniques 000
cc. Neuromusculoskeletal medicine/GMT 000 00. Role of medicine in community 000
dd. Nutrition 000 pp. Screening for diseases 000
ee. Pain management 000 qq. Teamwork with other health professionals 000
ff.
gg. Patient education
Patient follow-up 000
000 rr.
ss. Therapeutic management
Use of computers 000
000
hh. Patient interviewing skills 000 tt. Utilization review & quality assurance 000
0 a. Very satisfied O b. Satisfied O c. Neither satisfied nor dissatisfied O d. Dissatisfied O e. Very dissatisfied
a. General adult examination 0 0 0 0 0 ©
b. General pediatric examination 0 0 0 0 0 ©
a. Basic & clinical science course objectives were made clear to students 0 0 0 0 ©
b. Basic science courses were sufficiently integrated with each other 0 0 0 0 0
c. Basic science courses were sufficiently integrated with clinical training 0 0 0 0 ©
d. Course objectives & examination content matched closely 0 0 0 0 ©
e. Course work adequately prepared students for clerkships 0 0 0 0 0
f. The first two years of medical school were well organized 0 0 0 0 ©
OS.a. Please indicate whether you agree or disagree with the foUowing statements about your Required Clerkships during the last two years of medical education. Please use the scale below.
(1) Strongly Agree (2) Agree (3) Disagree (4) Strongly Disagree (5) No Opinion
I. Clear goals and objectives were set 0 0 © 0 ©
2.
3.
I.
2.
3.,
( I) Strongly Agree (2) Agree (3) Disagree (4) Strongly Disagree (5) No Opinion
options, management, and follow-up care
0 1. COMLEX Level 2-CE preparation 0 2. COMLEX Level 2-PE preparation
0 3. Distance learning 0 4. E-mail
0 5. Faculty visit 0 6. Newsletter
b. In your view bow appropriate was your osteopathk medical school involvement in your clerkship years?
0 l. Excessive involvement 0 2. Outstanding involvement
0 3. Adequate involvement 0 4. Some, but inadequate involvement
0 5. Not involved
08e. Other, please specify
0 a. Very satisfied·
0 b. Satisfied
0 C. Mixed feelings
0 d. Dissatisfied
0 e. Very dissatisfied
0 a.
The osteopathic medical school from which you are about to graduate
0 b. Another osteopathic medical school
0 c. An allopathic medical school
0 d. Would not have gone to medical school at all
a. Well prepared to diagnose structural problems
b. Well prepared to treat structural problems
c. Well prepared to document findings in a structural examination
d. Had opportunity to practice OPP during first two years in medical school
e. Had opportunity to practice OPP during in-hospital rotations
f. Had opportunity to practice OPP during ambulatory primary care rotations
g. Had opportunity to practice OPP during ambulatory non- primary care rotations
h. Had osteopathic physician role models during the first two years in medical school
i. Had osteopathic physician role models during required in- hospital rotations
j. Had osteopathic physician role models during ambulatory primary care rotations
k. Had osteopathic physician role models during ambulatory non- primary care rotations
I. Had osteopathic physician role models during selectives/electives
Part II: CAREER PLANS
Pl. Plans Upon Graduation: Please indicate what type of osteopathic internship you plan to do. (Choose only one.)
0 a.
Traditional rotating
0 b. Special emphasis Indicate type: I. Anesthesiology 0 2. Diagnostic Radiology 0
3. Emergency Med. 0 4. Family Practice 0
5. General Surgery 0 6. Psychiatry 0
0 c. Specialty track Indicate type: l. Internal Medicine 0 2. Internal Medicine/Peds. 0
3. Ob/Gyn 0 4. Otolaryn./Facial Plastic Surg. 0
5. Pediatrics 0 6. Urological Surgery 0
0 d.
0 e.
Pursue AOA/ACGME dual approved internship
Not planning osteopathic internship. Reason: I. Allopathic residency 0
Please specify
0 f. Undecided
P2. a. Immediate Post-Internship Residency Plans: Select the one item that best describes your plans immediately after internship {or upon graduation if not planning an osteopathic internship).
0 l. Pursue osteopathic residency
0 2. Pursue allopathic residency (see Item P2b)
0 3. Pursue AOA/ACGME dual approved residency (see Item P2b)
0 4. Enter governmental service (e.g., military, NHS Corps, Indian Health Service, V.A., state/local health dept.) (see
Item P2b)
If you are not doing a residency, please indicate your post-internship plans.
0 5.
0 6.
0 7.
0 8.
0 9.
Practice in an HMO
Self-employed with or without a partner
Employed in group or other type of private practice (salary, commission, percentage) Other professional activity (e.g., teaching, research, administration, fellowship) Undecided or indefinite post-graduation/internship plans
b. If you plan to pursue an allopathic or AOA/ACGM.E dual approved residency, please give all the reasons that apply to you.
0 I. Desire specialty training not available in osteopathic program
0 2. Believe better training and educational opportunities available
0 3. Located in more suitable geographic location(s)
0 4. Located in larger institutions
0 5. Better chance of being accepted in program
0 6. Allow ABMS Board certification
0 7. Opens more career opportunities
0 8. Military or government service obligation
0 9. Shorter training period
0 IO. Higher pay
0 l l. Other, please specify
P3. Long-Range Plans: Select the one item that best describes your intended activity five years after internship and residency training.
0 l. Enter governmental service (e.g., military, NHS Corps, Indian Health Service, V.A., state/local health dept.)
0 2. Practice in an HMO
0 3. Self-employed with or without a partner
0 4. Employed in group or other type of private practice (salary, commission, percentage)
0 5. Other professional activity (e.g., teaching, research, administration, fellowship)
0 6. Undecided or indefinite
P4. a. Area of Interest: Select one specialty in which you are most likely to work or seek training.
0 l. Family Practice 0 17. Ob/Gyn including subspecialties
0 2. General Internal Medicine 0 18. Ophthalmology
0 3. Internal Medicine Subspecialty 0 19. Otolaryngology
0 4. Osteopathic Manip. Ther. & Neuromusculoskeletal Med. 0 20. Pathology including subspecialties
0 5. General Pediatrics 0 21. Physical Medicine & Rehabilitation Med.
0 6. Pediatrics Subspecialty 0 22. Preventive Medicine including subspec.
0 7. Allergy and Immunology 0 23. Proctology
0 8. Anesthesiology 0 24. Radiology (Diagnostic) including subspec.
0 9. Critical Care 0 25. Sports Medicine
0 IO. Dermatology 0 26. General Surgery
0 11. Emergency Medicine 0 27. Orthopedic Surgery
0 12. Geriatrics 0 28. Surgery, subspecialty
0 13. Medical Genetics 0 29. Vascular Surgery
0 14. Neurology including subspecialties 0 30. Urology/Urological Surgery
0 15. Psychiatry including subspecialties 0 31. Undecided or Indefinite
0 16. Nuclear Medicine
b. Please select one item that best describes your plans for board certification.
0 I. AOA Boards (osteopathic)
0 2. ABMS Boards (allopathic) (see Item P4c)
0 3. Both boards (see Item P4c)
0 4. Other, please specify
0 5. Not planning board certification
0 6. Undecided or indefinite
c. If you selected ABMS or both boards in item P4b, please indicate all the reasons for your choice.
0 I . ABMS board certification is more widely recognized
0 2. ABMS board certification has more colleague acceptance
0 3. ABMS board certification carries more prestige
0 4. ABMS board certification provides more opportunities (career, residencies, etc.)
0 5. Personal desire for dual certification
0 6. Hospital privileges more readily obtained with ABMS board certification.
0 7. Licenses more readily obtained with ABMS board
certification
0 8. Other, please specify
PS. Please indicate the importance of each of the following factors affecting your specialty choice decision. Use the scale below.
(I) Major Influence (2) Strong Influence (3) Moderate Influence (4) Minor Influence (5) No Influence/NA
a. Intellectual content of the specialty (type of work, diagnostic programs, diversity) 0 0 0 0 0
0 0
0 0
d. Lifestyle (predictable working hours, sufficient time for family) 0 0 0 0 0
e. Like the emphasis on technical skills 0 0 0 0 0
f. Role models (e.g., physicians in the specialty) 0 0 0 0 0
g. Peer influence (encouragement from practicing physicians, faculty, or other students) 0 0 0 0 0
h. Skills/abilities (possess the skills required for the specialty or its patient population) 0 0 0 0 0
i. Debt level (level of debt, length of residency, high malpractice insurance premiums) 0 0 0 0 0
J. Academic environment (courses, clerkships in the specialty area) 0 0 0 0 0
k. Opportunity for research/creativity 0 0 0 0 0
Part IV: DEMOGRAPHIC DATA
This information is for classification purposes only and is considered confidential. Information will only be used by AACOM and affiliated organizations in totals or averages.
Dl. Date of Birth I I D2. Sex: Male 0
Female 0
D3. Marital Status: Married/cohabiting 0
Single/other 0
D4. SSN
AACOM asks for your Social Security Number so that we can track data longitudinally-a similar survey is administered on matriculation, and this number allows us to analyze changes in responses. AACOM provides reports to the COMs only in aggregate and does not include any individual identifiers.
D5. Dependents: Including yourself, how many dependents do you support financially? 2 3 4 5 or more
0 0 0 0 0
D6. Ethnic background: Indicate your ethnic identification from the categories below. Please mark all that apply.
0
der 0
D8. State of Legal Residence: Use 2 letter postal abbreviation.
D9. Population of city/town/area of legal residence:
a. Major metropolitan area (1,000,00 l or more) 0
b. Metropolitan area (500,00 I – 1,000,000) 0
c. City (100,001 – 500,000) 0
d. City (50,001- 100,000) 0
e. City or town (10,001 – 50,000) 0
f. City or town (2,501 – 10,000) 0
g. Town under 2,500 0
h. Other 0
n- Vietnamese) 0
0
0
Please specify
D10. a. Father’s Education: Select the highest level of education your father attained. Complete this item even ifhe is deceased.
l. Professional Degree (DO/MD, JD, DDS, etc.) 0 (See Item D lOb below)
b. If your father’s professional degree is in the Health Professions field, please select one of the following: DO/MD 0 Other 0
D11. a. Mother’s Education: Select the highest level of education your mother attained. Complete this item even if she is deceased.
I. Professional Degree (DO/MD, JD, DDS, etc.) 0
(See Item DI I b below)
b. If your mother’s professional degree is in the Health Professions field, please select one of the following:
DO/MD 0 Other 0
D12. Parents’ Income: Give your best estimate of your parents’ combined income before taxes for the prior year.
a. Less than $20,000 0 d. $50,000 – $74,999 0 g. $200,000 or more 0
b. $20,000 – $34,999 0 e. $75,000 – $99,999 0 h. Deceased/Unknown 0
c. $35,000 – $49,999 0 f. $100,000- $199,999 0
D13. Financial Independence: Do you consider yourself financially independent from your parents? Yes 0 No 0
medical
school
and wishes you all the best in your care(Jr as an osteopathic
physician.
Percent of NYCOM graduates completing internship/residency training programs.
Report provided by Office of Program Evaluation and Assessment
Data compiled from state licensure boards and other specialty certification organization (board certification) on NYCOM graduates.
Report provided by Office of Program Evaluation and Assessment
Data includes practice type (academic, research, clinical, and so on) and practice location. Data obtained from licensure boards, as well as NYCOM Alumni survey.
Report provided by Office of Program Evaluation and Assessment
Follow up survey periodically sent to alumni requesting information on topics such as practice location, specialty, residency training, board certification and so on.
Specific forms/questionnaires utilized to capture the above-detailed information include the following:
Alumni Survey Samples of the forms/questionnaires follow
ALUMNI SURVEY
NAME
LAST
FIRST
NYCOM CLASS YEAR
HOME ADDRESS
PRACTICE ADDRESS
HOME PHONE (
)
OFFICE PHONE (
)
E-MAIL ADDRESS
INTERNSHIP HOSPITAL
RESIDENCY HOSPITAL
FIELD OF STUDY
FELLOWSHIPS COMPLETED:
CERTIFICATIONS YOU HOLD:
IF SPOUSE IS ALSO A NYCOM ALUMNUS, PLEASE INDICATE SPOUSE’S NAME AND CLASS YEAR:
EXCLUDING INTERNSHIP, RESIDENCY AND FELLOWSHIP, HAVE YOU EARNED ANY ADDITIONAL ACADEMIC DEGREES OR CERTIFICATES BEYOND YOUR MEDICAL DEGREE (I.E., MPH, MBA, MHA, PHD, MS)? (PLEASE LIST)
CURRENT PRACTICE STATUS:
FULL-TIME PRACTICE
PART-TIME PRACTICE
INTERN/RESIDENCY
RETIRED/NOT PRACTICING
What specialty do you practice most frequently? (Choose one)
Allergy and Immunology
Anesthesiology
Cardiology
Colorectal Surgery
Dermatology
Emergency Medicine
Endocrinology
Family Practice
Gastroenterology
Geriatrics
Hematology
Infectious Diseases
Internal Medicine
Neruology
Neonatology
Nephrology
Neurology
Nuclear Medicine
Obstetrics & Gynecology
Occupational Medicine
Ophthalmology
Oncology
Otolaryngology
Orthopedic Surgery
Psychiatry
Pediatrics
Plastic/Recon. Surgery
Physical Medicine/Rehab
Pathology
Pulmonary Medicine
Radiology
Rheumatology
Surgery (general)
Thoracic Surgery
Radiation Therapy
Urology
Other (Please specify)
Current military status (if applicable): Active Duty Inactive reserve Active Reserve
What is the population of the
geographic area of your practice?
(Choose one)
How would you describe this geographic area? (Choose one)
5,000,000 +
1,000,000 – 4,999,999
500,000 – 999,999
250,000 – 499,999
Inner City
Urban
100,000 – 249,999
50,000 – 99,999
25,000 – 49,999
Suburban
Small Town – Rural
10,000 – 24,999
5,000 – 9,999
Less than 5,000
Small town – industrial Other
What functions do you perform in your practice? (check all that apply)
What best describes the setting in which you spend the most time ?
Preventive care/patient education
Acute care
Routine/non-acute care
Consulting
Intensive Care Unit of Hospital
Inpatient Unit of Hospital (not ICU/CCU)
Outpatient Unit of Hospital
Hospital Emergency Room
Hospital Operating Room
Freestanding Urgent Care Center
Freestanding Surgical Facility
Nursing Home or LTC Facility
Solo practice physician office
Single Specialty Group practice physician office
Multiple Specialty Group practice physician office
Supervisory/managerial responsibilities
Research
Teaching
Hospital Rounds
University Student Health facility
School-based Health center
HMO facility
Rural Health Clinic
Inner-city Health Center
Other Community Health Center
Other Freestanding Outpatient facility
Correctional facility
Industrial facility
Mobile Health Unit
Other (Please specify)
Do you access medical information What percent of your time is spent in primary What percent of your practice is outpatient?
0%
1 – 25%
25 – 50%
50 – 75%
75 – 100%
via the internet ? care? (family medicine or gen. internal medicine)
Never 0%
Sometimes 1 – 25%
Often 25 – 50%
50 – 75%
75 – 100%
Do you engage in any of the following activities? (check all that apply) Professional organization leadership position
Volunteer services in the community School or team physician
Free medical care
Leadership in church,
congregation Local government
Speaking on medical topics to community groups
How many CME programs or other
professional training sessions did you attend last year?
Have you ever done any of the following?
How often do you read
medical literature regarding new research findings?
How frequently do you apply
osteopathic concepts into patient care?
none
1-5
5-10
10-15
more than 15 Author or co-author a professional paper
Contribute to an article
Direct a research project
Participate in clinical research
Present a lecture at a professional meeting or CME program
Serve on a panel discussion at a professional meeting Rarely
Several times a year
Monthly
Weekly
Daily Never
Rarely
Often
Always
In your practice do you employ any of the following?
(check all that apply) Structural examination or musculoskeletal considerations in diagnosis Indirect OMT techniques
High Velocity OMT
Myofascial OMT Cranial OMT
Palpatory diagnosis
Please indicate how important each of the following skills has been in your success as a physician, and how well NYCOM prepared you in that skill.
Biomedical science knowledge base
Clinical skills Patient educator skills
Empathy and compassion for patients Understanding of cultural differences
Osteopathic philosophy Clinical decision making Foundation of ethical standards
Ability to communicate with other health care providers Ability to communicate with patients and families Knowing how to access community resources
Ability to understand and apply new medical information
Understanding of the payor/reimbursement system
How important to my practice
How well NYCOM prepared me
Strong
Moderate
Weak
Strong
Moderate Weak
Strong Moderate Weak Strong Moderate Weak
Strong Moderate Weak Strong Moderate Weak
Strong Moderate Weak Strong Moderate Weak
Strong Moderate Weak Strong Moderate Weak
Strong Moderate Weak Strong Moderate Weak
Strong Moderate Weak Strong Moderate Weak
Strong Moderate Weak Strong Moderate Weak
Strong Moderate Weak Strong Moderate Weak
Strong Moderate Weak Strong Moderate Weak
Strong Moderate Weak Strong Moderate Weak
Strong Moderate Weak Strong Moderate Weak
Strong Moderate Weak Strong Moderate Weak
Ability to search and retrieve needed information
Strong
Moderate
Weak
Strong
Moderate Weak
Manipulative treatment skill Strong Moderate Weak Strong Moderate Weak
Ability to use medical technology Strong Moderate Weak Strong Moderate Weak
Diagnostic skill Strong Moderate Weak Strong Moderate Weak
Skill in preventive care Strong Moderate Weak Strong Moderate Weak
Understanding of public health issues & the public health
system Strong Moderate Weak Strong Moderate Weak
Professionalism Strong Moderate Weak Strong Moderate Weak
Please return to:
NYCOM of NYIT, Office of Alumni Affairs Northern Boulevard, Serota Bldg., Room 218
Old Westbury, New York 11568 or
fax to (516) 686-3891 or (516) 686-3822
as soon as possible.
Thank you for your cooperation!
NYCOM Benchmarks
1- Applicant Pool
Benchmark: To maintain relative standing among Osteopathic Medical Colleges based on the number of applicants.
2- Admissions Profile
Benchmark: Maintain or improve current admissions profile based on academic criteria such as MCAT, GPA, or Colleges attended.
3- Academic Attrition Rates
Benchmark: To maintain or improve our current 3% Academic Attrition rate
4- Remediation rates (pre-clinical years)
Benchmark: A 2% a year reduction in the students remediating in pre-clinical years.
5- COMLEX USA Scores
Benchmark: Top quartile in the National Ranking of 1st time pass rate and Mean Score.
6- Students entering Osteopathic Graduate Medical Education (OGME) Benchmark: Maintain or improve the current OGME placement.
7- Graduates entering Primary Care (PC) 12
Benchmark: Maintain or improve the current Primary Care placement.
8- Career Data -Licensure (within 3 years, post-graduate), Board Certification , Geographic Practice, and Scholarly achievements.
Benchmark: TBD
12 Family Medicine, Internal Medicine, and Pediatrics
BIBLIOGRAPHY
Gonnella, J.S., Hojat, M., & Veloski, J.J. Jefferson Longitudinal Study of Medical Education.
Retrieved December 17, 2008, from http://jdc.jefferson.edu/jlsme/1
Hernon, P. & Dugan, R.E. (2004). Outcomes Assessment in Higher Education. Libraries Unlimited: Westport, CT
APPENDICES
NEUROLOGICAL EXAMINATION
1 Assess Cranial Nerve I
■ Examiner stands at approximate eye-level with patient, making eye contact.
■ Patient is then asked to return examiner’s gaze
e.g. by saying “Look at me.”
■ Examiner starts by placing his / her hands outside the patient’s field of vision, lateral to head.
■ With fingers wiggling (so patient can easily see them) the examiner brings his / her fingers into the patient’s field of vision.
s
d
■ Examiner must ask the patient “Tell me when you see my fingers.”
■ Assess upper, middle and lower fields, bilaterally.
NEUROLOGICAL EXAMINATION
3 Assess Cranial Nerve II – Optic: Accessing Visual Acuity
■ For ICC purposes, handheld Rosenbaum
Pocket Screener (eye
chart)
■ NOTE: Use handheld Snellen eye chart if patient stand 20’ from the chart
■ Ask patient to cover one eye while testing the other eye
■ Rosenbaum eye chart is held in good light approximately 14” from eye
■ Determine the smallest line of print from which patient can read more than half the letters
■ The patient’s visual acuity score is recorded as two numbers, e.g. “20/30” where the top number is the distance the patient is from the chart and the bottom number is the distance the normal eye can read that line.
■ Repeat with the other eye
NEUROLOGICAL EXAMINATION
4 Assessing Cranial Nerves II and III
■ Examiner asks the patient to look into the distance, then shines a light obliquely into each pupil twice to check both the direct reaction (pupillary constriction in the same eye) and consensual reaction (pupillary constriction in the opposite eye).
■ Must be assessed bilaterally.
5 Assessing Cranial Nerves II and III – Optic and Oculomotor: Assessing Near Reaction and Near Response
■ Assessed in normal room light, testing one eye at a time.
■ Examiner holds a finger, pencil, etc. about 10 cm. from the patient’s eye.
■ Asks the patient to look alternately at the finger or pencil and then into the distance.
■ Note pupillary constriction with near focus.
Close focus
Distant focus
NEUROLOGICAL EXAMINATION
6 Assessing Cranial Nerve III
■ Examiner asks the patient to follow his / her finger or pencil as he / she moves it in toward the bridge of the nose to within about 5 to 8 centimeters.
■ Converging eyes normally follow the object to within 5 – 8 cm. of the nose.
7 Assessing Cranial Nerve III, IV and VI
■ Examiner assesses muscle movements in at least 6 positions of gaze by tracing, for example, an “H pattern” with the hand and asking the patient to follow the hand with their eyes without turning the head.
NEUROLOGICAL EXAMINATION
8 Assessing Cranial Nerve V
Examiner assesses sensation in 3 sites:
Ophthalmic
Maxillary
Mandibular
■ Examiner may use fingers, cotton, etc. for the assessment.
■ Assess bilaterally.
Mandibular
9 Assessing Cranial Nerve V
■ Examiner asks the patient to move jaw his or her jaw from side to side
OR
■ Examiner palpates the masseter muscles and asks patient to clinch his / her teeth.
■ Note strength of muscle contractions.
NEUROLOGICAL EXAMINATION
Show teeth Puff cheeks
NEUROLOGICAL EXAMINATION
11 Assess Cranial Nerve VIII
– Acoustic
Weber test – for lateralization
■ Use a 512 Hz or 1024 Hz turning fork.
■ Examiner starts the fork vibrating e.g. by tapping it on the opposite hand, leg, etc.
■ Base of the tuning fork placed firmly on top of the patient’s head.
■ Patient asked “Where does the sound appear to be coming from?” (normally it will be sensed in the midline).
NEUROLOGICAL EXAMINATION
12 Assessing Cranial Nerve VIII – Acoustic
Mastoid Bone
Ear
Rinne test – to compare air and bone conduction
■ Use a 512 Hz or 1024 Hz turning fork.
■ Examiner starts the fork vibrating, e.g. by tapping it on the opposite hand, leg, etc.
■ Base of fork placed against the mastoid bone behind the ear.
■ Patient asked to say when he / she no longer hears the sound
■ When sound no longer heard, examiner moves the tuning fork (without re-striking it) and holds it near the patient’s ear and ask if he / she can hear the vibration.
■ Examiner must vibrate the tuning fork again for the second ear.
■ Bilateral exam.
NOTE: (AC>BC): Air
conduction greater than bone conduction.
NEUROLOGICAL EXAMINATION
13 Assessing Cranial Nerve VIII –
■ Examiner asks patient to occlude (cover) one ear.
■ Examiner then whispers words or numbers into non- occluded ear from approximately 2 feet away.
■ Asks patient to repeat whispered words or numbers.
■ Compare bilaterally.
OR
■ Examiner asks patient to occlude (cover) one ear.
■ Examiner rubs thumb and forefinger together next to patient’s non-occluded ear and asks the patient if the sound is heard.
■ Compare bilaterally.
NEUROLOGICAL EXAMINATION
14 Assessing Cranial Nerve IX and X – Glossopharyngeal and Vagus: Motor Testing
■ First, examiner asks the patient to swallow.
■ Next, patient asked to say ‘aah’ and examiner observes for symmetrical movement of the soft palate or a deviation of the uvula.
■ OPTIONAL: Use a light source to help visualize palate and uvula.
NOTE: sensory component of cranial nerves IX and X is testing for the “gag reflex”
Swallowing
Saying “Aah”
NEUROLOGICAL EXAMINATION
15 Assessing Cranial Nerve XI
■ Examiner asks the patient to shrug his / her shoulders up against the examiner’s hands. Apply resistance.
■ Note strength and contraction of trapezius muscles.
■ Next, patient asked to turn his or her head against examiner’s hand. Apply resistance.
■ Observe the contraction of the opposite sternocleido- mastoid muscle.
■ Assess bilaterally.
NEUROLOGICAL EXAMINATION
16 Assessing Cranial Nerve XII – Hypoglossal:
Motor Testing
Inspect tongue Protruding Tongue
Side to Side Movement
■ First, examiner inspects patient’s tongue as it lies on the floor of the mouth.
■ Note any asymmetry, atrophy or fasciculations.
■ Next, patient asked to protrude the tongue.
■ Note any asymmetry, atrophy or deviations from the midline.
■ Finally, patient asked to move the tongue from side to side.
■ Note any asymmetry of the movement.
NEUROLOGICAL EXAMINATION
17 Assessing Lower Extremities – Motor Testing
With patient in supine position, test bilaterally
■ Test flexion of the hip by placing your hand on patient’s thigh, and ask them to raise his / her leg against resistance.
■ Test extension of the hip by having patient push posterior thigh against your hand
CONTINUED
NEUROLOGICAL EXAMINATION
18 Assessing Lower Extremities – Motor Testing
With patient in seated position, test bilaterally
■ Test adduction of the hip by placing hands firmly between the knees, and asking them to bring the knees together
■ Test abduction of the hip by placing hands firmly outside the knees, and asking patient to spread their legs against resistance
NEUROLOGICAL EXAMINATION
19 Assessing Upper Extremities – Motor Testing
■ Examiner asks patient to pull (flex) and push (extend) the arms against the examiner’s resistance.
■ Bilateral exam.
20 Assessing Lower Extremities – Motor Testing
■ Examiner asks the patient to pull (flex) and push (extend) the legs against the examiner’s resistance.
■ Bilateral exam.
NEUROLOGICAL EXAMINATION
21 Assessing Lower Extremities – Motor Testing
■ Examiner asks patient to dorsiflex and plantarflex the ankle against resistance
■ Compare bilaterally
NEUROLOGICAL EXAMINATION
22 Assessing the Biceps Reflex
■ Examiner partially flexes patient’s arm.
■ Strike biceps tendon with reflex hammer (pointed or flat end) with enough force to elicit a reflex, but not so much to cause patient discomfort.
OPTIONAL: Examiner places the thumb or finger firmly on biceps tendon with the pointed end of reflex hammer only.
■ Reflexes must be assessed bilaterally.
■ Examiner must produce a reflex for
OR
23 credit.
Assessing the Triceps Reflex
■ Examiner flexes the patient’s arm at the elbow, and then taps the triceps tendon with reflex hammer.
■ Reflexes must be assessed bilaterally.
■ Examiner must produce a reflex for cr
NEUROLOGICAL EXAMINATION
24 Assessing the Brachioradialis Reflex
■ With the patient’s hand resting in a relaxed position, e.g. on a table, his / her lap or supported by examiner’s arm, the examiner strikes the radius about 1 or 2 inches above the wrist with the reflex hammer.
■ Reflexes must be assessed bilaterally.
■ Examiner must produce a reflex for credit.
NEUROLOGICAL EXAMINATION
25 Assessing the Patellar Tendon Reflex
■ First, patient asked to sit with their legs dangling off the exam table.
■ Reflexes assessed by striking the patient’s patellar tendon with a reflex hammer on skin.
■ Reflexes must be assessed bilaterally.
■ Examiner must produce a reflex for credit.
OPTIONS:
■ Examiner can place his / her hand on the on patient’s quadriceps, but this is optional.
■ Patient’s knees can be crossed.
NEUROLOGICAL EXAMINATION
25 Assessing the Achilles Reflex
■ Examiner dorsiflexes the
patient’s foot at the ankle
■ Achilles tendon struck with the reflex hammer on skin, socks completely off (removed at the direction of the examiner).
■ Reflexes must be assessed bilaterally.
■ Examiner must produce a reflex for credit.
NEUROLOGICAL EXAMINATION
26 Assessing the Plantar, or Babinski, Response
■ Examiner strokes the lateral aspect of the sole from the heel to the ball of the foot, curving medially across the ball, with an object such as the end of a reflex hammer.
■ On skin, socks completely off (removed at the direction of the examiner).
■ Assessment must be done bilaterally
■ Note movement of the toes (normally toes would curl downward).
NEUROLOGICAL EXAMINATION
27 Assessing Rapid Alternating Movements
Examiner must do all three assessments for credit:
■ Examiner directs the patient to pronate and supinate one hand rapidly on the other.
■ Patient directed to touch his / her thumb rapidly to each finger on same hand, bilaterally.
h
h
■ Patient directed to slap his / her thigh rapidly with the back side of the hand, and then with the palm side of the hand, bilaterally.
NEUROLOGICAL EXAMINATION
29 Assessing Finger-to-Nose Movements
■ Examiner directs the patient to touch the examiner’s finger with his or her finger, and then to place his or her finger on their nose.
■ Examiner moves his / her finger randomly during multiple movements.
NEUROLOGICAL EXAMINATION
30 Assessing Gait
Examiner asks patient to perform the following:
Walk, turn and come back
■ Note imbalance, postural asymmetry, type of gait (e.g. shuffling, walking on toes, etc.), swinging of the arms, and how patient negotiates turns.
Heel-to-toe (tandem walking)
■ Note an ataxia not previously obvious
Shallow knee bend
■ Note difficulties here suggest proximal weakness (extensors of hip), weakness of the quadriceps (the extensor of the knee), or both.
NEUROLOGICAL EXAMINATION
31 Performing the Romberg Test
■ Examiner directs the patient to stand with feet together, eyes closed for
at least 20 seconds without support.
■ During this test, examiner must stand behind the patient to provide support in case the patient loses his / her balance.
32 Testing for Pronator Drift
■ Examiner directs the patient to stand with eyes closed, simultaneously extending both arms, with palms turned upward, for at least 20 seconds.
■ During this test, examiner must stand behind the patient to provide support in case the patient loses his / her balance.
NEUROLOGICAL EXAMINATION
SPECIAL TESTING
and lower extremities.
TASKFORCE MEMBERS
John R. McCarthy, Ed.D. Associate Director, Clerkship Education
Pelham Mead, Ed.D. Director, Faculty Development
Mary Ann Achziger, M.S. Associate Dean, Student Affairs
Felicia Bruno, M.A. Assistant Dean, Student Administrative
Services/Alumni Affairs/Continuing Education
Claire Bryant, Ph.D. Assistant Dean, Preclinical Education
Leonard Goldstein, DDS, PH.D. Director, Clerkship Education
Abraham Jeger, Ph.D. Associate Dean, Clinical Education
Rodika Zaika, M.S. Director, Admissions
Ron Portanova, Ph.D. Associate Dean, Academic Affairs
My family tree directs back to the Irish Catholic Meade family with an “e” on the end of Mead who came over in 1857 to NYC, NY from England. Kenneth James Meade and his wife Mary Frazier came over on a boat and had a child Kenneth Joseph in NYC in the year 1857.
The Mead family separated from the MEADE Irish Catholics when my grandfather Kenneth James Meade change his name in 1916 to Pelham Kenneth Mead by dropping the ‘e” which made the Meade name Irish in origin. Grandpa Mead Sr. had issues with his father Kenneth Joseph Meade who divorced his mother Fanny Francis Kohler. Fanny later remarried and became Fanny Mosso living in New Jersey.
The Seabury connection comes from my Grandma Madeline Seabury Mead’s side of the family. She married Pelham Kenneth Mead Sr. by eloping with him because her father was the Police Chief of Peekskill, New York and he would never have agreed to his cultured daughter Madeline marrying some bum from Brooklyn that was only five feet six inches tall. Madeline was five feet ten inches tall.
The Seabury family line traces back to 1636 when John Seaberry aka Seabury seaman arrived on Boston town in Mass. He bought a home in Duxberry, Mass, 30 miles north of Salem, Mass. and began farming for a living. He married Grace Fellows the daughter of one of the original Pilgrims
After farming did not work out John Seaberry departed for the West Indies to grow sugar cane. He was an indentured servant that had to pay back his fee. Life was good in the West Indies and his farm was large and wealthy. Unfortunately, he died at age 40. Three of this children returned to Mass. colony to reclaim his home which was sold but never completely paid for. Samuel Seabury his oldest son and Elizabeth Seabury and John Seabury Jr. sued the buyer of their father’s home and won in court. Samuel Seabury had a privileged education in England and became a Medical Doctor and a religious leader in the local Congregational church. His first wife died and he remarried creating a large extended family
Fast forward to the American Revolutionary War and Samuel Seabury, Chaplain in King Georges III Army in the New York Colony. After the war most of the Seabury loyalists fled to Nova Scotia and Newfoundland. Samuel Seabury stayed in a farm in Westchester and changed from a Tory to an American Colonist. He was very vocal in his support of King George and wrote many articles in local papers. He was arrested and thrown in a jail in Conn. by a band of local colonists after the war. He finally got his rich friends to get him out of jail. He went to England to request that the Church of England grant him permission to become a Bishop of the church. They denied his request because he could not swear allegiance to King George III. After two years he went to Scotland and request that the Bishops there confer him as a Bishop of the new church in the American Colonies. They agreed but requested that he use their 1690 prayer book. When Bishop Samuel Seabury returned to the Colonies the local Episcopal priests all voted him in as the first Episcopal Bishop of the Colonies. Later on he became a Priest in Conn.
From Bishop Samuel Seabury came Judge Samuel Seabury of New York. Judge Samuel Seabury was a New York State judge and put NYC Mayor Walker in jail for taking bribes and conspiracy in 1930.
My Great Grandfather on my grandmothers side of the family was Nathaniel Newcomb Seabury of Peekskill, NY or Cortland Manor as it was called early on. He was educated at the Peekskill Military School at age 14-16. He became a Sergeant in the Peekskill City Police force in 1900. In three years he was promoted to Police Chief of the Peekskill Police force and remained in that position until 1916 when a Democratic Mayor ousted him with false charges.
Nathaniel Newcomb Seabury married Ida Leverich and had two children James Henry Seabury after his grandfather and Madeline H. Seabury. They lived on Division street in Peekskill and years later in Putnam Valley on Lake Oscawana. In retirement, Nathaniel built his own two story house and started a boating and fishing rental business on Lake Oscawana.
Madeline H. Seabury was educated at a woman’s finishing school and learned to play the piano and other social arts. She met a young man from Brooklyn , NY at the Herald Tribune Summer Camp at the other end of Lake Oscawana. A romantic affair developed, however Madeline’s over powering father was the Police Chief and no man was good enough for his daughter. Madeline knew her father would never approve of this man 18 years of age from Brooklyn, NY marrying his daughter, so they eloped and broke his heart.
During the summers Madeline and Pelham Sr. would dump off their children Ken, Nate, and Madeline Mead off at the Grandparent’s house on Lake Oscawana. My father learned to swim there and fish. They called him “Sunny,” as a nickname. Nate was named after his grandfather Nathaniel and Madeline was named after her grandmother.
Both Nathaniel and Ida Seabury died in the 1950’s and are buried in Hillside Cemetery just outside Peekskill in the town of Putnam Valley.
Cemetery Information for Seabury family
Hillside Cemetery, Peekskill, NY
Kenneth James Meade, Irish Catholic from England migrated to NYC prior to 1857 when his son Kenneth Joseph was born in NYC, NY. Kenneth was a draftsman and his wife Mary Frazier was Scottish. They lived in Conn.
James Meade , Irish Catholic, brother of Kenneth James and father of William T. Meade and Madeline Meade.
Madeline Meade daughter of James Meade lived in Deep River, Conn. Married and moved to Hartford, Conn.
William T. Meade, Lived in Middletown, Conn. His uncle Kenneth Joseph, lithographer died on Christmas Eve at William’s house in Middletown Dec. 24, 1916.
*recently discovered brothers and sisters and children of Madeline and William. The lost part of the Meade aka Mead family line. All recorded on software Ancestry.
James L. Seabury –(Millionaire, Iron works owner in Peekskill 1850’s to 1870. Ave. B, old section, Hillcrest cemetery, Putnam Valley, NY, The grave sits on a boulder in a stone memorial with draws for cremated remains. Sons James H. and Cornelius N. are also buried there with small stone crosses.
*When President Lincoln needed to pay for the expenses of the Civil War he started the Federal tax on income. Rich people like James L. Seabury tried to avoid the tax by buying negotiable bonds. James had his millions of dollars all wrapped up in negotiable bonds which could not be detected by the Federal Government. Unfortunately, James L. Seabury’s personal secretary and accountant stole all the negotiable bonds and left James L. Seabury with no money except the house on the top of division street, with its 8 rooms and barn and 100 acres of land which he had to sell and move to Brown Street where he lived in his final years. The bonds were never recovered and the accountant was never caught.
James H. and Cornelius N. are also buried there. Helen the sister of James L. also
Buried (cremated), James H. was a Civil War veteran for the NY 6th Heavy Artillery 1864.
Christina Seabury Valentine buried with her husband,
Judge Wm. Valentine of Sing Sing town next to James L. Seabury.
Nathaniel Newcomb Seabury and Ida Leverich
First Police Chief of City of Peekskill 1900-1916, Republican, Plot 3- Pine Row, brass name plates, directly on The knoll behind the office. Nate Mead bought the name plates with money from brother Ken Mead and Sister Madeline Frampton. Was unmarked previously.
The original St. Paul Methodist Episcopal church is the Chapel in the old section of
The Cemetery. There is a pew with a Seabury name plate on it. James L. Seabury was
An elder of the church in 1863.
James Henry Seabury Jr., son of Nathaniel and Ida Seabury is buried in the Sleepy Hollow Cemetery in Tarrytown, NY. Plot unknown. Ruth Seabury died of alzheimers in NYC while living with her son James H. Seabury 3rd, 15st. NYC, NY.
Kenneth Joseph Meade, father of Pelham K. Mead Sr. aka Kenneth James Meade is buried in Holy Cross Cemetery in Flatbush, Brooklyn, NY. No headstone. Madeline Meade Vail paid for his funeral. He was shipped by train in 1916 to NYC from Middletown, Ct. where he died on Christmas Eve at his nephew’s house Wm. T. Meade of Pearl st. , Middletown, Ct.
Pelham K. Mead Sr. and Madeline Seabury Mead are both buried in Dundalk, Maryland where they lived when they died. Cemetery and plot unknown. Never served in the Military. Changed his name Nov. 25, 1916. Married, eloped, on Nov. 22, 1916, Married in Roman Catholic Church in the Bronx, NY.
Pelham K. Mead Jr. was buried at sea by the US Navy on July 4, 1993. Doris Grace Werts Mead was cremated and her ashes were spread over the Pacific ocean from a Plane. Pelham served on the USS Antietam CV-36 during WWII.
Grandpa Charles L. Werts, father of Doris, and Grandma Ross Werts were both cremated in Flordia , and their ashes were scattered over the Atlantic Ocean. Charles served in the Merchant Marine service during WWI.
Charles L. Werts Jr.- (Sunny) Deceased, Burial unknown site- Died a Professor of Psychology at California. He had a second degree in Electrical Engineering. Served in the US Navy.
These are the actual notes for Mar. 19, 2002 when I was the Director of the Teacher Learning Center. Dr. Green was the Provost at the time and Dr. Richard Flynn was the President of the College. We had 1.1 million dollars in a Title V grant to use over five years from the US Dept. of Education.
Teacher Learner Center
Rm. 412, Admin. Bldg.
College of Mount Saint Vincent
Dr. Pel Mead, Director of the TLC
Meeting on Mar. 19, Wed.
Agenda
4- Need for a monthly or frequent meetings between Andrea Joba, et.al regarding Banner issues and technology related issues that overlap OIT and Shared Department of Computer Services. Year IDUES evaluation concerned with communication as to Goals of the Grant and Objectives ….Communication between departments toward those goals.
IDUES report wants to know what obstacles are preventing success in completing a goal. Web Publishing required of faculty 75% is included in the Grant.
Future TLC Needs that will affect OIT
I wrote and used this customized manual in 2000 for the Nyack, NY, BOCES adult education program in Rockland county New York. This manual deals with version 5.0 and Adobe now as version 10.0 out, but the tool bar and other features remain the same.
Part I Overview of the Institution
B. Mission Statement
As recent as this past December 2002, the board of trustees for the college approved a final draft of the college mission statement and Vision Statement. This mission statement and Vision Statement was approved by all the members of the College community, faculty and administrators and staff as of January 2003.
Vision Statement
In looking to the future, the College of Mount Saint Vincent is guided by its spirit, history, values and traditions which are reflected in the following directional statements:
• The College of Mount Saint Vincent will nurture and sustain its community of learners and scholars characterized by the value of civility that flows from respect for the dignity of each person; the intellectual tradition of the liberal arts; spiritual development and the spirit of the Sisters of Charity.
• The College of Mount Saint Vincent will seek a student population that reflects and celebrates unity within diversity, and is capable of achieving personal and academic success.
• The College of Mount Saint Vincent will act from the perspective of stewardship in the care of its campus and surrounding grounds.
• The College of Mount Saint Vincent will invite and encourage leadership that is responsible and enabling.
Mission and Goals
The College of Mount Saint Vincent provides to qualified, motivated students an excellent values-orientated education rooted in the Catholic heritage and in the liberal arts tradition. The College requires of its students a common core of learning experiences as well as specialization in a major field that will permit them to attain their academic, career and personal goals. Recognizing the ability and dignity of each person, the College teaches students to think critically, to develop self-respect and self-discipline, and to make informed choices which will affect their own lives and the world in which they live. Students who graduate from the College are prepared for a variety of careers and professions, and for responsible leadership in their field.
To achieve these ends, the College attempts to:
• Offer an integrated liberal arts program;
• Afford an educational environment of open inquiry into truth;
• Encourage students to think critically and constructively so that they constantly strengthen their abilities to identify academic and personal problems, and to make judgments on problems of professional development;
• Develop self-confident, informed, concerned individuals who possess convictions of self-worth and purpose, and respect for humanity;
• Provide a climate of appreciation for religious and spiritual values where students may form strong and enduring value systems based on integrity and respect for the rights of others;
• Foster respect for the views of others through opportunities to investigate various systems and cultures;
• Alert students to needs in the community and in the world as large and to promote a spirit of service;
• Infuse students with a sense of responsibility for their world, and a practical urgency to be an influence for good.
Together, the Vision, Mission, and goals guide the planning and development of the college, its programs and services. Both documents reflect the College’s emphasis on the importance of teaching and learning and the desire to provide quality educational programs and services.
Primary Service Population
The College enrolls most of its students from the Bronx, a borough of NYC; Manhattan borough, also a borough of NYC; and Yonkers a city on the border of our property in Westchester counts. Students from the Bronx enrollment________, from Manhattan, from Queens, __from Westchester (primarily Yonkers). A total of of our students come from one of the 5 boroughs of NYC. The largest group comes from the
Bronx both in 1998 and again in 2003.
The demographics of the surrounding area have a direct relationship to student ethnicity, unemployment, family income and high school graduation rate of our students. .Many of Yonkers students come to the College because we are in the neighborhood and accessible by public transportation. Yonkers is right on the border of the College campus has 5 high schools with the highest percentage of students Hispanic and black in all of Westchester county, New York. The Table 4 below indicates the Yonkers High School Enrolment for the school year 2000-2001. The Hispanic population is the highest with 39.7, 39.6, 44.0, 29.2 and 17.7 in the Trade high school. Black students are also in the 30 percent level except the Trade school and together with the Hispanic student population comprise 60% or more of each school’s student body..
School Grades Students %white %black %hisp. %asian %indian Tot B/H
Groton 9-12 1595 21.5 31.0 39.7 7.6 .02 70.70
Lincoln 9-12 1336 17.5 39.0 39.6 3.7 .02 78.60
Roosev 9-12 1649 16.1 35.1 44.0 4.8 .02 79.10
Yonkers Mts 9-12 1564 27.6 29.2 29.2 7.0 .01 58.40
Saunders
Trade 9-12 1465 34.3 17.7 17.7 5.7 .00 35.40
(Source Nat. Center of Ed. Statistics 2000-20001 )
The largest population comes from the Bronx which according to the Census 2000 is the only county in the northeast quarter of the US (north of the Ohio River; East of the Great Plains) where more than 40% of children live in families below poverty.
It is the only county in the same area where more than 30% of the population lives below the poverty line. Congressional District 16 (entirely in the Bronx, covering most of the South Bronx) had the highest poverty rate in the US (40.2%; the next highest rate was 32.4%). Congressional District 16 also had the highest proportion of children living below poverty (50.1%; the next highest was 42.2%, and the lowest median household income. See Figure 5 below comparing the Bronx with the rest of the US as being the highest county in the US with Single female head of household below the poverty level as being a most glaring sign of need.
Table 5 –Families with single Female Head of households for the entire US from the 2000 Census. Note the Bronx is one of the highest in the entire country.
In the Table 6 below the Hispanic population in the Bronx is indicated from the Federal Census of 2000. The area in dark green indicates 50-100 percent and it is the area that is two neighborhoods away from the College of Mount Saint Vincent campus. The majority of all the Hispanic population lives in this northeastern section of the Bronx bordering with Westchester and going down almost halfway into the Bronx. A majority of these students apply to and are accepted at the College of Mount Saint Vincent. The College is conscious of its obligation to server the local community and this service has seen an increase of Hispanic students since 1998 of 11% up from 25% to 36 percent in year 2003. The two neighborhoods adjacent to the college reflect a 10-25% Hispanic population whereas in 1998 these neighborhoods had less than 10 % Hispanics or Latinos living there. The trend is that the surrounding neighborhood is changing over the past decade and will continue to change as poverty values devalue and more affordable high rise apartments become available on the real estate market in the affluent Riverdale area.
(Table 6- The Bronx: Latinos as percentage of Total Population)
The ethnic census of the Bronx show one of the highest percentages of Hispanics in New York State. There are more Hispanics located in the Bronx than any of the other four boroughs of New York. The ethnic concentration has been mostly Puerto Rican and Cuban with a smaller percentage of Central American Latinos. Mexican Hispanics do not have a significant representation as in California and Texas, giving the New York Hispanics a little different ethnic composition and the third highest rate of Hispanics in the US.
(Table 7 Racial-Ethnic Concentration of Bronx Blocks)
The heaviest population of Hispanics is just to the south-east corner of Riverdale where the College is located. In addition to the highest Hispanic and minority population for any other county, the Bronx and Yonkers demonstrate a high level of families below poverty levels. The major red and pink zones show that the Hispanics populate the major portion of the Bronx. The College of Mount Saint Vincent is in the upper most Northeast corner of the Bronx, right on the Yonkers-Westchester county border. The little white box in the upper left corner in the Blue Riverdale area of the Bronx.
The Census 2000 Chart below demonstrates a comparison of the five boroughs of New York City as to the poverty levels. The Bronx leads and has continued to demonstrate a higher level of poverty among all of the five boroughs of New York City. With 54% of the total population below Poverty level, and the kids under 18 at 40% below poverty level and the Female headed families at 30% below poverty all paints a sad scenario. The College does everything in its power to give financial aid to these students living in below level poverty. Almost 88% of the entire student population at the College are on some form of financial assistance including work study, TAP, PEL grant and other scholarships available for Hispanics and other minority groups
(Table 9- Poverty Levels by NYC Boroughs from Census 2000)
The Bronx leads all five New York City boroughs in the total level of families below the poverty level at 52 %. This compares to the Unites States as one of the most concentrated pockets of poverty in New York State as well as other states. The infamous South Bronx area which numerous Presidents have come to see but give little Federal aid looks like the aftermath of an atomic blast. Empty buildings with windows knocked out and graffiti everywhere dot the horizon. All of the commercial building are closed up and abandoned and gangs rule the area. Only the poorest Hispanics and minorities live in or near this area because of cheap rent in depilated buildings
(Table 10- Families below Poverty by County, The Bronx is in the insert in RED, from the 2000 Census)
The families that live in the Bronx live in the one county that compares with all other counties in the US as having the highest rate per capita of poverty.
“Most Bronx children now live in single-parent homes, and almost half of those under four are below the poverty line – many in immigrant families that are new to the Bronx. For the population as a whole, the poverty rate has risen slightly to 30%, while for senior citizens, it has fallen slightly, to just under 20%.
Education levels are also continuing to rise as more of the borough’s population graduates from high school and then completes college. But while two-thirds of the borough’s adults now have at least a high school education, a good indication of a growing skilled labor force, the number of those employed continued to fall throughout the decade.(Bosworth, “First glimpse at Bronx Census Data,” 2002). The children in the Bronx suffer not only from poverty and overcrowded housing, but they also are being brought up by one parent. The chart below shows clearly how from 1960 to 2000 the children under 18 population have dropped drastically from a high of 350,000 in 1960 for two parent families to less than 150,000 two parent families in 2000. The single parent homes have been on a steady increase since 1960, to slightly less than 200,000 in year 2000.
(Table 11- Bronx Kids (under 18) Family Structure –one parent families vs two parent families)
To sum it all up the College of Mount Saint Vincent who was originally an academy run for poor children since 1847 has survived over one hundred and fifty years serving second generation children, below poverty level children, Hispanics and other minorities as a part of it’s tradition. The Sisters of Charity who originally foundedthe academy and who own half of the land where the college is now located has supported this tradition of helping the poor. Supporting the poor and underprivileged students of the Bronx and Yonkers (Westchester) is not without difficulty, however. The college had to merge with Manhattan College in an agreement to allow students from both colleges to cross-enroll for classes at either college in the 1960’s in order to survive.
In the early 1990’s the College of Mount Saint Vincent began to experience difficulties in meeting the new technical revolution of computers and computer driven devices. The faculty was dedicated to teaching but behind in modern methods of teaching using technology such as computers, LCD projectors, internet access and databases.
It was not until Oct. 1, 2000 when the College received a Title V HIS grant for Institutional Improvement did technology instruction for faculty really take hold with individual instruction for 15 professors each year and the installation of 5 smart classrooms each year for a period of five years.
Just recently in the spring of 2003 the Banner corporation began a complete administrative software upgrade both for the College of Mount Saint Vincent and Manhattan College, it’s sister school. This 1.3 million dollar data conversion would take 2-3 years to install. Manhattan College who has 5,000 students would agree to pay 60% of the payments for Banner, and the College of Mount Saint Vincent would pay 40% for this process over three years. The College of Mount Saint Vincent was able to fund their payments through their Title V HIS grant which made the whole process affordable and possible. When the complete database system for both colleges is completed, both colleges will be better able to cross-register and handle student financial aid, college financial services, admissions, Bursar, student services and graduate development offices.