Clerkship Experiences and Mid-Clerkship Feedback Policy

Purpose
To outline the required clinical experiences and their monitoring, and the provision of midpoint feedback in required clerkships.

Audience
All medical students, Clerkship Directors, and educators including Preceptors, Residents and Attendings, in the clerkship phase of the curriculum

LCME Standard
6.2 Required Clinical Experiences
8.6 Monitoring of Completion of Required Clinical Experiences
9.7 Formative Assessment and Feedback

Policy

Definitions

  • Incomplete grade: a temporary grade issued for student work has not been completed but is of passing quality.
  • Y mark: a temporary mark issued to a student for work has not been completed and is not of passing quality. A “Y” converts to an F grade unless the student completes the work within a specified time period. (Reference School of Medicine Bylaws and Regulations - Regulation 70, B.)
  1. Clerkships will establish and publish a list of required clinical experiences that students must complete to meet clerkship requirements.
  2. Students are responsible for maintaining documentation of clinical experiences in an ongoing manner for each required clerkship, in accordance with each clerkship’s requirements.
  3. Students must receive feedback from supervising faculty and/or clerkship directors midway through the rotation. This feedback must include a review of the documented required clinical experiences as well as an assessment of the student’s performance in achieving clerkship objectives and reaching the School’s competency milestones. Feedback will be documented.
  4. Each clerkship must have a system in place to check with students for missing required experiences prior to the completion of the rotation. Alternate methods for completing each required experience, in the event that the student cannot complete them in the assigned clinical setting, must be listed on course syllabus.
  5. A student who is unable to complete required experiences before the end of the clerkship is expected to engage with the Clerkship Director to develop a plan for completing the experience(s). The student will be assigned an "I" grade.
  6. An "I" grade will be converted to pass if all required experiences or their equivalent are satisfactorily completed by a specified deadline established between the Clerkship Director and the student and within the guidelines of the School’s Bylaws and Regulations.
  7. Failure to satisfactorily complete all required experiences during the clerkship or meet the deadline set for resolving an "I" grade will result in a conversion of the “I” grade to a “F” mark. (See the School of Medicine Registrar's Office, Forms webpage for I/Y Change Requests.)
  8. The Committee on Educational Policy has the authority to ensure clerkships comply with required oversight of the feedback and clinical experience tracking systems.

Procedure

Student Procedures

  1. Students must document their patient encounters per the established list of required clinical experiences specific to each clerkship on an ongoing basis throughout each clerkship.
  2. Each student should discuss any not-yet-completed clerkship experiences with the supervising housestaff or attendings during the rotation and with the site/course director. If a student is unlikely to accomplish all of the required activities through patient care experiences, despite best efforts, the student and course director should discuss alternate means for achieving the competency.
  3. Alternative activities will be scheduled on an individual basis, based on the likelihood of the student achieving the core experience during their time remaining in the rotation. However, each clerkship must specify a time point (e.g., one week prior to the end of the rotation) when an alternative activity will be triggered. Alternate methods might include directed reading, web-based or paper cases, simulation sessions, or additional clerkship time. If an experience is met through an alternative activity, this must be documented.
  4. If the remaining experience is not met by the end of the clerkship rotation despite best efforts, the student is expected to work with the Clerkship Director to develop a plan for completion or the required activities will receive an “I” grade.

Faculty Procedures

  1. Monitor items A and B of Student Procedures
  2. In relationship to Student Procedures item C, track the number of alternate experiences over the academic year. If 25% or more of students complete the same required experience through an alternate experience, bring this experience to the attention of the Committee on Educational Policy.
  3. Collaborate with the curriculum support staff on Student Procedure item D.

Responsibility
Clerkship Directors

References
I-EXPLORE Graduation Competencies
UC Davis School of Medicine Bylaws and Regulations, Regulation 60: Requirements for the Degree Doctor of Medicine; Regulation 70: Grades and Grading
School of Medicine Office of the Registrar

Related Policies
Clerkship Attendance, Participation and Absence Policy
Coursework and Professionalism Remediation Policy
Delayed Assignment Submission Policy
Grades and Grading Policy
Professionalism Policy

Policy Owner
Committee on Educational Policy

Reviewed and Approved By
Clerkship Directors Workgroup
Curriculum Steering Subcommittee
Committee on Educational Policy*
Office of Medical Education

Reviewed Date and Review Cycle
March 2024, annual review cycle

*Committee reviews, updates and approves policy