Syllabus - EP713 Introduction to Epidemiology

EP713 Syllabus - Fall 2015

Note: We are continually trying to improve the accessibility and usability of our learning modules. Please forward comments and suggestions to wlamorte@bu.edu.

Link to Syllabus Contents

 NOTE: The A1 section will meet in room L-112 in the instructional building, Most class meetings are on Mondays from 8:00-10:30 AM, except as noted on the course schedule.

Instructor:

Wayne W. LaMorte, M.D., Ph.D., M.P.H.

Professor of Epidemiology,

Talbot 422, East wing

Office phone: (617) 638-5073      

e-mail: wlamorte@bu.edu

Teaching Assistants:

Tali Cassidy cassidyt@bu.edu Students with last name A through Mc

Kaylie Patrick kap92@bu.edu Students with last name Mi through Z 

Course Objectives, Goals, and Structure

Course Objectives

Epidemiology is a discipline that identifies the determinants of defects, disease and injury in human populations and provides a means of assessing the magnitude of public health problems and the success of interventions designed to control them. Epidemiology is universally regarded as a discipline that is essential for understanding and solving public health problems, regardless one's area of concentration or specialization. The Council on Education for Public Health (CEPH) states that, "A professional degree is one that, based on its learning objectives and types of positions its graduates pursue, prepares students with a broad mastery of the subject matter and methods necessary in a field of practice; it typically requires students to develop the capacity to organize, analyze, interpret and communicate knowledge in an applied manner. " Accordingly, BUSPH has enumerated specific competencies in epidemiology based on the competencies identified by The Association of Schools of Public Health (ASPH). All MPH graduates are expected to mastered these competencies regardless of their area of concentration.

Course Goals

1. To introduce the basic principles and methods of epidemiology and demonstrate their broad applicability to public health.
2. To provide fundamental skills needed to interpret and critically evaluate literature relevant to public health professionals.
3. To provide a structured method for organizing and analyzing raw data and to enable you to interpret and communicate the results to public health professionals and to the general public.

In addition, each module has specific learning objectives that explicitly state the concepts and skills you will be expected to master. Achievement of these learning objectives is essential not only for successful completion of the course, but also for you to function effectively as a public health professional.

Course Structure

The course is designed with a mixed format that includes lectures, homework assignments, independent learning exercises, and in-class problems and discussion. The lecture segments are designed to establish a foundation for concepts, principles and skills. Homework assignments provide opportunities for active learning that are essential to mastery. Several topics will be covered not by lectures, but by independent learning exercises in which fundamental content is provided by the online modules, by the textbook, and by other readings, and structured exercises will provide opportunities for active learning and discussion. Attendance is required for all classes; you are responsible for all material presented in class.

Course Components

Since students differ in their preferred learning style. Many are visual learners, but others prefer textbooks or lectures, and some prefer to learn through solving real problems. Probably most of us rely on a combination of learning styles. In recognition of this I have tried to present course materials in several ways that emphasize different learning styles. While the actual classes would best be described as lectures, they incorporate a variety of techniques including visualization of concepts, in-class problems, small and large group discussion. I have designed the class to combine clear explanations of key concepts with opportunities for active learning and mastery of skills. I would strongly encourage you to attend classes.

• The course learning modules are interactive web pages that provide a fairly concise presentation of most of the essential concepts, principles, and skills. Some of the modules are still under construction.
• The recommended textbook is "Essentials of Epidemiology in Public Health" by Ann Aschengrau and George Seage. This is a widely respected textbook that is used in many schools of public health. It provides a more rigorous discussion of the concepts that are introduced in class and in the online modules. It is also a good general reference for epidemiology, and it makes a good addition to the library of anyone interested in public health. I strongly suggest using the online modules as your first means of engaging the material. You may want to use the textbook to supplement your learning or to clarify any points that are not clear from the online modules or from class activities. Note: The 1st and 2nd editions of this text are essentially identical; the third edition has some new material. However, editions 1 and 2 will be fine, and I would suggest looking online at Amazon.com or other vendors who may have used copies which may be cheaper.
• Assigned Journal Articles: Some classes also have assigned journal articles. The primary purpose of the journal articles is to provide insights about the details of how epidemiologic studies are conducted. Therefore, you should pay particular attention to the abstract, the introduction, and the methods sections of these articles. You should also take note of the presentation of results that are relevant to course learning objectives (e.g., interpretation of odds ratios, relative risks, confidence intervals, p-values, etc.). You are not expected to memorize any of the results presented. The links to these assigned readings can be found in the Assignments section of Learn.bu.edu for EP713.
• Http://Learn.bu.edu: All students are required to obtain a Boston University e-mail account and password in order to be able to access the Blackboard web site. The web site will enable students to check announcements, get links to all assigned readings, view lecture slides, watch video reviews of the lecture material, and take online quizzes.
• PowerPoint Slides: You are certainly not expected to print the PowerPoint slides. However, if you choose to do so, there is a specific method that will ensure optimal readability. Open the PowerPoint file that you want to print. From the toolbar at the top click on "File", "Print". When the Print window opens, indicate that you want to print "handouts", and choose 4 or 6 per page. Make sure that you select "Pure Black and White" in the lower left corner of the dialog box, otherwise the slides will be unreadable.
• Video Reviews: Online video summaries of the lectures are also available. These are currently available in QuickTime (.MOV) format, so they can be viewed on PCs, Macs, iPhones, and iPads. These are abridged versions of the lectures that are narrated by the instructor using illustrations similar to those used in class. While these are convenient reviews, they are not adequate substitutes for attending class.
• Epi_Tools.XLS: Epi_Tools is an application that I created specifically for my students. It is an Excel application consisting of a series of worksheets that make it easy to analyze epidemiologic data. (Note that it is NOT the same thing as EpiInfo, which is a CDC application). My Epi_Tools.XLS application is posted in Course Documents on Blackboard, but you must download the file in order to use it. You can download it by right-clicking on the link, or you can open the file from Blackboard and then selecting "File", then "Save as" and then saving it someplace on the computer you are using. If you try to use the file that is housed on the Blackboard site, you will get an error message, because you do not have "write access" to the server. The work sheets in Epi_Tools have a lot of calculations programmed into them that take the tedium out of analysis. I have "locked" most of the cells on the worksheets so that you don't inadvertently erase the formulas or change them. Therefore, the only cells you can enter numbers into are the bluish-green cells, such as the four cells in the 2x2 tables for cohort studies and case-control studies. You can change the numbers in the 2x2 tables, and then, if you click on any cell outside the 2x2 table, the program will automatically complete the calculations for you.

Graded Homework Assignments

I. Pre-Class Quizzes

You are expected to read the online, interactive web pages before you come to class in order to decrease the amount of "content delivery" by straight lecture. This makes it possible to utilize classroom time for more active learning that will include problems and discussions. To achieve this it is essential that you work through each online module before the corresponding class. In order to encourage you to do this, there is a short "pre-class quiz" each week consisting of five questions. These are "open-book" quizzes that generally consist of five questions that can be answered by thoughtfully reading the module. You are expected to complete these on your own. The pre-class quizzes may be taken only once and they must be submitted before the class that discusses that topic.

II. Post-Class Quizzes

Homework is intended to reinforce concepts, to identify misconceptions, and to provide practice questions that are very similar to what will be found in the exams, although you will be expected to show your calculations on exams, and exams will also include open-ended questions (e.g. List four advantages of cohort studies). Unlike the pre-class quizzes, the post-class quiz questions are randomly drawn from a pool of questions on a given topic. When you begin a post-class quiz on a given topic, Blackboard randomly selects 10 questions from the pool of questions on that topic. The post-class quizzes are also "open-book", and the are not timed, but you should complete them in a timely manner so that the system doesn't suspend or "time-out" on you. You are expected to work through the post-class quizzes on your own. However, if you are having difficulty with a question, you may ask the instructor or the Teaching Assistants for help on the related topic, but not  the answers to specific quiz problems. You must complete and submit the post-class quiz for a given topic at least once during the week following the class discussion of that topic and before the next class. However, unlike the pre-class quizzes, the post-class quizzes may be taken as many times as you like; each time you take a quiz, Blackboard will randomly select 10 questions from the relevant question pool . The last score achieved on a post-class quiz will be used to compute your semester quiz grade.

NOTE: Approximately 20-25% of the questions on the midterm and final exams will be taken from the post-class quiz pools. Therefore, it may be to your advantage to take a given quiz again even after achieving a good score. This strategy would enable you to see more of the questions that will appear on the exams, and it will give you additional practice. There is little down-side to this, because if you get a lower score, you can always take it again until you get a high score.

Reviewing past quizzes and feedback:

After your quizzes have been submitted and graded, you can still review them to see what you got wrong and what the feedback was. To review, go to Blackboard.bu.edu to the "Tools" section, and click on "Check Your Grade". You should see a table that summarizes all of your quizzes and test grades. (Ignore the total score; this is meaningless.) To review a quiz click on the score for that quiz, and you should be able to see how you answered, what the correct answer was, and what the feedback was (if any).   

III. Pass/Fail Data Analysis Assignments

You are required to complete two analyses of raw data sets:

1. Effect of Low HDL Cholesterol (HDLC) on Coronary Heart Disease in the Framingham Heart Study. (A prospective cohort study)
2. Effect of Smoking on the Need for Femoral Artery Bypass Surgery (A case-control study)

For each of these assignments there is a folder posted in the Assignments section of Blackboard. The respective folders contain:

1. A video on how to conduct the raw data analysis using Excel. The video is very detailed and walks you through the steps.
2. A detailed set of instructions regarding what you are required to submit.
3. The raw data set in an Excel file.

You are required to complete these assignments independently, i.e. you must do the analysis yourself. For each analysis, watch the video (which will walk you through how to do the analysis); then conduct the analysis, and summarize your findings as described in the detailed instructions. Use a second Worksheet in the raw data file that you analyzed to paste your analysis from EpiTools.XLS and your interpretation of the analysis. When you are done, save your Excel file using your name in the file name, e.g., Myfirst-Mylast-analysis1.XLS and send it to your to your teaching assistant as an email attachment. NOTE: Do NOT send a ZIP file.

This is a required Pass/Fail assignment. If you have questions about how to conduct the analysis, you may ask your TA or the instructor for help.

If your analysis is incorrect, you will be notified by your TA, and you will be given an opportunity to correct any mistakes. Nevertheless, each student must successfully complete this assignment in order to demonstrate mastery of this skill. If you do not successfully complete both pass/fail assignments, you will receive a grade of "Incomplete" for the course.

Questions and Help

If you have questions or don't understand something, please ask. You may interrupt and ask questions at any time during class. I have also reserved the classroom for the hour before class as a help session. I will generally arrive at class an hour early for extra help and to answer questions, and I will be happy to stay after class as well. You may also call my direct office phone line at any time, and you may also email questions to me. I check my email frequently, and I will generally answer email questions promptly. You may also arrange to meet with me for additional help. I do not have fixed office hours, because your schedules are so varied. However, feel free to email to set up a meeting for additional help. Again, if you are struggling with something, please ask promptly.

Tutoring Service for MPH Candidates

There is a free tutoring service for MPH students taking core courses. If you are struggling with the course, you should ask for help early and often, and utilize all of the many resources, including the Teaching Assistant, the instructor, and the tutoring service. The tutoring service can be contacted at sphtutor@bu.edu. If you are struggling with the course, ask the instructor to refer you to the tutoring service.

Exams and Semester Grades

Semester grades will be based on the following:

• Pre-class quiz average- 10% of semester grade
• Post-class quiz average - 30% of semester grade
• An in-class midterm exam (closed-book) - 30% of semester grade
• An in-class final [closed book] - (30%) of semester grade

Additional Notes:

• The midterm exam and the final exams will be "closed book," i.e. you may not use any books or notes. You may use a non-programmable calculator during the exams if you wish.
• The final exam will be cumulative (i.e., it may include questions from any part of the course. However, the final exam will focus mainly on material covered after the midterm exam.

Computation of Semester Average

The grades entered into the online grade book in Blackboard will be downloaded into an Excel spreadsheet, and a formula reflecting the weights outlined above will be used to compute the overall semester average for each student. This average will be rounded off to two decimal places, and letter grades will be assigned according to the table below. Also note that grades of "A" or "A-"are generally earned by less than half of the class.

Minimum Grades

EP713 has a minimum grade requirement of:

• B- for all MPH degree candidates;
• B for MS degree candidates in Environmental Health, Epidemiology, and Health Services Research; and
• B for PhD degree candidates in Environmental Health and Health Services Research.

If you feel you are in danger of failing to meet the minimum grade requirement for your program as you progress through the course, please speak to the instructor about resources that might be available to you, including the free core course tutoring program for MPH students. 

At the conclusion of the semester, students with extenuating circumstances that prevented them from meeting the required minimum grade may contact the instructor to request an opportunity to remediate a specific portion of the course in order to demonstrate mastery of material on an additional final exam.  The additional final exam must be completed prior to the start of the next semester.  This remediation option applies only to EP713, and the vast majority of student with grades below the minimum requirement will not be allowed this remediation option.  The decision regarding whether the student will be allowed this option is entirely at the discretion of the instructor.

Students who fail to achieve the minimum grade requirement for their degree program at the conclusion of the course must retake the course in the next semester it is offered and should contact the Registrar's Office not more than 14 days after the final class to arrange the retake.

See also:

• The Policy on Incomplete Grades
• The University Refund Policy
• The Policy on Grade Changes

Attendance and Classroom Environment

You are expected to attend all classes. I have tried to present the course content in a variety of formats to suit several learning styles; nevertheless, classroom activities are an important component of the course. Experience has shown that students who attend classes regularly tend to achieve high grades, while students who attend irregularly do not.

I expect the classes to provide an atmosphere of mutual respect. All of us should be able to express our ideas and views even when they conflict. All of us should listen respectfully. This requires that side conversations unrelated to classroom activities should take place before or after class. In addition, cell phones should not be used in the classroom. If you have an emergency and must use your cell phone, please leave the classroom.

Use of Laptops, Tablets, iPads, Smart Phones, and Other Electronic Devices in Class

I regard the classroom as a sanctuary for thoughtful discussion of concepts, ideas, and problems related to public health. A key element of this discussion is mutual respect among students and instructors. Laptops and other devices connecting to the Internet are allowed in my classroom (but not during exams) provided they are used only to enhance the teaching environment. By this, I mean that students are encouraged to utilize course materials, to take notes, and to research relevant topics on the Internet. However, these devices may not be used for purposes unrelated to this class; emailing, use of social media, playing computer games, and other uses unrelated to the course are not allowed. These practices are disrespectful to me and to other students, and they are distracting and disruptive. Many students have complained about this to me. Therefore, these trivial uses that are unrelated to course activities are not allowed. If you absolutely must use Facebook or play computer games when the class is in session, then don't come to class. If you engage in these unauthorized uses during class, you will be asked to leave.

Course Schedule - Assignments, Classes, and Exams

Learning Objectives by Topic Area

History of Epidemiology

After successfully completing this unit, the student will be able to:

• Define epidemiology
• Describe the history of epidemiology and its current role in medicine and public health

Descriptive and Scientific/Analytic Epidemiology

After successfully completing this unit, the student will be able to:        

• Describe the difference between descriptive and scientific/analytic epidemiologic studies in terms of information/evidence provided for medicine and public health
• Explain the role of descriptive studies for identifying problems and establishing hypotheses, including their use during acute disease outbreaks
• Identify whether a particular study is descriptive or scientific/analytic
• Identify case reports and case series and explain their uses and their limitations

Cross-sectional studies

After successfully completing this unit, the student will be able to:

• Describe and explain the distinguishing features of a cross-sectional study
• Describe  and identify the types of epidemiologic questions that can be addressed by cross-sectional studies
• Identify the potential strengths and limitations of cross-sectional studies

Ecologic studies

After successfully completing this unit, the student will be able to:

• Describe and explain the distinguishing features of an ecologic study
• Explain the concept of "ecologic fallacy" both in general, and in the context of a study Identify the potential strengths and limitations of an ecologic study

Measures of Disease Frequency

After successfully completing this unit, the student will be able to:

• Define study population, and explain the difference between fixed and dynamic populations
• Explain what is meant by the term "at risk"
• Define and explain the differences between proportion, ratio, and rate
• Define and calculate prevalence, and distinguish between point prevalence and period prevalence  
• Explain what is meant by "person-years of observation" and calculate the number of person-years of observation from epidemiologic data
• Define and calculate cumulative incidence and incidence rate
• Explain the mathematical relationship between prevalence and incidence rate (P=IRxD)
• Explain the mathematical relationship between cumulative incidence and incidence rate (CI=IRxT)
• Define and calculate the following special types of incidence: morbidity rate, mortality rate, attack rate, case-fatality rate, live birth rate, and infant mortality rate
• Be able to define the following special types of prevalence: autopsy rate, birth defect rate  

Measures of Association

After successfully completing this unit, the student will be able to:

• Construct a 2x2 table for summarizing epidemiologic data
• Explain how to compare the prevalence or incidence of illness in 2 or more groups
• Define "reference group" and identify the appropriate reference group from a study with a dichotomous exposure, or from a study with more than 2 exposure categories  Explain the importance of using explicit definitions of exposed and unexposed groups, and diseased and non-diseased groups in all types of epidemiologic studies
• Define, calculate, and interpret the following measures of association:  

–   Cumulative incidence ratio

–   Cumulative incidence difference

–   Incidence rate ratio

–   Incidence rate difference

• Define, calculate, and interpret the following measures: 

–   Attributable proportion/fraction

–   Population attributable proportion/fraction

•  Discuss the differences between absolute and relative differences measures and when they are most appropriate (absolute: prognostic research, decision making pertaining to risk; relative: etiologic research)

Random Error

After successfully completing this unit, the student will be able to:

• Explain the effects of sample size on the precision of an estimate
• Define and interpret 95% confidence intervals for measures of frequency and association
• Define and interpret p-values
• Discuss common mistakes in the interpretation of measures of random error

Research Ethics [OPTIONAL]

NOTE: This unit will be completed as an independent learning module supplemented by an online discussion of a controversy dealing with research ethics, followed by a directed in-class discussion.

After successfully completing this unit, the student will be able to:

• List and discuss the Belmont Principles
• Define what "human research" is and how to identify it
• Define "equipoise" and discuss its relevance to decisions about whether clinical trials are ethical
• Explain what is meant by "informed consent"
• Describe the composition responsibilities of a Data Safety and Monitoring Board

Intervention Studies (Experimental Studies, Clinical Trials)

After successfully completing this unit, the student will be able to:

• Describe  and identify the types of epidemiologic questions that can be addressed by experimental studies
• Explain the distinguishing features of an intervention study
• Differentiate between preventive, therapeutic, individual and community RCTs
• Explain why randomization is used
• Explain how to determine whether randomization has been successful
• Define "blinding" and explain its purpose
• Define "placebo" and explain why placebos are used
• Identify situations where use of a placebo is not appropriate, and discuss alternatives
• Explain what the placebo effect is
• Explain why it is important to maintain high rates of follow-up in an intervention study (i.e., selection bias)
• Explain why compliance is important in an intervention study, and describe the effects of non-compliance (i.e., exposure misclassification)
• Define and distinguish between an intent-to-treat analysis and an efficacy analysis
• Estimate and interpret measures of association from intervention studies
• Discuss the potential strengths and limitations of interventions studies

Cohort Studies

After successfully completing this unit, the student will be able to:

• Define and explain the distinguishing features of a cohort study
• Describe  and identify the types of epidemiologic questions that can be addressed by cohort studies
• Define and distinguish among prospective and retrospective cohort studies using the investigator as the point of reference  
• Distinguish between general and specific cohorts
• Explain the differences between an internal and external reference group, and explain the potential problems of using an external reference group
• Explain what the "healthy worker effect" is (a form of selection bias)
• Define "loss to follow-up" and explain how it can result in selection bias and/or loss of precision
• Estimate and interpret measures of association from cohort studies
• Identify the potential strengths and limitations of cohort studies

Case-control studies

After successfully completing this unit, the student will be able to:

• Define and explain the distinguishing features of a case-control study
• Describe  and identify the types of epidemiologic questions that can be addressed by case-control studies
• Define what is meant by the term "source population"
• Describe the purpose of controls in a case-control study
• Describe differences of hospital-based and population-based case-control studies
• Describe the principles of valid control selection
• Review the importance of using specific diagnostic criteria and explicit case definitions in case-control studies
• Estimate and interpret odds ratio from a case-control study
• Identify the potential strengths and limitations of case-control studies

Bias

After successfully completing this unit, the student will be able to:

• Define bias (systematic error) and differentiate between the three types of bias:  selection bias, misclassification/information bias, and confounding bias
• Define and identify selection bias
• Define and identify non-differential misclassification of disease and exposure
• Define and identify differential misclassification of exposure in a case-control study (recall bias)
• Identify the effect that a particular bias can have on a particular study Identify which types of studies are prone to which types of bias
• Identify common sources of bias

Confounding

After successfully completing this unit, the student will be able to:

• Describe the three properties of a confounder (associated with exposure, independently associated with outcome, not in causal pathway)
• Define and identify confounding
• Identify three ways to control confounding in the design phase of a study (matching, restriction, randomization), and identify the strengths and weaknesses of each approach
• Describe three ways to control for confounding in the analysis phase of a study (standardization, Mantel-Haenszel, regression)
• Explain and calculate crude, stratum-specific, and adjusted measures of association
• Compare crude and adjusted measures of association to identify whether confounding is present [(crude-adjusted)/crude]; characterize the direction and magnitude of confounding
• Describe residual confounding and identify possible sources
• Calculate an adjusted rate of disease or death using standardization and interpret the findings in words

Effect Measure Modification

After successfully completing this unit, the student will be able to:

• Describe what effect measure modification is
• Perform a stratified analysis to identify whether effect modification is present

Screening for Disease

After successfully completing this unit, the student will be able to:

• Identify which types of diseases are appropriate for screening
• List the characteristics of a good screening test
• Define what is meant by the reliability of a screening test, and list the factors that influence reliability
• Define "detectable pre-clinical phase" of disease
• Define, calculate, and interpret the sensitivity, specificity, positive predictive value and negative predictive value of a screening test
• Explain how increasing or decreasing the cut-off value used to identify an abnormal test result influences sensitivity and specificity of the screening test
• Explain how predictive value is influenced by prevalence of disease
• Explain what is meant by "lead time bias"
• Explain what is meant by "length time bias"
• Discuss the potential harms of screening

Causal Inference

After successfully completing this unit, the student will be able to:

• Define the terms "cause" and "causal inference"
• Distinguish between association and causation
• Describe the sufficient-component cause model
• Describe Hill's criteria for causality, and the limitations of these criteria
• Discuss bias as an alternative to causality
• Describe the assessment of causal evidence by the scientific community
• Discuss in general the difference in the weight of evidence needed for asserting  causality compared with the weight of evidence needed to take public health action

Academic Policies

BUSPH Policy on Academic Misconduct

Academic misconduct is any intentional act or omission by a student which misrepresents his or her academic achievements, or attempts to misrepresent these achievements. While not an exhaustive list, the following acts constitute academic misconduct:

• Cheating on examinations. The use or attempted use of any unauthorized books, notes or other materials in order to enhance the student's performance in the examination, copying or attempting to copy from another student's examination, permitting another student to copy from an examination or otherwise assisting another student during an examination, or any other violation of the examination's stated or commonly understood ground rules.
• Plagiarism. Any representation of the work of another person as one's own constitutes plagiarism. This includes copying or substantially restating the work of another person in any written or oral work without citing the source, or collaborating with another person in an academic endeavor without acknowledging that person's contribution.
• Submitting the same work in more than one course without the consent of all the instructors.
• Misrepresentation or falsification of data
• Allowing another student to represent your work as his or her own.
• Violating the rules of an examination or assignment

Charges of academic misconduct will be brought to the attention of the Associate Dean for Education, who will review all such cases and decide upon the appropriate action. A student who is found guilty of academic misconduct may be subject to disciplinary action, up to and including dismissal from the School. See Policy on Academic Misconduct.

Plagiarism Tutorial

The Alumni Medical Library has created the BUSPH Plagiarism Tutorial, which can be found at http://www.medlib.bu.edu/tutorials/.  This link also includes additional resources and tutorials for students.  Please see the following Student Insider post for full details and login instructions for students http://sph.bu.edu/studentinsider/Required-Reading/new-plagiarism-tutorial-for-student-review.html.

BUSPH Policy on Timely Completion of Course Requirements

All students are required to take examinations on the day they are scheduled and to hand in assignments no later than the due date. Syllabi should indicate examination dates and project (which includes papers) due dates, and penalties associated with late submissions of assignments. If a student cannot take an exam or submit a paper or project on time, the student must request an alternate date in writing from the faculty member. The request for extensions should only be approved if the student has encountered a serious problem that arose unexpectedly and that will make it impossible or extremely burdensome for the student to take the exam or fulfill the assignment requirements as scheduled.  In such a circumstance faculty may grant a request for an alternate exam or due date.  Substitute examinations should ordinarily be scheduled as soon as possible after the scheduled exam date. Students should be warned that if they request a delay in taking a final exam or in completing a final assignment they may receive a grade of "incomplete."

It is the student's obligation to request an extension prior to the time of the exam or date an assignment is due. Only in circumstances when it would be impossible or extraordinarily burdensome for a student to make the request prior to the scheduled date may the faculty member consider a request for an extension of time after the date of the exam or assignment due date.

Faculty may require a student to provide documentation of the circumstances the student submits as the reason for granting an alternative exam or due date, such as a note from a physician. 

A student's failure to adhere to this policy may result in a failing grade being granted for the exam or paper.

Disputes between faculty and students arising out of this policy will be decided by the Associate Dean for Academic Affairs.

See Policy on Timely Completion of Course Requirements.