With its foundation as a content management system used to manage horizontal and vertical integration of curriculum TUSK's comprehensive platform built for health sciences schools develops tools that focus on six areas:

Curriculum Management

As health sciences students typically follow a common curricular pathway TUSK provides options for administrators to easily manage enrollment by groups of students and to create reports for the content and objectives presented to these groups across the curriculum. For instance, administrators can track the number of lecture hours and types of learning objectives a class is exposed to during the course of a semester or year.

Curriculum Mapping (essential for highly integrated curricula, both horizontal and vertical)

Curriculum Planners need to track a) what content is taught in which course, b) where are competencies taught in the curriculum, c) how competencies are taught, d) who teaches them, and e) how are they assessed - this tool is currently in progress.

Curriculum Hours Report

TUSK takes information from the schedule and produces a report by course or by year showing the number of hours by type (lecture, small group, clinical presentation, etc.) for each class meeting within the course. A report can be generated from the schedule which shows the course events by week with their learning objectives. Faculty hours can be derived from this report as well.

Published Competencies

The TUSK competency model follows the MedBiquitous standard for competency objects and a competency framework. School can publish a list of parent and child competencies within the school. Published school and course competencies mapped to specific learning objectives and competencies.

Unified Medical Language system (UMLS)

The US National Library of Medicine's UMLS provides indexing and mapping of content to health sciences standardized vocabulary within a robust content repository. Content uploaded to TUSK is automatically indexed and matched to the UMLS taxonomy. Using this taxonomy, terms such as breast cancer, breast neoplasm, ductal carcinoma, and Phyllodes tumor would all be linked. Another example would be high blood pressure and hypertension. Faculty can easily find, share and reuse relevant content across courses, disciplines and schools. The indexed terms facilitate search and are reflected in the curriculum hours report.

Time Period

Another way TUSK is built around the workflow of a health sciences school is through a flexible tool that allows for the creation of time periods of various lengths e.g. from 2 weeks (for a clinical rotation) to 6 months (semester), full year, or forever. Students and course tools can be linked through time periods at teaching sites which rotate throughout the year.

Teaching Sites

Much of clinical education occurs outside of the classroom at various teaching sites (e.g. a teaching hospital or a physician’s office). One or more teaching site can then be affiliated with each course. Students and faculty can be linked to specific teaching sites and course evaluations can be organized by those teaching sites. In addition, the course evaluations for individual teaching sites can be merged to compare teaching sites for the same course. Clinical tools are built around students at teaching sites, for example the patient logs.

Schedule and Linking to Content

The schedule is an organizing principle for a school. It shows the user group/class their schedule for the day/week/semester/year. It shows content and competencies linked to individual class events. It allows us to count the hours associated with parts of the curriculum, faculty teaching hours, and competency hours. It is also used to plan the schedule with faculty in advance of the semester. TUSK allows for the importing of class-schedules. School administrators can create/import calendar information from another scheduling system for individual user groups (for example, the first year dental class group). Students within the user group will find related schedule links on their personal homepages. Content, objectives, and other metadata can be attached to specific class-meetings in the schedule, so students can easily access related information for upcoming lectures. Students can subscribe to the schedule and access it on mobile devices.

Automated Feed from Enrollment Database

Enrollment in the clinical years is complicated by the fact that there are multiple time periods (e.g. ranging from roughly 21 to 100 time periods) and multiple courses with multiple teaching sites. At the Medical School, this information is tracked in a database and students can update their enrollments at any time. To facilitate course enrollment in TUSK we have a nightly feed from the Medical School which places students in the right course, at the right time, and at the right place.

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Course Management

Integrated Courses (Parent/Child Courses)

In the 2009-2010 academic year the Medical School implemented its new integrated curriculum. During that year the integrated course feature was released to support this effort. Child courses are related to these parent courses in a way that allows things like assignments and quizzes to be part of the parent course while content is linked and viewable from the child course. The user can filter the view to see all child courses or only a particular child course. Quiz questions carry metadata regarding which child course generated the content related to the quiz question.

Course Management Features

  • Announcements
  • Assignments
  • Calendar
  • Course groups/sections
  • Discussions
  • Email
  • Grade Book
  • My Groups/Project sites
  • Podcasts
  • Polls/blogs
  • Quiz/Tests & Assessments
  • Resources/Content Mgmt.
  • Tracking and Statistics

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Content Management

Content Upload Metadata

The TUSK content repository and management system uses the NLM's Unified Medical Language System as its controlled vocabulary for metadata to describe and manage its content. In addition, the required form includes other metadata such as copyright, authors, source (for non-Tufts material), learning objectives, links to class meetings and read/write rights. Users thus have the ability to search for and reuse existing content in new contexts across all the health sciences—critical to the cross-disciplinary and integrated curricula that are now the standard for health sciences education.


Content in TUSK is stored in a content repository with rich metadata to be shared. See UMLS above

Content Reuse

A core principle of TUSK is to make content available for reuse across courses, years, and schools. As content is uploaded it is stored with a variety of metadata. The concept of reusing content across semesters/years was an essential philosophy. TUSK allows users to reuse content across courses and schools. As a content management system, content objects can be shared and pulled into various tools (e.g. the Quiz tool, the Virtual Patient tool) without having to re-upload the content. Content is not relegated to just one course or one tool. For example, images on the anatomy of the heart in the Anatomy course can be reused in the Cardiovascular Physiology course. Normal images in Histology can be compared to abnormal images in Pathology. Content can be mapped to the curriculum with learning objectives to understand what things are taught at what time.

Converting PPT to Images

Faculty are sensitive about sharing native PowerPoint files with students. To solve this problem, TUSK provides the option to convert PowerPoint slides to images. When this is done, a folder is automatically created by the database then each slide is converted to an image and added to the folder. This allows students to add notes to slides individually on TUSK and drop slides into Flash Card folders or Personal Folders. The slide images can also be pulled into other tools (such as the Quiz tool or Virtual patient tool).

Image Overlay

TUSK provides a tool for faculty to create image overlays, or images that can have labels. An overlay is usually a duplicate copy of an image with added text or an outline which highlights part(s) of the image. An example use for an overlay would be to have an x-ray as an original image and the overlay would show an outlined area of a stress fracture when the "Show Overlay" button is pressed.

Image Zoom

Images uploaded to TUSK are automatically converted into various sizes. Students/users can use the Image Zoom feature to view alternative image sizes – medium, large, x-large, or original.


Faculty in health sciences schools develop syllabi that are essentially books as long as 200+ pages. To assist faculty in conveying meaning to students, we developed an xml-standard for semantic markup for a syllabus. A Microsoft Word template provides a tool for faculty to use standardized markup in their syllabus documents. Faculty work in Word, documents are stored in TUSK as XML, and then presented to students as HTML with semantic markup. Through this mechanism, faculty can convey the main ideas, keywords in an organized outline conveying things such as topic sentences and keywords and pearls of wisdom.

Mobile Access

TUSK content, as well as announcements and schedule, are available via handheld devices. TUSK detects the mobile users and provides content properly formatted for the small screen. Users are given the option to use TUSK classic if they choose (i.e. for iPhones or iPads).

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Clinical Teaching

Virtual patient builder/Cases

TUSK has been working with the MedBiquitous virtual patient working group to build a standards-based tool to assist in learning clinical reasoning that is essential to health sciences education. The authoring tool allows faculty to create robust tutorials with interactive exercises for presenting a patient case, performing physical exams, ordering diagnostics studies, and generating differential diagnosis among others specific to health sciences/patient presentations. Administrators can create various patient types and enter in data for normal values of tests, as well as cost data associated with a test. Faculty can create gated/rules-based tutorials and review pathway summaries for students who have completed the case. The case builder includes tools for adding quizzes and TUSK content/media into phases of a case.

Patient Logs

This tool allows course directors and school administrators to create customized patient-encounter log forms for students in clinical rotations. Course directors can generate customizable log menus and reports of student log data. Students can enter data, view a history of their logs, and see librarian-referenced content related to diagnoses. The patient log tool is accessible via mobile device making it easier for students to enter in information while at their rotation. The reporting tool is flexible enough to show current data as well as summary data across sites and across years.

Simulated Patients

Actors known as simulated patients test whether students are able to perform adequately in a clinical setting. The Simulated Patient tool allows a course director or manager to build an entry form listing required examination procedures. This fo an Objective Structured Clinical Examiniation (OSCE: an exam to test clinical skill performance and competence in skills such as communication and clinical examination). The simulated patient indicates on the form whether or not the student satisfactorily performed each skill listed. The responsible faculty/staff members can then view the exam results sorted by student.


Health sciences students spend at least half their time in clinical settings and it’s important for course faculty to assess how these students are meeting competencies. This TUSK tool provides admins and course managers the option to create student assessment forms with custom rubrics and performance criteria. Faculty can be added as assessors and assigned to assess specific students in the class. Students can be assessed by multiple assessors or a single assessor. Course directors have tools to review the individual assessors’ scores and also have the ability to override scores for students and post the final assessment grade to the grade bo

Course Evaluations

The course evaluation tool was one of the earlier TUSK features. There are14 question types each with its own display. A "group by" feature allows answers to be group by a particular question. This feature provides the ability to merge evaluation across teaching sites, courses and years. A tool for batch eval creation for multiple clinical placements by time period in the 3rd and 4th year was added several years ago to facilitate the work of school administrators. The evaluation search tool, allows school administrators to search all evaluations for a particular faculty member, course or keyword. Among other uses this has been used for promotion and tenure. The merge evaluation tool allows the Medical School to merge and compare individual teaching sites into one evaluation. The split tools allows the ability to choose which questions to show in a report, ie. only numeric ratings or only full text or whatever is needed.

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Personalized Knowledge Management

Personal Folders

Students can create and manage their own folders of content. Image slides and other TUSK content can be added to a folder along with options for students to add folder notes. Students can then refer to their own private collections of TUSK content for later studying.

Flash Cards

TUSK allows users/students to easily test themselves on image slides. Students can create and manage their own “decks” (folders) of flash cards. Slides can be added to a deck along with options for students to add their own questions and answers for self-assessment. The flash card tool is accessible via mobile device.


TUSK allows faculty to convert their PowerPoint slides into images. Students can then review these images during class and use the notes feature to record their notes. TUSK will record and save each user’s notes in the database. Student’s can add notes to individual pieces of content or to folders of content.

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Student and Faculty Enrollment Management

School-based Administration

All administrative functions can be separated out by school in a decentralized model for administration. Content and users can float between schools but are affiliated with a single school.

Role-based Management

In keeping with school-based administration, user accounts can be associated with the major administrative roles including School administrators, Evaluation administrators, and Grade/registrar administrators (in development). Each account type then has access to specific functionality. For example, only users listed in the Evaluation administrator group have access to course evaluations.

User Group Management

TUSK has been built around the business processes of a health sciences school. User group management is one of these processes aligned with the fact that health sciences students generally take courses together in lock-step fashion for the first 2 years of their curriculum. TUSK allows for the creation of student groups or “user groups” which can then be attached to various courses both official and unofficial (e.g. HIPAA compliance and orientation). For example, the entire incoming medical class could be added to a group entitled M2015. This M2015 group can then be attached to multiple courses in the first-year curriculum, rather than adding each student to courses individually. User groups can see most frequently content viewed within their group. Curriculum reports can be created by user group. Registrars can use the user group tools to manage students who opt-in or –out of individual courses (e.g. a second year Veterinary student who needs to retake a first-year course or a first-year student who places out of a first year course).

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