Competency-Based Curriculum

The University of Florida College of Medicine’s curriculum is competency-based. Prior to graduation, a student must demonstrate competence in six areas of training to satisfy all education requirements (Table I). Student performances in courses and clerkships are formatively assessed and summatively evaluated by level of mastery demonstrated in assigned competencies. Competency is the currency of the education program. The College of Medicine’s primary goal is to graduate practicing physicians whose role is to be responsible for the health and well-being of people. This responsibility carries with it special requirements regarding the character, abilities (skills) and knowledge of our graduates. The listing of Professional Behavior at the top of the competency categories is informative about the way we view our students’ development in the education program.

Table I. University of Florida College of Medicine’s Graduation Competency Categories and Specific Competencies (Learning Objectives). The specific competencies (learning objectives) serve as explicit criteria to measure mastery of student’s behaviors, skills, and knowledge.�

Competency Categories Specific Competencies
(Learning Objectives)
I. Professionalism Professional Behavior

  • Accepts personal responsibility for care of one’s patients.
  • Demonstrates appropriate truthfulness and honesty with colleagues.
  • Communicates an attitude of caring (empathy) in the course of health care delivery.
  • Recognizes personal beliefs, prejudices, and limitations.
  • Demonstrates respect for patients, families, members of the health care team, and colleagues.
  • Demonstrates initiative in patient care and a consistently good work ethic.
  • Respects patient confidentiality at all times in verbal and written communication with others.
II. Patient Care Diagnostic: Physical Examination

  • Demonstrates ability to perform a comprehensive physical examination.
  • Demonstrates ability to perform a problem focused physical examination.

Diaognostic: History

  • Demonstrates ability to obtain a comprehensive patient history.
  • Demonstrates ability to obtain a focused patient history.
  • Demonstrates use and interpretation of diagnostic procedures and laboratory data.

Information Management

  • Demonstrates mastery of the traditional organization of medical data in oral presentations.
  • Demonstrates mastery of the traditional organization of medical data in written presentations.

Procedural

  • Demonstrates mastery of adequate medical record keeping.
  • Demonstrates knowledge of accessing data and information systems.
  • Demonstrates the ability to perform a specific set of procedures identified by the faculty.
III. Medical Knowledge Core Discipline

  • Competencies unique to the discipline.
  • Competencies derived from the clinical presentation list.

Problem Solving

  • Demonstrates the ability to identify and find information relevant to a clinical problem, using consultation, texts, and the archival literature.
  • Demonstrates the ability to generate an initial list of differential diagnoses given a specific chief complaint and patient characteristics (such as age, sex, vital signs, etc.).
  • Demonstrates the ability to use history taking, physical exam, and auxiliary studies to test initial hypotheses/differential diagnoses.
  • Demonstrates the ability to re-rank the differential diagnoses based on information gathered from the history, physical, and auxiliary studies.
  • Demonstrates the ability to explain a mechanism for each aspect of a patient’s problem, including biological, behavioral, and social aspects.
  • Demonstrates the ability to evaluate scientific/clinical information and critically analyze conflicting data and hypotheses.
IV. Practice-Based Learning Physician Scholar

  • Demonstrates the ability to analyze the quality and implications of medical literature.
  • Demonstrates an interest and ability to identify future areas of inquiry in medical research.
  • Demonstrates an interest in communications and applying new knowledge in the delivery of health care.
  • Demonstrates initiative in seeking information and new knowledge.
  • Demonstrates enthusiasm and positive attitude in the educational process and participates fully in educational activities.
V. Interpersonal and Communication Skills Human Relationships

  • Demonstrates knowledge of or appropriately inquires about family and support systems.
  • Demonstrates an effective system for identifying and addressing ethical, cultural, and spiritual issues associated with health care delivery.
  • Accurately assesses a patient’s expectations and assumptions in accessing the health care system.
  • Demonstrates knowledge or applies an understanding of psychological, social, and economic factors which are pertinent to the delivery of health care.

Communications

  • Effectively engages the patient and/or family in verbal communications.
VI. Systems-Based Practice Health Care Management

  • Demonstrates a practical, efficient and cost effective approach to diagnosis and treatment planning.
  • Demonstrates the ability to engage the patient and family in diagnosis and therapeutic treatment planning.
  • Demonstrates the ability to recognize and outline initial treatment for patient with life threatening cardiac, pulmonary and neurological emergencies regardless etiology.
  • Demonstrates knowledge of alternative medicine options and understands their role in health care delivery.
  • Recognizes the impact of social and economic factors on the delivery of health care and utilizes this information patient care.

Health Service Delivery

  • Demonstrates knowledge of health care financing and applies it in assisting patients access the best possible care.
  • Demonstrates knowledge of health care financing and applies it in assisting patients access the best possible care.
  • Utilizes knowledge of population based and evidence based medicine in making patient management decisions.
  • Utilizes knowledge of managed care systems in making patient treatment plans and health care maintenance plans.
  • Demonstrates an understanding of the roles and competencies of other health care providers.
  • Demonstrates the ability to engage other health care professionals in the delivery of health care.
  • Demonstrates the ability to follow and lead in a team approach to health care delivery.

Health Care Team

  • Demonstrates an understanding of the roles and competencies of other health care providers.
  • Demonstrates the ability to engage other health care professionals in the delivery of health care.
  • Demonstrates the ability to follow and lead in a team approach to health care delivery.

Academic Performance

The Academic Status Committee (ASC) continuously monitors a student’s academic performance. Information upon which assessment of satisfactory progress is made includes: mastery of competency-based behaviors, skills and knowledge; letter grades; written evaluations; data submitted by the faculty regarding cognitive and non- cognitive skills; scores on the United States Medical Licensing Examination (USMLE); and scores on Performance-Based Examinations (PBEs) that are given at intervals to assess students’ competence.

Competencies

Students’ mastery of the graduation competencies is monitored by the ASC. Students are expected to progress in their competency attainment. Assessment of student competency during course and clerkships will be evaluated independent of the actual course grade.

Grades

Student performance in academic course work is evaluated by level of competency achieved, and secondarily by letter grades A through E or Satisfactory/Unsatisfactory. Only letter grades or satisfactory/unsatisfactory marks are forwarded to the registrar.

Levels of Grades

  • A (Exemplary): The student has performed consistently in a manner adjudged as truly outstanding. The performance is worthy as a model.
  • B (Superior): The student has performed consistently in a manner adjudged to be clearly above average competency; his/her performance may occasionally be exemplary but not consistently so.
  • C (Competent): The student has performed consistently in a manner adjudged to be at or above the minimum level of competency. His/her performance may occasionally be superior, but not consistently so. No significant portion of his/her performance has been below the minimum level of competency.
  • D (Unsatisfactory): The student has performed in a manner adjudged as marginal in relation to the minimal level of competency. In some aspects, performance may have been above the minimum level, but in other aspects or at other times, performance has been below the minimum level. Confidence has not been engendered that the student has demonstrated adequate mastery of the pertinent competency. REMEDIATION IS REQUIRED.
  • E (Failure): The student performed in a manner adjudged to be below the minimum level of competency; while his/her performance may occasionally meet or even exceed the minimum acceptable level, this is the exception rather than the rule. REPEATING COURSEWORK IS GENERALLY REQUIRED.
  • I (Incomplete): This grade is to be used for students in courses where the work is incomplete because the student fails to complete required components of a course. The grade of I must be remediated before a student progresses to the next academic year, unless an extension is granted by the ASC. Incompletes change to E grades if the remediation is not completed. The deadline for completion of Incompletes does not apply while a student is on an approved leave of absence. The Incomplete will be replaced on the transcript when a final grade has been assigned. All Incompletes must be removed before a student is eligible for graduation.
  • H (Hold): The grade of H may be given when a student is unable to complete coursework due to serious illness. The grade does not convert automatically to an E at the end of the next semester. The rules on the removal of the H are the same as the I. They must be replaced by a passing grade before a student is allowed to progress or graduate.

Students must meet with the Associate Dean for Student Affairs, and their academic performance may be reviewed by the ASC if they receive:

  • Probationary status during the 1st or 2nd year
  • One grade below “B” in the 3rd or 4th year

The Associate Dean for Student Affairs and/or the Academic Status Committee may notify a student�s advisor and subsequent directors about performance that is deemed unsatisfactory.