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COURSE DESCRIPTION:

This course provides instruction in health policy, clinical epidemiology, biostatistics, preventative medicine, and quality improvement/patient safety.  The critical appraisal of recent medical literature is emphasized. 

COURSE OBJECTIVES

The course in the Fall and Spring semesters of the second year of medical school covers the critical issues in health policy, epidemiology, biostatistics and evidence-based medicine. The goal of the course is to provide the students with the opportunity to understand: 1) how the U.S. healthcare system functions, 2) how evidence-based medicine and information mastery are pivotal to their ability to assimilate and critique important health related information and, 3) the basic concepts of biostatistics and epidemiology as they relate to the healthcare field.

At the completion of the course, you will have an understanding of the organization and structure of health care delivery in the U.S. and Florida, and the challenges that confront physicians and policymakers in the 21^st Century.

COURSE FORMAT:

Instruction is predominantly lecture-based.

Contact Person: The course director is Robert G. Brooks, M.D., M.B.A., who can be contacted at 644-3845 (admin. assist contact # is: 644- 9398).  Dr. Brooks’ e-mail address is: Robert.Brooks@med.fsu.edu.  Office Hours: By appointment (please call 644-9398). Course Co-Director is Nir Menachemi, Ph.D., M.P.H., who can be contacted at 644-2362, or by email at: Nir.Menachemi@med.fsu.edu.

Additional Faculty Include:

Leslie Beitsch, M.D., J.D. - 645-1830

Nancy Clark - 644-9706

Art Clawson, M.S. - 644-3454

Tom Arnold - 413-9660

Dan Van Durme, M.D. - 645-1539

Tom Liberti - 245-4334

Ken Brummel-Smith, M.D. - 644-2291

Lois Sheperd, J.D. - 644-7269

Ken DeCerchio - 414-9063        

TEXTBOOKS:

Required:

Thomas S. Bodenheimer and Kevin Grumbach, Understanding Health Policy: A Clinical Approach, 4^rd Ed., (Stamford, Conn.: Appleton & Lange, 2005). 

Electronic Resources:

Agency for Healthcare Research and Quality: http://www.ahcpr.gov

American Medical Association: http://www.ama-assn.org

Association of American Medical Colleges: http://www.aamc.org

Association of University Programs in Health Administration: http://www.aupha.org

Department of Health and Human Services: http://www.dhhs.gov

Health Care Financing Administration: http://www.hcfa.gov

Library of Congress: http://thomas.loc.gov

Joint Commission on Accreditation of Healthcare Organizations: http://www.jcaho.org

National Committee for Quality Assurance: http://www.ncqa.org

National Institute on Aging: http://www.nih.gov/nia

National Institutes of Health: http://www.nih.gov

Institute of Medicine: http://www.iom.edu

Centers for Disease Control: http://www.cdc.gov

Other articles and materials:

Selected articles from the following journals: Health Affairs, Journal of Health Politics, Policy and Law, The Milbank Quarterly, The New England Journal of Medicine, Journal of the American Medical Association, and the American Journal of Public Health.

COURSE REQUIREMENTS:

Reading Assignments: Active, informed participation in class discussions will be encouraged. Complete each week’s readings prior to class and come to class prepared to discuss.

Research Paper: In the Fall there will be a research paper that should be based on your thoughtful assessment of the readings, lecture material, assimilation with other assignments in other Year 2 classes, and class discussion. Topics for the term paper will be on health policy or patient safety/medical errors. Topics for papers must be approved by the course director or co-director. 

One possible format for the research paper could be as follows: in Part I, write an opening statement that explains why the issue you have chosen is important; in Part II, provide an overview of the most important arguments and concepts supporting your topic; Part III, provide your assessment of the strengths and weaknesses of the positions reflected in Part II; and in Part IV, draw conclusions about the issue. The body of the paper will be 10 pages (double-spaced). The paper will require the use of “Endnotes” and should have both primary and secondary references.  Students will be required to attend a presentation by the medical informatics faculty on accessing medical literature and use of endnotes provided during the Fall term.

Quizzes: Three quizzes will be given during the class period based on reading assignments for the week. Quizzes are unannounced.

Evidence-based Practicum:  This exercise will allow you to utilize skills learned in class to evaluate an assigned article.  Please note: This will be performed differently this year than previously.  A 50 minute additional class period will be scheduled in late January or early February to take this evaluative practicum in a classroom setting.  Students will be given an article upon entry to the room, and will be expected to write a critique of the article while present using an evidence-based format.

Medical Informatics: Students will be required to attend a 2 hour session on searching for medical references and use of Endnotes in the Fall semester.

EVALUATION:

Your course grade will be determined by your performance on Examinations, Issues Paper, Quizzes, and Professionalism.

Examinations: (50% of total grade) The material for examinations will come from lectures, the textbook, and other assigned readings. The format for examinations will be as follows:

·    Written examination items: multiple-choice questions (single best answer and extended matching)

There will be three integrated block examinations in the Fall semester and five integrated block examinations in the Spring semester.  These examinations will cover material in all the courses for the four weeks prior to each examination.  The Health Issues in Medicine component of each examination will be as follows: Ten to twelve 1 point multiple choice written questions

Research Paper: (25% of total grade) One paper, 10 pages in length, will be required.  The paper will be due by 5 pm on Friday, November 30th.  Rough drafts or other evidence of progress may be requested by the course director during the period of paper development.

Quizzes: (15% of total grade; 5% each) Three unannounced quizzes will be given during the course of the year.  They will cover material from the reading assignments for the week in which they are given.

Evidence-based Practicum:  (10% of total grade).  Please see above for explanation of requirement.

Professionalism: Students will be expected to demonstrate professional attributes that are in keeping with FSU College of Medicine policies.  Points may be deducted from the final grade in this category for such behaviors as frequent lateness to class, unexcused absences, academic honor code violations, or other unprofessional behavior.  The FSU College of Medicine Honor Code will be used as the overall benchmark for consideration of professional behavior.

Summary of Grading: The final grade in Health Issues in Medicine -- 6823 will be determined as follows:

Grading for the course is based upon a numeric score calculated as a percentage achieved from all possible points, as follows:

Attendance Policy  

FSU COM ATTENDANCE POLICY

COM Philosophy

We believe that:

Professionalism is a major component of our medical curriculum.  We believe students should conduct themselves appropriately in the various educational activities of the curriculum. This conduct includes coming to educational activities on-time, using the laptop computers only for course work during the educational activity, and not disrupting the class if late.  The faculty should also demonstrate professionalism, by starting and ending all scheduled educational activities on time and providing a course schedule with clearly explained course policies in the course syllabus. Any changes in the schedule should be given to the students in a timely manner.

Students will be accountable and personally responsible for attending all educational activities (small groups, labs, clinical experiences, examinations, lectures, computer sessions, etc.).

Unexcused absences reflect negatively on the goals and objectives of the medical curriculum and demonstrate unprofessional behavior by the respective student.

We owe it to our state legislature and the citizens of the State of Florida to provide a quality educational program that meets the needs of our students in preparing them for the M.D. degree.

Attendance Policy

Students are expected to attend all scheduled activities.  Students are expected to be on time.  Being on time is defined as being ready to start at the assigned time.  If a student has an emergency that prevents her/him from attending a scheduled activity, s/he is to call and notify the Office of Student Affairs (Year 1/2) or the Regional Campus Dean (Year 3/4) and request that they inform the supervisors/professors/clerkship faculty/education director for that activity.  If at all possible, the student should also call and at a minimum, leave a message with one of the course/clerkship directors.  It is important that students realize that their absence or tardiness negatively impacts a number of other people.  Attendance, including tardiness, is part of the student’s evaluation for professionalism.  Negative evaluations may result in decreased grades and in severe cases, referral to the Student Evaluation and Promotion Committee.

Procedure for Notification of Absence

Year 1/2

If the student knows in advance of an upcoming legitimate absence, the “Advance Request for Absence from Educational Activity(ies)” form should be completed with signatures from the student, the Assistant Dean for Student Affairs, the course faculty member and the Course Director.  The form will be filed in the Office of Student Affairs. The implications for the absence (e.g., remediation, course grade adjustment, make-up exam, etc.) will be given to the student by the course director and final decisions regarding these actions shall rest with the course director.

If the absence occurs due to an unforeseen emergency, the student should contact the course director and the Assistant Dean for Student Affairs immediately to report the absence including the reason for the absence.   The implications for the absence (e.g., remediation, course grade adjustment, make-up exam, etc.) will be given to the student by the course director and final decisions regarding these actions shall rest with the course director.

Remediation Policy for Absences from Examinations, Quizzes, Small Group Sessions, Preceptor visits, and Clerkship Call

The remediation policies for absences from examinations, quizzes, small group sessions, and clerkship call are: 

1. POLICY ON MISSED EXAMINATIONS:  Students are required to take major in-term and final examinations.  Based on Curriculum Committee policy, a student can only be excused from an examination by a course/education director decision based on the personal situation of the student.  The Course/Education Director will determine the time of the exam make-up session. Also, according to the Curriculum Committee decision and the existence of the FSU COM honor code, the student will be given the same examination given to the other students.

2. POLICY ON MISSED QUIZZES:  Students are required to take scheduled and unscheduled quizzes in the courses/clerkships.  A student can only be excused from a quiz by a Course/Education Director decision based on the personal situation of the student. The student must make arrangements with the Course/Education Director to make up a missed quiz.  Make-up quizzes will be with questions on the same material and of similar difficulty to the original quiz.  The course director may, at their discretion, substitute a short written assignment of the week’s material.

Academic Honor Code:

The Florida State University Academic Honor Policy outlines the University’s expectations for the integrity of students’ academic work, the procedures for resolving alleged violations of those expectations, and the rights and responsibilities of students and faculty members throughout the process. Students are responsible for reading the Academic Honor Policy and for living up to their pledge to “. . . be honest and truthful and . . . [to] strive for personal and institutional integrity at Florida State University.” (Florida State University Academic Honor Policy, found at http://www.fsu.edu/~dof/honorpolicy.htm.

Students With Disabilities

Students with disabilities needing academic accommodations should: 

(1)  Register with the Student Disability Resource Center [SDRC], and provide

      documentation of their disability.

(2)  Bring a letter to the Clerkship Director from the SDRC indicating the need for

      academic accommodations.  This should be accomplished within the first week

      of the rotation.  Specific arrangements should be made with the Clerkship Director

      five working days prior to any examination for which accommodations are being

      requested.  

CopyRight Notice:

“This course website may contain copyrighted materials that are used in compliance

with U.S. Copyright Law. Under that law, materials may not be saved to your computer, revised, copied, or distributed without permission. They are to be used in support of instructional activity as part of this course only and shall be limited to the duration of the course, unless otherwise specified by the instructor or owner of the material. You may only download or print materials at the direction of your instructor, who knows which materials are copyrighted and which are not.”

COURSE OBJECTIVES:

Students must be able to:

Knowledge

1. Understand the history of public health along with the traditional and emerging organizational structures.

2. Understand the emerging public health concerns at each stage of the life cycle, the needs of special populations, especially the elderly, disadvantaged and vulnerable social groups, and the range of policy and program responses.

3. Understand major issues in health policy including:  costs of health care, access to health care, quality of health care, the role of prevention in health care, the needs of special populations, and ethical issues in health care delivery.

4. Understand the impact of information technology on health services.

5. Understand how health care is organized with special attention to the impact of managed care on public health, health care providers, and patients.

Skills

1. Demonstrate the ability to design and integrate prevention, quality assurance and sensitivity to special populations into a clinical practice.

2. Demonstrate the ability to make use of academic and other sources of information (including a growing volume of material available on the world-wide-web) about health policy and health policy-making.

3. Demonstrate the ability to apply evidence-based medicine to a case and describe its application to clinical practice.

Attitudes/Behaviors

1. Exhibit an attitude of collegiality and appreciation for teamwork in relationships with other students in the small group setting.

2. Exhibit well-developed interpersonal skills in interacting with other students and the instructors.

3. Exhibit appropriate value for the patient’s familial, cultural, and spiritual circumstances within the context of the health care delivery system.

4. Demonstrate professionalism and high ethical principles and standards, respect for others, professional responsibility and social responsibility.

5. Exhibit a capacity for self-evaluation, moral reflection and ethical reasoning in the written assignments.

6. Demonstrate a respect for the roles of healthcare providers and an appreciation of the need to collaborate with others in caring for individual patients and in promoting public health and community service.