Pharmacology Review with Action List · Review&of&Year&Y2Medical&Pharmacology&Essentials ... and&the&use&of&the&Pharm&cards. ... important&information&about&each&drug.

Review of Year Y2 Medical Pharmacology Essentials(PHAR 216)

• Course occurs in the fall term of Year 2.

• Course Director – Sarah J. Freemantle, PhD(co-‐director) David Nierenberg, MD

• Course has 33 curricular hours (plus the Final Exam and Narrative Assessment evaluation events)

• Course was last reviewed in April 2012. The formal review is missing, however, and annual summary letters from Dr Nierenberg are substituted for this purpose.

Action Plan from Prior ReviewFrom David Nierenberg's letter dated Oct 30, 2012:Overall, well organized with excellent scores and logical organization.Suggestions -‐Provide written notes in addition to lecture PPTInvolve all students in each small group conference, not just the students presenting the cases.Have other lecturers use the “pharm card” system to help students focus on the most important information they need to know.

From David Nierenberg's letter dated Oct 28, 2013:New method of student survey through Oasis, however, the overall evaluation was “good to very good”, with the overall evaluation of 3.71. The students really loved the “clinical correlations” and the use of the Pharm cards.Suggestions -‐Provide written notes in addition to the PPT files, which most but not all lecturers do.Get all students involved with the small groups, not just the student presenters. Also, prepare “model” answers to the cases discussed.Having all lecturers use the Pharm card system, in order to help students know the most important information about each drug.

Old Course Objectives (Ilios)

1 Explain the basic concepts of drug-‐receptor interactions and second messenger systems how dose response curves can be used to define safe dosing practice.

MS2,MS1 40

2 Demonstrate the ability to assess pharmacodynamic and pharmacokinetic parameters using commonly prescribed drugs as examples.

MS2,MS1 23

3 Solve common pharmacokinetic calculations including loading doses and maintenance doses using knowledge of volume, distribution and clearance.

MS2,MS1 11

4 Formulate different regimens for special patient groups (e.g. pregnant women, patients with compromised immune/kidney/liver function etc.)

MS2,MS1, MS5,CC13,PH2

11

5 Recognize and anticipate common drug-‐drug interactions including those interactions that can be predicted from genetic testing of metabolizing enzymes e.g. P450 isozyme testing,

MS2,MS1,CC6,CC10,CC1,P7,PPLD3

16

6 Recognize and anticipate common drug interactions with OTC medications, herbal or nutritional supplements and specific food groups.

MS2,MS1,CC6,CC10,CC1,P7,PPLD3

7

7 Discriminate between pharmacological substances, based on generic drug name, pharmacological classification (using class representative compounds), mechanism of action, major clinical indications and most clinically relevant adverse effects.

MS2,MS1,CC6,CC10,P1,P6

67

8 Distinguish treatments, which may become the standard of care on the horizon based on their proximity to FDA approval e.g. Qnexa for weight loss.

MS2,MS1,MS5,PPLD1,MS4,CC14,EIM2,PH4

2

Course Objectives (CO) Links (GO) Sessions (CO)

GO = New Geisel Objectives

Old Course Objectives (continued)

9 Recognize signs of common drug overdose, and propose how to initiate therapy where appropriate when the causal agent is known or unknown.

MS1,MS2,CC13, PH2

0

10 Integrate their knowledge from years 1 and 2 of anatomy, biochemistry, genetics, microbiology, physiology, and pathophysiology with the actions of drugs at all levels from the receptor to the cell, organ, circulatory systems and whole-‐body levels.

MS1,MS2 49

11 Access and evaluate different levels of biomedical literature relevant to the treatment of disease through experts, Internet sources, books, and other databases

MS1,MS5 3

12 Discuss the principals of evidence based medicine and be familiar with the current resources available online and through the biomedical library

MS1,MS5 1

13 Discuss procedures relevant to disease diagnosis and alternatives to medical therapy (e.g., percutaneous coronary intervention, arrhythmia ablation, implantable defibulator)

MS1,MS2,MS5,CC8,CS6,CS1,PH1

4

14 Discuss how to serve patients interest when evaluating brand name vs. generic drugs, and pharmaceutical advertising to patients and clinicians.

CC13,PH2,P2,PPLD1,PH3,CC7,EIM2,PH1,EIM5,EIM3,P5

6

15 Explain what is required to write a complete, unambiguous, and legal prescription and also what is required to insure the patient is fully counseled about medications, their drug history is comprehensively evaluated and they have printed drug information.

MS2,CC13,PH2,P2,PPLD1,PH3,CC7,EIM2,PH1

0


Old Course Objectives (continued)

16 Recognize signs of drug/alcohol abuse and describe potential treatment strategies. CC13,PH2,P5,PH5

0

17 Communicate effectively with fellow students and faculty. CC8,CS6,CS1 418 Demonstrate team skills by participating effectively in team exercises. CC1,P7 319 Take responsibility for his-‐ or her-‐own medical education. PPLD1 1620 Search efficiently for and obtain recent, high quality, relevant medical information and scientific literature to solve problems.

MS1,MS4 4

21 Read critically, evaluate, and assess medical information and scientific literature about important neurological topics and questions.

MS1,MS4 3

22 Practice clinical reasoning skills in the context of a simulated patient scenario. CC6,CC7 623 Demonstrate skills necessary for assisting patients to understand treatment options and the need for care.

CC12,CS4,CS7 4

24 To help colleagues by contributing constructive suggestions during peer review PPLD3, 3

25 To meet professional responsibilities fully, including being punctual, present, and engaged, and being reliable in commitment to tasks.

P7 6


Updated Course Objectives

# Course Objectives (CO) Sessions

Geisel Competency

How Assessed

1Describe an overview of drug pharmacokinetic properties (e.g. absorption, distribution, metabolism, and excretion) that applyto all therapeutic agents 1, 3, 4, 5, 6, 8, 24 MS Exam

2Describe how drugs interact with receptors, cells, tissues, and organs to produce their desired and unintended pharamcodynamic effects 1, 5, 8 MS Exam

3

Calculate a loading dose, maintenance dose, and half-‐life of a drug, using previously validated measurement of drug bioavailability, clearance, and volume of distribution

1,3,4,7,28 MS Exam

4

Explain the basic concepts of drug-‐receptor interactions)e.g. agonists, antagonists, partial agonists, ED50, potency) 5,6

MS Exam

5

Describe how drug-‐receptor binding can lead to a cascade of intracellular changes through second messenger systems and beyond (e.g. cyclic AMP, cyclic GMP, etc.)

5,6

MS Exam

6

Describe in detail the most common pathways in man for drug metabolism, and their pharmacogenetic importance and implications (e.g. ultraslow or ultrafast metabolizers)

8, 24

MS Exam

7

Describe the purpose, neuroanatomy, neutrotransmitters, and phsiological effects of the two branches of the autonomic nervous system (sympathetic, parasympathetic)

9

MS Exam

8

Describe in detail the most common drugs used clinically as agonists and antagonists at the various adrenergic receptors (e.g. beta-‐receptor agonists and antagonists, alpha-‐receptor agonists and antagonists)

10, 11

MS Exam

9

Describe in detail the most common drugs used clinically as agonists and antagonists at the various cholinergic receptors (e.g. muscarinic-‐receptor agonists and antagonists, nicotinic-‐receptor agonists and antagonists)

12, 13

MS Exam

10

Describe the most common adverse drug reactions for drugs presented in the course, as well as the most common drug-‐drug interactions (e.g. tremor from albuterol, sedation from clonidine)

1, 5, 6, 8, 10, 11, 12, 13, 15, 16, 17, 20, 21,

22, 26, 27, 29

11

Explain how foods, herbal products, nutritional supplements, and over-‐the-‐counter drugs can cause clinically important interactions with commonly used therapeutic drugs

8, 17

MS, CC Exam

12

Describe how each class of therapeutic drugs is named in a common fashion, and also how generic and branded drugs have different types of testing prior to approval, naming, and pricing strategies

1

MS, CC Exam

13

Describe the basic and clinical pharmacology of the most common drugs used to treat hypertension and coronary artery disease (e.g. angina, MI, etc.)

15, 16, 22

MS, CC Exam

14

Describe the basic anc clinical pharmacology of the most common drugs used to treat hyperlipidemia and cardiac arrhythmias

21, 26

MS, CC Exam

15

Describe the basic and clinical pharmacology of the most common drugs used to treat congestive heart failure 27, 29

MS, CC Exam

16

Describe the most common drugs used to treat respiratory conditions such as asthma, reactive airways disease, chronic obstructive pulmonary disease, and cough

20, 25

MS, CC Exam

17

While discussing clinical cases in small groups, demonstrate the ability to reason from symptoms and signs to a diagnosis, and from a diagnosis to recommendations for treatment of that condition, including the ability to access and evaluate different current reliable sources of biomedical information

14, 18, 23

CC, Conf

18

While discussing clinical cases in small groups, demonstrate the ability to communicate clearly and effectively with students and faculty, and to participate effectively as a team member

14, 18, 23

CS,CT Conf

19

By completing all assignments on time, and coming to each conference on time and well prepared, demonstrate the ability to behave professionally, and to take responsibility for your own medical educaton

14, 18, 23

PP, ProfConf, modules

20

Discuss the concepts of value-‐based care and medical ethics, that relate to such drug-‐related issues as periods of patent protection, pricing of drug products, appropriate use of genertic drug products, direct-‐to-‐consumer advertising, direct-‐to-‐physician drug detailing, and direct-‐to-‐physician consulting fees

1, 29

PH, PPL, EIM, Prof Conf

Updated Course Objectives

Course Objectives – Geisel Competencies

There are 20 updated course objectives that fulfill Geisel competencies as follows:

• 15 address specific medical science knowledge• 7 address clinical care• 1 addresses population health• 1 addresses communication skills• 1 addresses personal, professional & leadership development• 1 addresses evaluation and improvement in medicine• 2 address professionalism• 1 addresses collaboration and teamwork

Course Objectives – Geisel Program Objectives

The Old Course objectives #9, #15 and #16 did not map to any particular session and have been changed accordingly in the new objectives.

Course Objectives – Format/Distribution

• 3 overarching Course objectives are provided in the syllabus in Canvas, however, the 20 new course objectives are only in Ilios. These should be added to Canvas to ease student availability.

Course Objectives – USMLE Brochure

http://www.usmle.org/pdfs/usmlecontentoutline.pdfGeneral Principles of Foundational SciencePharmacodynamic and pharmacokinetic processes: general principles, absorption, distribution, metabolism, excretion, dosage intervalsMechanisms of drug action, structure-‐activity relationships (eg, anticancer drugs)Concentration and dose-‐effect relationships (eg, efficacy, potency), types of agonists (eg, full, partial, inverse) and antagonists and their actionsIndividual factors altering pharmacokinetics and pharmacodynamics (eg, age, gender, disease, tolerance, compliance, body weight, metabolic proficiency, pharmacogenetics)Mechanisms of drug adverse effects, overdosage, toxicologyMechanisms of drug interactionsSignal transduction, including structure/function of all components of signal transduction pathways such as receptors, ligands (eg, general principles of nitric oxide, autocrine and paracrine signaling)

USMLE continuedSystems Pharmacology:Immune SystemAdverse effects of drugs on the immune system: Jarisch-‐Herxheimer reaction; Drugs affecting the immune system (eg, prednisone, azathioprine, cyclosporine, methotrexate, monoclonal antibody drugs [eg, abciximab, adalimumab; bevacizumab, infliximab, omalizumab, rituximab]);Behavioral HealthAdverse effects of drugs: Steroid-‐induced psychosis; varenicline and suicide; drug-‐induced psychogenic polydipsiaSkin & Subcutaneous TissueAdverse effects of drugs on skin and subcutaneous tissue: drug reactions, eruptions,Musculoskeletal SystemAdverse effects of drugs on the musculoskeletal system: drug-‐induced myopathy (eg, steroids, statins, cocaine, AZT); malignant hyperthermia

USMLE 1 continuedSystems Pharmacology ContinuedAdverse effects of drugs on the cardiovascular system: adriamycin; cocaine, amphetamine,PCP; ACE inhibitors, calcium channel blockers, alpha blockers, minoxidilAdverse effects of drugs on the respiratory system: bleomycin, amiodarone; adverseeffects of 100% oxygen; tobacco, inhalants, cocaineAdverse effects of drugs on the gastrointestinal system: drug-‐induced changes in motility(chronic laxative abuse, opioids); drug-‐induced gastritis, duodenitis, peptic ulcer disease(NSAIDs); drug-‐induced hepatitis (eg, acetaminophen, isoniazid); drug-‐inducedpancreatitis (eg, thiazide diuretics)Adverse effects of drugs on the renal and urinary system: ACE inhibitors; aminoglycosides;amphotericin B; cisplatin; furosemide; gadolinium (nephrogenic systemic fibrosis);heroin; iodinated contrast dye; lithium; NSAIDs; penicillins; sulfa drugs; tenofovir; drug -‐induced urinary retentionAdverse effects of drugs on pregnancy, childbirth, and the puerperium: alcohol, tobacco,and other drugs (ATOD); prenatal radiation exposure; teratology (eg, ACE inhibitors,SSRIs, warfarin, infections, toxins)Adverse effects of drugs on the female reproductive system and breast: antihistamines,H2-‐receptor blockers; benzodiazepines; beta-‐adrenergic blockers; hormonereplacement; opioids; spironolactone; selective serotonin reuptake inhibitors;tricyclic antidepressants

USMLE 1 continuedSystems Pharmacology continuedAdverse effects of drugs on the male reproductive system: alcohol; androgens, testosterone;antipsychotics, antidepressants including selective serotonin reuptake inhibitors; betaadrenergicblockers; diuretic including thiazides; drug-‐induced priapism (eg, trazodone);finasteride, dutasteride; sildenafil, tadalafil, vardenafil; marijuana; nitric oxide reductaseinhibitorsAdverse effects of drugs on the endocrine system: drug, medicinal, and biologic substanceeffects; exogenous steroid suppression of adrenal glands, anabolic steroids

Medical Error PharmacologyMedication errorsOrdering, transcribing, dispensing, administration (wrong quantity, wrong route,wrong drug)Medication reconciliation

USMLE final thoughts

Between Pharm 216 and Pharm 217, all areas listed in the USMLE content brochure appear to be accounted for according to the Syllabus.

The USMLE listed details for the topic of Pharmacology (e.g.-‐names specific drugs and effects).

Suggestion -‐ The Lecturer’s responsible for the sessions on these topics should review their lectures and to be sure they include each item on the USMLE list. Consider the creation of Pharm Cards on each listed drug.

Course Objectives – AMSPC

1.GENERAL PRINCIPLES2.DRUGS ACTING AT SYNAPTIC AND NEUROEFFECTOR JUNCTIONAL SITES AUTONOMIC AND NEUROMUSCULAR PHARMACOLOGY3.DRUGS ACTING ON THE CENTRAL NERVOUS SYSTEM (21)4.AUTACOIDS/NONSTEROIDAL ANTIINFLAMMATORY/ASTHMATIC DRUGS5.CARDIOVASCULAR AND RESPIRATORY PHARMACOLOGY6.DIURETICS AND DRUGS AFFECTING RENAL FUNCTION, WATER, AND ELECTROLYTE METABOLISM7.GASTROINTESTINAL DRUGS8.CHEMOTHERAPY9.HEMOSTASIS AND BLOOD FORMING ORGANS10.ENDOCRINE PHARMACOLOGY11.TOXICOLOGY AND THERAPY OF INTOXICATION12.VITAMINS13.HERBALS

Covered elsewhere

Covered in 4thyear

Session Objectives – Format/Distribution

• Session objectives are provided in the course materials for each session.

• Session objectives are mainly written in the correct format.

• A few of the session objectives use the word “Understand” and a few simply list facts such as

“The students are expected to ….The only antiarrhythmic that has ever been shown to improve mortality in the post infarct patient is a beta blocker”

Session Objectives -‐ Redundancy• Pharmacology touches each system. The depth of coverage of the drugs in this course appears planned.

Course Learning Opportunities• Lecture 21 hrs. (64%) – this includes flipped sessions with pre-‐work and is well received by students.

• Small groups 6 hrs. (18%)• Large Groups 2 hrs. (6%)• Online tutorials 4 hrs. (12%)• = 100%• Exam – 1 event• Narrative Assessment – (a comment about the students general attendance and contribution)

Course Learning Opportunities• Some of the lectures have pre-‐lecture materials• Students liked Dr Nierenberg's pre-‐lecture prep materials, ie -‐ Camtasia previews

Assessment• Phar 216 is Pass/Fail• “Students who perform more than 2 standard deviations below the class mean or students whose grades are outliers are at risk of receiving a grade of fail” From the syllabus

• Final Exam – ~80 question/~3 per lecture• Other Grading -‐ 16 points/4 each from each of the online sessions.

Assessment – Final Exam• The syllabus states there is an 80 question exam. The Sept 2014 Exam (submitted for review) is 65 questions.

• Questions 5, 13, 18, ask “Which of the following statements are true?”

• Suggestion -‐ Re-‐write these 3 questions.

Measures of Quality – AAMC GQ

Geisel mean 2010

Geisel mean 2011

Geisel mean 2012

Geisel mean 2013

Geisel mean 2014

All schools means 2014

Biochemistry 2.7 2.5 2.6 2.6 2.8 2.7

Biostatistics/Epidemiology 2.9 3.2 3.2 2.9 3.2 2.8

Genetics 2.9 2.8 2.8 2.6 2.8 2.9

Gross anatomy/Embryology 3.6 3.5 3.6 3.4 3.6 3.4

Immunology 2.9 3.0 3.1 2.7 2.7 3.1

Intro to ClinMed/On Doc 3.5 3.4 3.5 3.0 3.3 3.5

Microanatomy/Histology 2.8 2.9 3.1 2.8 3.1 2.9

Microbiology 3.1 3.2 3.3 3.0 3.1 3.2

Neuroscience 3.2 3.0 3.0 3.0 3.2 3.2

Pathology 3.2 3.1 3.4 2.8 3.1 3.3

Pharmacology 3.4 3.1 3.1 2.6 3.1 3.1

Physiology 3.6 3.6 3.5 3.1 3.4 3.4

Behavioral Science 3.2 3.3 3.3 3.0 3.2 3.2

Pathophysiology of Disease 3.5 3.5 3.5 3.3 3.5 3.5

Measures of Quality – AAMC GQ“Indicate how well you think that instruction in [basic science topic] prepared you for clinical clerkships and electives.” [1=poor; 2=fair; 3=good; 4=excellent]

Measures of Quality – Step I

TRADITIONAL CORE DISCIPLINES2012* 2013* 2014* Means 12-‐14

Biochemistry 0.30 0.20 0.22 0.24

Biostatistics/Epidemiology 0.43 0.40 N/A N/A

Biostatistics 0.08 0.08

Genetics 0.28 0.18 0.28 0.25

Gross anatomy/Embryology 0.33 0.26 0.14 0.24

Histology/Cell Biology 0.37 0.26 0.23 0.29

Microbiology/Immunology 0.31 0.47 0.39 0.39

Pathology 0.26 0.24 0.20 0.23

Pharmacology 0.22 0.22 0.12 0.19

Physiology 0.38 0.35 0.25 0.33

*values reported for core disciplines are SD above the US/Can mean for Geisel mean scores

Measures of Quality – Step ISYSTEMS-‐BASED TOPICS 2012* 2013* 2014* Means 12-‐14

Behavioral sciences 0.43 0.26 0.15 0.28

Biostatistics, Epidemiology, Pop Health 0.01 0.01

Cardiovascular system 0.20 0.47 0.02 0.23

Endocrine system 0.39 0.39

Gastrointestinal system 0.32 0.59 0.54 0.48

General Principles of Found Sciences 0.25 0.25

Hematopoietic/lymph systems 0.14 0.18 0.09 0.14

Immune system 0.22 0.53 0.16 0.30

Multisystem Processes & Disorders 0.23 0.23

Musculoskeletal, skin, CT systems 0.24 0.34 -‐0.02 0.19

Nervous system 0.25 0.21 N/A

Nervous system and Behavioral Health 0.06 0.06

Nutrition 0.56 0.39 0.22 0.39

Renal/urinary system 0.42 0.21 0.23 0.29

Reproductive/endocrine systems 0.42 0.39 N/A

Reproductive system 0.39 0.39

Respiratory system 0.29 0.31 0.18 0.26

*values reported for core disciplines are SD above the US/Can mean for Geisel mean scores


Year 1 courses Overall Satisfaction AY 2013-‐2014

Human Anatomy and Embryology II 4.57

Human Anatomy and Embryology I 4.33

Physiology-‐Renal 4.32

Biostatistics and Epidemiology 4.28

Metabolic Basis of Disease 4.23

Biochemical and Genetic Basis of Medicine 3.97

Neuroscience 3.90

Physiology-‐Endocrine 3.81

CTO 3.79

Basic Science of Microbial Disease 3.78

Virology 3.71

General Pathology 3.46

Physiology-‐Cardiovascular 3.45

Physiology-‐Respiration 3.38

Immunology 2.35

Measures of Quality – Course Reviews

scale [1=poor; 2=fair; 3=good; 4=very good; 5=excellent]

Year 1 courses (fall, winter) Overall Satisfaction AY 2014-‐2015

Human Anatomy and Embryology II 4.57

Human Anatomy and Embryology I 4.35

Metabolic Basis of Disease 4.35

Biochemical and Genetic Basis of Medicine 4.34

Physiology-‐Renal 4.19

CTO 4.07

Virology 3.77

Physiology-‐Endocrine 3.76

Immunology 3.67

Physiology-‐Respiration 3.34

Physiology-‐Cardiovascular 3.23





Respiration 4.39

Cardiology 4.29

Hematology 4.29

FEK 4.28

Dermatology 4.24

Endocrine 3.97

GI 3.96

CT & Bone 3.82

Infectious Diseases 3.79

Pharmacology I 3.71

Psychiatry 3.44

Neurology 3.34

Reproduction 3.25





Respiration 4.38

Cardiology 4.27

Pharmacology 4.15

Hematology 4.44

Nervous system 3.46

Psychiatry 4.20

Endocrine 4.09

FEK 4.19

CT & Bone 3.62

Dermatology 4.11

GI 4.47

Infectious diseases not yet available

Reproduction not yet available




Measures of Quality – Course Evaluation

Course X2012 (97%)*

Course X2013 (97%)*

Course X2014 (99%)*

Overall satisfaction of course 3.43 3.71 4.15

Clarity of learning objectives 3.49 3.60 4.06

Organization of the course n/a 3.84 3.91

How well the course introduced me to this discipline 3.87 n/a 4.15

Congruence of assessment questions to material emphasized in course 3.80 3.84 3.98

*student participation rate on course evaluation

Measures of Quality – Course ReviewsStrengths (summary):1 – Good overall organization of the course, “the flow of the course matched the topics in other courses”. “well organized”2-‐ The pre-‐lecture material, esp the Camtasia previews3-‐ the Pharm Cards4-‐ The case based practice problems throughout some lectures.

Measures of Quality – Course ReviewsSuggestions for Improvement (summary):1-‐ The List of Drugs on Canvas ought to be updated at the beginning of the course, and made more complete; to include the important drugs from all sessions and on the USMLE12-‐ Consider Pharm cards for all sessions (espcholinergics)3-‐ Try to coordinate the teaching of anti-‐arrhythmicswith the cardiology course4-‐ Re-‐structure small groups to include/involve more students in all of the cases

Final Recommendations (1 of 2)I. Course Objectives

I. Updated (done)II. Add the full list of updated Course Objectives to the

Syllabus in Canvas

II. USMLE 1I. Review the drug list in Canvas to be sure each drug listed

in the USMLE1 content list in included. Consider Pharm Cards. Distribute the list of USMLEs drug to each appropriate session teacher.

Final Recommendations (2 of 2)I. Session Objectives – consider re-‐write of objectives

that state facts rather than objectives.II. Syllabus –

I. Update the syllabus front page to the current yearII. Update summary of Final Exam (states 80 Q exam)

III. Final Exam (2014)I. Questions #5, 13 and 18 are True/False lead questions and

should be re-‐written.

IV. Coordinate with the Cardiology is possibleV. All small session cases should be completed and

discussed by all students. A few students can moderate, but all should be involved.

Action Plan (1 of 3)I. Course Objectives

I. Updated (done)II. Add the full list of updated Course Objectives to the

Syllabus in Canvas (on canvas site for 2015-‐16 and in “Medical Pharmacology Essentials” document)

II. USMLE 1I. Review the drug list in Canvas to be sure each drug listed

in the USMLE1 content list in included. Consider Pharm Cards. Distribute the list of USMLEs drug to each appropriate session teacher. (We are reviewing USMLE resources to ensure our drug list is up to date and will be updating the drug lists and lectures where appropriate. Commonly used drug class members can be listed).

Action Plan (2 of 3)I. Session Objectives – consider re-‐write of objectives

that state facts rather than objectives (will review format with lecturers and adjust as appropriate).

II. Syllabus –I. Update the syllabus front page to the current year

(done)II. Update summary of Final Exam (done)

Action Plan (3 of 3)I. Final Exam (2014)

I. Questions #5, 13 and 18 are True/False lead questions and should be re-‐written (these questions will be removed from our question bank and new ones written).

II. Coordinate with the Cardiology is possible (this was a specific problem with 1 session and we will attempt to align this content with SBM. Our lecturer for this session retired this year so potentially this might be an online session)

III. All small session cases should be completed and discussed by all students. A few students can moderate, but all should be involved (this year we will change the format of these sessions so while specific students lead a case ALL students are expected to have studied the material and be able to discuss it).

Pharmacology Review with Action List · Review&of&Year&Y2Medical&Pharmacology&Essentials ... and&the&use&of&the&Pharm&cards. ... important&information&about&each&drug.

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