Pre-Clerkship Attendance, Participation and Absence Policy

Purpose

This policy outlines the attendance, participation and absence policy for pre-clerkship learning activities, aligned with the following Graduation Competencies:
1. IPCS 3. Work effectively with others as a member of a health care team or other professional group.
2. LL5: Demonstrate commitment towards professional identity formation.
3. P1: Demonstrate empathy and integrity.
4. P2: Demonstrate responsiveness to patient needs that supersedes self-interest.
5. P5: Demonstrate self-compassion.
6. P7: Demonstrate commitment to uphold ethical principles and medico-legal aspects of the profession.
7. P8: Contribute in teaching others (patients, families, students, trainees, peers and other health professionals).
Similar to the team-based structure of the clinical environment, active learning sessions in the pre-clerkship curriculum depend on the engagement and participation of peers to maximize the value and effectiveness of teaching sessions for students.
Managing the balance between personal and professional obligations is a key professional skill that is developed as part of the medical training process.
The School recognizes that students will have scheduled and/or emergent personal obligations that may conflict with required elements of the curriculum.
Attendance patterns can be an indicator of how students are managing the balance between personal and professional obligations and can help identify students with additional resource needs.
Communication around attendance and one’s ability to fulfill professional obligations is a required skill for health care providers.
Therefore, attendance management is an integral part of delivering medical education curriculum and ensuring the personal wellbeing and professional development of students.

Audience
All medical students, faculty, and staff in the pre-clerkship phase of the curriculum

LCME Standard
8.8 Monitoring Student Time
12.4 Student Access to Health Care Services

Policy

Definitions

Absence: Missing a majority or greater of a required curricular activity, after accounting for time allocated to any attendance grace period and student breaks.
Allotted Personal Day: A calendar day for which a student has an approved scheduled or emergent absence from one or more required curricular activities.
Scheduled Absence: An absence that the student anticipates in advance for a previously scheduled reason.
Emergent Absence: An absence that occurs due to an acute medical or mental health illness, an acute flare of a chronic medical or mental health illness, or a personal or family emergency.

Students are expected to arrive on time, fully engage in all required educational sessions in their entirety, and act professionally.
Students are expected to reference the learning management system regularly to determine which learning events have required attendance. Any event noted in the event details as ‘attendance required’ is a mandatory session.
Each pre-clerkship course will provide students 2 personal days away from the required curriculum for every 6 weeks of curriculum time, proportional to the length of each course.
1. Allotted Personal days are to be used for scheduled or emergent absences from the required curriculum.
2. Scheduled absences may not be requested on exam days. Absences on examination days are governed by the Required Courses Exam Policy.
3. Allotted Personal days do not carry over from course to course.
Students with scheduled absences must provide prior notice and obtain approval (see Procedure).
Students with emergent absences must still provide notice (see Procedure) as part of maintaining professional communication regarding their responsibilities.
Any absence from the required curriculum may have make-up work assigned at the discretion of the course (see Make-Up Work).
Students who exhaust their allotted personal days and require additional time away from a course will meet with the relevant course directors, faculty, staff, and Office of Medical Education stakeholders to determine whether additional resources or a modified curriculum may be appropriate (see Procedure).

Procedure

Emergent Absences
1. Students must notify the pre-clerkship manager and their course directors of their absence as soon as possible. Students must complete the Pre-Clerkship Absence Notification Form as soon as they are able. (The absence notification form is located on the course syllabus and within the course page in Elentra.)
2. If an emergent absence prevents a student from attending their scheduled Longitudinal Clinical Experience (LCE) day, the student must additionally contact their preceptor/clinic manager and the curriculum team to inform them of the absence as soon as possible.
Scheduled Absences
1. Students are expected to request an allotted personal day in advance for scheduled absences.
2. Students must complete the Pre-Clerkship Absence Notification Form as soon as an absence is anticipated and at least 1 calendar week in advance of the scheduled absence unless the absence occurs on a scheduled LCE day. LCE absences must be requested at least 6 weeks in advance to limit the impact of rescheduled clinic days on patient access and patient care.
3. Scheduled absences will be reviewed by the Office of Medical Education for alignment with this policy. Absence notifications that meet the advance notice requirements of the policy and can be fulfilled with the student’s available Allotted Personal Days will be considered approved.
4. Students with educational responsibilities during a scheduled absence are expected to communicate in advance with the relevant course directors regarding any required make-up work and their peers to ensure that the student’s responsibilities are accounted for in their absence.
Request for Additional Absences
1. Students who use all their allotted personal days within a course and need additional time away from the curriculum must complete the Pre-Clerkship Absence Notification Form for the additional absences and receive notice of approval from the Workgroup or its representatives for the additional absences.
2. Prior to approval by the Attendance Workgroup, all requests for absences beyond the allotted days as defined in the Policy (C) will be reviewed by the Workgroup to determine if the student would benefit from referral to additional resources.
  1. The Workgroup will be composed of the appropriate curricular phase Curriculum Manager, the Curriculum Phase Director (or other designated faculty representative), the Associate Dean for Students (or other designated Student Affairs representative), the Director of the Office of Student Learning and Educational Resources and the Director of Student Wellness.
  2. The Workgroup will periodically report de-identified class attendance data to the Committee on Educational Policy (or a designated subcommittee) to inform the curriculum review process.
3. The Workgroup may consult with stakeholders pertinent to student performance or wellness, including the Pre-clerkship course directors or Academic coaches, to inform the decision-making process.
4. Students may be required to meet with the Attendance Workgroup to discuss the need for the additional time away.
5. Granting additional personal days may be contingent on referral to resources for student wellness, health, or academic resources to maximize the student’s success in the curriculum.
6. Students with a need for significantly more time away (equivalent to 20% of a course as specified in the course syllabus) from the standard curriculum, or who require significant changes to curriculum delivery as determined by the Workgroup, may be required to enroll in an educational leave or modified curriculum plan.
7. Educational leave and modified curricula will require an educational plan developed jointly with the relevant course directors, longitudinal curriculum faculty, curriculum manager, the Associate Dean for Students, and the Office of Student Learning and Educational Resources for the period of the leave or modified curriculum.
Tracking of Allotted Personal Days
1. The number of allotted personal days per course will be specified in the syllabus for each course. Courses with fractional prorated personal days will round up to the next whole calendar day.
2. Each calendar day with a scheduled or emergent absence will be considered one allotted personal day, regardless of the number of sessions missed.
3. The Office of Medical Education will be responsible for centrally tracking and managing allotted absences.
Attendance-related Communication Concerns and other Attendance Policy Violations
1. Attendance-related communication concerns and other attendance policy violations include but are not limited to:
  1. An absence from a required session that does not fall under the definition of an emergent or previously approved scheduled absence.
  2. Signing in to a session without attending the session.
  3. Signing in to a session for another student.
2. Students with identified attendance-related communication concerns or other attendance policy violations will be referred to their Academic Coach and the Director of Medical Student Professionalism to develop a practice improvement plan.
3. Students with a recurring pattern of attendance-related communication concerns or other attendance policy violations will be referred to the Associate Dean for Students and the Director of Medical Student Professionalism.
4. Students with continued attendance-related communication concerns or other attendance policy violations despite a referral to the Associate Dean for Students and Director of Medical Student Professionalism will be referred to the Committee on Student Promotions (CSP). Students referred to CSP for violations of this policy will have this noted on their Medical Student Performance Evaluation.

Make-Up Work

Make-up work for any absences may be required by the course to facilitate the achievement of the learning objectives of the missed session and potentially earn the points lost due to the absence. This will be at the discretion of the individual courses, with the following exceptions:

Peer-Teaching sessions: Due to the nature of this active learning experience, no make-up work can be offered for Peer Teaching session absences. Students with approved absences per this policy will have the affected Peer Teaching sessions removed from their grade calculation.

Clinical Skills sessions: Due to the experiential nature of clinical skills teaching, make-up work will be required for all clinical skills session absences.

Longitudinal Clinical Experience (LCE): Students with absences will be required to reschedule the missed visit with their preceptor. Since the LCE is experiential, and each session has specific goals and objectives that are built upon over time, the student should make up the missed clinical time within 14 days of the initial visit when possible unless otherwise approved by the LCE discipline leads.

Responsibility
Office of Medical Education
Attendance Workgroup

References
UC Davis School of Medicine Bylaws and Regulations, Regulation 60: Requirements for the Degree Doctor of Medicine

Policy Owner
Committee on Educational Policy

Reviewed By
Committee on Educational Policy*
Committee on Student Promotions
Curriculum Steering Subcommittee
Pre-Clerkship Course Director Workgroup
Pre-Clerkship Curriculum Managers

Reviewed Date and Review Cycle
April 2023; annual review cycle

* Indicates the policy owner