MSIV Instructions

MLC III: Introduction and Guidelines for Students (2010-2011)
Directors: Paul Shanley, M.D., John Epling, M.D.
Thomas Poole, Ph.D. and Karen Kelly, M.S.

General information

The course will run from July 6, 2010 to March 15, 2011. All students must complete an online orientation within Blackboard before the first session start date on July 20, 2010. All work in the course must be submitted by midnight on March 15, 2011.

On-campus sessions will be held beginning July 27, 2010 on designated Tuesday evenings at 5:00 p.m. in Room 318 Library. See schedule tab for specific dates.

What does this course consist of?

The course is designed to supplement the growing clinical experience students have gained through clerkships and clinical electives by offering a return to a more fundamental scientific and mechanistic approach to problems in medicine. The focus will be on the promise and limitations of research in medicine through exposure to timely clinical problems that are informed by primary reports of clinical and basic science studies, with the format for the course similar to that of the MLC I and MLC II courses.

The course is composed of three themed units, each comprised of 5 sessions over a 10-week period, consisting of:

1. The main paper - a report of clinical or translational research that sheds light on the clinical problem at hand
2. An accompanying background paper which may range from a perspective piece (editorial, short review of the subject or tutorial) to a report of some concrete event (patient case or news release) that makes the reason for studying the subject more obvious or compelling
   

The following are the objectives that students will be asked to demonstrate on the quizzes, written assignments and in-class discussion with respect to the readings:

• Knowledge of the relevant background concepts in the basic sciences
• Knowledge of what is established and what the question is with respect to the clinical issue being addressed
• Ability to translate the findings of the study and the state of knowledge in the field into lay language appropriate for communication with patients
• Ability to critically assess the information presented in terms of the conclusions drawn by the authors
• Ability to appropriately apply the findings to specific clinical problems
• Ability to suggest further research questions stemming from the study results
• Awareness of the ethical issues raised by the investigation (e.g., conflicts of interest, patient safety, informed consent, etc.)
• Attitudes of curiosity, skepticism, humility in the face of the unknown and intent to pursue a career of lifelong diligent questioning and learning.

What are the grading and attendance policies?

Grading in MLC-III will be similar to that of MLC-I and MLC-II. As always, faculty review of online quiz questions will occur and will sometimes result in extra credit, dropped questions or alternative acceptable answers on quizzes.  In addition, spot checking of peer grading of written assignments by faculty will be conducted and may result in warnings or penalties for graders, investigation into possible unprofessional patterns of grading and resulting adjustment of scores. All of this precludes real-time posting of session grades. Session grades will be posted in Blackboard following completion of each theme, with an additional posting mid-theme during the spring semester.

The timeline for each of the 15 sessions is depicted below:

What is the alternate completion approach?

Participation in 10 sessions (including on-campus participation at one)
Writing a paper suitable for publication and presentation of the paper at Student Research Day in the spring as a substitute for the remaining 5 sessions

Students will write a case report and review of the relevant clinical and basic science literature from a field of their own choosing . The goal of this experience will be for the student to learn how to apply clinical and basic science knowledge and concepts to dissecting the mechanisms of disease manifestations in a case from their own personal experience. Students will be asked to identify a clinical mentor (ideally, the physician who was involved with the case) to advise in the writing and to review the final manuscript to ensure that it is of a quality and effort worthy of submitting it for publication.

Students wanting to participate in the alternate approach should indicate their interest to course faculty.

What is the make-up session option?

Two make-up sessions have been scheduled for April 2011. These sessions allows for increased flexibility since they are optional and may be used in place of a maximum of two online sessions during the academic year. Alternatively, the make-up can be used as a session for students who have participated in all required sessions during the year to raise their grade by dropping their lowest grade(s) and replacing it with the score from the session(s) (provided the low grade is not due to plagiarism). The make-up sessions may not be used to fulfill the class attendance requirement during the year; students must still sign up for on-site attendance at one of the 15 regularly scheduled sessions. Students needing to miss more than two sessions must enroll in the Alternate Completion Approach of writing a mentored, publication quality paper.

A link has been posted on the course web site allowing students to indicate a maximum of two online sessions (each comprised of a two-week block related to a set of readings) during the academic year that they wish to opt out of in favor of completing one or more April 2011 make-up sessions. Timely notification of an anticipated absence is appreciated to ensure that penalties for perceived missing work are not applied.

What is the written assignment standard format?

Submit a written assignment to Turnitin by the posted deadline on the schedule addressing the following points given below.
Each assignment must be single-spaced, 3-4 pages, with 1-inch margins in size 12 Times New Roman font.

• Part I: Address what is established and what the question is with respect to the clinical issue being addressed, making sure to demonstrate knowledge of the relevant background concepts in the basic sciences
  • Elaborate on what is known about the disease, interventions and/or methods of study that would be necessary for fully understanding the research paper
  • Identify the most important clinical question being addressed by the study and give a summary of the current state of knowledge including which research gaps remain
• Part II: Translate the findings of the study and the state of knowledge in the field into lay language appropriate for communication with patients
• Part III: Critically assess the research presented in terms of the conclusions drawn by the authors and suggest how the study methodology might be improved for future research
  • Identify the study type and specify the validity issues inherent in that type of study for drawing conclusions
    • Assess the external validity (generalizability) of the study as it relates to the overall clinical question
    • Identify important questions and/or populations NOT addressed by the current study
    • Indicate the strategy of the authors in addressing these validity issues and make a judgment on the adequacy of their approach with respect to their conclusions
• Discuss the magnitude and significance (statistical and clinical) of the results obtained
• Summarize the highlights from the background and critical appraisal of the study and leave the reader with a concrete "bottom line" about whether and how current practice should be changed on the basis of this study
• Suggest alternative or additional studies to overcome limitations of the current study and realistically assess the constraints and obstacles to carrying out such studies
• Part IV: Outline any ethical issues raised by the investigation if present (e.g., conflicts of interest, patient safety, informed consent, etc.)
  
  

As the quizzes will occur online, you will be allowed to have printed copies of the readings (and any other typewritten material) available to you, so highlight and make notes on them as you read. In turn, the quizzes will be tightly timed so that it will not be possible to read the papers in real-time (well-annotated copies of the readings should prove very helpful though).