Program Review - Marshall University

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Program Review




Marshall University

Joan C. Edwards School of Medicine














Medicine






November

20
09








MARSHALL UNIVERSITY

2


1/13/09



Program Review

Marshall University



Date: ____
October 7, 2009
_____________


Program:_
Doctor of
Medicine__________

Degree and Title


Date of Last Review: ____
2005
__________________________________________________


Recommendation

Marshall University is obligated to recommend continuance or discontinuance of a program and to
provide a brief rationale f
or the recommendation
.



Recommendation


Code (
#):

1.

1.

Continuation of the program at the current level of activity; or


2.

Continuation of the program
at a reduced level of activity or
with
corrective action
: Corrective action
will apply to programs that have deficiencies that the program itself can address and correct.
Progress
report due b
y November 1 next academic year;

or


3.

Continuation of the program with i
dentification of the program for
resource dev
elopment
:


Resource
development will apply to already viable programs that require additional resources from the
Administration to help achieve their full potential. This designation is considered an investment in a
viable program as opposed to addressing

issues of a weak program.
Progress report due by
November 1 next academic year
; or


4.

Development of a cooperative program with another institution,

or

sharing of courses, facilities, faculty,
and the like; or


5.

Discontinuation of the program


Ration
ale for Recommendation
: (Deans, please submit the rationale as a separate document. Beyond
the College level, any office that disagrees with the previous recommendation must submit a separate
rationale and append it to this document with appropriate
signature.)


_________

_______________________________________
________
__


__________
__
__

Recommendation:

Signature of pe
rson preparing the report:




Date:


_________

_________________________________________________


______________

Recommendation:

Si
gnatu
re of Program Chair:






Date:


________


__________________________________________________


______________

Recommendation:

S
ignature of Academic Dean:







Date:


________


_________________________________________
_________


____________
__

Recommenda
tion:

Signature of Chair, Academic Planning Committee: (Bacc
alaureate pgms only)

Date:


________


______________________________
___________________


______________

Recommendation:

Signature of President, Faculty Senate/ Chair
, Graduate Council:


Date:


________


_________________________________________________


______________

Recommendation:

Signature of the Provost and Senior Vice P
resident for Academic Affairs:

Date:



_______


__________________________________________________


______________


Recom
mendation:

Signature of the President:






Date:


________


_________________________________________________


______________

Recommendation:

Signature of C
hair, Board of Governors:





Date:

3


1/13/09



College/School Dean’s Recommendation


Deans, please indicate your recommendation and submit the rationale.


Recommendation:


Recommend continuation at the current level


Rationale:

(If you recommend a program for
resource

development identify all areas for specific development
)


Marshall University Joan C. Edwards School of Medicine continues to
provide high quality
medical education
, especially
to
West Virginia students,
with an emphasis on primary care.
The
school is accredited by the Liaison Committee on Medical Education (LCM
E) and undergoes
constant and stringent
internal and external
review
.



In addition to education, the faculty continues to contribute to the betterment of society by
conducting
leading
-
edge research, providing medical care to the tri
-
state area and contr
ibuting
to community service.
The medical school serves as a catalyst for economic development,
enhances Marshall University’s ability to recruit and retain high quality faculty and contributes to
the overall
reputation of the tri
-
state area.


N
ew outst
anding physical facilities
,

with improved contemporary learning capacities
, during the

period
of this review
have
distinctly

strengthened our medical education activ
ities, contributed to
the addition of new services and made possible a modest increase in class size.



















___
Charles H. McKown, Jr., MD., Vice President/Dean
__


____
11/19/09
______________

Signature of the Dean





Date




4


1/13/09


(Nar
rative limited to 15 pages, Aria
l 12 pt. 1” margins single spaced)


Marshall University

Program Review


For purposes of program review, the academic year will

begin in summer and end in spring
.



Program: _____
Medicine
_______________________________________


College: ______
Medicine
__________
_____________________________


Date of Last Review: _____
2005
_________________________________



I

CONSISTENCY WITH UNIVERSITY MISSION


Provide your program’s mission statement
.

Explain how your mission supports
the mission of your college and the mission of Marshall University.



The Marshall University Joan C. Edwards School of Medicine, a community
-
based medical
school, strives to meet the special needs of a largely rural pop
ulation in a state which historically
has been economically and educationally disadvantaged.


As a community
-
based medical school, Marshall has a curriculum that more accurately reflects
the national trends in health care by conducting a greater degree of
ambulatory clinical
education than traditional in
-
patient education. All clinical departments require students to
complete ambulatory care as part of their educational experiences. Prior to the clinical years,
students are exposed to the philosophy of am
bulatory care, reflecting the educational mission of
Marshall. Early pre
-
clinical experiences further support the institutional perspective of the
importance of ambulatory medicine.


Recognition of other disciplines as resources for team
-
building, an emph
asis on presentation
skills, and commitment to community service contribute to the generation of lifelong learning
habits. Exposure to the team
-
building concepts during the formative years increases the
likelihood that graduates will use other health care

and allied health professionals as vital and
valued contributors to the patient care team. Communication and presentation skills are
necessary components of medical education for present and future practice. To integrate the
students into the community
and to provide them with proper service values, community service
projects are required as part of rural experiences. Exposing students to community service,
promotes this value as a lifelong habit.


In fulfilling its mission of primary care medical educa
tion, the school of medicine has become an
outstanding and cost
-
effective investment for the state of by coupling its award
-
winning
educational and clinical training programs with extensive health care delivery services to West
Virginians and other area ci
tizens, especially armed forces veterans. As a participant in West
Virginia’s Rural Health Education Partnership Program, the medical school has also developed
educational and health delivery outreach programs in more than 73 rural West Virginia sites.



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1/13/09

II

ACCREDITATION INFORMATION

(NOTE: If your program has been accredited by

a national organization,

supply the
following information. If your pr
ogram is not accredited, skip to section III. U
se the
appendix numbers as indicated in each section. If you skip a section
do not

renumber
the appendices. )



Provide the following information about the program’s accreditation status:



A

Name and description of the accreditation organization:





The Liaison Committee for Medical Education (LCME) is the accreditation
agency for all United States medical schools. The committee is comprised of
members from the Association of American Medical Colleges (AAMC), the
American Medical Association (AMA) a
nd public members.



B

Most recent year program accredited: (include a copy of the letter
conferring accreditation.)




2005



C

Accreditation status: (regular, probationary, unaccredited, other)




Continued Accreditation



D

Attach a copy of the
accreditation organization’s report to the University if
different from B.



E

If program deficiencies were noted, attach the report to the accrediting
agency outlining the deficiencies and corrective action taken or proposed.



F

Provide 1
hard
cop
y of the most recent self
-
study report
to the Office of
Assessment and Program Review
.




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1/13/09

III

PROGRAM STATEMENT on Adequacy, Viability, Necessity and
Consistency with

University/College

Mission



A
.

ADEQUACY

Provide a narrative summary for each of the f
ollowing in
addition to the requested appendices.


1.

Curriculum
: Summarize degree requirements and provide
commentary on significant features of the curriculum. In
Appendix I
,
list required courses, elective courses, and total hours required. The
list o
f courses must provide specific course titles and numbers.


Requirements for the Degree of Doctor of Medicine

The doctor of medicine degree is conferred upon students who have satisfactorily completed the
equivalent of four years of study in the medical
sciences. All courses and clerkships, required
and elective, must have been completed with a passing grade. A minimum of the final two years
of study must be completed as a student at the MUJCESOM.

Year 2

Students must pass the United States Medical Lice
nsing Examination (USMLE) Step 1.

Year 3

Students must pass the MUJCESOM Clinical Competency Examination.


Students must successfully complete two months at approved rural sites during their third and
fourth years.

Year 4

Students must become ACLS certif
ied.

Students must complete their Patient and Procedure Logs.

Students must pass a required Year 4 Radiology Exam.

Students must pass the USMLE Step 2
-
Clinical Knowledge and USMLE Step 2
-
Clinical Skills
examinations.


Continuous and successful progre
ssion toward the requirements for graduation throughout the
curriculum is expected. In compliance with the LCME, students have a maximum of six years to
complete the M.D. requirements. Maximum time for completing requirements may only be
waived to permit
the student to engage in research or other scholarly pursuits.




The concept of satisfactory progress mandates monitoring of a student's academic performance
through grades, professional behaviors, the number of credits successfully completed, and
timely

passage of the USMLE licensing examinations.


The Academic Standards Committee
may also set conditions for meeting satisfactory academic progress.


The M.D. degree is awarded by Marshall University upon certification by the school’s faculty that
the stu
dent has successfully completed all requirements.


GRADUATION REQUIREMENTS FOR MUSOM


Requirements specific to Year 1:



Successful completion of all required courses

Requirements specific to Year 2:



Successful completion of all required courses

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1/13/09



Successful
completion of OSCE



Successful passage of USMLE Step 1

Requirements specific to Year 3:



Successful completion of all required clerkships



Successful completion of Clinical Competency Examination

Requirements specific to Year 4:



Successful completion of ACLS



Successful completion of 12 weeks required rotations



Successful completion 8 weeks rural rotations



Successful completion


22 weeks of electives



Successful passage of USMLE Step 2 CK



Successful passage of USMLE Step 2 CS



Successful passage of the Radi
ology Exam



Successful completion of patient logger requirements



Successful completion of procedure logger requirements


2.

Faculty:
Summarize significant points relating to faculty teaching
courses within the major (percentage of faculty holding tenure, exten
t
of use of part
-
time faculty, level of academic preparation, faculty
development efforts, books & journal articles, papers & attendance at
state, regional and national professional organization meetings).
Include part
-
time faculty and graduate assistants

you employed during
the final year of this review. Prepare an
Appendix II
Faculty Data
Sheet

for each full
-
time faculty member, part
-
time faculty member and
adjunct faculty
member.

For

part
-
time faculty members and adjuncts
,

prepare data through question

one on the
Faculty Data Sheet
. Use
Appendix II
-
A

for all graduate teaching assistants.


All faculty are appointed by the individual department chairs, with approval of the Dean.



Basic Science and Clinical
Departments


Full
-
Time Faculty

Prof

Asso

Prof

Asst

Prof

Inst/O

M

F

M

F

M

F

M

F

Anatomy and Pathology

5

1

1

3

5

7



Biochemistry & Microbiology

4

3

3

2

2

1



Pharmacology, Physiology &
Toxicology

3

1

1

1

1

1



Basic Science Totals

12

5

5

6

8

9



Cardiovascular Services

1

1

2

1

3

1


2

8


1/13/09














Total Full
-
Time Faculty in Basic Sciences _
29

Total Full
-
Time Faculty in Clinical Departments _
193
__

Grand Total Full
-
Time Faculty, Basic Science and Clinical Departments
_
222
__





3
.

Students:

NOTE: If your program is accredited, refer to the
appropriate page number
s in your accreditation report.



Entrance Standards: Describe the admission standards
and procedures employed for
making the admission decision. (GPA, ACT, other tests)
.



The Admissions Committee, which is made up of school of medicine faculty, faculty from the
main campus and community representatives interview prospective students and m
ake
recommendation to the full committee. Selection criteria include the following:


1)

Academic Background. Both quantity and quality are assessed with a four
-
year program of study suggested. Exceptionally well
-
qualified applicants may
be considered after

ninety semester hours of academic work if other
requirements are met. Specific entrance requirements include one year each
of English, Zoology or Biology with lab, Inorganic Chemistry with lab, Organic
Chemistry with lab, Physics with lab and Social or B
ehavioral Sciences. A
major criterion is the overall grade point average for undergraduate studies with
particular emphasis in correlating the grade point average in science and
science related courses.


2)

Medical College Admission Test. The value of the M
CAT is as follows:
evaluates an applicant’s ability to retain knowledge acquired from his/her
undergraduate curriculum; assesses his/her ability to exercise practical
application of his/her acquired knowledge through a comprehensive testing
program; and e
quates the applicant’s performance with a nationwide ranking
from which some correlation may be established from applicants of varying
undergraduate backgrounds.

Family & Community Health

9

2

4

1

5

3

4

2

Internal Medicine

7

3

7

2

18

6


6

Neuroscience

6



1

1

1


1

Obstetrics/Gynecology

5

1

4

1

2

1


2

Orthopaedic Surgery

2


1


8


2

1

Pediatrics

5

1

9

2

4

10



Psychiatry & Behavioral Medicine

1

1

1


3

4


0

Radiology

1








Surgery

2

1

8

1

7

2



Clinical totals

33

10

34

13

30

17

1

4

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3)

Recommendations. Three written recommendations from professors are
required. Two of these r
eferences must be science faculty and one reference
must be from the applicant’s major department. Additional pertinent references
are welcomed, but not required.


4)

Interviews. Interviews are arranged only by invitation of the Admissions
Committee. Perso
nal qualities, which are deemed essential for a career in
medicine, include, but are not limited to, logical and coherent thinking, sound
judgment, personal insight, and appropriate perception.


Candidates are notified in writing if they have been accepted

or rejected.



2004
-
2005

2005
-
06

2006
-
07

2007
-
08

2008
-
09

STUDENTS






APPLICANTS







In
-
State

180

167

198

189

209


Total

719

785

1,573

1,945

1,316

ACCEPTANCES ISSUED







In
-
State

80

83

96

90

94


Total

96

102

123

123

128

FIRST YEAR NEW
ENROLLMENT







In
-
State

43

50

48

51

57


Total

52

60

64

72

78

TOTAL MED. STUDENTS

200

211

227

246

281



a.

Entrance Abilities: Identify potential ability of students
admitted to the program as measured by standardized tests
(ACT,

SAT, GED, TOEFL, etc.) and high school GPA.



Mean MCAT Scores for past years

ENTERING CLASS DATA

2004
-
05

2005
-
06

2006
-
07

2007
-
08

2008
-
09

Mean GPA

3.5

3.5

3.5

3.6

3.51

Mean MCAT Scores







Biology/Biological Science

9.2

8.9

8.7

8.9

9.3


Physics/Physical Science

8.4

8.2

8.3

8.7

8.3


Reading/Verbal Reasoning

9

9.1

8.9

8.9

8.7


Quantitative/Writing Sample

M

O

O

M

Q




b.

Exit Abilities: Identify abilities of students who graduate from
the program (GPA, licensure exam, certification
tests, etc.)
.


Immediately following medical school graduation
,

students enter into residency
programs to continue required training. This is achieved via
the

National Residency
Matching Program (NRMP) overseen by the Association of American Medical Schools
(AAMC). Students and residency programs submit a “ranking” of preferred matches.
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1/13/09

The NRMP runs an algorithm to compare student choices with residency prog
ram
choices. A final match list is then generated. This additional training is required by all
50 states before a graduate can become a practicing physician; some states require as
much as three years for licensure.


The majority of student’s acquire t
heir preferred residency positions in the National
Residency Match Program (NRMP). Students match at a rate of between 90


95%. If a
student does not match during the NRMP they “scramble” for a residency position based
on unfilled positions available aft
er the match. All students enter a residency program.



NRMP RESULTS FOR THE PAST FIVE YEARS





2004
-
2005

2005
-
20
06

2006
-
20
07

2007
-
20
08

2008
-
20
09

Primary Care







Family Practice







Grads. with Internship/Residency in WV

5

6

2

5

5


Grads. with Internship/Residency Outside WV

1

3

4

1

1


Internal Medicine







Grads. with Internship/Residency in WV

1

6

4

3

8


Grads. with Internship/Residency Outside WV

6

5

4

2

8


Pediatrics







Grads. with Internship/Residency in WV

6

1

4

2

1


Grads. with Internship/Residency Outside WV

5

2

4

8

8


Obstetrics/Gynecology







Grads. with Internship/Residency in WV

2

1

3

2

0


Grads. with Internship/Residency Outside WV

1

3

1

3

0


Internal Medicine/Pediatrics







Grads. with Internship/Residency in WV

0

1

4

0

0


Grads. with Internship/Residency Outside WV

2

0

3

0

1

Psychiatry







Grads. with Internship/Residency in WV

0

3

2

0

1


Grads. with Internship/Residency Outside WV

2

0

2

0

2

Medical Specialty







Grads. with Internship/Residency in WV

0

0

0

0

0


Grads. with Internship/Residency Outside WV

3

0

1

0

1

General Surgery







Grads. with Internship/Residency in WV

0

2

3

2

4


Grads. with Internship/Residency Outside WV

4

0

2

6

6

Surgical Specialty







Grads. with Internship/Residency in WV

0

0

0

0

0


Grads. with Internship/Residency Outside WV

0

1

1

2

0

Support Specialty







Grads. with Internship/Residency in WV

0

0

0

1

0


Grads. with Internship/Residency Outside WV

6

10

5

3

6

Transitional

0

1

0

2

0







TOTAL

44

45

49

42

52


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The school conducts an exit survey of each graduating class in which our graduates are asked
to rate their preparedness for residency training in several areas. These surveys indicate that
our graduates see themselves as generally well
-
prepared for reside
ncy training. The graduates
are surveyed again while they are in residency and the same self
-
assessment is borne out. In
the AAMC annual Graduation exit survey, students site their hands
-
on
-
experiences as strength
of the school.


After graduation and
during residency training alumni take the USMLE Step 3 examination.
Graduates performance on the USMLE is comparable to the national standard
.








Year of Graduation

2003

MU
National

2004

MU
National

2005

MU
National

2006

MU


National

Number tested

48

15332

42

15174

38

13026

38

13722

Number passed

43

14688

40

14662

38

12601

38

13024

Percent passing

90
%

96
%

95
%

97
%

100
%

97
%

100
%

96
%








4
.

Resources:

NOTE: If you
r program is accredited,
refer to the
appropriate
page number
s in your accreditation report.





a
.

Financial:

Provide information related to financial support of
the program, including what portion of the unit’s resources
was devoted to this program. Include state
-
appropriated
funds, grants, contracts,
supplemental state funds or student
fees. If this program were terminated as a major, what
resource changes would occur, e.g., reduced faculty, staff,
space, courses taught, etc. If this program were reduced or
terminated, what changes would occur and ho
w would it
affect the university?



The School of Medicine’s M. D. educational program is supported from its unrestricted
operating budget which is comprised primarily of State appropriated funds, student fees,
hospital support, practice plan educational s
upport and other miscellaneous revenue.
For FY 2010 the SOM’s total unrestricted operating revenues are estimated at $34.5
million. Although this budget supports a multitude of additional educational, research,
clinical service and public service initiat
ives the M.D. program provides the foundation
for all of these activities. In addition, the M.D. program and these budgetary resources
provide the catalyst to generate more than $80 million in additional economic activity
through patient care activities,
contractual medical services, sponsored research,
private giving and affiliated programs. In addition, the community hospitals who partner
12


1/13/09

with the SOM to offer its medical education and graduate medical education and patient
care programs also receive mo
re than $25 million in enhanced federal and state
reimbursement for education and indigent care provision. Termination of the M.D.
program would not only derive the State and southern West Virginia with its major
source of future doctors, but would crippl
e a very substantial health care delivery
system and stifle an economic engine of growth and development.


Because medical education is provided symbiotically in the context of ongoing patient
care, medical research, advanced residency and fellowship train
ing and critical public
service programs it is impossible to separate the costs associated with the purely
educational portion of the M.D. program, but its termination would surely cripple
programs such as the joint regional trauma service, high risk obste
trics and
gynecological sub
-
specialty care, the Neonatal Intensive Care Unit (NICU), Pediatric
Intensive Care Unit (PICU) and other pediatric sub
-
specialty programs all of which are
unique in the region.


Although balanced for FY 2010 the School of Medicin
e’s Unrestricted Operating Budget
experienced a $418,196 reduction in state funding for the current year. This reduction
required all of the School’s student fee increase to be applied to cover this reduction.
Although indications are that federal stimul
us funding may be available to offset some or
all of this reduction by mid
-
year, the uncertain nature of these funds and the potential for
future State funding reductions are very worrisome. Given the significant leveraging of
economic activity for which
the M.D. program serves as a foundation and the critical
service programs which are dependent on it, further funding cuts could be truly
counterproductive, and the reduction or elimination of the program almost unthinkable.
13


1/13/09





b
.

Facilities:

Describe fa
cilities available for the program
including classrooms, laboratories, computer facilities, library
facilities, or equipment needed for program delivery.



Type of Room
1

Seating
Capacity

Main Educational Use(s)
2

Byrd Clinical Center

Auditorium Room 1025

125

Lectures, presentations


Byrd Clinical Center

Rooms 1020&1021

Rooms 1022&1023


40

40

Small
-
groups, testing, study

Can be set up as 4 rooms of 20 or
2 rooms of 80

Byrd Clinical Center

Clinical Skills Lab Room
1037


50

Training demos, lectures, small
groups,
clinical skills practice
testing, etc

Byrd Clinical Center


Standardized Patient Training
Room 1030 (with kitchen)


25

Training room for standardized
patients, lectures, small groups

Byrd Clinical Center

Rooms
1031
-
1036

3

Six fully equipped complete
patient examination rooms

Byrd Clinical Center

Room 1028

12

Used by evaluators for Clinical
Competency Exam, small groups;
has 8 computers

Byrd Clinical Center

6 conference rooms (2 per
floor)

8
-
20

Small groups, t
esting, lectures

Coon MEB Gross Anatomy
Lab

80

Lab, dissection

Coon MEB Class Room (2)

80 & 50

Lectures

Coon MEB Conference
Rooms

8
-
30

Small groups, testing, lectures

Biotech Building

Room 101

Room 102

Room 203

Room 204

Room 205

Room 206


94

75

12

12

12


8


lectures

small groups, study

Biotech Building 3
rd

& 4
th

floor conference rooms

15 each

Small groups, study, lectures

Biotech Building labs

Room 125

Room 127

Room 128

Room 130


17

27

28

28


Labs

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1/13/09

MU Medical Center

Harless Auditorium

225

Lectures, conferences, multi
-
media presentations

MU Medical Center

10 conference rooms

8
-
20

Lectures, small groups





The new
Erma Ora
Byrd

Clinical Center
, developed as part of Marshall University's Robert C.
Byrd Center for Rural Health, is an
80,000 square foot, four
-
story Clinical Education & Outreach
Center, which houses major new medical student teaching facilities and clinical education
patient care clinics. The ground floor of the new facility contains state
-
of the
-
art medical
education
teaching resources, including a 125
-

seat tiered classroom and several smaller
classrooms. Most significantly, a Clinical Skills Center is included where medical students and
residents can develop and hone their patient care skills using both computer
-
bas
ed models and
live simulated patients, before moving into the "live" patient care settings contained on the upper
floors. Three floors of patient care and clinical education space above provide expanded patient
care capacity for up to 75,000 patient visits

per year.


The main floor of the building is dedicated to the educational activities of the medical school. In
addition to the rooms listed above, there is additional study space, lockers and other amenities
for the students. There are two large areas d
edicated to student study s
pace. One area
is the
quiet study room, complete with 12 individual study carrels, each with a computer. The second
area is a more open lounge/study area with vending machines, a copy machine, kitchen area,
etc.


The
Robert

C. Byrd Biotechnology Science Center

is located along Third Avenue across
from the Science Building, bringing together faculty, staff and students from both the Joan C.
Edwards School of Medicine and the College of Science.

Labs were built for biotechnolo
gy
research and teaching. Seminar rooms for small group meetings and faculty and student offices
are on the second floor. The third and fourth floors have similar layouts and are used exclusively
by students and faculty of the School of Medicine. Faciliti
es on these two floors include cancer
research facilities, rooms for equipment and offices for graduate students and faculty.


Information technology resources and wireless network access is provided to authenticated
network domain users (SOM students, sta
ff, faculty and administrators) in all classroom, lab,
study, lounge and common space in all School of Medicine buildings. The following represents
the number of public access PC workstations available to students in each of the SOM buildings

i.

MEB:


10 (do
wn from 17 workstations prior to the opening of the Biotech
Center)

ii.

Biotech Center: 24 (up from 0 prior to the opening of the Biotech Center)

iii.

Byrd Clinical Center:


10 (up from 0 prior to the opening of the Fairfield
Building)

iv.

HSL:


10 (up from 6 as of Jul
y 2008)


Our total number of PC workstations has more than doubled from 23 to 54 as the class size has
increased. This has
improved the Student
-
to
-
PC ratio

from 10.4 (assuming 4 class years of 60
students) to 5.9 (assuming 4 class years of 80 students).


W
e have an integrated system in all three main SOM lecture classrooms (MEB, Biotech & Byrd
Clinical) to capture and seamlessly/automatically post audio recordings of all SOM lectures.


15


1/13/09

The main Health Science Library is located on the 2
nd

floor of the MU Me
dical Center and offers
24 hour access for students. The Library subscribes to approximately 300 journals in the
biomedical research and clinical medicine disciplines. A fifteen year run is kept for most
journals. The book collection contains approximatel
y 8,000 volumes. The VA maintains a small
library in the Coon Medical Education Building (MEB) which provides resources and study areas
for medical students.


Additionally, The John Deaver Drinko Library, located on the western side of Marshall’s main
campus, melds a full range of traditional library services with state
-
of
-
the
-
art computer and
advanced technological education facilities that include multimedia training and presentation
rooms, workstations, distance education and computer carrels. There

is a 24
-
hour reading
room/computer lab with computer consultation stations and assistive technology. The collection
includes books, bound periodicals, and a wide variety of media and Internet accessible
electronic materials. The Drinko Library has study r
ooms, conference collaboration rooms, and
an auditorium, and also houses offices of Information Technology, University Libraries,
Instructional Technology, University Computing Services, and Telecommunications.


All three of the community hospitals have re
cently undergone growth, expansion of new clinical
facilities and renovations. The five
-
story, $88 million North Patient Tower at Cabell Huntington
Hospital is now open and accepting patients.



16


1/13/09



5
.

Assessment Information
: NOTE: This section is a
summary of
your yearly assessment reports.


a.

Provide summary information on the following elements.
Please include this information in Appendix V
.




S
tudent
learning
outcomes



assessment tools/measures




standards/benchmarks



results/analysis



action taken






August 11, 2008 was the inauguration of the newly integrated systems
-
based second year
curriculum for Marshall University Joan C. Edwards School of Medicine. The block
-

based
curriculum is the culmination of 15 months of work by the Curriculum Integratio
n Committee
(CIC), a subset of the Curriculum Committee.


In December of 2006 the Curriculum Committee initiated discussion regarding changing the
discipline
-
based second year curriculum to a more integrated systems
-
based curriculum. Over
the next sever
al months multiple meetings, phone calls and correspondence laid out the
framework for the revisions and a formal presentation was given on April 1, 2007 to the second
year faculty regarding the proposed change. On April 26, 2007 the Curriculum Committee
officially approved a proposal to establish the Curriculum Integration Committee (CIC) to
reorganize the second year curriculum into an integrated systems
-
based model. The CIC
consisted of second year course directors, selected second year faculty, medica
l students, and
representatives from the Office of Medical Education. From May 25, 2007


August 14, 2008
monthly CIC meetings were held to reorganize the existing content into the proposed systems
-
based format. Additional goals for the CIC included enha
ncing vertical and horizontal
integration, improving institutional objectives such that they are competency
-
based, and
rewriting test questions to reflect NBME format.


Obviously one of the first tasks for the CIC was to review the content of the second ye
ar
curriculum to identify redundancy and gaps. Through the CIC meetings, several hours of
material were eliminated; allowing for the addition of important topics and more comprehensive
coverage of others. Secondary to this process, individual second year

faculty gained greater
insight and understanding for synergistic and complementary programs of education with
ongoing emphasis on content and sequencing. Several new topics were incorporated or
expanded in a thematic way including new lectures on Bioter
rorism, Clinical Genetics, Law and
Medicine, Geriatrics, Nutrition, Occupational Medicine, Pain Management and Transplantation &
Organ Donation.


As the pace of biomedical discovery continues to accelerate an evolving need for additional
exposure to ongo
ing scholarly activity, particularly at our institution, was felt to be appropriate,
therefore emphasis on research and the importance of scholarly activity was enhanced. While
previously discussed in the Biostatistics & Epidemiology course, a more comple
te introductory
presentation for students was needed. One full hour of IRB training was added in the B&E
section and to increase insight, students are now required to complete their Comprehensive IRB
Training Initiative (CITI) requirement prior to the actu
al lecture. This training is web
-
based and
can be reviewed at
http://www.marshall.edu/research/ori/education.asp
.

17


1/13/09


General introductory lectures were added including two hours on “Introd
uction to Laboratory
Tests” and two hours on “Introduction to Radiology Tests”, with greater emphasis on sensitivity,
specificity, and indications for the various lab and diagnostic imaging elements. These occur in
block 2 to assist students in understand
ing the various lab and diagnostic elements discussed
throughout the year. A summary of new or expanded topics is listed below:


New or Expanded Topics

# of Hours

Biostatistics/Epidemiology

14

Bioterrorism

4

Electronic Health Record

1

Ethics

12

Clinical Genetics

24

Geriatrics

2

Integrative Medicine

7

Health Care Reimbursement

2

Law & Medicine

2

Medical Informatics

1

Nutrition

13

Occupational Medicine

2

Pain Management

3

Pediatrics

14

Research

1

Transplantation & Organ Donation

4


The
new curriculum is divided into ten blocks, each 3
-
4 weeks in length. The total year two
curriculum increased from 34 to 35 weeks. However, the total curriculum hours including class,
laboratory and testing time only increased by ten

hours (from 752 to 76
2 hours).
The one
additional week is due to the addition of a NBME miniboard in the Approach to Patient Course
and the increase in the OSCE exam from one day to three days. The new Byrd Clinical Facility
contains 6 dedicated standardized patient rooms an
d has allowed for expansion of the exam
which has eliminated undue strain on the preceptors, students and the standardized patients.


Pedagogical methods largely remained the same. Previously we had an adequate balance of
sessions including didactic, s
mall group, lab, workshop, problem solving, case
-
based and so on
which have remained.


Although the curriculum in now systems
-
based, courses largely remained the same. This was
accomplished by merging of some smaller courses into our Approach to Patient

Care Course
(APC). The Clinical Skills course was revamped making our

total number of courses seven
.
Also, there was general consensus that students could benefit from greater exposure to
musculoskeletal pathology, as well as clinical practice in muscul
oskeletal physical examination.
The Department of Orthopaedics now provides eight hours of lecture and introductory clinical
experience to students in concert with the Clinical Skills course.


In addition to the basic science faculty, nearly all courses
continue to use clinicians to present
material to the medical students. The Approach to Patient course is taught almost exclusively by
practicing physicians from the departments of internal medicine, family medicine, pediatrics,
obstetrics and gynecology,
and surgery. The Microbiology course extensively uses the services
18


1/13/09

of one of our Infectious Disease specialists. The Immunology course uses our
Allergy/Immunology specialist to present topics on asthma and allergy. The Pathology course is
heavily taught by

practicing clinical pathologists. Pharmacology uses cardiologists, neurologists
and a practicing Pharm D to help connect the pharmacological principles and practices with
clinical medicine.


Although changing to a block, systems
-
based curriculum there we
re several aspects of the
curriculum we wanted to maintain and possibly enhance; one in particular was the early patient
exposure for students in the mentoring program. In the Approach to Patient Care course
students are required to work with mentors on t
hree different occasions each semester
accumulating at least 24 total hours of mentoring experience. In addition, they are to write two
mentor reflections focusing on their mentoring experience in an effort to enhance their training in
medical humanities.

While voluntary, Community Service opportunities are offered throughout
the school year. The majority of Tuesday afternoons are unscheduled to give students time off
to participate in these activities.


As with all medical schools we are constantly st
riving to most appropriately educate the
students. One concern has been the passive learning style of students and the need to improve
their lifelong learning habits. As a way of encouraging the students to reference their textbooks
more effectively and d
evelop better study habits, the faculty have pared handouts down to
outlines and are providing background reading assignments for their lectures. Our Clinical
Skills course is using extensive observational sessions and homework assignments to
challenge s
tudents to critically think and develop clinical competence to better prepare them for
the clinical clerkships. The Biostatistics and Epidemiology portion of the Approach to Patient
Course is deriving their grade almost exclusively from homework assignmen
ts and class
problem
-
solving cases, eliminating to a great extent the usual didactic formats.


Overall, the new integrated curriculum will provide a more realistic approach to the ways in
which students will recognize and manage their patient's problems
as physicians, while
strengthening the connection between the basic sciences and clinical medicine.
Under the
original curriculum, medical principles and concepts were presented in free standing discipline
-
based courses (e.g. Medical Microbiology, Medica
l Immunology, Medical Pharmacology,
Clinical Medicine, Pathology etc.). In the new curriculum, although the disciplined
-
based
courses will be retained, concepts will be presented in a disease
-
based or organ
-
based format
in which material from all second ye
ar courses will be integrated in a logical fashion.


Testing will occur also in a block format with ten block exams. Each exam is three hours in
length and contains 150 questions. Students will be required to pass five NBME miniboard
exams, given at th
e end of the school year, in addition to a required OSCE. In an effort to
improve our test and faculty communication, faculty work together to improve their questions
and will meet prior to the block exam to review all questions for the test. This has h
elped
eliminated ambiguous and “bad” questions and required rewriting of some questions to be
consistent with an established NBME format.


In the previous discipline
-
based curriculum all faculty maintained their questions separately, but
now they are poo
led into one large password protected web
-
based question bank that all faculty
can access. Questions can be reviewed, created or revised when needed. The question bank
offers a built in keyword search feature which gives faculty the ability to track the
content, the
type of questions we are using to test a concept and the balance of the material we are testing.
The search feature utilizes over 1,500 terms which includes disease, symptoms, and
medications.

19


1/13/09


A unique student feedback system has been establ
ished to complement the new curriculum.
Seven student liaisons have been selected and each is linked with a particular course director.
At the end of each block the student liaison will meet with the course director to review the block
to provide feedbac
k and on
-
going evaluation. Also, the office of medical education and the
associate dean for academic affairs will review and evaluate each block as it is completed. The
Curriculum Committee will monitor grades, NBME miniboard results, USMLE pass rates, e
tc. to
ensure students continue to perform well as the new second year curriculum progresses.


Now that the main work has been completed on the second year curriculum, there has been an
initial session with the first year faculty regarding integrating th
eir content in a similar systems
-
based fashion. The ultimate goal is to have in place by 2011 a four
-
year fully integrated,
competency based curriculum


Outcome Measures Documenting the Impact of the New Curriculum


Step 1 Outcomes


Below is a chart depicting the Step 1 results at MUJCESOM since 2000. The 92% pass rate for
first time takers this past May was the second highest since 2000. The 212 average was the
third highest since 2000.


USMLE Step 1


# Pass

#
Sat

% Pass

% Ntl.
Pass

Average

Ntl. Ave.

Min. Pass

2009

59

64

92%

Pending

212

Pending

185

2008

50

65

77%

93%

205

222

185

2007

53

55

96%

94%

210

222

185

2006

41

45

91%

93%

215

218

182

2005

40

44

91%

93%

213

217

182

2004

43

48

90%

92%

210

216

182

2003

39

46

85%

92%

205

216

182

2002

37

43

86%

91%

201

216

182

2001

45

50

90%

90%

208

215

182

2000

37

45

82%

92%

196

215

179


Test Questions & Format


Members of the teaching faculty met approximately one week before each of 10 block exams
during which each of the 150 test
questions were reviewed. These sessions served as
opportunities to greatly improve the quality of the test questions through an integrated working
environment between scientists and clinicians.

Several benefits were noted from these
interactions including:




Improved ability to meet course objectives through improved question writing



More clinical relevant and up
-
to
-
date questions in basic science course questions



Enhanced basic science material in clinical course questions

20


1/13/09



Elimination of redundant question
topics when, for example, microbiology and pathology
were both asking the same question about Lyme disease.



Improved camaraderie and esprit de corp

among faculty members


In its initial year, the integrated systems
-
based Year 2 curriculum provided innumer
able benefits
for the students and faculty. Many improvements have been put in place for next year based on
the feedback received. The pass rate and board score averages are reassuring and we hope to
continue to improve the curriculum in efforts to continu
e to enhance the medical education even
further.





b
.

Other Learning and Service Activities

Provide a summary of learning and service activities not
covered explicitly in section a.


In light of Marshall University Joan C. Edwards School of Medicine's co
mmitment to our
community and to the greater good, the Community Service Organization (CSO) was
established to make available, promote, and encourage opportunities for medical students to
participate in service
-
learning activities. The CSO is composed of r
epresentatives from each
year of medical education. Students are elected as Community Service Liaisons by their peers
each year and are responsible for making their classmates aware of service opportunities as
well as taking leadership roles in the develop
ment and implementation of service learning.


The CSO has created a mechanism by which to promote awareness and encourage
opportunities for medical students to participate in service
-
learning activities. A proposal by the
CSO to establish recognition for c
ommunity service was approved by the Curriculum Committee
and the Dean of the SOM.


Students who annually complete 40 hours of community service and
two “Service Reflections” will be recognized for “Honors in Community Service” at our award
ceremonies and
by other means deemed appropriate by Administration.




Volunteer activities do not interfere with students’ academic responsibilities but are intended to
enhance the medical education of our students.


Students seeking “Honors in Service” report
their service hours via the Community Service website and the Off
ice of Student Affairs will
monitor the program.


Faculty and students are encouraged to review the website which has
already been populated with information about the organizations with which students have
worked over the years and will be updated by stud
ents involved in community service projects
and by liaisons from the CSO.


Once a semester, students from all years of medical education
who are working toward “Honors in Service” will gather to share their community service
experiences and the needs of t
he community they feel need more focus.




c.

Plans for Program Improvement

Based on assessment data, provide a
detailed

plan for
program improvement. This plan
must
include a timeline.



d.

Graduate and Employer Satisfaction: Provide evidence and
results of follow
-
up studies to indicate graduate and
employer satisfaction with the effectiveness of the
21


1/13/09

educational experience. Indicate the number of individuals
surveyed or contacted and the numb
er of respondents.


e.

Attach the previous five years of
evaluations of your annual
assessment reports

provided by the Office of Assessment.





6.

Previous Reviews:

Describe the last program review action
(including committee recommendation)
. Identify weak
nesses and
deficiencies noted in the last program review and provide
information regarding the status of improvements implemented or
accomplished.





7.

Strengths/Weaknesses:

Identify the strengths and weaknesses of
the program. Describe program plans for removing the
weaknesses.




B.

VIABILITY

Provide a

narrative summary

for each of the following items in



addition to requested appendices.



1.

Articulation Agreements:

Describe program specific articulation
agreements with other institutions for delivery of this program.



2.

Off
-
Campus

Classes:

Describe/Summarize off
-
campus (other than the
Huntington,

or South Charleston campuses)
courses offered. (Include
locations, cou
rses, enrollments,
in

Appendix VI
.
)
This information
will
be provided by the Office of Institutional Research.


3.



Online Courses:
Describe/Summarize online courses

offered
. (Inc
lude
courses and enrollments in

Appendix VI
.
)
This information will be
provided by the Office of Institutional Research.








N/A





4
.

Service Courses:

Describe/Summarize departmental courses that
are required for students in other majors and support programs
outside the major. (Include enrollment data for these courses
in

Appendix
VI
.)
This information will be provided by the Office
of Institutional Research.





N/A


22


1/13/09



5
.

Program Course Enrollment:

Describe/Summarize program area
courses taken by students who are majors and include enrollment
by semester for the past

5 years. Indicate required or elective
courses. The purpose of this section is to indicate the availability
and relative strength of the program area courses. Include all
students enrolled in the courses, whether majors or not. (Include
enrollment data

for these courses in
Appendix
VI
.)
This
information will be provided by the Office of Institutional
Research.




6
.

Program Enrollment:

Summarize data indicating the number of
new students admitted, number of principal majors enrolled from
your college,
number of second majors, the number of students
enrolled as majors from other colleges (i.e., College of Education
specialization majors), the number of minors, and the number of
graduates for the program for each of the past five years. (Include
a chart
as
Appendix
VII

and provide separate data for each option
offered under the program.)
This information will be provided by
the Office of Institutional Research.

Finally, provide trend lines
for total number of students enrolled in the program a
nd number
of
graduates (Figure 1
) for the period of the review.




7
.

Enrollment Projections:

Identify trends that will influence
enrollment over the next five years. Provide enrollment projections.




C.

NECESSITY:

NOTE: If your program is accredited, please refe
r to the
appropriate page number
s in your accreditation report.

Provide a

narrative summary

for each of the following items in addition to
requested appendices.




1.

Advisory Committee:
Identify whether the program has an
Advisory Committee, and, if so,

briefly indicate the role and impact
of the Committee.




2.

Graduates
: Provide information on graduates in terms of places of
employment, starting salary ranges (where appropriate and known),
number employed in field of specialization, and/or acceptance
into
baccalaureate or graduate programs. (NOTE: Do not identify
students by name.)

Include
this information in
Appendix VIII
.




3.

Job Placement:
If the job placement rate reported above is low,
can a course of action be identified that would improve this
situation? Provide a summary of procedures utilized by the
institution to help place program graduates in jobs or additional
educational programs
. Include activities supported by both the
23


1/13/09

student’s academic department as well as the institution’s
placement office. This summary should include the institution’s
procedures and program organization for continuing contact and
follow
-
up with graduates.




IV
.

RESOURCE DEVELOPMENT (If applicable)

Please

prepare the following materials: 1) Program vision and mission
statements with a strategic plan to achieve the program’s vision and mission, and 2) a
specification o
f the resources needed to accomplish the program’s vision, with an
evidence
-
based rationale as why these resources are needed and how they will help
the program to accomplish its vision. The mission and vision statements, strategic plan,
and needed resourc
es with evidence
-
based rationale must be included in the program
review when submitted. Additionally, the chair and dean must make an additional
presentation to either the Academic Planning Committee or to the Graduate Council
before final votes are taken.


24



Appendix I

Required/Elective Course Work in the Program



Degree Program:

MEDICINE

Person responsible for the report:

__________________



Courses Required Year 1

Total

Required

Hours

Gross Anatomy (ACB 720)

8

Molecular Basis of Medicine (IDM 725)

8

Introduction to Patient Care I & II (IDM 716)

7

Behavioral Medicine (PSI 701)

2

Ethics (IDM 761)

1

Microanatomy & Ultrastructure (ACB 724)

4

Neuroscience (IDM 777)

6

Physiology (PHS 701)

8

Courses Required

Year 2


Approach to Patient Care (MED 725)

12

Clinical Skills (MED 755)

6

Immunology (MCB 743)

3

Microbiology (MCB 720)

6

Pathology (PTH 720

13

Pharmacology (PCM 720)

8

Psychopathology (PSI 721)

2

Courses
Required

Year 3


Family Medicine Clerkship (FCH 742)

8

Internal Medicine Clerkship (MED 742)

8

Obstetrics & Gynecology (OBG 742)

8

Pediatric Clerkship (PED 742)

8

Psychiatry & Behavioral Medicine (PSI 742)

8

Surgery Clerkship (SUR 742)

8

Courses
Required Year 4


ACLS (EMS 720)

1

Emergency Medicine (EMS 744)

4

Internal Medicine (MED 744)

4

Surgery (SUR 744)

4

Electives

23

25



Appendix V


Assessment Summary

Marshall University

Assessment of the Program’s Student Learning Outcomes

5
year summary


Component Area/Program/Discipline: ____________
MEDICINE
____
2009
___________________________



Program Level

Program’s
Student

Learning
Outcome
s

Assessment
Measures
(Tools)

Standards/Benchmark

Results/Analysis

Action Taken

to
improve the
program

Knowledge

Written Exams, Oral
Exams, Oral
Presentations,

Observation,
Evaluations,

USMLE Exams,

Clinical Competency
Exam

“C” or better

in all classes,
passage of USMLE Exams,
passage of Clinical
Competency Exam

Students are
performing at national
norm on USMLE
Exams.


Skills

Observation, Oral
Presentations, Oral
Exams, Evaluations,
USMLE Exams

Clinical Competency
Exam, Employer
Surveys

Passage of USMLE Step II
Clinical Skills section,
passage of Clinical
Competency Exam,
satisfactory evaluations

Students are
performing at national
norm on USMLE
Exams.


Attitudes & Behaviors

(Professionalism)

Oral Presentations,
Evaluations, Mentoring
Evaluation, Employer
Surveys

Satisfactory evaluations,
passage of USMLE exams,
Employer satisfaction

Students are
performing at national
norm on USMLE
Exams