Grading

Policies
Grading Policy for Vertical Courses The final grade for each of the vertical courses is made up of a variety of summative and formative components. Students must meet expectations or meet expectations with recommendations for each of the following summative components to achieve a passing grade for the course: 1. End-of-course Final Essay Questions (includes post-simulation questions) 2. End-of-course PEARLS Faculty Assessment of Student 3. Completion of all formative and administrative components The following are the formative and administrative components, which the students must complete to achieve a passing grade for the course: 1. Weekly Essay Questions 2. NBME Multiple Choice Questions 3. Vertical course projects (as applicable) 4. Mid-course PEARLS Faculty Assessment of Student 5. Mid-course PEARLS Self-Assessment by Student 6. Student Course and Faculty Evaluations The final grade for the course is either pass or fail. For a student to pass the vertical courses, he/ she must meet expectations or meet expectations with recommendations for all summative components and must meet expectations for all formative and administrative components listed above. For each of the summative components, a student receives one of three narrative descriptors: meets expectations, meets expectations with recommendations, or does not meet expectations. For each of the formative or administrative components, a student receives one of two narrative descriptors: meets expectations or does not meet expectations. Summative Components The summative Final Essay Questions, including the post-simulation exercise questions, are scored according to a question-specific, criterion-based rubric. Each question is written, reviewed, and scored by one faculty member who is a content expert. After all Final Essay Exams have been graded, students have the opportunity to attend a facilitated review session with course faculty to discuss the suggested answers to the Final Essay Questions. The summative end-of-course PEARLS Faculty Assessment of Student, completed by the PEARLS faculty members, includes feedback on the students strengths and areas of improvement, based upon their participation in PEARLS group discussions, professional behaviors, and attendance. Students are also expected to complete all formative and administrative assignments in a timely manner.

The Course Directors and Director of PEARLS, in consultation with the Office of Assessment, determine what constitutes meets expectations, meets expectations with recommendations, and does not meet expectations for each of the summative assessments related to the vertical course. A meets expectations with recommendations for any of the summative components identifies the need for targeted tutoring. A student in receipt of meets expectations with recommendations for the same summative component in more than one course, is required to develop an individualized remediation plan guided by his/ her Society Master, and to review and implement the plan with the assistance of the Course Directors or Director of PEARLS. A does not meet expectations for any of the summative components triggers global remediation of the course.

Formative and Administrative Components The formative Weekly Essay Questions are reviewed by the students PEARLS faculty member. After the PEARLS faculty review all the weekly essay questions, students receive the suggested answers as a means of self-assessment. If a students responses repeatedly trigger the concern of the faculty member, he or she guides the student towards targeted tutoring. The formative NBME Multiple Choice Questions are reviewed by course faculty and scored, but not graded. Each student receives a number that indicates his/ her performance compared to the mean performance of USMLE Step I test takers as a means of self-assessment. The formative mid-course PEARLS Faculty Assessment includes feedback on the students strengths and areas of improvement based upon their participation in PEARLS group discussions, professional behaviors, and attendance. In addition, the students complete a mid-course PEARLS Self-Assessment in preparation for a mid-course meeting with their PEARLS facilitators. Students must complete all required course and evaluation forms at the completion of each vertical course.

Upon completion of each of the above in a timely manner, the student receives a meets expectations or does not meet expectations. The completion of all formative and administrative components of the course is also reflected as a summative component of the vertical course as described above.

Grading Policy for Structure I and II Courses The final grade for the Structure I and II courses is made up of multiple components, some of which are summative and some of which are formative. Because each Structure course spans multiple vertical courses, its duration within a single vertical course is referred to as a module. Structure I has four modules (corresponding to the C.P.R., Biologic Imperative, Fueling the Body, and Homeostasis courses), and Structure II has two modules (corresponding to the Interacting with the Environment and Human Condition courses). Students must meet expectations or meet expectations with recommendations for each of the following summative components to achieve a passing grade for the course: 1. End-of-module Structure Laboratory Exams 2. End-of-module Problem-Based Structure (PBS) Facilitator Assessments (as applicable) 3. Completion of all formative and administrative components The following are the formative and administrative components that students must complete to achieve a passing grade for the course: 1. Student Evaluation of Problem-Based Structure (PBS) Group/ Faculty 2. Student Course and Faculty Evaluations 3. Structure Narratives The final grade for the course is either pass or fail. For a student to pass the Structure I and II courses, he/ she must meet expectations or meet expectations with recommendations for all summative components and must meet expectations for all formative and administrative components listed above. For each of the summative components, a student receives one of three narrative descriptors: meets expectations, meets expectations with recommendations, or does not meet expectations. For each of the formative and administrative components, a student receives one of two narrative descriptors: meets expectations or does not meet expectations. Summative Components The summative end-of-module Structure Laboratory Exams are scored according to a question-specific, criterion-based rubric. Each question is written, reviewed, and scored by one faculty member who is a content expert. The cut-off points for scoring each individual question are determined by the faculty member who wrote that question, in consultation with the course director. After all Structure Laboratory Exams have been graded, students have the opportunity to attend a facilitated review session with course faculty to discuss the suggested answers. The summative end-of-module PBS Facilitator Assessments include narrative feedback on strengths and areas of improvement based on the students participation in and completion of PBS exercises. Students are also expected to complete all formative and administrative assignments in a timely manner. The Course Directors, in consultation with the Office of Assessment, determine what constitutes meets expectations, meets expectations with recommendations, and does not meet expectations for each of the summative components related to Structure I and II. A meets expectations with

recommendations for any of the summative components identifies the need for targeted tutoring. A student in receipt of meets expectations with recommendations for the same summative component in more than one module is required to develop an individualized remediation plan guided by his/ her Society Master, and to review and implement the plan with the assistance of the course directors. A does not meet expectations for any of the summative components triggers global remediation of the module.

Formative and Administrative Components The formative student evaluation of PBS Group/ Faculty is completed by each student at the end of each module during which a PBS project occurs. The evaluation must be completed for the student to receive meets expectations for this component of the course. Students must complete course and faculty evaluations at the mid-point and end of each Structure course. Formative Narrative prompts are issued several times in each of the Structure courses. Students must respond to each prompt. Upon completion of each of the above in a timely manner, the student receives a meets expectations or does not meet expectations. The completion of all formative and administrative components of the course is also reflected as a summative component of Structure as described above.

Grading Policy for Patient, Physician, and Society I and II Courses The final grade for PPS I and II is made up of multiple components, some of which are summative and some of which are formative. Because each PPS course spans multiple vertical courses, its duration within a single vertical course is referred to as a module. PPS I has four modules corresponding to the C.P.R., The Biologic Imperative, Fueling the Body, and Homeostasis courses, and PPS II has two modules corresponding to the Interacting with the Environment and The Human Condition courses. Students must meet expectations or meet expectations with recommendations for each of the following summative components to achieve a passing grade for the course: 1. End-of-module Post Clinical Skills Exercises 2. End-of-course Comprehensive Clinical Skills Assessment (CSA) 3. End-of-course ICE Community Preceptor and ICE Site Director Professionalism Assessment 4. Hofstra Write-up/Mentored Casebook (PPS II) 5. Completion of all formative and administrative components, assessed at the end of every module. The following are the formative and administrative components which students must complete to achieve a passing grade for the course: 1. Patient Log of ICE and Ambulance Runs 2. Designated class assignments, including attendance at Site Director meetings 3. Completion of all RIA week components 4. Student Course and Faculty Evaluations The final grade for the course is either pass or fail. For a student to pass the PPS I and II courses, he/ she must meet expectations or meet expectations with recommendations for all summative components and must meet expectations for all formative and administrative components listed above. Students receive a tentative grade in PPS I and II at the completion of each module based on the end-of-module assessments. For each of the summative components, a student receives one of three narrative descriptors: meets expectations, meets expectations with recommendations, or does not meet expectations. For each of the formative and administrative components, a student receives one of two narrative descriptors: meets expectations or does not meet expectations. Summative Components The summative end-of-module Post Clinical Skills Exercises are questions asked in the context of standardized patient interactions. The summative Comprehensive Clinical Skills Assessment (CSA) is completed at the Center for Learning and Innovation (CLI) Clinical Skills Center and includes checklist items addressing multiple skill-based competencies. The summative End-of-course ICE Community Preceptor and ICE Site Director Professionalism Assessment is completed by the students Site Director(s), with contribution from each of his/ her individual ICE Community Preceptors.

The Hofstra write-up/ Mentored Case Book is assigned to the student as part of PPS II. The first write-up is formative and the second, completed in the second half of the academic year, is summative. Upon its completion during PPS II, the write-up is submitted for assessment to the PPS course directors and contributes to the grade for PPS II. The project is scored by a rubric intended to assess the achievement of competency-based milestones. Students are also expected to complete all formative and administrative assignments in a timely manner. Students are assessed in these efforts at the completion of every vertical course (also known as the end of a course module). The Course Directors, in consultation with the Office of Assessment, determine what constitutes meets expectations, meets expectations with recommendations, and does not meet expectations for each of the summative components related to PPS I and II. A meets expectations with recommendations for any of the summative components identifies the need for targeted tutoring. A student in receipt of meets expectations with recommendations for the same summative component in more than one module is required to document an individualized remediation plan guided by his/ her Society Master, and to review and implement the plan with the assistance of the course director. A does not meet expectations for any of the summative components triggers global remediation of the course.

Formative and Administrative Components The formative Patient Log is a document that must be completed for each patient encounter, after every session in a community practice clinical site and following ambulance runs. The minimum expectation is for a student to complete at least one patient log encounter per session or per ambulance run. Throughout PPS, a variety of designated class assignments will be distributed and must be completed in a timely manner. These include, but are not limited to: Formal write-ups of patients from ICE Web modules as preparation for PPS

 Attendance at site director meetings Each RIA week includes several components performed at CLI. These are largely formative in nature. They include clinical skills exercises, simulation scenarios, skills training in communications and physical diagnosis, and completion of narrative prompts, and completion of all course evaluations and peer assessments. Participation and completion of all RIA week components is required. Students are given individualized formative feedback after each of these exercises. If the observed level of skill triggers concern, he/ she is recommended for targeted tutoring overseen by the PPS Course Directors. Students must complete all required course, faculty evaluation forms at the midpoint and end of every PPS course. Peer assessment forms must be completed at the end of every PPS course. Upon completion of each of the above in a timely manner, the student receives a meets expectations or does not meet expectations. The completion of all formative and administrative components of the course is also reflected as a summative component of PPS as described above.

Grading Policy for the Advanced Clinical Experience Students will receive a tentative grade in the each core clerkships after the Reflection, Integration, and Assessment week following completion of each respective 12 week cycle. The following will contribute to each students grade in each core clerkship: % Person Category Components Contribution Responsible for to Grade Collating (1) ACE Director Feedback (ACE Rounds, 20% Write-ups/Mentored Case Books) Clinical Setting (2) Faculty and ACE Director Assessment Resident Feedback (Minimum 2 Faculty, 2 15% residents, multisource, and Longitudinal Preceptor in Medicine) TOTAL 35% (1) Pearls facilitator (case presentations, 15% Core Learning group process) Faculty Facilitator Assessment (2) Literature Search/ 5% Mini-Journal Club TOTAL 20% (1) Shelf 15% ACE Director (2) Short Essay OR Oral 15% Exam Central Standardized (3) Standardized Assessment Patient Encounters Clinical Skills with Post-encounter 15% Assessment Team Exercises and Simulation TOTAL 45% Each of the above components will be graded according to a pre-specified rubric and assigned a numerical value. Each component will contribute to the final grade according to the percentages given above. Thus, a final numerical score will be calculated accordingly. Grades of Honors, High Pass, Pass, and Fail will be set according to standards specified by the Second 100 Weeks Subcommittee. Students who are unhappy with their tentative grade assigned after a 12-week cycle may opt to retake any or all of the following at the end of the year:

 shelf exam oral or essay exam The better of the two scores on each repeated component will contribute to the final grade. Final grades in each core clerkship will be given at the end of the year.

Grading Policy for the Acting Internships during Preparation For Residency and Selectives during the Advanced Clinical Experience The final grade for each Acting Internship and Selective is made up of multiple components. Students must meet expectations or meet expectations with recommendations for each of the following summative components to achieve a passing grade for the acting internship or selective: 1. End-of-Acting Internship Supervising Physician Global Assessment OR End-of-Selective Supervising Physician Global Assessment AND 2. AT LEAST ONE of the following (chosen by the physician in charge of the Acting Internship or Selective): a. End-of-Acting Internship or Selective Final Essay Exam Questions b. End-of-Acting Internship or Selective Oral Examination c. End-of-Acting Internship or Selective Assessment (CSA) d. End-of- Acting Internship or Selective Simulation Assessment e. Submission of one or more Hofstra Write-ups/Mentored Case Book 3. Completion of all formative and administrative components, assessed at the end of the acting internship or selective The following are the formative and administrative components that students must complete to achieve a passing grade for the acting internship or selective: 1. Patient Log 2. Designated assignments or assessments 3. Student Acting Internship or Selective and Faculty Evaluations The final grade for each acting internship or selective is designated as honors, high pass, pass, or fail. Each of the above assessments is graded based on a criterion-based rubric and contributes to the final grade based on a pre-determined percentage. Students will receive honors, high pass, pass or fail based on pre-determined cut-offs. Summative Components The summative End-of-Acting Internship or Selective Supervising Physician Global Assessment is completed by the primary faculty supervisor, with input from both house staff and multi-disciplinary staff, and includes checklist items addressing all competencies. The summative End-of- Acting Internship or Selective Final Essay questions are questions asked during the End-of- Acting Internship or Selective Final Essay Exam that encompass relevant material. The summative End-of- Acting Internship or Selective Oral Examination questions are questions asked during the End-of- Acting Internship or Selective Oral Exam that encompass relevant material. The summative Clinical Skills Assessment (CSA) is completed at the CLI Clinical Skills Center and includes checklist items addressing multiple skill-based competencies from standardized patient interactions.

The summative Simulation Assessment is completed at the CLI Clinical Skills Center and includes checklist items addressing multiple skill-based competencies from simulated encounters. The summative Hofstra Write-up/Mentored Case Book is a formal write-up of a patient under the students care. It is graded according to a criterion-based rubric. Students are also expected to complete all formative and administrative assignments in a timely manner. Students are assessed in these efforts at the completion of the acting internship or selective. The Director of ACE, in consultation with the Office of Assessment, determines each summative assessments contribution to the students competency assessment. This group also determines the contribution of each competency assessment towards the grade. Formative and Administrative Components The formative Patient Log is a document that must be completed for each patient encounter. Participation and completion of any assignments or assessments is required. The Student Acting Internship or Selective and Faculty Evaluations forms must be completed at the end of each acting internship or selective.

Grading Policy for Electives during Preparation For Residency Students must meet expectations or meet expectations with recommendations for each of the following summative components to achieve a passing grade for the electives: 1. End-of-Elective Supervising Physician Global Assessment 2. Completion of all formative and administrative components, assessed at the end of the elective The following are the formative and administrative components that students must complete to achieve a passing grade for the elective: 1. Goals for the Elective Experience 2. Patient Log (if applicable) 3. Student Elective and Faculty Evaluations The final grade for each elective is designated as pass, or fail and is assigned by the students primary supervising faculty. Faculty Supervisors are given criteria by which to assign grades. Summative Components The summative End-of-Elective Supervising Physician Global Assessment is completed by the primary faculty supervisor, with input from both house staff and multi-disciplinary staff, and includes checklist items addressing all competencies. Students are also expected to complete all formative and administrative assignments in a timely manner. Students are assessed in these efforts at the completion of the elective. Formative and Administrative Components Students are expected to write goals for their elective experience prior to the start of the elective. The formative Patient Log is a document that must be completed for each patient encounter. The Student Elective and Faculty Evaluations forms must be completed at the end of each elective.