Body
Unit Policy
Title
School of Medicine Offices of Medical Student Education: Academic Performance Monitoring and Support Policy
Introduction
Purpose
This Policy establishes criteria and processes to:
- provide ongoing monitoring of students' performance, including academic and professional performance, and well-being as they work towards meeting the Medical Doctorate (MD) degree program's Technical Standards; and
- request support for students experiencing Difficulty.
Scope
This Policy applies to students ("Students") and faculty ("Faculty") of the University of North Carolina at Chapel Hill ("University") School of Medicine's (SOM) MD degree program in all phases of the curriculum and at all regional campuses/sites.
Policy
Policy Statement
Use of Midpoint Feedback Forms
Course directors must conduct a formal Midpoint Feedback Session with each Student using the Midpoint Feedback Form in the SOM's evaluation system, One45. Midpoint Feedback Forms are not limited to a course's midpoint. Course directors are encouraged to use these forms at any point in a course to document concerns, including low performance, exam failures, and unprofessional behavior. The use of these forms provides clear documentation of each incident when a Student's performance is below expectations.
Faculty should use the comment section of the Midpoint Feedback Form to detail a Student's concerning behaviors and performance and to make recommendations for improvement. The Midpoint Feedback Form also prompts the Faculty to indicate:
- If the form is being submitted at a time other than the course midpoint.
- Concerns about the Student.
- Details of the conversation with the Student reviewing the points of concern and the action plan, if applicable.
Use of Formal Referrals to the Office of Academic Excellence (OAE)
A Student may be referred to the OAE to support the Student in successfully meeting the objectives of MD degree program courses and passing the milestones necessary to advance in the program's curriculum. In most cases, a Student's course director is the appropriate person to make the referral. However, any Faculty member, including a Student's college advisors or clinical preceptors, can refer to the a Student to the OAE. Students may also self-refer themselves to the OAE by reaching out to the Medical Education Learning Specialist, Ben Shirley, at ben_shirley@med.unc.edu.
Reasons to refer a Student to OAE may include, but are not limited to, a Student's:
- Poor test performance;
- Shelf Exam failure;
- Poor clinical performance; or
- Low performance score(s) on an evaluation.
Required Actions Prior to Formal Referral to OAE
Before referring a Student to the OAE:
- Faculty must have an honest, constructive conversation with the Student outlining the behaviors that did not meet the expectations and competencies involved. Data sources to inform conversation may include preceptor ratings and comments, exam scores, and observations made by Faculty, preceptors and staff.
- Faculty may complete a Midpoint Feedback Form in the school's evaluation system that details the issues affecting performance at any point during the course, using the steps in this Policy.
- Faculty must reach out to the Student's advisor via email to let them know of their concerns.
- If contact with the Student is not possible because they do not respond to email/phone calls or attend required activities, Faculty should use the Midpoint Feedback Form to document these concerns and then submit a referral to OAE noting the unsuccessful attempts to reach the Student. In addition, the Student should be referred to the Student Progress Committee (SPC) due to the lack of a response.
Formal Referral to OAE and College Advisor
An evaluator can submit a referral via email detailing the evidence of issues that impact performance and whether a conversation has taken place with the Student. No reference to any presumed diagnoses should be included. The referral should be copied to all the following:
- The Student being referred;
- The Office of Academic Excellence at academicexcellence@med.unc.edu; and
- The Student's college advisor.
- To identify the Student's advisor, Faculty should either ask the Student directly or find their advisor here.
Student Evaluations
Course directors must consider the identified behaviors that show a Student's level of knowledge and skills on the midpoint and final evaluations even if a referral is made to OAE, their advisor, and SOM Student Affairs. A referral to school resources is not a substitution for honest, constructive evaluation of Student performance. It is at the course director's discretion to determine if the Student's behaviors that affected their performance should be included in the "for Dean's Letter" or "not for Dean's Letter" comments on a final evaluation.
Student Academic Monitoring and Supported Status
Students who are experiencing difficulty may be placed on Academic Monitoring and Supported Status voluntarily or by the SOM's Office of Student Affairs (which includes the Committee of Professionalism Education [CoPE], OAE, college advisors, Student Affairs leadership, etc.) for support and to improve their likelihood of success. Students on Academic Monitoring and Supported Status must:
- Fully comply with attendance requirements based on current attendance policies
- Be compliant with health and safety requirements
- Meet all academic deadlines
- Remain fully engaged in required coursework
- Meet with OAE regularly (weekly to monthly)
- Meet with their college/campus advisor (weekly to monthly)
- Have no CoPE reports or Professional Difficulty during their time on Academic Monitoring and Supported Status
- Refrain from participating in extracurricular activities including, but not limited to research, shadowing, and leadership roles.
The duration of the Academic Monitoring and Supported Status will be predetermined and can be as short as the remainder of a particular course or as long as the remainder of the phase.
A Student's ability to apply to or resume extracurricular activities, summer programming, or graduate degree programs will be reviewed on a case-by-case basis by Student Affairs leadership.
Student Clearance from Academic Monitoring and Supported Status
A Student can be cleared from Academic Monitoring and Supported Status by adhering to the requirements listed above for the specified duration.
If Students do not meet the requirements of Academic Monitoring and Supported Status, they will be reviewed by the Student Progress Committee (SPC).
Definitions
Midpoint Feedback: Written formative evaluations provided to Students at or near the midpoint of a course that is four (4) or more weeks in duration.
Shelf Exam: A standardized subject exam from the National Board of Medical Examiners used to assess Student knowledge at the end of a clinical clerkship.
Difficulty: Broadly defined as Academic Difficulty and/or Professional Difficulty.
Academic Difficulty: See Policy on Student Progress Committee Functions for definition.
Professional Difficulty: See Policy on Student Progress Committee Functions for definition
Extracurriculars: Activities at UNC SOM that do not earn academic credit.
Student Affairs: Centralized group that coordinates Student support.
Services
- Serves a triaging function for other resources. Can help Students who need resources know where to go and can help Faculty access appropriate resources as well.
- Holds weekly meetings to review all referrals and feedback from other sources.
Communication
- Communication must always include a written email detailing concerns. Phone calls can supplement the referrals if clarification is needed
- Student Affairs will also make referrals to/communicate with the UNC Student Conduct Office, Honor Council, CoPE, Student Progress Committee and other entities funded by UNC SOM regarding course failures, exam failures, and Professional Difficulty.
Documentation
- Documentation of the meeting and resources offered along with any plan for remediation should be documented in Navigate.
- Student Affairs is responsible for keeping central documentation that can be requested on a needed basis.
Office of Academic Excellence (OAE): Foundation Phase Academic Coach (FPAC), Clinical Phase Academic Coach (CPAC), Medical Education Learning Specialist (MELS).
Services
- Offers assistance with shelf study, clinical reasoning, medical knowledge, and study skills.
- Refer to additional available resources including question banks, practice exams, simulation lab standardized patients.
Communication
- Communication from the OAE to the referring person will not occur without consent from the Student. If the Student consents, that consent should be noted in the email along with the meeting date.
Documentation
- Documentation of the meeting and resources offered along with any plan for remediation should be documented in Navigate.
Advisory College:
Services
- Serves as an advocate for Students and can triage Students to necessary resources.
Communication
- Communication from the advisor to the referring person will not occur without the consent of the Student or in the case of concern for the Student's well-being. If the Student consents, that consent should be noted in the email along with the meeting date.
Documentation
- Documentation of the meeting and resources offered along with any plan for remediation should be documented in Navigate.
Psychological Support:
Services
- Confidential service offered by Taking Care of Our Own (TCOOO).
Communication
- In most cases, there will be no contact with psychological services and the referring person unless requested by the Student.
- In cases involving concerns around Student and/or patient safety, Student Affairs has an obligation to refer for an evaluation and will inform the Student of this concern in written communication.
- When this referral is made, Student Affairs receives the following response: "Student Affairs appreciates the consult, and we have met with the Student." This ensures the safety of the Student at risk. Any further communication between Taking Care of Our Own requires the Student to sign a release of information.
Committee for Professionalism Education (CoPE):
Services
- Blinded committee that focuses on early intervention for Professional Difficulty with a focus on feedback, education and remediation. Can refer to Student Progress Committee (SPC).
Communication
- The chair of CoPE will communicate directly with the Student and their college advisor regarding the reported Professional Difficulty.
- The Student will submit a blinded professionalism packet addressing the reported concern that will be reviewed by the committee.
- The committee's recommendations will be communicated directly to the Student and their college advisor by the chair of CoPE.
Documentation
- CoPE's decision will not be part of the permanent transcript, but any COPE reports will be considered in the evaluation of any future Professional Difficulty.
Related Requirements
External Regulations
Unit Policies, Standards, and Procedures
Contact Information
Primary Contact
Title: Senior Director for Student Affairs
Name: Valerie Glassman
Email: valerie_glassman@med.unc.edu
Publication Details
Issuing Officer: Alice Chuang, Associate Dean for Student Affairs, alice_chuang@med.unc.edu
Effective Date: December 1, 2024
Review Cycle: The Office of Student Affairs will review this Policy biennially and the Education Committee will review and approve it.
Next Review Date: November 30, 2026