It is the policy of the University of Arizona College of Medicine – Phoenix that students are assessed on the Educational Program Objectives (EPO) within the six competency domains of Medical Knowledge, Patient Care, Professionalism, Interpersonal and Communication Skills, Critical Appraisal and Quality Improvement, and Societal Awareness and Responsiveness.

Formative1 and summative2 assessment of student performance targeting the competencies and their respective outcomes serve as the basis for ongoing feedback to students. All students must ultimately meet or exceed expectations in all competencies as a requirement for graduation.

Process

Assessment of Student Performance

Performance in the competencies are assessed in each curricular unit3 by developmental levels of progress using the following levels:

Blocks and Courses

  • Level 1 - Failure to meet even minimal expectations.
  • Level 2 - Meeting expectations.
  • Level 3 - Exceeding expectations.

Clerkships

  • Level 1 - Failure to meet even minimal expectations.
  • Level 1.5 - Acquiring necessary skills/behaviors to meet expectations.
  • Level 2 - Meeting expectations.
  • Level 2.5 - Acquiring skills/behaviors to exceed expectations.
  • Level 3 - Exceeding expectations.

Note: For the purpose of assessment in clerkships, an individual EPO rating of Level 1.5 will not be considered a Level 1.

Electives and Selectives

  • Does not meet expectations
  • Almost meets expectations
  • Meets expectations
  • Exceeds expectations

Pre-clerkship curricular units must offer opportunities to medical students for formative assessment. Examples include practice tests, thought questions, reflective writing and practice problem sets. These formative assessment opportunities will be monitored by the Curriculum Committee on an annual basis.

Competency Assessment Within a Single Curricular Unit

  1. Mid-Point Formative Assessments – All courses, blocks and clerkships provide mid-point formative assessments. Formative assessment feedback must be provided to students at mid-point to allow adequate time for learners to address deficiencies before course end.
    1. Pre-Clerkship: Within the pre-clerkship block curriculum, students will receive assessment feedback from their Case-Based Instruction facilitators at the mid-point and end of each block, and by their table leaders following each unit within Clinical Anatomy. Students will also receive feedback from their Course Directors at the mid-point and end of each course. All blocks with Case-Based Instruction over four weeks in length are strongly recommended to have one-to-one meetings for the mid-point formative feedback. Competencies will not be formally assessed in Introduction to Medicine.
    2. Clerkship: A mid-clerkship formative assessment for each student is required, and the Mid-Clerkship Formative Feedback Form approved by the Curriculum Committee is used for this purpose. The student’s performance must be reviewed in a one-to-one meeting with a clinical teacher.
    3. In the Doctoring, Capstones, Community Clinical Experience, Scholarly Project, Personal and Professional Development (PPD) and Longitudinal Patient Care courses, as well as the Personalized Active Learning and Transitions Blocks, students will receive assessment feedback in the applicable competency areas as outlined in the respective course syllabi.

All mid-point competency assessments serve as a formative assessment of developmental progress, but do not accumulate summatively.

Mid-point formative assessments are monitored by the Curriculum Committee on an annual basis.

For behavior requiring formative feedback that occurs outside of the formal formative assessment processes, a curricular unit director assigning a formative Level 1 to a student will use an on-the-fly competency assessment form.  Faculty will meet with the student when assigning a Level 1.

  1. End-Point Summative Assessments – Students receive summative assessment feedback in applicable competency areas from all curricular units. If a critical competency deficiency is recognized late in the course, a summative Level 1 may be given without prior formative feedback. A curricular unit director is able to assign a summative Level 1 separate from a grade to a student using an on-the-fly competency form. Faculty will meet with the student when assigning a Level 1.

Cumulative Competency Assessment Across the Curriculum

  1. Multiple, Cumulative Formative Level 1s in the Same Competency*
    1. Receipt of two or more formative Level 1 assignments in the same competency domain will result in the following:
      1. The Associate Dean, Student Affairs and/or representative will email the student and Career and Professional Advisor requesting the student and advisor arrange to meet within 30 days.
      2. The Career and Professional Advisor and the student will discuss the student’s progress toward fulfilling the requirements of meeting expectations (Level 2) in the competency.
    2. Three formative Level 1 ratings within the same competency will become a single summative Level 1 for tracking purposes.     
  2. Progression and Disciplinary Actions Based On Cumulative Summative Level 1s – All competency data from curricular units are compiled by the Office of Assessment and Evaluation and presented to the Office of Student Affairs to be included as part of the holistic review with the student for Years 1 through 4. All summative, or “final,” Level 1 ratings are tracked by the Office of Assessment and Evaluation in collaboration with the Office of Student Affairs. Cumulative Level 1 ratings are retained throughout the student’s enrollment.
    1. Multiple EPOs with Level 1s in a single competency on a summative evaluation count as one Level 1 in that competency, and a single summative evaluation counts toward a maximum of two Level 1s toward the cumulative level ratings.
    2. A single summative Level 1 rating in any EPO is considered a warning. Both the student and the student’s Career and Professional Advisor are notified. Should a student progress through the four-year program with only a single Level 1 rating in any EPO, the Level 1 rating defaults to a meeting expectations (Level 2) prior to graduation.
    3. Two summative Level 1 ratings either in a single EPO or multiple EPOs result in the student meeting with their Career and Professional Advisor to discuss their progress toward fulfilling the requirements of meeting expectations (Level 2). In clerkships, electives and selectives, a Level 1 rating in two or more different EPOs results in a final grade of fail; two or more Level 1 ratings in a single EPO may result in failure unless considerable improvement occurs throughout the clerkship, elective or selective.
    4. Three summative Level 1 ratings in either a single EPO or multiple EPOs result in a mandatory meeting with the student, the student’s Career and Professional Advisor and the Associate Dean, Student Affairs to develop an action plan4 which addresses the deficiencies. The student must complete the action plan in a designated time frame.
      1. If the student successfully completes the action plan, the student has met expectations in the deficient area(s). The three Level 1 ratings (corrected) are converted to Level 2.
      2. If the student does not successfully complete the action plan, the student is referred to the Student Progress Committee (SPC) and placed on a remediation plan5.
        1. If the student successfully completes the remediation plan from SPC, the student has met expectations in the deficient area(s). The three Level 1 ratings, although remediated, are not converted to Level 2 until graduation.
        2. If the student does not successfully carry out the remediation plan, the student has not met expectations in the deficient area(s) and is referred back to the Student Progress Committee for potential dismissal.
    5. Upon receipt of a fourth summative Level 1 rating, and with each subsequent summative Level 1 rating, the student is referred to the Student Progress Committee.

For significant, urgent concerns in any competency area, the student is immediately referred to the Associate Dean, Student Affairs. Such behavior may result in immediate suspension (until the student is presented to the Student Progress Committee), or in immediate dismissal. See Student Code of Conduct.

Definitions

1Formative Assessment: Measures developmental learning and occurs at multiple instances within a given period of time.

2Summative Assessment: Measures if a student is demonstrating the expected behaviors at the end of a given period of time.

3Curricular Unit: Any component of the curriculum where a grade is earned, including blocks, courses, clerkships, electives and selectives.

4Action Plan: A collaborative, individualized plan developed by the Office of Student Affairs and the student to meet the expectations of the deficient competency program objective(s). Completion date is dependent upon issues raised.

5Remediation Plan: A collaborative, individualized plan developed by the Student Progress Committee, the student and faculty to meet the expectations of the deficient competency program objective(s). Completion date is dependent upon issues raised. Remediation plans are documented on the Medical Student Performance Evaluation.

*Level 1s assigned after the approval of policy revision on January 20, 2020

Curriculum Committee
  • Original Approval Date:
    06/20/2013
  • Revision/Reaffirmation Date:
    02/28/2023
  • Current Effective Date:
    05/8/2023