Grading Policy

While rotating on the Neurology Services, you are responsible to participate fully in the team activities. Try to practice your H&Ps with first time patients and follow a minimum of four patients during your clerkship. You will be observed and evaluated by faculty, fellows, and/or residents. These assessments are based on the six ACGME Core Competencies:

1. Medical Knowledge (10%): knowledge about different neurological conditions, especially those commonly seen in the clinic or inpatient service.
2. Patient Care (10%): history taking, physical exam, clinical reasoning, medical decision making
3. Practice-Based Learning (10%): seeking feedback, intellectual curiosity, eagerness to learn, application of EBM, teaching others
4. Interpersonal & Communication Skills (10%): rapport with patient and family, oral presentations, showing a sense of situational awareness in your communications
5. System-Based Practice (10%): helpfulness to the team

The Neurology Clerkship Feedback & Clinical Evaluation Form will be used to grade these six Core Competencies. These evaluations will be completed online (New Innovations) by the faculty, fellows and/or residents that worked with you. You will receive a minimum of 4 evaluations. You can find these evaluations online or attached on the welcoming email.

Respectfulness (1.25%): displaying consideration, regard, and courtesy toward others, including the rights, feelings, beliefs, boundaries, and dignity of others.

Work Ethic and Dependability (1.25%): the attitude and commitment you display in doing your job well, reflecting diligence and a sense of responsibility to your patients and other members of the team.

Motivation and Excellence (1.25%): displaying an internal drive to take appropriate actions to expand your knowledge and improve your patient care. This includes many of the skills assessed as part of “Practice-Based Learning,” but also includes your desire to contribute to your team, foster an environment in which all team members can thrive, show up to lectures on time (in-person, whenever possible).

Honesty (1.25%): the ability to be truthful, sincere, and transparent in your words and actions. The highest grades will go to those who are able to be honest without compromising respectfulness.

During the clerkship you need to complete one neurology clerkship bedside skills evaluation. This is an opportunity for you to display one of the most important skills you can obtain on this rotation regardless of your future career: The ability to obtain a basic neurological history and exam. This evaluation should be supervised by a SENIOR NEUROLOGY Resident (PGY3 or PGY4) or NEUROLOGY Faculty member. It can be an inpatient or an outpatient case. The history and exam may be done separately on the same and/or different patients if circumstances preclude the history and exam being done at the same time. The highest grades will go to those who not only check all the boxes but display proficiency and mastery when obtaining the history and exam. You are recommended to complete this during the 2^nd or 3^rd week of the clerkship.

The portfolio is a mixture of completion items intended to ensure a well-rounded education, prepare you for the NBME, and prepare you for clinical practice. Completing all of the following items within the timeframes allotted will result in full credit being received:

Attend Simulations (2%): Most clerkship sessions will have a Stroke simulation session and a Status Epilepticus simulation session. These are 2 conditions known to receive subpar management in many healthcare settings, especially by non-neurologists. Hence, these sessions are intended to give you exposure to how to implement basic management as well as practice leadership, teamwork, and communication skills. Attend both sessions to receive full credit.

Mid-Clerkship Feedback Session (2%): Attend the session to receive full credit. If you are late or miss it, you will receive half credit at most.

USMLE Step Preparation Exams (2 exams, 1% each): These formative exams are intended to help you identify areas of weakness in your knowledge base and therefore help direct your studying for the NBME. Your score on these exams does not contribute to your grade in any way. One of the 2 exams should be completed by the first Sunday of your Neurology Clerkship. The second of the 2 exams should be completed before you take your NBME exam.

Required Clinical Experiences (2%): A checklist just making sure you are familiar with some basic neurological findings. Anything you did not have the opportunity to see clinically on the wards can be supplemented through videos on canvas or online. The point is to have some idea of what various neurological findings look like.

Online Module Completion (2%): the neurology clerkship has a “flipped classroom” model where you are expected to watch a quick 15-20 minute module video before each lecture. The modules include the most high-yield information you need to know for your NBME, which enables us to use the classroom time to solidify your knowledge and help you learn how to implement it.

There is not a minimum exam NBME pass score for the clerkship. However, as with all UF COM clerkships, students who score below the 10th percentile nationally will need to meet to discuss whether a test taking remediation plan should be developed to promote improved performance and may be referred to UF COM Learning Specialist for further assistance (Dr. Jim Gorske). Shelf exams are usually scheduled on the last Friday of the Clerkship and will occur IN PERSON. Most years, the 10^th percentile is a score of 70% or below.

All students will meet with clerkship leadership at GNV or JAX at the end of the 2^nd week or the beginning of the 3^rd week of the clerkship to discuss their progress in terms of evaluations, portfolio and receive pertinent feedback. During this session, the student will be provided insights from any clinical evaluations that are available in order to help improve their performance on the neurology rotation and prepare them for post-graduate training and work. The student will also have an opportunity to share any challenges they are experiencing in completing the clerkship requirements and any general feedback they have for the clerkship.

The Neurology Clerkship uses a Clerkship Grading Committee. The GNV and JAX Clerkship and Associate Clerkship Directors, GNV Neurology Vice chair of Education, and several GNV neurology faculty interested in education compose this Committee. The Grading Committee reviews all the evaluations, portfolio documents, exam grades, and comments. In addition, they can ask evaluators for additional information before assigning a clinical core competency grade and a final grade.
 
The Grading Committee determines your final grade based on clinical evaluations, examination scores, and required assignments as outlined in the grade explanation. “Coaching up” faculty (telling them that certain numeric scores on their evaluation correlate to the grade) is misleading, unfair to the majority of students who do not do this and is considered unprofessional behavior. Engaging in this behavior will result in a lower professionalism evaluation and could affect your grade and the comments submitted for the MSPE.
  
The final grade of the Neurology Clerkship Program is determined by the outcomes of these five sections: Core Competency Evaluations, Bedside Skills Exam, Portfolio Compilation, and Medical Knowledge Examinations.
  
Total Grade (100%) = Clinical Core Competency (50%) + Professionalism (5%) + BSE (10%) + Portfolio (10%) + NBME Exam (25%)

Neurology Clerkship Grade Cutoffs:
 
A >7.98
B+ 7.31-7.97
B 6.50-7.30
C+ 5.80-6.49
C 5.0-5.79