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Dept. of Pharmacology, SL 83
School of Medicine
Tulane University
1430 Tulane Ave
New Orleans, LA 70112
tel
504-988-5444 or 800-347-5935
fax
504-988-5283
webmaster

Medical Pharmacology Course Policies (Graduate)

 

I. COURSE ADMINISTRATORS & TEACHING FACULTY

Course Director: Craig W Clarkson PhD
(Office: Rm 3554, 1430 Tulane Ave.; Tel: 504-988-2641; Email: cclarks@tulane.edu)

Teaching Faculty: A current list of the office room numbers, phone numbers and email addresses for the Medical Pharmacology teaching faculty can be found in the "Faculty" section located on the main page of the Pharmacology Department Web Site. 

II. TEXTBOOKS

This is a "team taught" course involving more than a dozen faculty. Each lecture, team-based learning or  problem based learning session will have a handout covering the content of the lecture or exercise, along with a list of learning objectives. It is recommended that you purchase a text to use as a reference for finding further detail on subjects covered in class or in PBL sessions, or to clarify a point made in lecture. The 10th edition (2007) of Katzung’s “Basic and Clinical Pharmacology” is our recommended text. This text should be considered your authoritative reference that you can rely upon for accurate information. It is an information resource and supplement to the information that is presented to your in lecture, TBL &  PBL sessions.

Recommended Text:

  • Basic and Clinical Pharmacology, 11 th Edition, B. G. Katzung. AJ Trevor & S Masters (Eds). ISBN: 978-0071604055. McGraw Hill / Lange Med. Pub., Norwalk, Conn./San Mateo, CA, July 31, 2009. (An excellent text with a good balance of depth of coverage & illustrations.) $53 softback 

Some other texts:

  • Goodman & Gilman's The Pharmacological Basis of Therapeutics 12th Ed. ISBN: 978-0071624428. McGraw-Hill Pub, 2010. (The most authoritative text. It covers all the details on a topic, with large & small text, similar to an encyclopedia. It’s big: 8.3 lbs hardbound) $140.
  • Katzung & Treavor's Pharmacology. Examination & Board Review. 9th Edition 2010. McGrawHill/ Lange  ISBN: 978-0071701556. (Covers the basic points of a drug or drug class, but does not give any details. Good for board review. Some students have been happy with it as a text. Contains a thousand or more USMLE type questions & practice exams.) $42
  • Lipincott's IlIustrated Reviews: Pharmacology. Lippincott Williams & Wilkins; 4th Edition. 2008. ISBN: 978-0781771559. (A student favorite. Less text & more illustrations. However, it contains some errors in some of its chapters & hence it is not a faculty favorite. Does not have cited references.). $48
  • Lange Pharmacology Flash Cards  2nd Edition. 2009. Baron S & Lee C (Authors).  Lange / McGraw Hill. ISBN: 978-0071622417. (Remember those flash cards you had as a kid? Some students find these quite useful.) $35
  • Principles of Pharmacology. The Pathophysiologic Basis of Drug Therapy. 2nd Edition, 2007. Golan David E. et al. Editors. ISBN-13: 978-0-7817-8355-2. Wolters Kluwer, Lippincott Williams & Wilkins, Philadelphia, 2007. (An integrated mechanism-based & systems-based approach to understanding the actions of pharmacological agents. An excellent new text). $66

Course Wiki:

  • PharmWiki: a collaborative effort between students & faculty at Tulane.
    Url: http://tmedweb.tulane.edu/pharmwiki/doku.php/

 

III. COURSE ORGANIZATION

 

A. Lectures & Lecture-Related Media

Lectures & small group activities will be given primarily in the DeBakey Educational Center (Murphy Building). A few additional graduate-only lectures may be given in Rm 4700 (Pharmacology Dept Conference Room). See the lecture schedule for exact times. Lectures will cover primary concepts such as mechanisms of drug action, drug indications, contraindications, drug interactions & side effects.

Each lecture will have a pdf copy of a lecture guide (posted online on Greenspace) that will include most of the essential concepts and facts to be learned.  Each lecture guide will include a list of learning objectives that clarify the major facts and concepts for that topic.  Lecture guides will also typically contain a drug list, which will list the essential drugs covered during the lecture.  All of the material provided in the lecture guide may not be covered in class, however, students are still responsible for all material included in the guide as it pertains to the learning objectives. The drugs included in the drug lists represent those that you should be familiar with prior to an exam, with respect to the learning objectives. You are not expected to ever know every detail about each drug. The information you are expected to know about each drug is outlined in the learning objectives.

A pdf version of the lecture slides will also be available on Greenspace for each lecture, as well as a Tegrity lecture recording, which can be used to review lecture details after the lecture.

A pharmwiki containing a summary of information on the indications, contraindications, mechanisms of action, side effects, drug interactions, and pharmacokinetic information on each drug discussed in the Med Pharm course has been created. This is intended to be used as an information resource only. It is not something to be memorized word for word. Students are encouraged to contribute to the wiki if they come across additional useful information or useful online resources.

A copy of the learning objectives and drug lists are also available on the course web site. Links to additional on-line resources are also typically provided for each drug on the pharmwiki.

 

What is Covered During Lectures

During traditional lectures, we will cover the vast majority (if not all) of the drugs and learning objectives that you will be assessed on during the block exams. For Just-in-Time-Teaching sessions, you will be given a reading assignment that covers all of your learning objectives, and you will be expected to have completed the reading assignment before attending class. (A further description of JiTT is provided in section G below). JiTT class sessions will focus on your identified areas of difficulty and core concepts using a Class Response System to assess your level of understanding, as well as Peer Instruction/Discussion to maximize the classroom learning experience.

 

B. Problem-Based & Team-Based Learning Sessions

In the case-based PBL sessions you will work with a group of ~10 students to answer questions related to a developing clinical problem. You should bring resources with you to all PBL sessions (e.g. text books, class notes & laptop). One instructor will be assigned to each PBL group as a facilitator. Attendance is mandatory (rooms & groups as assigned) & participation will contribute towards the “professionalism” component of your final grade (5%). During Team-Based-Learning (TBL) sessions you will be working initially on your own, and then as groups of 6 students to solve a series of clinically relevant problems. TBL sessions are "closed book" except for the Group Application Exercise component, which is open book. The following case-based PBL & TBL sessions are currently scheduled:

TBL Sessions:


  1. ANS Unknown Drugs (Clarkson)
  2. Treatment of Diabetes (Beckman, Clarkson)

PBL Sessions:

  1. Drug Metabolism (Coordinator: Dr. Clarkson) - PBL
  2. Chemical Warfare (Coordinator: Dr. Clarkson) – PBL
  3. Antiarrhythmic Drugs (Coordinator: Dr. Clarkson) - PBL
  4. Hypertension (Coordinators: Drs. Kadowitz & Clarkson) - PBL
  5. Psychotherapeutic Drugs (Coordinator: Dr. Clarkson) - PBL
  6. Contraception (Coordinator: Dr. Beckman) - PBL

One of the main purposes of the PBL & TBL sessions is to give you an opportunity to assess your mastery of a topic using interactive exercises that require you to apply your knowledge of a topic using deductive reasoning to “solve” a problem or to answer a series of questions. Information covered in the PBL & TBL sessions will be covered on upcoming progress exams.

Sharing of information between different PBL groups (e.g. between those in Section A vs. Section B) will “short circuit” the learning process for the latter groups taking the lab. For this reason it is an honor code violation for students to share information between lab groups/sections until all groups have completed the PBL exercise.

Absences from Case-based PBLs will need to be made up independently (students may consult their classmates & faculty for answers to case-based questions).

C. Cardiovascular Lab (Adrenergic & Cholinergic Drugs)

A pre-recorded lab session has been designed to provide you with the opportunity to evaluate the effects of various adrenergic & cholinergic agonists and antagonists on cardiovascular function. During the lab you will observe & evaluate the effects of selected agonists & antagonists.


D. Human Patient Simulation Exercises


At present, three simulation exercises have been developed using our high fidelity METI Human Patient Simulator (adult & pediatric). These exercises will be conducted during the cardiovascular, pulmonary and neurology blocks, and will allow students to practice history taking, physical diagnosis, treatment & proper methods of handing-off patient care to senior attending physicians. Each simulation exercise is immediately followed by a debriefing session.

 

E. Online Learning Modules

Several learning modules (posted on Pharmwiki) will be offered that contain a set of learning objectives with a online assignment consisting of a clinical case, discussion of therapeutics, an interactive formative assessment quiz, followed by a summative assesment quiz worth 3-4 points that will contribute to the 10% professionalism component of your course grade.

 

F. Review Sessions

Review sessions will be held at the end of most blocks, a few days prior to block exams. These will be held in the main lecture hall. Attendance is optional. You are expected to come prepared to ask questions of the Instructor(s) (i.e. having studied and reviewed the lecture content).

G. Just-in-Time-Teaching (JiTT) sessions

We recently implemented periodic interactive teaching sessions based upon the Just-in-Time-Teaching strategy (Novak et al., 1999; Crouch & Mazur, 2001). In these sessions you will be given a reading assignment with learning objectives that is to be completed before class. When you complete  the reading assignment you will be asked to complete a short online quiz on the course Blackboard (MyTulane) course management system. Quizzes will typically consist of 2-3 multiple choice questions, followed by an essay question that asks you to:


Explain what areas you found most difficult or confusing. If nothing was difficult or confusing, what points did you find most useful?”

These questions must be completed on Blackboard by midnight before the next day’s JiTT class session. Blackboard will not allow you to complete the quiz after that deadline. The reading assignments will provide you with a foundation of knowledge about the topic to be covered. Class sessions will then focus on discussing areas of student-identified confusion & difficulty, and any major concepts for that topic. JiTT class sessions will make use of the Classroom Response System (CRS) to foster an interactive learning experience - and to provide you with real-time feedback on your ability to apply knowledge to solve clinically relevant problems. The technique of Peer Instruction (Mazur, 1996) related to solving CRS questions will be used to facilitate active learning. Using the feedback you obtain from the CRS, you can immediately judge your level of mastery of the topic, rather than waiting to see if you can pass a block exam. Response histograms will be used as "teachable moments" if the vast majority of the class is unable to select the correct answer(s). The 5-6 possible points earned from the online pre-class quizzes before JiTT sessions will contribute to the 10% of course grade determined by JiTT performance. The following topics will be addressed in JiTT sessions:

  1. Basic Principles of Pharmacology
  2. Glucocorticoids / Corticosteroids
  3. Rx of HIV
  4. Rx of Heart Failure
  5. Rx of GI Disorders
  6. Antiarrhythmics
  7. Antidepressants

H. Interactive Online Quizzes (Formative Assessment)

Over 500 interactive quiz questions on ~34 topic areas covered during the course have been authored and placed online to help students determine their level of mastery, and increase learning about the various topics covered during the course. A majority of these questions contain clinical vignettes. Each question provides interactive feedback with an explanation of correct & incorrect responses. These quizzes are organized by thematic blocks, and have been authored using Adobe Flash (swf files). They are available 24/7, and are open to the public (see "Quizzes" link on the 2nd tier bar at the top of this web page).


I. Exams (Summative Assessment)

We have 11 progress exams scheduled, plus an NBME shelf exam as a final exam. The NBME shelf exam will count for 25% of your course grade. On progress exams, you will be held responsible for the lecture material, laboratories, lecture handouts, roundtable discussions, team-based & problem-based learning sessions, self studies and assigned readings. The majority of USMLE-style exam questions on block exams will focus on concepts, drug mechanisms of action and the application of knowledge in a clinical context, rather than factual recall. Up to 15-20% of each exam will be cover cumulative material covered on prior exams, beginning with Exam II.  These review questions over the previous block will focus on the most important concepts & objectives, and not “minutiae”. Interactive versions of questions from previous progress exams are available on the Medical Pharmacology Web Site. Due to the uneven number of contact hours in each "Subject block", there will be a highly variable number of questions on each exam (e.g. varying from 10 to 60 questions). This is a consequence of the coordination of our schedule with the other 2nd year courses, and the variable number of contact hours per block. While there will be a variable number of questions on each exam, each question on each exam will have equal weight.

An answer key will be posted within an hour after the exam is completed, and will remain posted until 4-5 p.m. on the day of the exam. Challenges to the answer key may be submitted on-line from the exam section of the course website. For most exams (given on Friday morning) the deadline for acceptance of key challenges will be Sunday the day after the exam.

A zero will be given for an unexcused absence from an exam. Approval Dr. Craig Clarkson (Course Director) is required to obtain an excused absence from an exam. Students with valid excuses will typically be required to take the exam within a week of the original date.

Goals of the Examinations

They are used:

  1. As a motivational force to stimulate you to achieve a minimal knowledge of drug actions to prepare you for the practice of medicine.
  2. To determine your areas of strength and weakness.
  3. To stimulate you to study further in your area of weakness.
  4. As a teaching modality and learning process.

J. Copyright Restrictions on Summative Assessment Questions:


All exam questions, PBL cases and questions, TBL IRAT/GRAT and Application of Knowledge questions, quizzes, JiTT questions and all other questions used to assess knowledge in this course are copyrighted and owned by Tulane University School of Medicine and this department. REPRODUCTION OF THESE QUESTIONS BY ANY MEANS and/or DISTRIBUTION OF THESE RESOURCES is strictly prohibited, and will be considered A VIOLATION OF THE TULANE UNIVERSITY HONOR CODE.


K. Tips on How To Study Medical Pharmacology

During the Med Pharm course, you will be faced with the daunting task of learning about hundreds of drugs, and sometimes up to a dozen facts about each drug category. As recommended in James Olson's book (2006) it is unneccessary to memorize many of the facts related to a particular drug or drug category if you learn to predict the behavior of each drug based upon a few facts along with an understanding of the basic principles of pharmacology. For example, when you learn about a new drug, try to learn the "story" of each crug instead of memorizing a table of facts. Try to associate new material with what you already know. Think about relatives or friends who have taken drugs within the drug class you are studying. Then ask yourself why is this information important? (Adults learn best when they feel they need to know the material). Why was this information important enough to be included in this lecture, self study, or small group session? Use your knowledge of human physiology to predict the actions, clinical uses (indications), predictable side effects & drug interactions based soley on the drugs mechanism of action. If you can do this, you will greatly reduce the number of isolated facts needed to understand drug actions. Putting drug actions into a logical clinical context should also increase your long-term retention compared to pure memorization of isolated facts. This is because "deep foundational understanding" (which expert clinicians have) is built around conceptual frameworks that facilitate retrieval & application. 

Remember Einstein's quote "You do not really understand something unless you can explain it to your grandmother". If your grandmother isn't available, you should review frequently with smal groups of your classmates (peers) to challenge each other about your depth of understanding. The best way to learn is to try and teach others! This is a tenant of peer instruction/discussion and team-based learning. In teaching others you will achieve a depth of learning that cannot be obtained by attending traditional lectures or by self study. Review frequently. Use the online interactive questions & see if you can explain why the 4 "false" answer options are "false" instead of true. In this way you can solve 5 questions instead of just one.

 

IV. CALCULATION OF COURSE GRADE

  • 10% of your grade will be based upon: a) attendance, performance & participation in PBL exercises, b) TBL session performance, c) JiTT performance on Blackboard (MyTulane) homework assignments that precede interactive class sessions, d) the summative assessment component of online learning modules, & e) completion of course surveys at the end of each block (the later is worth 1%).
  • The remainder of your course grade will be determined from the percent of the total possible points you obtain from all exam questions.
  • Each semester will be graded separately. However, the Spring semester grade will include a comprehensive National Board of Medical Examiners computer-based exam that will count for 25% of the exam component for the Spring semester grade. The scope of this exam covers all systems blocks (all material for both semesters, from July through March).

While there will be a variable number of questions on each exam, each questions on each exam will have equal weight, except for the final. The final exam will count for 25% of the exam component of your course grade.  As an example, if you obtained a score of 35 out of 40 possible correct on the first exam, 10 out of 15 correct on the second exam, 20 out of 25 correct on the third exam, and 50 out of 60 correct on the forth exam, your current cumulative average would be: (35+10+20+50)/(40+15+25+60) = 82.1%.

 

Letter Grades:

  • The semester course grade will be determined from the percent of the total possible points you obtain from all exam questions.
  • An end of semester cumulative average of ≥ 90% is needed to earn an A
  • A cumulative average of ≥ 80% is needed to ensure a B letter grade.
  • Cumulative averages of less than 80% are likely to result in a grade of B- or lower.

V. Attendance Policy

Attendance at formal lectures & end-of-block review sessions is not manditory, but is highly encouraged. Attendance at PBL & TBL sessions is required (since small-group learning will be compromised if team members do not attend). Lack of attendance at small group (PBL & TBL) sessions will therefore negatively affect a student's grade as indicated in Section IV above. 

 

Excused Absence Policy

If a student has a legitimate reason for missing a required event (e.g. PBL, TBL, Exam), they should request an excused absence from Dr. Clakson as soon as possible. If an excused absence is granted, lack of participation in the small group activity will not negatively affect their grade. It is the student's responsibility to request & obtain the excused absence in a timely manner, and to consult with classmates & the course director for any questions on the missed activity. Students should also notify the course director concerning their excused absence ASAP since records are kept regarding absences at PBLs, TBLs & Exams. Exams missed with an excused absence will be made up in a timely manner.

 

VI. References:

  • Novak GM, Patterson ET, Gavrin AD, Christian W. Just-in-Time Teaching: Blending ActiveLearning with Web Technology. New Jersey: Prentice Hall; 1999.
  • Crouch CH, Mazur E. Peer Instruction: Ten years of experience and results. Am J Physics.69 (9): 970-977, 2001.
  • Mazur E. Peer Instruction. A User's Manual. Benjamin Cummings. 1996.
  • Olson J. Clinical Pharmacology Made Ridiculously Simple. 3rd Ed. MedMaster Inc. Miami, FL. 2006.

 

1430 Tulane Avenue, SL-83, New Orleans, LA 70112 504-988-5444 cclarks@tulane.edu