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If there is an expectation we come to class prepared then ALL documents and supplementary information needs to be uploaded in a consistent, timely manner. And because there is grace for us as imperfect beings, if things are uploaded late....please let us know so we are aware. For example, the 4 slides we needed to know for last week's derm patient encounter were uploaded late and we were never informed what the purpose of the document was until 1 hour before I was being tested. I spent hours studying through 4 different Powerpoints, unaware of what we actually needed to know. Come to find we only needed to know 4 slides. It ends up creating an incredibly stressful (more-so than any other class) environment, never feeling prepared or knowledgeable about what is actually happening.

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Someone else mentioned on here that we need to start practicing like physicians from day 1 in OMS1 because it will continue into residency and so on. To go along that, telemedicine visits are not completed in real life with physical exams. Physicians specifically must tell patients that they cannot examine a patient over a telemedicine visit. So in a way, we are being taught something that we cannot do as a physician. I understand there is a sense of virtual learning that needs to be adapted but given that we don't have a foundation of in-person SP encounters, this is cementing the wrong habits into us about how to act during OSCEs and our boards.

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How can Dr. D help make the CMR experience fruitful and interactive for the DO2024 students?

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How can Dr. D help make the CMR experience fruitful and interactive for the DO2024 students?

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There needs to be a complete restructuring of the class. Lectures have not been helpful. TA’s are not consistent in the information they share, not their fault. There are not clear instructions and proper teaching of the material. I honestly have not learned anything in these classes. It is rote memorization and how we are learning things is not how it works in clinic anyway.

Medical decision making is an art. It comes from knowing what questions to ask, why ask a question and how your thinking changes and adapts as you interview the patient. Then you use the physical exam to either confirm and/or rule out other diagnoses. You end up with the most probable answer and give next steps or treatment. We are not learning this.

Maybe something to consider is work with anatomy or whatever we are learning that week and teach that material for CMR. For example, last week we learned about the knee, dorsalis pedis pulses, and LE. What if we learned about the anterior drawer tests and other knee exam tests to solidify the information we learned last week. Like if you felt an enlarged lymph node in the inguinal area what are we thinking? This week we are learning about the foot, ankle and low back pain. Now would be a great to introduce those exams and what they mean. Connect it with what we are learning.

You could do these through online modules like Thrush. Then when we come to class we practice those things taught. Even if we can’t do the physical exam then that doesn’t mean we can’t learn what things mean and how to treat. This may require more but I expect better than this for the money I’m spending.

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1.     I feel like there is a lot of disorganization, multiple time the wrong schedule or information has been on Elentra, documents are uploaded late. Etc. Also there seems to be a lot of time when what she says contradicts what a TA said, what a slide said, or she previously said (for example in today’s lecture when the same question had to be asked multiple times).

2.     The disorganization feel is compounded by poor communication about what is expected each week, especially since the format seems to change every week. I feel like I am scrambling trying to figure out what I need to prepare for every week. There are so many documents that I have to parse through just to find out what I need to, let alone actually trying to do it.

3.     I feel like I’m not actually learning how to think like a physician. I feel like I am just memorizing boxes to check without knowing how or why so that the hospital can bill for it.

4.     I feel like calling on individual students in class not only creates unnecessary anxiety, it doesn’t test if the rest on the class knows or understands anything. Using Tophat (I don’t really like the program, but I paid for it, so let’s use it!) lets you see if everyone gets it or if you need to go into more depth.

I think that having a standard structure rather than having it change weekly would help. But one of the big things that I think would benefit the class would be a short list of common diagnoses and treatments for each system that we are going over. We don’t need anything crazy because we all know that we will be going into a lot of depth later, however having those really common issues (maybe along with a more serious issue or something commonly mistaken as another) gives us a basis for WHY we are doing these tests, asking these questions. For the Derm SP we were just told to “make something up” for diagnosis and treatment. While I’m glad that I won’t be marked off for getting the ddx wrong, it seems like a bad idea to get in the habit of “just making something up” as a physician, it is also diametrically opposed to what the administration has told us regarding ethic in that we need to “act like physicians now” because “ habits that start in OMS1 will continue into residency”.

Give us something that makes us feel like future doctors, I think that it will give the majority of the class drive to engage in this course, it will help us enjoy it, but most importantly, it will start developing those clinical reasoning skills that we NEED, but are severely lacking.

Doing this online is HARD, we cannot adequately learn physical exam over Zoom, and I feel like it is a disservice to everyone involved to shoehorn it in. Instead I think we should focus on getting our cognitive skills crazy sharp, make us a bunch of Sherlock’s!

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Instructions are TLDR and make it  hard understand what to do and when - please simplify

Too many downloads for each session - condense high yield stuff for that week into more useful/fewer files.

Helpful hints guides are very hard to navigate  - layout not user friendly, roundabout way to get answers.

Simple Lecture from Dr. D might be much more useful/efficient than all the pre-lecture videos - For sake of time and continuity of instruction/focus on pertinent material.

Consider TopHat or Zoom polling to engage more of the class during sessions - More engagement/less spotlighted=more learning.

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I'm going to start by saying that I love the idea that I am learning the skills to treat my future patients, something I know I will use far more often than most other things I am learning currently. More frequently though, CM&R has been causing more stress and frustration than I think is necessary.The sheer amount of prep work and documents we sift through causes quite a bit of anxiety in the sense of feeling like I'm constantly going to class ill-prepared. With how much didactic material we are responsible for knowing (a higher percentage of our grade at present), I often find that I can't focus on CM&R until the last minute, and then the instructions are often long and complicated-- to where I spend far too much time trying to figure out what is actually expected of me during class.

Solutions:
-Making a platform (either on Elentra or a website perhaps) that contains all the info per block and per week for CM&R organized in one place. Instead of having to scroll through multiple emails/files on Elentra to find information, everything would be in one universal location.
-Pre-work time being included into our class schedule if >1 hour, or at least knowing the exact amount of pre-work time that is going to be required for the next week so I can better organize my time.
-Opportunities (zoom sessions maybe?) for students to "get together" and practice skills with peers/TAs in a low stress setting-- not always in front of the entire class or on the day of our competency/SP encounter. I understand that part of our career is learning to operate well in a high stress environment, but I would personally appreciate more chances to practice and know I am learning it the right way.

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I take the SP encounters very seriously, and mentally prep for them just like any other exam. It takes time to get into the right mindset for them, and I feel like others who experience stress/nervousness with public speaking would agree that it takes a deal of energy to get ready.

Because of this, I wish that the encounters wouldn't be double booked with other courses, or have multiple classes lined up in front of them. I will often simply skip these "morning" classes just because I can't sit down and focus on learning high yield biochemistry/anatomy/ect when I know I have a speaking/test in a few hours I could be prepping for.

I feel like this sets me up to get behind on my pancakes and wish the SP encounters where scheduled like an exam/quiz. Not just thrown in the week like another extra class.

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What is 'clear' for Dr. D isn't always 'clear' for everyone else.

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What is 'clear' for Dr. D isn't always 'clear' for everyone else.

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For someone whose job it is to understand people are coming from different places, she doesn't have a lot of compassion when we point out points of confusion. I don't think something is clear if it's buried within a 100 page PDF, or a huge list on elentra. Please simplify everything and have more empathy when we express frustration.

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If you can't teach something in a virtual setting, you cannot expect us to learn something in a virtual setting.

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If you can't teach something in a virtual setting, you cannot expect us to learn something in a virtual setting.

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Her words from today regarding the physical exam were "I can't do this in a virtual setting like I normally do, so I sent you the recording from last year"

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Please stop using underscores in file names.

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Please stop using underscores in file names.

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It is not 2001. You can use capital letters and spaces in file names. It hurts my eyes.

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The amount of attached files need to be reduced.

Each weeks course has 5+ documents attached with a multi paragraph explanation of everything we need to do. It would be easier if all the information and goals of each class was more concise and organized

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I just hope Dr. D respects our time. The longest this class has ran over time was 1 hour and 40 minutes. Running over time for over 35 mins is normal for CMR. This does not happen for any other class. Could she respect our time a little bit more going forward? 

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I just hope Dr. D respects our time. The longest this class has ran over time was 1 hour and 40 minutes. Running over time for over 35 mins is normal for CMR. This does not happen for any other class. Could she respect our time a little bit more going forward? 

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I know that part of our medical education is learning to be adaptable, to triage, and to understand that we can't always know everything and to do the best we can, but we get a lot of prep work that I know lots of us feel is busy work. It would be really great to know more about the reasoning Dr. D has in having us do all of these videos. We have a short amount of time, and I would be more amenable to the amount of prep work for CM&R if we could have a better idea of the lessons we are supposed to get out of it. I appreciated Dr. D today telling us that there were in fact reasons why she was doing what we are doing, but could we also know what these reasons are? It always feels like everything is so unclear by the shear amount of material we have to take in that seems kind of unnecessary. Even today, the document she gave us for Upper/Lower extremity she ordered things in the examinations (I'm looking at you, palpation) that when I read them I figured I should do first, but then in lecture she said you'd want to do that last or towards the end. I also still don't totally understand what is happening today. Having 7 documents that you have to flip back and fourth through for one class (plus the three from earlier) is not clear. While this won't help us, maybe she should make a text book for next year (I'm actually serious)? She's putting in a ton of work into the course, and perhaps if this was a normal year and it was easier to have conversations with each other to clarify our understanding that could help, but I feel like with the online format we really need to have a clear and concise understanding of what we are supposed to be doing each week in order to be successful.

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Too many documents, too much prep work, too many different places with different information. 

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Too many documents, too much prep work, too many different places with different information. 

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There are way too many documents involved in this course. It is VERY difficult to sift through the 8-12 documents posted for each lecture to figure out what is being asked of us, and what information we need to know.

There is far too much prep work (as has been mentioned by many people). Between the lectures, videos, and class, we are hearing the same information three times, which is not needed. That repetition feels like a waste of time rather than a learning tool. Honestly a traditional lecture would be a much better format for class, as opposed to the "flipped session" style.

Also, information is posted in many locations (helpful hints, Elentra, email) and that just doesn't need to be the case.

Overall, simplify the structure!

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It is dangerous and inappropriate to be teaching physical exam skills virtually. 

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It is dangerous and inappropriate to be teaching physical exam skills virtually. 

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I have had to straight memorize everything for CM&R so far. I have absolutely zero understanding of the skills because I cannot understand them via zoom. Even if I practice on family and friends, there is no one to correct my errors and it is going to cause me to have a harder time re-learning everything the proper way when we do return to in person instruction. I know COMP-NW prides itself on clinical skills, but this is a potentially dangerous waste of our time currently. Dr. D says "Practice perfect makes perfect". Currently I have no way to practice perfectly, and am instead learning incorrect information that will lead to more confusion later.

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If this class can't be properly taught in a virtual manner, then it needs to be postponed to when we are back on campus. I am tired of going to a class where the professor doesn't even teach. Like it's your job! Teach!

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CM&R pre-recorded videos should be counted as instruction time.

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CM&R pre-recorded videos should be counted as instruction time.

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If you have 1 hour live + 4 hours assigned, that is 5 hours of instruction time for that week. Not 1 hour of instruction.

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Stop giving us so much busy work before class since we are already so busy. Actually teach us in class and not calling on students randomly for stuff no one has a clue about. Send out stuff in a timely manner and not the night before or few days before. Actually explain what’s happening to us all instead of making us ask questions at the end to get a clue what’s going on.

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I'm nervous that the school will assume that we all are competent in the physical exam skills that we learned via zoom... i certainly have not been practicing my otoscope, percussing, blood pressure, etc. because I don't really know what I'm doing and don't want to have to teach myself!

It is nice when virtual CMR focuses more on SP encounter strategy, roleplaying, larger concepts, but i DON'T think it's a way to learn physical skills.

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Every encounter feels so artificial that I know I am getting very little out of it.

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Every encounter feels so artificial that I know I am getting very little out of it.

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I need to - want to - repeat CMR "for real" with real people in-person. CMR right now is time taken away from didactic learning, which is more feasible in this virtual world.

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Emails detailing what we need to prep for upcoming classes are sent out wayyyy toooo lateeee!!!

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Emails detailing what we need to prep for upcoming classes are sent out wayyyy toooo lateeee!!!

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Seriously, it is one thing that they expect us to prep/watch a tons of vids every week before class, however, the fact that they let us know about the things we need to do is way too late. For instance, next week CMR prep is gonna be a lot, prepping cases, learning how to do all of the PE for each parts of the MSK, and yet they only let us know that yesterday and expect we get it done over the weekend. Many of us plan out our study schedule and spread it out over days to avoid burnout. This is just cruel. At least let us know a week beforehand!

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Would appreciate receiving feedback about SOAP notes and encounters and to not be receiving the scores for things done at the beginning of the block when we have already finished the block.

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Would appreciate receiving feedback about SOAP notes and encounters and to not be receiving the scores for things done at the beginning of the block when we have already finished the block.

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Other than the excessive amount of prework and lack of timely feedback, I don't have any other problems with the course. It feels like we're just going through the motions of a patient encounter, but I think that's the point right now. I appreciate that we aren't graded on a correct diagnosis during the patient encounter.

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Making the content of assignments clearer - and distributing that information at a time when both Groups A and B can digest it - would be  really helpful.

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Making the content of assignments clearer - and distributing that information at a time when both Groups A and B can digest it - would be  really helpful.

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I understand telemedicine is, and certainly will continue to be, extremely important in the 21rst Century. 

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I understand telemedicine is, and certainly will continue to be, extremely important in the 21rst Century. 

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That being said, as first years, with no foundation for how patient encounters are supposed to go, practicing in an exclusively virtual setting is not productive. Because I do not understand the assignments, I feel like I am reciting checklists and buzzwords.

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Giving us up to 4 hours of prep videos is unreasonable, and saying that you can just watch them at 2x speed seems inconsiderate to the students and the workload we have to deal with each week.

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I do not see the point of giving us hours and hours of prep videos, just to go over it again in class. As soon as I see the same PowerPoint in class as what I just spent hours watching pre videos on It makes me feel like I just wasted  multiple hours of valuable time and I immediately check out mentally during class.

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I have asked Dr. D questions in class and she responds with "I will dig it up and get back to you" this has never happened. Additionally when I send her emails, she never responds. I don't understand how we can learn if we can't get questions answers. Also, when bringing up test questions. she adds in comments on how most people got that question right. I find this extremely derogatory. A solution to this is to get back to students, and maybe not make comments on how everyone else did well on a certain test question.

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No more streaming YouTube videos over Zoom, please. My internet isn't even that bad, but the quality of streaming is awful. Maybe we could do something like if there's a 15 minute video she wants us to watch, like the TEDtalk, we could start watching it at 1:00pm on our own, then come in to class at 1:15pm sharp to talk about it so it doesn't cut into our study time or other classes. 

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No more streaming YouTube videos over Zoom, please. My internet isn't even that bad, but the quality of streaming is awful. Maybe we could do something like if there's a 15 minute video she wants us to watch, like the TEDtalk, we could start watching it at 1:00pm on our own, then come in to class at 1:15pm sharp to talk about it so it doesn't cut into our study time or other classes. 

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I think that the instructions for this course are VERY confusing. The TAs are lost, my classmates are lost and I am lost. Why are our instructions found in this goofy Word document or PDF? Why are the videos in a different place than the other classes? Please make this class more similar to the other classes with the information for each assignment posted clearly on Elantra. Please help the TAs figure out what we are supposed to be doing so that we all aren't lost at the same time. Thanks for coming to my Ted talk.

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It would be really helpful to have smaller groups work with TAs/faculty. It’s really hard to be interactive via zoom with more than 4-5 people because people talk over each other or they don’t want to participate because it doesn’t feel like they’re being seen. 

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It would be really helpful to have smaller groups work with TAs/faculty. It’s really hard to be interactive via zoom with more than 4-5 people because people talk over each other or they don’t want to participate because it doesn’t feel like they’re being seen. 

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"Lost" is the perfect word. CMR has not been about "learning how to be a doctor." For me, it has been, "wait. what are we supposed to be doing?" and crying over the technology. By the time an encounter starts, I am emotionally and intellectually checked out because it is the only way I can talk without sobbing on camera. I have never felt like I have gotten anything out of CMR, this is despite the first couple of weeks of me determinedly staying positive, preparing as much as I could, and practicing with classmates in-person and on Zoom. 

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"Lost" is the perfect word. CMR has not been about "learning how to be a doctor." For me, it has been, "wait. what are we supposed to be doing?" and crying over the technology. By the time an encounter starts, I am emotionally and intellectually checked out because it is the only way I can talk without sobbing on camera. I have never felt like I have gotten anything out of CMR, this is despite the first couple of weeks of me determinedly staying positive, preparing as much as I could, and practicing with classmates in-person and on Zoom. 

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It would have been really helpful to have a TA/Prof give us feedback on how we were doing before actually SP encounters. I missed a couple points because of a mistake I’d been making consistently but my peers didn’t have enough information to correct. 

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It would have been really helpful to have a TA/Prof give us feedback on how we were doing before actually SP encounters. I missed a couple points because of a mistake I’d been making consistently but my peers didn’t have enough information to correct. 

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1st thought: I really appreciate Dr. D's passion and desire to make us into excellent clinicians. I realize that we need to be well-rounded doctors with the utmost concern for our patient's entire well-being. However, at this point, I think we are all simply concerned about getting through med school. I don't have the brain cells or the time to think about the physical exam being a sacred ritual between doctor and patient: While I believe that fact is 100% true, and while I hope to realize that when caring for each of my patients someday, I can't think about that right now. My primary concern is figuring out what I'm supposed to be doing in order to pass. If I don't pass, I will never have the opportunity to exercise that sacred ritual with my patients.

2nd thought:
I think CM&R is the type of class that you have to learn by doing - actually doing, hands on, in person. Maybe CM&R could be saved for when we're back on campus? Learning this over Zoom has been extremely difficult. It is one thing to have years of experience in patient interactions and then switch to virtual; it is a very different thing to be learning this from the ground up in a virtual environment. I thought of the example of learning to ride a horse over Zoom: Yes it could probably be done. But would I really know what to do when someday I went to a stable and saw an actual horse? I feel the same way with this class. When I finally see my first patient, whether that's an SP on campus or during clinicals in 3rd year, will I really know what to do? I have practiced with the equipment at home, but how do I know I'm doing it correctly? I write SOAP notes - but if I don't get feedback on them, how do I know how to improve them? I am concerned that we are missing out on so much by doing this class virtually, and I fear our OSCEs will suffer because of it.

3rd thought: I would appreciate 1-2 practice SP encounters / SOAP notes per block, after which I can get feedback to improve. Like other students have mentioned: How do I know that what I'm practicing at home is correct? I especially feel lost when it comes to the SOAP note - I get a grade, but what did I do wrong that I should avoid next time?

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I would like to actually learn about different diagnoses and symptoms. Have a cheat sheet of them just to connect it better to the SP encounters. Rather than just make up something for the sake of making something up.

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I would like to actually learn about different diagnoses and symptoms. Have a cheat sheet of them just to connect it better to the SP encounters. Rather than just make up something for the sake of making something up.

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I feel like often, we’re expected to do an insane amount of prep, just to go over it again in class. I would prefer to get it once and then just study on my own as needed

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I feel like often, we’re expected to do an insane amount of prep, just to go over it again in class. I would prefer to get it once and then just study on my own as needed

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The amount of prerecordings is very unreasonable.  

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The amount of prerecordings is very unreasonable.  

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I feel that sometimes we are expected to complete SP encounters/OSCEs without actually being really taught why we are asking the specific questions and how that is helpful in an encounter. Perhaps restructuring class time to be more teaching in that sense rather than just letting us loose with TAs who are equally as confused?

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I feel that sometimes we are expected to complete SP encounters/OSCEs without actually being really taught why we are asking the specific questions and how that is helpful in an encounter. Perhaps restructuring class time to be more teaching in that sense rather than just letting us loose with TAs who are equally as confused?

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I feel that CM&R does not have to be mandatory

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I feel that CM&R does not have to be mandatory