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(Adopted by the Y4CC: 3.06.2006)

Monitoring Student Lapses in

Non-Cognitive Behaviors During Electives

This proposal outlines a procedure that will enable the institution to track student performance in the area of Non-Cognitive Behaviors during Electives and required curricular components in Year Four. The goal of this system is twofold. First, it allows the school to document and track a student's professional development during the fourth year of medical school when rapid changeover of environments and evaluators can mask the severity or frequency of poor performance in the area of non-cognitive behaviors.  Second, it allows elective faculty and the Year Four Curriculum Director the opportunity to provide vigilant oversight of the noncognitive behaviors exhibited by students in an attempt to identify and address any areas of deficiency prior to Graduation.

It is a rare occurrence that a student with deficiencies in the area of non-cognitive behaviors will have eluded the scrutiny of previous faculty, but not impossible. As the end of undergraduate work nears, it is recognized that this is the last opportunity before graduation to instill the attributes of responsibility, attention to detail, and modeling the professional behaviors desirable in a self-regulated profession.

Year Four presents a final attempt to detect any problems of a non-cognitive nature that would put the student's future performance in peril. It is recognized that there are opportunities in Year Four which do not exist during the first three years of medical school. Students may attend other institutions where greater freedom exits in educational parameters afforded only a higher level of learner. It is in this domain that a student's character and ability to maintain resolve in an independent structure may be further tested. Fundamentally, this process is a safety net that will, hopefully, reveal any non-cognitive behaviors that are observed to be problematic for a student at that level of training and assist her/him to remediate such behaviors prior to Graduation and entry into a residency program.

Elective and Year 4 Clerkship faculty are often aware of students who have deficiencies in non-cognitive behavior. In this proposed system, if the faculty member determines that an identified incident or behavior is a source of concern, s/he will then fill out an 'Early Concern' Form outlining the problem identified and then send the form to the Year 4 Curriculum Director. The Year 4 Curriculum Director will then meet with the student and forward it to the Associate Dean for Student Affairs. The form includes a place for the student's signature and space for the student to provide an explanation for the deficiency described. The Year 4 Curriculum Director may also generate a form due to failure to adhere to policies and guidelines.

The Associate Dean for Student Affairs, after receipt of a form, will meet with the student, discuss the concerns, and assign appropriate follow-up. This might include counseling, frequent feedback sessions with faculty, close monitoring of non-cognitive behaviors, or other interventions. In the majority of cases, the form will be filed in the Associate Dean's office, with the expectation that the behavior will be corrected and no further action or consequence will occur. In rare instances, the Associate Dean may view the problem behavior as particularly egregious, and in this case will direct the form to the full Student Progress Committee for discussion, decision and action.

If a student receives a second concern form, then the Associate Dean for Student Affairs will forward both forms to the Student Progress Committee for discussion, decision and action. In this situation, the student's non-cognitive academic performance deficiencies and the action of the Student Progress Committee will be either addressed in the Dean's Letter or discussed with the student's future Residency Program Director.

Faculty reports of non-cognitive academic performance deficiencies will be neither linked to nor limited by a student's pass/fail status within the course. Therefore, it will be possible for a student to pass all courses but have his or her progress through the year impeded by the SPC on the grounds of poor non-cognitive behaviors alone.

The Associate Dean for Student Affairs will follow identified students throughout the year and document student progress or lack of progress. Because the Associate Dean for Student Affairs is centrally involved in this process, the commitment of the School of Medicine to the concepts of Professionalism as manifested by non-cognitive behaviors is underscored, and problems in this area of academic performance will be viewed seriously. It is anticipated that with the implementation of a procedure in which documented deficiencies in non-cognitive academic performance are fairly and appropriately acted upon by the School, faculty will be more willing to be complete and forthright in their documentation of student behavior. It is further anticipated that as long as the process is fair and reasonable, students will also support it.

A diagram version of this procedure follows:




early concern note


preliminary report