Grade Policy for Courses, Clerkships, and Electives in Phases 2 and 3

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IUSM-PO-EDU-CUR-0016

Full Policy Contents

Scope
Policy Statement
Reason for Policy
Procedures
Definitions
Sanctions

ADDITIONAL DETAILS
Additional Contacts
Related Information
History

Effective: 01/08/2014
Last Updated: 03/20/2019

Responsible University Office:
Medical Student Education

Responsible University Administrator
Associate dean of curricular development and oversight

Policy Contact:
askmse@iu.edu

RESPONSIBLE Associate dean of curricular development and oversight
ACCOUNTABLE Senior associate dean for medical student education
SUPPORT Phase 2 assistant dean and Phase 3 directors; Curriculum Council Steering Committee
CONSULT Assistant dean of academic records and promotion
INFORM Students; Phase 2 and Phase 3 course directors; competency directors; Phase 2 and Phase 3 course instructors

LCME Standards

9.5 Narrative Assessment
9.8 Fair and Timely Summative Assessment


Scope

Students enrolled in Phases 2 or 3 of the curriculum at Indiana University School of Medicine and faculty, residents, and other personnel working with these students in the School of Medicine.


Policy Statement

At the conclusion of each Phase 2 and Phase 3 required course, all students will receive an honors – high pass – pass – fail grade in accordance with the tiered grade scale criteria for that course. In addition to the Phase 2 or Phase 3 course grade, all students will receive written narrative feedback at the midpoint and conclusion of each course. Courses will provide a clear and concise description of criteria for determination of grades in the course syllabus.


Reason for Policy

To define the grading system used by IUSM to evaluate students in Phases 2 and 3 of the competency-based curriculum and to ensure consistency and fairness of grades.


Approval

Approved by the Curriculum Council Steering Committee 03/19/2019.


Procedures

This policy does not apply to Transitions and Intersessions courses.

All Phase 2 and Phase 3 courses will provide grading criteria in their syllabus. Phase 2 required clerkship grading will be consistent with the Phase 2 Grading Schema (see below).

A faculty member/attending physician who is a relative of, in a relationship with or has had a prior relationship with a student that could be perceived as a conflict of interest may not evaluate that student.

Grade and evaluation reports will be made available to each student after the completion of each clinical course. The duration between the end of Phase 2 or Phase 3 courses and availability of the course grade should not exceed 30 days (see Timeliness of Grades policy).

If a student receives a failing grade in a Phase 2 or Phase 3 course or demonstrates deficiency in at least one competency, the Student Promotions Committee will recommend an action to address the concern (see the Guidelines for Promotion, Suspension, Dismissal and Withdrawal)

Final grades are reported to the Registrar’s Office, where these become a part of the student’s permanent academic record. The assistant dean for academic records and promotions reports grades to the Student Promotions Committee. At the end of each academic year, the Curriculum Council Steering Committee will review a summary of grades awarded that year.

Course and Clerkship Grades

All Phase 2 and Phase 3 required courses will use the honors, high pass, pass, fail, and withdrawal grade options.

Phase 2 Required Clerkship Grading Schema

The determination of grades in the Phase 2 required clerkships will be based on a points system whose total is determined by each clerkship. The points system for each clerkship will be approved by the assistant dean of medical education, phase 2 to assure comparability and consistency. The percentages for each component will match the requirements below. Students will be provided the grading criteria in the clerkship syllabus.

a. NBME 25 % of total points

i. Must achieve the 5th percentile to Pass as determined by the NBME/final exam statistics provided from the most recent academic year available or
ii. Must achieve the 50th percentile to achieve Honors as determined by the NBME/final exam statistics provided from the most recent academic year available.

b. Clinical Portfolio 75 % of total points

i. Preceptor Evaluations 40-50 % of total points
ii. Clinical Skills Development 25-35% of total points

c. For clerkships that do not utilize an NBME exam for the final examination, the clerkship will designate in the syllabus the examination score required to Pass the clerkship and the score required to be eligible to achieve Honors.

d. The clerkship will designate the specific number of points required for the achievement of honors, high pass and pass.

e. Timeliness of Assignments: It is expected that all required assignments and tasks will be submitted on time. Late submissions of assignments or failure to complete tasks on time without approval from the statewide clerkship director will result in a deduction of up to 5% of the total course points.

If a student submits two or more graded assignments or non-graded clerkship tasks late OR other type of professionalism concerns arise, a professionalism AOC will be submitted.

If a student fails to achieve a passing score on the NBME or equivalent standardized examination, he/she will be given an ID-MK and will be referred to the Student Promotion Committee for remediation of the isolated deficiency.

Phase 3 Grading

The required Phase 3 courses will provide a clear and concise description of the grading criteria in the course syllabus.

Fail – (see Sanctions) A failing grade is assigned to a student who meets any ONE of the following criteria:

  • Has failed to demonstrate competence in the requirements of the Phase 2 or Phase 3 course (e.g., write-ups, patient encounters, clinical skills, etc.).
  • Has received a failing cumulative course score or has failed to complete all required assignments (e.g., essays, papers, history and physicals, etc.) by the end of the Phase 2 or Phase 3 course.
  • Has failed to remediate a competency in which he/she received an isolated deficiency (see below).
  • Has received isolated deficiencies in two or more competencies.

The following designations may be used as placeholders for grades, but will not appear on the official final transcript once the final grade has been determined:

Incomplete – May be assigned by a clerkship director when exceptional circumstances, such as illness, prevent a student from finishing all work required in a course within the term. The designation of I will be awarded only if the work is mostly complete and of passing quality. If coursework is not completed within one year from the end of the course, the student will fail the course.

  • Isolated Deficiency – Will be assigned to a student who would receive an overall passing grade except for failing one of the competencies taught and assessed in the course. The isolated deficiency designation is not a final grade and will not appear on the final transcript. Instead, the ID serves as a designation while the remediation process is carried out and will transition to a pass or a fail based on the remediation process. The isolated deficiency must be remediated for the student to pass the course.
  • Two or more isolated deficiencies results in course failure.
  • Failure of patient care, the main competency taught and assessed in clinical courses, results in failure; thus, no isolated deficiency may be assigned for patient care in clinical courses

Area of Concern Notifications

An Area of Concern identifies at-risk students with “low-level” problems that may escalate if not addressed early in a course, clerkship or elective.

  • The AOC designation is not a final grade and will not appear on transcripts; rather, AOC marks an opportunity for intervention/improvement by a student when low-level concerns are raised in any competency that, if not addressed, could escalate to the student receiving an isolated deficiency or a “Fail” grade (see AOC policy for details).

Definitions

Phase 2 and Phase 3 required courses: Includes courses, clerkships, sub-internships, and selectives taken during Phase 2 and Phase 3 of the curriculum. Electives are considered courses but not encompassed in the term “required courses,” under this policy.

The Indiana University School of Medicine evaluation system is built on competency-based learning as defined by the Curriculum Council Steering Committee. The IUSM uses the following letter grade markers for the official transcript:

  • Honors (H): Signifies exceptional and superior performance.
  • High Pass (HP): Signifies performance above and beyond expectations.
  • Pass (P): Signifies satisfactory performance.
  • Withdrawal (W): Signifies that the student withdrew before completing course objectives
  • Fail (F): Signifies that the student has not performed satisfactorily.

The IUSM uses the following placeholders for grades which will not appear on the official transcript until the final grade is determined:

Incomplete – May be assigned by a clerkship director when exceptional circumstances, such as illness, prevent a student from finishing all work required in a course within the term. The designation of I will be awarded only if the work is mostly complete and of passing quality. If coursework is not completed within one year from the end of the course, the student will fail the course.

Isolated Deficiency (ID): Signifies that a student has performed adequately in the course, except for a particular area of weakness in a competency other than patient care for clinical courses. The student must complete remedial work in the designated competency to pass the educational experience. Failure of patient care, the main competency taught and assessed in Phase 2 and Phase 3 courses, results in failure; thus, no isolated deficiency may be assigned for patient care.

  • The ID will serve as a designation while the remediation process is carried out, and will not appear on the permanent transcript. Successful remediation of the ID will result in a passing grade (P) for the course. Unsuccessful remediation of the ID will result in a failing grade (F) for the course.

Sanctions

If a student fails a Phase 2 or Phase 3 course or receives an isolated deficiency in a competency other than patient care, the Student Promotions Committee will recommend an action to address the problem.


Additional Contacts

Subject Contact Phone Email
Student Records Kim Sandrick 317-274-1970 ksandric@iu.edu
Medical Student Education Operations (317)274-1965 askmse@iu.edu

Related Information

  • Competencies
  • Grade Appeal Policy
  • Area of Concern Policy
  • Formative Feedback Policy
  • Timeliness of Grades Policy
  • Requirements to Graduate
  • Guidelines for Promotion, Suspension, Dismissal, and Withdrawal
  • Non-Involvement of Health Care Providers in Student Assessment Policy

History

Approved by the Curriculum Council Steering Committee 4/8/2014.
Exemption from grade distribution for electives and sub-internships approved by the Curriculum Council Steering Committee 11/15/2016.
Isolated Deficiency approached revised. The revised procedure endorsed by the Student Promotions Committee on 07/16/2018.
Approved by the Curriculum Council Steering Committee 7/17/2018. Retroactive to start of AY2018/2019 in April 2018 for Phase 2 and Year 4 (Phase 3).
Removed reference to legacy curriculum and added Phase 2 Grading Schema to procedures section with updates 02/04/2019.
Removed “Forms” section and updated list of “Related Information” 03/04/2019.
Approved by CCC on 3/05/2019.
Title changed to “Grade Policy for Courses, Clerkships and Electives in Phases 2 and 3” to better reflect the scope and content of the policy 03/12/2019.
Approved by CCSC 3/19/2019.
Phase 2 Grading Schema Policy retired and its grading schema procedures added to this policy. 03/20/2019.