Student assessment in the WR2 Curriculum is designed to accomplish the following: 1) facilitate the types of learning and inquiry that are goals for the WR2 Curriculum; 2) ascertain whether students attain the level of mastery necessary for graduation from Case; and 3) prepare students for the Multiple Choice Question (MCQ) USMLE exams. These three goals are accomplished through multiple different assessment methods.
Independent study and inquiry are hallmarks of WR2 through assessment strategies that are formative and summative, focus on the synthesis of concepts, and promote student responsibility for the mastery of skills and material. The following assessments are used in the Foundations of Medicine and Health:
- Assessment of students’ participation in weekly Case Inquiry (IQ) groups by faculty facilitators, utilizing observable behavior anchors and focusing on 1) contributions to the group content and process, 2) critical appraisal of resources, and 3) professional behaviors.
- Synthesis Essay Questions (SEQs). Weekly, formative, open book concept reasoning exercises in which students are given a brief written clinical scenario and asked to explain a clinical phenomenon and its basic science underpinnings. Throughout a teaching block, students complete SEQs at the end of each week. They then compare their answers to an ideal answer template as well as get feedback on their reasoning ability from their IQ group facilitator.
- Summative Synthesis Essay Questions (SSEQs) are exercises that measure what students know at the end of each block in the Foundations of Medicine and Health. They are closed book exercises with approximately 5 clinical scenarios and accompanying questions and take 3-4 hours to complete. These SSEQs are similar in format to the synthesis essays students have done in an open book fashion throughout the block. These summative exercises are scheduled at the end of each large teaching module (every 3-4 months) and are graded by the faculty who are content specialists.
- Structure Practical Examinations: These assessments occur in the final week of blocks 2-6 and integrate anatomy, histo-pathology and radiology through clinical scenarios and questions that ask for anatomic localization and histo-pathologic identification.
- Self Assessment Multiple Choice Questions (MCQs). Each week approximately 20-30 MCQs are posted electronically that highlight important teaching points. Students submit answers by the end of the week and receive immediate feedback about the correct response. These questions are representative of those given during the USMLE Part I. Students can use these MCQs through the block as a study aid and method for self-assessment.
- Cumulative Achievement Tests (CAT). At the end of each block, students complete a secure formative MCQ achievement test, based on content covered in the current teaching block as well as on content from each previous block. These exams are designed, utilizing test question resources available through the NBME. Tests become progressively longer throughout the Foundations of Medicine and Health. The final CAT reflects material across all curriculum blocks. These formative tests are for student use only, and enable students to gain perspective on their overall progress and preparedness for the USMLE.
- Student progress in Foundations of Clinical Medicine (FCM) is measured by small group facilitator assessment in the FCM Seminars, direct observation of skills, preceptor evaluation of patient-based activities, and OSCE examinations.
- Personal Learning Plan. At the midpoint of each block students reflect on their learning, identifying their strengths and areas for further study. A quality improvement template (in the form of the plan-do-study-act cycle) is completed At the end of the block students meet in societies to assess their success and barriers in carrying out their quality improvement plans.
- Portfolios: The WR2 curriculum is a competency-based curriculum with 9 core competencies. Students submit portfolios with reflective essays to demonstrate that they have met the target achievement levels as they progress through the WR2 curriculum. Portfolios are submitted at the end of year 1, just prior to the start of core clinical rotations and in the fourth year.
The WR2 Curriculum has a limited number of classroom hours, but expects that students will engage in self-directed learning outside the classroom to master the curriculum's learning objectives. The content of WR2, organized across biological systems, provides students with an integrated view of medicine and health and a clearer understanding of how the basic sciences and clinical practice relate to one another. The flexibility of WR2 permits students to explore in depth an area of interest to them alongside a mentor. The curriculum’s focus on the social and behavioral context of health and disease as well as on population medicine prepares students for the challenges of today’s health care system.
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