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Academic and Student Services

LCME Spotlight

LCME Spotlight is a resource from the Office of Educational Improvement (OEI) within the Department of Academic Affairs. The LCME Spotlight is designed to increase faculty and staff awareness and understanding of the Liaison Committee on Medical Education (LCME) standards (elements) that guide all aspects of the Medical Education Program and their impact upon MCW’s medical school accreditation status.

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October 2018: Element 4.5 Faculty Professional Development

“A medical school and/or its sponsoring institution provides opportunities for professional development to each faculty member in the areas of discipline content, curricular design, program evaluation, student assessment methods, instructional methodology, and research to enhance his or her skills and leadership abilities in these areas.”

What does this mean?

The LCME requires that faculty be provided with sufficient opportunities for professional development to support them in their educational and research roles.

MCW’s Efforts to Provide Faculty Development

  • The Office of Educational Improvement offers instructional design services and faculty development programming focused on educator skill refinement and development.
  • The Office of Measurement and Evaluation regularly assesses post-event course and instructor evaluation and provides data analysis and individualized feedback reports.
  • The Office of Research provides a variety of training sessions on issues such as human research protections and grant development.
September 2018: Element 3.2 Preparation of Resident and Non-Faculty Instructors

"A medical education program is conducted in an environment that fosters the intellectual challenge and spirit of inquiry appropriate to a community of scholars and provides sufficient opportunities, encouragement, and support for medical student participation in the research and other scholarly activities of its faculty."

What does this mean?

The LCME requires that medical students have the opportunity to participate in research projects with faculty members. The medical school is expected to foster a scholarly environment for faculty and students, with appropriate support and encouragement for students to participate in research opportunities.

MCW’s Efforts to Foster Scholarly Activities for Medical Students

  • MD/PhD, MD/MS, and MD/MPH programs
  • Medical Students Summer Research Program (Milwaukee campus)
  • Medical student research electives
  • Scholarly Pathway graduation requirement
July 2018: Element 9.1 Preparation of Resident and Non-Faculty Instructors

"In a medical school, residents, graduate students, postdoctoral fellows, and other non-faculty instructors in the medical education program who supervise or teach medical students are familiar with the learning objectives of the course or clerkship and are prepared for their roles in teaching and assessment. The medical school provides resources to enhance residents’ and non-faculty instructors’ teaching and assessment skills, and provides central monitoring of their participation in those opportunities."

What does this mean?
The LCME requires that anyone who teaches medical students receives the learning objectives for the course or clerkship and must be prepared for their role as an educator. At MCW, the Curriculum and Evaluation Committee (CEC) is responsible for determining what constitutes appropriate preparation for teaching and holding courses and clerkships accountable in documenting their compliance. 

Characteristics of an effective preparation system: 

  • Course or clerkship objectives are shared with faculty and non-faculty educators on a routine basis
  • How and when non-faculty teachers are prepared for their role as teachers are well documented
  • Medical students are aware of the training made available to educators in preparation for working with them
 
June 2018: Element 11.2 Career Advising

"A medical school has an effective career advising system in place that integrates the efforts of faculty members, clerkship directors, and student affairs staff to assist medical students in choosing elective courses, evaluating career options, and applying to residency programs."

What does this mean?

The LCME requires schools to have an integrated, comprehensive system in place that includes faculty, student affairs staff and course/clerkship directors to provide support in selecting electives, evaluating career options, and applying for residencies.

Characteristics of an effective career advising system:

  • Comprehensive services and activities that begin at matriculation and are offered throughout the students’ tenure at the institution
  • Services are built into the curriculum and enable students to explore interests
  • Time is provided for students to reflect on their experiences
  • Students have access to human and online resources to help inform their decision making
  • Appropriate personnel are available to aid in decision making
  • Students have a choice in who will write their MSPE letter for residency application
May 2018: Element 11.1: Academic Advising

"A medical school has an effective system of academic advising in place for medical students that integrates the efforts of faculty members, course and clerkship directors, and student affairs staff with its counseling and tutorial services and ensures that medical students can obtain academic counseling from individuals who have no role in making assessment or promotion decisions about them."

What does this mean?

The LCME requires schools to have an effective, longitudinal system in place across the M1-M4 years to provide advising and mentorship to medical students. This system must include professionals who have no role in grading or academic advancement decisions.

Characteristics of an effective academic advising system:

  • Defined system of methods and timelines for identifying students with academic difficulties
  • Longitudinal with methods to catch problems and difficulties that may be missed earlier in the student’s academic career
  • Student engagement through understanding expectations and resources available for assistance
  • Access to multiple mentorship opportunities at multiple touchpoints throughout the curriculum
  • Evidence of established processes and resources available to students in an accessible manner
  • Internal and external resources to help students identify their needs and direct them to appropriate resources
  • Avenues to bring together student affairs and education personnel to communicate shared observations of students experiencing difficulties
February 2018: Element 6.1: Program and Learning Objectives

"The faculty of a medical school define its medical education program objectives in outcome-based terms that allow the assessment of medical students’ progress in developing the competencies that the profession and the public expect of a physician. The medical school makes these medical education program objectives known to all medical students and faculty. In addition, the medical school ensures that the learning objectives for each required learning experience (e.g., course, clerkship) are made known to all medical students and those faculty, residents, and others with teaching and assessment responsibilities in those required experiences."

What does this mean?

The LCME requires schools to have an effective system in place for informing students, faculty, and residents who teach medical students of the program and learning objectives. This includes the Global Competencies for the MCW Medical School curriculum and all course and clerkship learning objectives.

Tips for Disseminating Program and Learning Objectives

  • Develop a plan to provide program and learning objectives to your faculty, residents, and fellows on a routine basis.
  • Provide the objectives using more than one delivery method to help ensure awareness (e.g., orientations, seminars, retreats, email communications, etc.).
January 2018: Element 8.3: Curriculum Design, Review, Revision/Content Monitoring

"The faculty of a medical school are responsible for the detailed development, design, and implementation of all components of the medical education program, including the medical education program objectives, the learning objectives for each required curricular segment, instructional and assessment methods appropriate for the achievement of those objectives, content and content sequencing, ongoing review and updating of content, and evaluation of course, clerkship, and teacher quality. These medical education program objectives, learning objectives, content, and instructional and assessment methods are subject to ongoing monitoring, review, and revision by the faculty to ensure that the curriculum functions effectively as a whole to achieve medical education program objectives."

What does this mean?

The Curriculum and Evaluation Committee, or CEC, is an autonomous faculty committee responsible for the design, approval, and ongoing evaluation of the undergraduate medical curriculum. The CEC evaluates and approves all changes to existing curricular policies and programs as well as new policies and programs.

To fulfill their responsibilities, the CEC engages in:

  • Review and approval of all new courses and rotations
  • Routine, in-depth course and rotation reviews
  • Oversight of the course, teaching, and student evaluation processes
  • Oversight of curriculum objectives and resources

Tips to Support Curriculum Design and Monitoring

  • Be familiar with MCW's Global Competencies (PDF), the list of what medical students will be able to demonstrate upon completion of the curriculum. 
  • Be familiar with the Medical School Curriculum and Evaluation Process, managed by the Curriculum and Evaluation Committee (CEC). 
  • Review evaluation data as available and access appropriate resources to address areas of relative weakness.
  • Submit any desired curriculum modifications, additions or deletions to the CEC for review and approval prior to implementing changes.
December 2017: Element 8.1: Curriculum Management

"A medical school has in place an institutional body (e.g., a faculty committee) that oversees the medical education program as a whole and has responsibility for the overall design, management, integration, evaluation, and enhancement of a coherent and coordinated medical curriculum."

What does this mean?

The Curriculum and Evaluation Committee (CEC) is charged with oversight of the undergraduate medical curriculum. In this role it is responsible for evaluation of all teaching and learning programs, making modifications to the current curriculum as well as reviewing and approving any new courses or curriculum.

According to the LCME, an effective oversight committee exhibits the following characteristics:

  1. Participation by faculty, students, and administrators,
  2. Availability of experts in curricular design, methods of instruction, student assessment, and program evaluation,
  3. Empowerment to work in the best interests of the medical education program without regard to political influences or departmental pressures.

Tips to Support Curriculum Oversight

  •  Be familiar with the Medical School Curriculum and Evaluation Process, managed by the Curriculum and Evaluation Committee (CEC).
  • Submit all course proposals to the CEC by each year's designated deadline. The committee will review each proposal as part of the overall medical education program and approve courses for the following academic year's catalog.
  • Review and update your course information annually or as changes occur.
November 2017: Element 8.3: Curriculum Design, Review, Revision/Content Monitoring

"The faculty of a medical school are responsible for the detailed development, design, and implementation of all components of the medical education program, including the medical education program objectives, the learning objectives for each required curricular segment, instructional and assessment methods appropriate for the achievement of those objectives, content and content sequencing, ongoing review and updating of content, and evaluation of course, clerkship, and teacher quality. These medical education program objectives, learning objectives, content, and instructional and assessment methods are subject to ongoing monitoring, review, and revision by the faculty to ensure that the curriculum functions effectively as a whole to achieve medical education program objectives."

What does this mean?

The curriculum must be organized to support students' development of knowledge, skills, and attitudes based on the competencies and objectives set forth by the medical school. The LCME requires that an explicit, faculty-driven process is utilized to ensure that content is appropriately selected and coordinated to support student learning. Curricular content, whether produced internally or externally, must address the school's objectives and be available to all students, regardless of their location.

A coherent and coordinated curriculum includes:

  • Logical sequencing of curricular segments
  • Horizontal and vertical integration of content across academic periods of study
  • Methods of instruction and assessment appropriate to achievement of program objectives

Tips to Support a Coherent and Coordinated Curriculum

  • Be familiar with MCW's Global Competencies, the list of what medical students will be able to demonstrate upon completion of the curriculum.
  • Be familiar with the Medical School Curriculum and Evaluation Process, managed by the Curriculum and Evaluation Committee (CEC).
  • Be aware of the course and session learning objectives for which you are involved.
October 2017: Element 8.1 Curricular Management

"A medical school has in place an institutional body (e.g., a faculty committee) that oversees the medical education program as a whole and has responsibility for the overall design, management, integration, evaluation, and enhancement of a coherent and coordinated medical curriculum."

What does this mean?
At MCW, the Curriculum and Evaluation Committee (CEC) oversees the medical education curriculum. According to the LCME, an effective system of curriculum management exhibits the following characteristics:

  • Evaluation of program effectiveness by outcomes analysis, using national norms of accomplishment as a frame of reference
  • Monitoring of content and workload in each discipline, including the identification of omissions and unplanned redundancies
  • Review of the stated objectives of each individual curricular component and of methods of instruction and student assessment to ensure their linkage to and congruence with programmatic educational objectives.

Tips to Support Curriculum Management

  • Be familiar with MCW's Global Competencies (PDF), the list of what medical students will be able to demonstrate upon completion of the curriculum.
  • Be aware of the learning objectives for the course(s) and session(s) with which you are involved.
 
September 2017: Element 3.5 Learning Environment and Professionalism

"A medical school ensures that the learning environment of its medical education program is conducive to the ongoing development of explicit and appropriate professional behaviors in its medical students, faculty, and staff at all locations and is one in which all individuals are treated with respect. The medical school and its clinical affiliates share the responsibility for periodic evaluation of the learning environment in order to identify positive and negative influences on the maintenance of professional standards, develop ad conduct appropriate strategies to enhance positive and mitigate negative influences, and identify and promptly correct violations of professional standards."

What does this mean?

The LCME requires schools to designate policies, procedures, and processes for immediately reporting, responding to, and remediating breaches of professionalism and instances of student mistreatment. MCW and its clinical partners must foster an environment that promotes professionalism and addresses lapses in professional behavior. 

Tips to Foster Professionalism in the Learning Environment

  • Be aware. Understand the standards of professionalism, and the associated policies and procedures, to which MCW holds faculty, staff and students accountable.
  • Role model. Lead by example, demonstrating adherence to standards of professionalism in your words and actions. In addition, role model appropriate responses to lapses in professional behavior by reporting them according to institutional policies and procedures. 
August 2017: Element 9.3 Clinical Supervision of Medical Students

"A medical school ensures that medical students in clinical learning situations involving patient care are appropriately supervised at all times in order to ensure patient and student safety, that the level of responsibility delegated to the student is appropriate to his or her level of training, and that the activities supervised are within the scope of practice of the supervising health professional."

What does this mean? 

Faculty supervising medical students in the clinical setting must take care when delegating learning activities and/or skills training to others (such as fellows, residents, etc.). It is the faculty member’s responsibility to ensure teaching delegates are supervising learning within the scope of their practice and have the necessary skills to teach. In addition, faculty should ensure assigned learning activities are suitable for the student’s level of training.

Tips to Ensure Appropriate Clinical Supervision

  • Choose wisely. Select teaching delegates who possess the appropriate licensure, education, and preparation to teach medical students.
  • Don’t assume – observe. Observe any teaching delegates to ensure they have the necessary skills to teach the medical students before entrusting them with that task on their own.
  • Be explicit. Clarify your expectations for teaching activities to ensure they are within the teaching delegate’s scope of practice and appropriate for the student’s level of training.
 
July 2017: Element 9.4 Assessment System

"A medical school ensures that, throughout its medical education program, there is a centralized system in place that employs a variety of measures (including direct observation) for the assessment of student achievement, including students’ acquisition of the knowledge, core clinical skills (e.g., medical history-taking, physical examination), behaviors, and attitudes specified in medical education program objectives, and that ensures that all medical students achieve the same medical education program objectives."

What does this mean?

Faculty who assess medical students must directly observe the students performing the tasks on which they are being assessed, such as taking a history, conducting a physical examination, giving an oral presentation, etc. Faculty assessments must be based on their own observations of the student’s performance and not inferred from other activities (i.e., assessing the student’s ability to conduct a physical examination based on the contents of the student’s written H&P).

Tips to Enhance the Direct Observation of Student Performance

  • Plan your time – set aside a small, regular block of time to observe your student’s performance
  • Conducting teaching rounds with your student(s) is a great time to provide direct observation
  • Be explicit – tell the student when you are observing their performance
  • Ensure students understand you are assessing their skills to help them improve
  • Foster a culture that values direct observation through role modeling and open dialogue
 
June 2017: Element 9.5 Narrative Assessment:

"A medical school ensures that a narrative description of a medical student’s performance, including his or her non-cognitive achievement, is included as a component of the assessment in each required course and clerkship of the medical education program whenever teacher- student interaction permits this form of assessment."

What does this mean?
Faculty completing assessments must provide written comments whenever their interaction with the student(s) is of sufficient duration and depth. MCW must have policies and procedures in place to ensure that courses and faculty interactions of a suitable duration provide narrative feedback to the student(s).

Tips to Enhance the Narrative Assessment

  • Take brief notes as you work with students to serve as a reference for drafting narrative feedback
  • Focus on remediable behaviors, not personal attributes
    • Knowledge/skills versus personality traits
  • Define areas of relative strength and deficiency and provide supportive examples
  • Include descriptions of preferred behaviors to encourage performance improvement