Pre-Clinical Elective Submission Form (for New Electives)

Pre-Clinical Elective Submission Form (for New Electives)

This form is for Non‐Clinical Foundational Courses taken during a BCM Student’s pre‐clinical years.

Elective Course Name - primary*

NON‐CLINICAL ‐ FOUNDATIONS

NEW ELECTIVES: To be considered, each elective must be adequately described in writing & suitable supplementary documentation provided. Please review the institutional Core Competency Graduation Goals

to show how your course will help achieve the students Graduation Goals & Objectives. Please also review the Electives Course Catalog. If a similar elective exists, please describe how your proposed elective is unique and different from an existing elective. Please complete all the details below Sections A & B.

ELECTIVE CRITERIA: Please consult the criteria for electives before completing the form.

Please return all completed forms to: electives@bcm.edu

This form has been reviewed by the DLEO.*

Before completing this form, all changes must be approved by the DLEO. Confirm DLEO review by checking the box below.

SECTION A

Sponsoring Department*

Select

Elective Offering Location*

Please indicate which campus you plan to offer this elective.

Select

Elective Course Name*

Elective Director*

I.E. Faculty in charge of elective

BCM ID*

Elective Director BCM I.D.

Teaching Faculty & BCM ID*

I.E. John Smith (123456)

BCM Elective Director Qualifications*

Course Level

I.E. MD, Master's Program, PhD

Requirements for Consideration

Must include Board Certification if applicable.

In addition, include if applicable:

Earned Doctorate/Terminal Degree in Teaching Discipline or Related Discipline AND/OR Relevant Research/Scholarship Experience

Administrative Contact*

Administrative Contact's Phone*

Administrative Contact's Email*

Administrative Contact Interoffice Mail Code or Physical Address*

Will this course be active in AY2024-2025?*

Select

Start Term(s) of elective*

Select

Continue over multiple terms?

Select

If this course will continue over multiple terms, indicate the starting term and ending term

I.E. Begins in Term I and Ends in Term III

Day(s) of the Week

Select

Location*

If a location will be secured at a later date please notify the Office of the Registrar so that we can share the information with students.

Time (s)*

I.E. 12 pm - 1 pm

Meeting Dates*

I.E. MM/DD

Minimum number of students allowed to enroll in this elective.*

Maximum number of students allowed to enroll in this elective.*

Recommended Credits*

16 hours of Course Instruction = 1 Credit; 0.5 Min

Blackboard Course Set-up

If Blackboard assistance is needed, please contact Billy McKinney (wwmckinn@bcm.edu)

Select

Please describe the hours required for credit allotment in the table below:*

Hours

I.E. 20 Hours

Description of Activities

I.E. Lecture Title/Class Time

Course Description*

Upload additional page(s) as required.

Goals & Objectives of Course*

Each objective must be mapped to the BCM Institutional Core Competency Graduation Goals

Objective; Relevant CCGG; Assessment Method

I.E. Objective: Student will describe algorithms of ACLS; CCGG: 2.6; Assessment Method: Oral Exam

Grading Rubric*

Please indicate how the grade will be comprised. Research & Foundation Courses are graded Pass/Fail. If using any method aside from attendance only (verbal presentation, writing assignment, etc.) include the grading rubric used to assess it.

I.E. Attendance 70%, Writing Assignment 30%

Section B

Learning Activities*

Please attach schedule of daily activities this should include scheduled lectures/seminars, self‐directed learning time, etc.

Justification/Need for this New Elective*

Please provide needs assessment data, if done.

Resources Needed*

Please list the resources needed for this elective.

I.E. Room/Space, Equipment (AV, computers, etc.), Supplies, Fees, SIM Lab or equipment, Standardized Patient utilization, etc.

Elective Content Area*

Please indicate the content area for your elective. This will assist with elective counseling by Learning Community Advisors.

Check all that apply.

Select

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