University of California San Francisco
UCSF School of Medicine UCSF Medical Center

Assessment and Grading in the Bridges Curriculum

Purpose:

Below is an overview of assessment and grading in Foundations 1 of the Bridges Curriculum. For an explanation of the grading process in the Foundations 2 Core Clerkships, please review to the comparison of grading across the clerkships.

Overview:

The approach to assessment of student performance in the Bridges Curriculum is a program of assessment that is integrated across the curriculum beyond any one subject or course and which embraces the philosophy of assessment FOR learning. Integrated courses along with integrated assessments and grades encourage students to connect all of the knowledge and skills they are learning in the classroom and in clinical settings, just as a physician integrates knowledge and skills in patient care. The Bridges Curriculum program of assessment promotes each student’s individual path toward competence in the unique knowledge, skills, and attitudes that characterize the Bridges physician. In the assessment FOR learning philosophy, assessment activities contribute significantly to student learning by giving each student ongoing information (data and other feedback) about performance that is key to guiding their individual next steps in the MD Competency Milestones.

Seven core competencies and associated milestones define the expectations for students throughout the curriculum. Frequent formative assessments will guide students’ future learning, promote reflection, and help shape students’ values about continuous improvement of their practice of medicine.

The School has developed several key resources to support student learning and professional development:

  • Coaches: Learning and professional development is supported throughout medical school by mentorship and guidance from Coaches. Each student is assigned a clinician educator Coach who provides advising and mentoring, teaches foundational clinical skills, and supports the student in reviewing individual progress and setting learning goals.
  • Dashboard: The Bridges Student Dashboard houses performance data for each student and provides space for students to reflect on progress with their Coach and to generate individual learning plans. Students take responsibility for the mastery of skills and knowledge with frequent receipt of information in their dashboard, regularly reflecting on ways to improve, and seeking additional practice.
  • Physician Identity Weeks/ARCH Weeks*: Physician Identity Weeks ((formerly known as Assessment, Reflection, Coaching, and Health (ARCH) Weeks)) are four weeks in the Foundations 1 phase of the Bridges Curriculum that provide students dedicated time for reflection and professional growth, opportunities to work with peers, coaches, and other facilitators, and time to pursue activities related to career exploration as well as para-curricular activities of interest.
  • Frequent formative assessment activities: Weekly Checkpoints for medical knowledge throughout Foundations 1 promote learning and self-assessment. Weekly, students complete multiple choice questions (MCQs) and open-ended questions (OEQs) designed to confirm if students have achieved the expected level of competency with the material for the week. The Weekly Checkpoints have additional benefits because the act of testing has a positive direct impact on learning. Numerous studies suggest the active process of retrieving information from memory strengthens memory more and leads to longer retention than re-studying or reviewing material: this phenomenon is called “the testing effect.”

Related LCME Standards:

Std. 9.5 Narrative Assessment

Std. 9.8 Fair and Timely Assessment

Principles:

Student assessment in the Bridges Curriculum is designed to meet multiple goals:

  1. Provide ongoing feedback to students about their learning
  2. Promote deep learning, critical thinking, retention of knowledge, and habits of inquiry aligned with the Bridges Curriculum mission
  3. Provide opportunities for frequent formative feedback
  4. Determine that students have attained upon graduation the knowledge, skills, and attitudes at a level of mastery necessary to provide high-quality care
  5. Prepare students to excel on USMLE licensing exams
  6. Provide timely grades within 6 weeks of the end of each course.

Policy:

  1. Weekly Checkpoints: Students are required to complete the required number of weekly checkpoint MCQs and OEQs assigned by the course, as requirements in the Practice-Based Learning and Improvement competency.
  2. Small Group Evaluations: Each F1 course includes assessments by small group leaders of students’ performance in multiple competency domains in Foundational Science and Core Inquiry Curriculum (CIC) groups. Faculty assess students using a performance rubric with numerical scores and a narrative description of the student’s performance.
  3. Summative Medical Knowledge Assessments: Summative assessments of medical knowledge will occur at the end of each Foundations 1 Foundational Science (FS) block and in some cases at the mid-point of in an FS block. These summative assessments will consist of open-ended questions (OEQs). The OEQs on the summative assessments are similar in format to the Weekly Checkpoint OEQs and emphasize application of knowledge (rather than recall of facts alone), critical thinking, and written communication skills.
  4. Grading: In Foundations 1, students receive one grade for each of the Interdepartmental Studies (IDS) courses. This grade integrates student performance in all elements within the IDS course, including the Clinical Microsystem Clerkship (CMC), Foundational Science (FS) block(s), the Core Inquiry Curriculum (CIC), and Physician Identity/ARCH Weeks*.
  5. All grades are returned to students within six weeks of the end of the course.

*Beginning with the Class of 2026,  Assessment Reflection Coaching and Health (ARCH) Weeks were redesigned and renamed Physician Identity (PI) Weeks. 

Accountable Dean or Director:

Associate Dean for Competency Assessment and Professional Standards

Procedures:

Summative OEQ examinations are closed book examinations consisting of 5-6 clinical vignettes, each with 2-5 associated OEQs. Each Summative OEQ exam will take 3-4 hours to complete.

  1. Weekly checkpoints
  2. Checkpoint MCQs: Each week, the MCQ Checkpoint provides 20-25 MCQs that test key objectives from the week. Students submit their answers, and then the correct answers with explanations are revealed immediately. Students may attempt the MCQ Checkpoint as many times as they wish, adjusting incorrect answers to improve their understanding and scores, until the Checkpoint closes at the end of the week. A score of at least 50% is required for the MCQ Checkpoint to be considered complete. The MCQ Checkpoints serve as an efficient study aid and key mechanism for self-assessment, and allow students to practice the types of questions asked on the USMLE Step 1. The MCQs will contain content relevant to the current and prior blocks to promote retention of knowledge over time.
  3. Checkpoint OEQs: Each week, the OEQ Checkpoint provides two clinical vignettes, each with 2-3 associated questions that explore interdisciplinary applications of basic and clinical knowledge. Students choose one vignette and create a response; the student then sees a model answer and reconciles their own answer with the model answer. While comparing their answers to the model answers, students reflect on their level of understanding, and if necessary, request additional help with their learning. The student then submits the final response before the Checkpoint closes at the end of the week. The OEQ Checkpoints are designed to provide students with practice of skills they need to apply on the Summative OEQ exams, including application rather than recall, critical thinking, and written communication skills.
  4. The Weekly Checkpoint assessments deliberately emphasize test-enhanced learning, by combining frequent repeated information retrieval, mixed practice in both recognizing and producing answers, and self-evaluation in response to testing. Because these approaches are so critical and effective for learning, completion of Weekly Checkpoints will be displayed in the Bridges Student Dashboard for each student.
  5. Faculty members of grading committees or academic progress committees with a conflict of interest (i.e., personal or family relationship or provision of medical or psychiatric care for the student) must recuse themselves from voting upon or contributing to decisions about a potential adverse action against a student.