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

Core clinical experiences and midpoint feedback

Purpose

To outline the requirements for core clinical experiences and midpoint feedback in required core clerkships.

Overview

The program of assessment at UCSF emphasizes assessment for learning. During and after learning experiences, students receive feedback that informs the next steps in their learning, and they participate in summative assessments of their learning.

Completion of the clinical core experiences for a clerkship is a joint obligation between the student, the student’s clinical instructors, and the site director. In turn, logging and reviewing the completed experiences in MedHub Procedures helps the site and clerkship directors see when students are meeting these goals. The process of reviewing the experiences periodically may also provide students and supervisors convenient opportunities to give and receive feedback about the rotation. Core clinical experience logging is intended to help students meet the educational goals of the clerkship.

Related LCME Standards

9.7: Formative Assessment and Feedback

8.6: Completion of Core Experiences

Principles

  1. Core learning experiences are essential to clerkship education.
  2. Students benefit from timely feedback on their performance.
  3. Students need the opportunity to practice and receive feedback before summative assessments.
  4. Procedures for midpoint feedback can identify students who need extra support and are not on track to meet expectations at the end of the course.

Policy

  1. Clerkships will establish and publish a list of required clinical experiences that students must complete to meet clerkship requirements.
  2. Students are responsible for maintaining an electronic log of clinical experiences in an ongoing manner for each required clerkship, in accordance with that clerkship’s requirements.
  3. Students must receive feedback from supervising faculty and/or clerkship site directors midway through the rotation. This feedback must include review of the electronic log of clinical experiences as well as an assessment of the student’s performance in comparison to clerkship objectives and School of Medicine performance milestones. Students will log receipt of the feedback.
  4. The clerkship director and coordinator will track completion of midpoint feedback. Aggregate data on midpoint feedback is distributed twice yearly to the F2 operations committee.
  5. Each clerkship must have a system in place to check with students for outstanding clinical experiences prior to the completion of the rotation as well as a set of alternate strategies for completing required clinical experiences in the event that the student cannot complete them with continued participation on the clerkship.
  6. Failure of a student to maintain a log of required experiences and/or complete all required experiences or their equivalent by the end of the educational experiences will result in a grade of “I.”
  7. A grade of “I” will be converted to pass once all required experiences or their equivalent are completed by a specified deadline. Failure to meet the deadline will result in a conversion of the “I” grade to a provisional non-passing grade of “E.”
  8. The Associate Dean for Competency Assessment and Professional Standards has the authority to ensure that clerkships comply with required oversight of the feedback and clinical experience tracking systems.

Procedure

  1. Students must log their experiences in MedHub Procedures in an ongoing manner throughout the clerkship based on clerkship requirements. 
  2. Each student should discuss any outstanding clinical experiences with the supervising attendings and residents along the way during the rotation, and with the site/course director. If a student is unlikely to accomplish all of the clinical core experiences through patient care experiences, despite best efforts, the student and site/course director should discuss alternate ways of learning that material.
  3. Alternative activities will be scheduled on an individualized basis, based on the likelihood of the student getting the clinical core experience during their time remaining in the rotation. However, each clerkship must specify a time point (e.g. one week prior to the end of the rotation) when an alternative activity will be triggered. Available alternatives for each clinical core experience are listed on the clerkship's iROCKET/CLE page. These methods might include directed reading or web-based or paper cases, or additional clerkship time. If a clinical core experience is met through an alternative activity, this must be documented as such on MedHub Procedures.
  4. If a clinical core experience is not met by 5 PM on Friday of the fifth week after the end of the rotation, a grade of "I" (Incomplete) will be assigned until the core experience is completed and the student will also receive notification about being at risk of receiving a physicianship form. A student who does not complete the experiences within the next week – six weeks after the end of the course – will receive a physicianship form and notification about being at risk of receiving an "E" (provisional non‐passing) grade. A student who does not complete the experiences by seven weeks after the end of the course will receive an "E" grade.

Accountable Dean or Director

Associate Dean for Curriculum

Associate Dean for Competency Assessment and Professional Standards

Related Policies

  1. UCSF School of Medicine Foundations 2 Assessment and Grading Policy
  2. Replacing Completion of Core Policy 

Approval Date and Governing Body: October 10, 2017, CCEP

Last Updated: October 31, 2018