An Analysis of Ross University School of Medicine Two Track Curriculum Sequence

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


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.


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.


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.

http://www.rossu.edu/medical-school/


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.).


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 Final %success rate

Four session curriculum

Five session curriculum


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


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,


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?


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).


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.


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.


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


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).


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-


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,


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;


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.


References:

Bauer, S. C. & Brazer, S. D. (2012). Using research to lead school improvement:Turning

evidence into action. Thousand Oaks, CA: Sage Publications, Inc.

Franco, K. (2013). Understand common reasons students leave Medical school. U.S. News

Weekly. Retrieved from http://www.usnews.com/education/blogs/medical-school-

admissions-doctor/2013/10/22/understand-common-reasons-students-leave-medical-

school

Frenkel, M. (2007). Lessons learned from complementary and integrative medicine curriculum

change in a medical school. Medical Education, 41(2), 205-213. Retrieved from EBSCO

database

Hecker, K., & Violato, C. (2009). [PDF document]. Medical school curricula: Do curricular

approaches affect competence in medicine? Retrieved from

http://www.stfm.org/fmhub/fm2009/june/kent420.pdf

Mann, S. (2011, October). Linking technology to medical school offers benefits, flexibility.

Association of American Medical Colleges. Retrieved from

https://www.aamc.org/newsroom/reporter/october2011/262458/technology.html

Najimi, A., Sharifirad, G., Amini, M.M., & Meftagh, D.S. (2013). Academic failure and

students’ viewpoint: The influence of individual, internal and external organizational

factors. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3778557/

Olson, B.G., Mata, M., & Koszalka, T.A. (2013). Implementing an online curriculum for medical

education: Examining the critical factors for success. International Journal on E-

Learning, 12(2), 197-208. Retrieved from ERIC database

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3778557/




Ross University School of Medicine. (n.d.). About Ross University School of Medicine.

Retrieved from http://www.rossu.edu/medical-school/About-Ross-University-School-of-

Medicine.cfm

Ross University School of Medicine. (n.d.). Ross Med Achieves High Marks on USMLE Step 1.

Retrieved from http://www.rossu.edu/news/Ross-Med-Achieves-High-Marks-on-

USMLE-Step-1-.cfm

Salend, S. (2009). Using Technology to create and administer accessible tests. Teaching

exceptional Children, 41(3), 40-51. Retrieved from ERIC database

Stebbings, S., Bagheri, N., Pierre, K., Blyth, P., & McDonald, J. (2012). Blended learning and

curriculum renewal across three medical schools: The rheumatology module at the

University of Otago. Australasian Journal of Educational Technology, 28(7), 1176-1189.

Retrieved from ERIC database

Vandre, D.D., & Ermie, E. (2014). Design of a tagged electronic database of exam questions

(TEDEQ) as a tool for assessment management within an undergraduate medical

curriculum [White paper]. Retrieved August 10, 2014, from ExamSoft:

http://learn.examsoft.com/white-paper/item-tagging

http://www.rossu.edu/medical-school/About-Ross-University-School-of-Medicine.cfm

http://www.rossu.edu/medical-school/About-Ross-University-School-of-Medicine.cfm

An Analysis of Ross University School of Medicine Two Track Curriculum Sequence

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