an analysis of ross university school of medicine two track curriculum sequence
TRANSCRIPT
Running head: AN ANALYSIS OF (RUSM) TWO TRACK CURRICULUM SEQUENCE 1
AN ANALYSIS OF RUSM TWO TRACK CURRICULUM SEQUENCE
Adonis Charles-Barnes, BBA., MSc., M.Ed.
September 21, 2014
AN ANALYSIS OF (RUSM) TWO TRACK CURRICULUM SEQUENCE 2
Table of Contents
Introduction ..................................................................................................................................... 3
Executive Summary ........................................................................................................................ 4
School Characteristics ..................................................................................................................... 5
Narrative ......................................................................................................................................... 8
Action Plan.................................................................................................................................... 12
Budget ........................................................................................................................................... 13
Training Needs .............................................................................................................................. 13
Evaluation Plan ............................................................................................................................. 14
Consequence Analysis .................................................................................................................. 16
Considered Alternative Methods .................................................................................................. 16
Stakeholders .................................................................................................................................. 17
Conclusion .................................................................................................................................... 19
References: .................................................................................................................................... 20
AN ANALYSIS OF (RUSM) TWO TRACK CURRICULUM SEQUENCE 3
Introduction
Ross University School of Medicine commenced a two-track core curriculum for the
Foundations of Medicine quota of the Doctor of Medicine program with the May 2013 arriving
class, proposing two routes for the learner achievement. The new Foundations of Medicine
program is five semesters in duration and the accelerated path four semesters. Importantly, the
two-track curriculum constitutes a similar program of education.
American medical school’s curriculum frequently undergoes modification. The effect of
official curriculum approaches on expertise in medicine is weighed by the U.S. Medical
Licensing Examinations (USMLE) Step 1, 2, and 3. The kind of school curriculum does not
factor in the inconsistency in the scholar performance on the USMLE Step Exams. The purpose
of this study is to highlight how learners of RUSM who are enrolled in the four session
curriculum sequence perform better (have higher scores, have greater achievement) on
Examinations compared to students who are enrolled in the five session curriculum sequence.
AN ANALYSIS OF (RUSM) TWO TRACK CURRICULUM SEQUENCE 4
Executive Summary
The objective of this research is to highlight how learners of RUSM who are enrolled in
the four session curriculum sequence perform better academically on Examinations compared to
students who are enrolled in the five session curriculum sequence. Beginning with the May 2013
incoming class RUSM created the two-track curriculum sequence with the objective of
increasing students’ options and chances for success in their medical education endeavor. One of
the main goals of this new two-track curriculum is to significantly reduce the attrition rate among
students.
It can be said that the root cause of the disparity in examination performance of students
in the two-track curriculum is as a result of some student’s inability to put in the study time and
develop the motivation that RUSM school curriculum demands. Closing the achievement gap
between students enrolled in the four and five curriculum sequence will require the following
questions to be answered: What is the strategy in place for faculty to effectively impart the
information and standards necessary for scholars to establish a successful career as a medical
doctor? How could the University develop a method to properly streamline students in the
curriculum sequence that would be most appropriate for their motivation level and cognitive
aptitude?
Furthermore, within the last two years RUSM has implemented electronic testing for one
hundred percent of the students. The University has therefore realized a degree of success and
benefits with the implementation of this e-testing initiative and technology on a whole, and
therefore can continue the successful use of technology to improve learning, content areas, and
outcomes.
AN ANALYSIS OF (RUSM) TWO TRACK CURRICULUM SEQUENCE 5
School Characteristics
RUSM is a medical school located in the Commonwealth of Dominica that provides a
chance for motivated medical learners throughout the world to become medical doctors.
Established in 1978, RUSM alumni are working in the 50 states of the U.S., Canada, and
elsewhere. Students complete a demanding basic science curriculum, and then finish their
medicinal schooling by enrolling in essential and optional medical cycles throughout the United
States, Canada, and United Kingdom (Ross University School of Medicine, n.d.).
According to the RUSM website, the task of the University is to organize greatly devoted
learners to become successful medical doctors. The website highlighted that this is done by
concentrating on communicating the information, expertise, and standards essential for all
learners to generate a rewarding and substantial career as a doctor. Furthermore, RUSM teaching
staff for the Foundations of Medicine program in the Commonwealth of Dominica is consisted of
approximately seventy medical doctor, instructors, and academics. Each associate of the faculty
holds a MD and/or PhD degree, and several are licensed by the medical board in their respective
fields (Ross University School of Medicine, n.d.).
Additionally, the University has implemented electronic testing for 100 percent of the
students. The benefits realized from this initiative so far are as follows: improvement in the
confidentiality, integrity, and security of the examination process; Automatic Scoring - multiple
choice questions are automatically graded by the computer system as soon as a test is submitted;
Statistical Analysis - quick results reports allow faculty members to see how well students did on
their tests in real time; and Ecologically Friendly - printed paper copies of tests and scantrons are
no longer needed.
AN ANALYSIS OF (RUSM) TWO TRACK CURRICULUM SEQUENCE 6
Also, based on the significant reduction in students’ grievance with the testing center, it
can be concluded that the testing experience of the students has tremendously improved.
However, it must be noted that despite the success of electronic testing, as a result of the two-
track curriculum sequence there is an increased in the number of scheduled examinations. This
has therefore resulted in students been asked to be sequestered and tested in two-groups because
of space limitation in the testing center.
Data has shown that Ross University School of Medicine students attained a Ninety-Six
percent first-time pass rate in 2012 and a Ninety-Seven percent first-time pass rate in 2013 on
Step 1 of the USMLE Examination. RUSM’s performance on USMLE Step 1 matched United
States and Canadian medical schools. It is mandatory that graduate students of international
medical universities take and pass the USMLE Exam in order to practice medicine in the U.S.
The Step 1 exam is intended to assess medical school students’ knowledge of the basic science
foundation of clinical practice (Ross University School of Medicine, n.d.).
Also, most attrition at RUSM occurs in the first year of study, and while the University
policy is not to sacrifice academic quality for graduation numbers, the school offers an
introductory program to learners who have been given provisional acceptance, namely the
Medical Education Readiness Program (MERP). This program is geared to assist in deciding the
willingness of learners to meet the demands of an accelerated and demanding medical school
curriculum that RUSM offers (Ross University School of Medicine, n.d.).
AN ANALYSIS OF (RUSM) TWO TRACK CURRICULUM SEQUENCE 7
Table 1 illustrates Exam performances of Semester 2 students (Sep – Dec 2013) enrolled
in the four session curriculum sequence and five session curriculum sequence:
Table 1 Exam Performances of Semester 2 Students (Sep – Dec 2013)
Source: ExamSoft Confidential Assessment Performance Summary Report.
Table 1 highlights for the Term (Sep – Dec 2013) Semester 2 students enrolled in the 4
session basic science curriculum sequence academically outperformed their colleagues enrolled
in the 5 session basic science curriculum sequence.
72%
74%
76%
78%
80%
82%
84%
86%
88%
Sem. 2 Mini 1 %success rate
Sem. 2 Mini 2 %success rate
Sem. 2 Mini 3 %success rate
Sem. 2 Final %success rate
Four session curriculum
Five session curriculum
AN ANALYSIS OF (RUSM) TWO TRACK CURRICULUM SEQUENCE 8
Table 2 Students’ Grievance Data
Source: Stowe Exam Center
Table 2 indicates that prior to the e-testing initiative by RUSM students’ grievance with
the Testing Center was significantly higher.
Narrative
Research data from Ross University School of Medicine has shown that for the term (Sep
– Dec 2013) Semester two students enrolled in the four session basic science curriculum
sequence academically outperformed their colleagues enrolled in the five session basic science
curriculum sequence. The two-track curriculum that comprised the Foundations of Medicine
program began with the May 2013 incoming session, proposing two routes for learner success.
The regular curriculum track is five semesters, while the accelerated curriculum track is four
semesters in duration. The two track curriculum sequence constitutes the same program study. At
the end of Semester 1 learners will receive academic counseling guidance and select between the
0%
5%
10%
15%
20%
25%
30%
35%
40%
Semester 1 Semester 2 Semester 3 Semester 4
Students Grievance with the Testing Center
Post e-testing Grievance Pre e-testing Grievance
AN ANALYSIS OF (RUSM) TWO TRACK CURRICULUM SEQUENCE 9
5-semester regular curriculum and the 4-semester accelerated curriculum programs (Ross
University School of Medicine, n.d.).
The main objective of the new RUSM two-track curriculum is to reduce the attrition rate
among students. Moreover, the new two-track curriculum requires a team effort from all
stakeholders, a cooperative climate among the various faculty and departments, accessibility to
required resources, course content inserted into the present curriculum, and vigorous institutional
backing. The factors highlighted can therefore lead to viable changes in incorporating the new
medical school curriculum. In short, there is a need to develop a method to properly streamline
students in the curriculum sequence that would be most appropriate for their motivation level and
cognitive aptitude.
Additionally, Tests are considered an essential part of the education process and are
intended to highlight significant concepts and improve problem-solving capabilities. It can be
said that the root cause of the disparity in examination performance of students in the two-track
curriculum is as a result of some student’s inability to put in the study time and develop the
motivation that RUSM school curriculum demands.
The key for students to keep themselves intellectually sound is disciplined study habits
that will enable them to digest a huge amount of information in a limited period of time. Also,
during orientation for RUSM first semester students, students should be made aware of the
School’s academic support departments such as the Center for Teaching and Learning (CTL) and
also be reminded that medical school demands that students have good study skills and a strong
work ethic.
Furthermore, understanding the elements involved in educational failure is important and
can be categorized as follows: students objective, enthusiasm, apprehension, studying technique,
AN ANALYSIS OF (RUSM) TWO TRACK CURRICULUM SEQUENCE 10
intellect, attention, planning, emotional and psychological conditions, and regular absence from
the course, the expert features of lecturers, space and suitable amenities and tools, and the
socioeconomic standing of relatives and uncertain and undefined professional forecasts (Najimi,
Sharifirad, Amini & Meftagh, 2013).
Hecker &Violato (2009) found in their research study of medical school curricula that the
highest disparity in academic performance is between learners within universities, not between
universities. They further stated that while the core curriculum is significant, the importance that
several medical universities place on the core curriculum renewal may need to be reassessed.
Thus, the curriculum method may well be less significant than the quality of the core curriculum
execution, suggesting that in medical education improvement there should be a change from
curriculum rearrangement to directing more important study on areas such as learner
characteristics, excellence of medical instructors, the appropriate use of educational philosophy,
educational concept, assessment, and pedagogical procedures on the learner-teacher connection
in the framework of medical schooling (Hecker & Violato, 2003).
Closing the achievement gap between students enrolled in the four and five curriculum
sequence will require the following questions to be answered and appropriate measures taken:
why students who are enrolled in the four session curriculum sequence perform better on
Examinations compared to students who are enrolled in the five session curriculum sequence?
How well does faculty believe they are motivating students? What is the strategy in place for
faculty to effectively impart the information, expertise, and standards necessary for learners to
build a positive and substantial career as a medical doctor? How could the University develop a
method to properly streamline students in the curriculum sequence that would be most
appropriate for their motivation level and cognitive aptitude?
AN ANALYSIS OF (RUSM) TWO TRACK CURRICULUM SEQUENCE 11
Furthermore, in addition to utilizing the reporting function in the testing application,
namely ExamSoft to help guide students as they prepare for remediation, RUSM can also use it
as a performance indicator to measure the outcome of the improvement strategy. The report
function significantly reduces the problems associated with item recall, provides a guide to areas
of strength and weakness, and develops a remediation process to help students effectively
process this information, improve study skills, and or assist them through tutoring or other
proactive participation activities (Vandre & Ermie, 2014).
The establishment of Technology-based assessment has numerous benefits and great
prospective for helping learners’ access assessment resources. Also, a variety of technology-
based procedures and resources can be incorporated throughout the curriculum to distinguish the
testing technique that will address learners’ specific strengths and weaknesses, as well as the
distinctive and diverse teaching settings in which educational professionals work. Nevertheless,
when using testing environments that is technology based, educational professionals ought to
detect and treat with possible issues, measure the numerous technologies to determine if they are
suitable for use by scholars and faculty, carry on gradually, and envision if the technology offers
learners with entrance to assessments without altering the assessment’s content, concepts, and
grades (Salend, 2009).
AN ANALYSIS OF (RUSM) TWO TRACK CURRICULUM SEQUENCE 12
Action Plan
Objective: To improve the Examination performance of students enrolled in the five-semester
curriculum sequence.
Tasks
Who’s
Responsible
Timeline
Resources
Needed
Success Signals
1. Construction of a
new Exam Center to
test all students in
one group or
seating.
2. Develop the
capability to simply
generate
Examinations, and
classify testing
questions in multiple
ways.
Senior
Associate
Dean,
Dominica
Campus.
Assistant Dean
for
Educational
Assessment.
10/25/2014 -
10/24/2015
10/25/2014 -
12/24/2014
Allocation of
Capital funds
to procure and
source the
required
Human and
Physical
resources for
the project
Development
funds to train
faculty and
staff members
to competently
use the
ExamSoft
application.
Ability to test
students at the
same time
through the use
of technology
and availability
of the required
space and
accommodation.
Reduction in
students’
grievance with
the testing center.
An increase in
the number of
students using
examination
reports as a guide
to improve their
academic
performance.
AN ANALYSIS OF (RUSM) TWO TRACK CURRICULUM SEQUENCE 13
Budget
The objective of this budget is to make the best use of all the required Human and
Financial resources that is needed to improve the testing experience and Examination
performance of students enrolled in the five-semester curriculum sequence. This is of utmost
importance in order for the University to achieve its mission of preparing highly committed
students to become skilled and caring physicians, and also creating an environment that is highly
conducive for the cognitive development of medical students.
The funding required for this project are as follows: construction of a new testing center
with the required infrastructure - $1000000.00; purchase of additional ExamSoft licenses -
$150,000.00 yearly; and ExamSoft training for faculty and staff - $60,000.00.
Training Needs
The purpose of this training needs analysis is to highlight the knowledge, skills, and
abilities needed by RUSM faculty and Staff to improve the testing experience and Examination
performance of learners enrolled in the five-semester curriculum. This will therefore contribute
to fulfilling the University’s mission of preparing highly committed learners to turn out to be
skilled and compassionate doctors, and improve the overall quality of the school’s medical
educators.
Ten Faculty and Staff members working in the Stowe Exam Center and the Center for
Teaching and Learning (CTL) departments of RUSM will be provided training to proficiently
use the ExamSoft software. This training will be provided by ExamSoft training personnel’s at a
cost of $60,000.00. The training will be broken down into the following areas: Analyzing
Assessments, Account Administration, and Question Banking and Assessment Building.
AN ANALYSIS OF (RUSM) TWO TRACK CURRICULUM SEQUENCE 14
Evaluation Plan
The evaluation of this project will be based on the Examination performance of students
enrolled in the five-semester curriculum sequence and the ability of RUSM to improve the
learning experience of all students by providing the required resources and infrastructure. The
research will also explore how curriculum mapping programs have been used by RUSM to
enable the management of the integrated medical school curricula to keep track of the university
objectives, course objectives, content areas, learning resources, learning events, assessments, and
outcomes.
RUSM has also utilized the report function in ExamSoft to help guide students as they
prepare for remediation. The University has also created a technique to classify the assessment
items used in the core curriculum using a distinctive classifying tag to generate a tagged
electronic databank of test questions using the SofTeach unit of the ExamSoft testing software.
Thus, an in depth report of assessment performance is at present provided to learners following
the conclusion of each individual assessment.
Also, RUSM Curriculum department can piggy back off the SUNY Upstate Medical
University Pediatrics department. SUNY Medical University in conjunction with the Educational
Design, Improvement, and Assessment Department in the Syracuse University School of
Education newly started a curriculum improvement drive that comprised transformation of the
residency curriculum's yearly primary didactic lecturing series to an online system (Olson, Mata
& Koszalka, 2013).
Thus, RUSM can use a similar curriculum reform effort and collaborate with other
University’s School of Education department in the U.S. to implement a similar online learning
AN ANALYSIS OF (RUSM) TWO TRACK CURRICULUM SEQUENCE 15
system for students who are in the clinical aspect of their studies, and in the residency aspect of
their medical career.
Additionally Stebbings, Bagheri, Pierre, Blyth, & McDonald (2012) highlighted how the
University of Otago established a multimedia online educational resource program organized to
support lecture based problem-based educational conferences, and improve the learner
commitment and encourage clinical intellectual ability. According to the authors the objective
was to support teaching over three physically separate campuses, encourage more student-
centered methods to education and meet the challenge of the restricted lecturing time available
for students’ educational pursuit in the arena of rheumatology (Stebbings, Bagheri, Pierre, Blyth,
& McDonald, 2012).
They emphasized that the evaluation of the restructured course indicated that with the use
of technology there was a tremendously positive reaction to the modifications in teaching
approaches. Thus, the online resources combined into the new core curriculum and integrated
with in-class PBL and clinical periods, proved prevalent with learners (Stebbings, et al.).
Moreover, Mann (2007) highlighted in her article that American medical schools first
embarked on a technology revolution during the period when patients’ record was still in paper
form. She illustrated that today, medical schools, are incorporating technology because of its
significant role in the present and future. According to her it is used as a direct educational tool
through virtual patients and simulations, and to help students navigate the curriculum and
enthusiastically manage their own educational experience (Mann, 2007).
She further indicated that the infusion of technology changed the experience in the
anatomy lab, and presented an example of how technological innovation now allows students to
learn radiology principles alongside anatomy (Mann, 2007).
AN ANALYSIS OF (RUSM) TWO TRACK CURRICULUM SEQUENCE 16
Consequence Analysis
The overall benefits of improving the Examination results of students enrolled in the five-
semester curriculum sequence are as follows: to reduce the school’s attrition rate, ensuring
competence of the required learning material, negotiating the curriculum well, and to ensure that
students are well prepared for the USMLE licensure exams. On the other hand the potential
limitations of the project are as follows: lack of funding; students objective, enthusiasm,
apprehension, studying technique, intellect, devotion, preparation, emotional and psychological
circumstances, space and proper facilities and equipment; and the social and economic standing
of relatives and undefined and unclear professional forecasts.
Franco (2013) highlighted in his article that students fail their medical schooling as a
result of the battle as to whose career objective they are really pursuing. According to him
Medical schooling needs a high level of discipline and requires a great level of student’s time,
and if students are living out their parents' vision and not their own, the internal battle can lead to
unconscious failure. The article also highlighted that Medical schooling is demanding and can at
times be an emotional draining experience for scholars who do not have a passion to turn out to
be doctors (Franco, 2013).
Considered Alternative Methods
An alternative solution to improve the Examination performance of students enrolled in
the five-semester curriculum sequence and reduce the attrition rate among students would be to
enrolled students in the medical program with a 3.3 or higher GPA undergraduate degree that
entails the prerequisite science courses for a medical degree program. However, RUSM is a for-
AN ANALYSIS OF (RUSM) TWO TRACK CURRICULUM SEQUENCE 17
profit institution and introducing such criteria may affect enrollment numbers and ultimately
lower revenue for the institution.
Therefore, my proposed recommendations of constructing a new Exam Center to test
students in one group or seating; implementing a resolution that would allow faculty to use
individual student performance data to impact their education outcomes; generate reports for
students to determine their own strengths and weaknesses; and allow faculty to use assessment
information to forecast students at-risk of failure, and therefore intervene are much more ideal
and feasible for all stakeholders of the University.
Stakeholders
The improvement plan by RUSM to improve the Examination performance of students
enrolled in the five-semester curriculum sequence and the ability to improve the learning
experience of all students will benefit all stakeholders of the University. For instance Students
will be more prepared to meet curriculum requirement; faculty and staff will have the capability
to simply build assessments, and classify exam questions in multiple ways; and it will allow
faculty members to forecast learners who may be at-risk of failing, and therefore get involved.
Moreover, Team members’ collaboration is valuable; as a result working together with
other people is vital to conduct effective research and to evaluate effectiveness. Multiple
perspectives are important in order to evaluate current situations and perceptions. Therefore,
collaboration of all the team members will be critical to help build a common perspective based
on the interaction of the team members and their various points of view. Further, the main
criteria of team members for this research project will be their expertise for the project,
AN ANALYSIS OF (RUSM) TWO TRACK CURRICULUM SEQUENCE 18
motivation level to engage in the project, and their habits approach to the project (Bauer &
Brazer, 2012).
Frenkel (2007) illustrates a research that analyzed instructions learned from the
introduction of complementary and alternative medicine components into a medical school core
curriculum. According to him the research on the mixture of CAM subject matters into the
school’s curriculum is a good indication that amendments can take place when suitable
consideration is given to anticipated classes of concerns. It further highlighted that presenting
CAM related subject matters into the medical school core curriculum call for a devoted group to
effect the necessary change (Frenkel, 2007).
Furthermore, he stated that this transformation call for CAM practices that are made
noticeable to learners and educators, a cooperative environment is produced, resources are easily
reached, CAM content is inserted into the present core curriculum, and there is dynamic
institutional backing. These elements can therefore lead to sustainable alterations in
incorporating the new medical school curriculum (Frenkel, 2007).
The team members and their involvement for this project are as follows: the Senior
Associate Dean, Dominica Campus, his role at RUSM is the ongoing development,
implementation and evaluation of the school’s basic science program. His responsibility for the
project will be to negotiate for the construction of a new Exam Center; secondly, Assistant Dean
for Educational Assessment, his role at RUSM is to guide faculty on assessment protocols and
manage students testing arrangements. His responsibility for the project will be to provide
student’s assessment information because of his direct access to grade and analysis report for all
students enrolled in the four and five session curriculum sequence;
AN ANALYSIS OF (RUSM) TWO TRACK CURRICULUM SEQUENCE 19
Thirdly, the ExamSoft Administrator, she is responsible for administering all electronic
Examinations at RUSM, and working with faculty to create, deliver, analyze, and manage exams.
Her responsibility for the project will be to provide information on Exam performance, and at-
risk students report generated via ExamSoft.
Conclusion
RUSM created the two-track curriculum sequence with the objective of increasing
students’ options and chances for success in their medical schooling endeavor (Ross University
School of Medicine, n.d.). One of the main goals of this new two-track curriculum is to
significantly reduce the attrition rate among students. However, data derived thus far from
Examinations results for students enrolled in the five-semester curriculum sequence and the four-
semester curriculum sequence has clearly shown that students in the four session curriculum
sequence have perform better on Examinations compared to their colleagues who are enrolled in
the five session curriculum sequence.
As a result, the University has embarked on a number of initiatives to develop students’
ability to meet curriculum requirement; enable faculty and staff to simply build assessments, and
group exam questions in multiple ways; and allow educators to use assessment information to
forecast learners who are at-risk of failing. Furthermore, the University has begun the planning
phase for the construction of a new testing center, with the required resources to test students
using the ExamSoft software in one group / seating; and have allocated funds to train additional
faculty and staff to competently use the ExamSoft software.
AN ANALYSIS OF (RUSM) TWO TRACK CURRICULUM SEQUENCE 20
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