Articulating and measuring competencies across the continuum of osteopathic medical education
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Articulating and Measuring Competencies Across the Continuum of Osteopathic Medical Education. Articulating and Measuring Competencies Across the Continuum of Osteopathic Medical Education. Peter B. Dane, D.O. FACEP Associate Dean for Pre-doctoral Education

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Articulating and measuring competencies across the continuum of osteopathic medical education2 l.jpg
Articulating and Measuring Competencies Across the Continuum of Osteopathic Medical Education

  • Peter B. Dane, D.O. FACEP

    Associate Dean for Pre-doctoral Education

    Ohio University College of Osteopathic Medicine

  • Paul M. Krueger D.O. FACOOG

    Associate Dean for Education and Curriculum

    UMDNJ-School of Osteopathic Medicine

  • Karen M. Steele, D.O. FAAO

    Associate Dean for Osteopathic Medical Education

    West Virginia School of Osteopathic Medicine


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Objectives of Osteopathic Medical Education

At the end of the session attendees will:

  • Define the process of developing a competency based curriculum

  • Link learning objectives to appropriate assessment tools

  • Outline a method of competency assessment and documentation.

  • Use institutional assessment to achieve the AOA Core Competency #1 – Osteopathic Philosophy and Osteopathic Manipulative Medicine


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How? of Osteopathic Medical Education

  • Competency Based Education 101

  • Assessment Mapping

  • OMM & Institutional Assessment

  • Questions

  • Discussion


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INSTITUTE OF MEDICINE of Osteopathic Medical Education

A Bridge to Quality


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IOM Crossing the Quality Chasm of Osteopathic Medical Education

  • “Competencies are defined here as the habitual and judicious use of communication, knowledge, technical skills, clinical reasoning, emotions, values, and reflection in daily practice.”

  • Hundert et al. Acad Med 1996; 71(6):624


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IOM Competencies of Osteopathic Medical Education

  • Provide patient-centered care

  • Work in interdisciplinary teams

  • Employ evidence-based practice

  • Apply quality improvement

  • Utilize informatics


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Seven Core Competencies of the Osteopathic Profession of Osteopathic Medical Education

  • Osteopathic Philosophy and Osteopathic Manipulative Medicine

  • Medical Knowledge

  • Patient Care

  • Interpersonal and Communication Skills

  • Professionalism

  • Practice-Based Learning and Improvement

  • Systems-Based Practice


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Competency Based Education of Osteopathic Medical Education

  • Who is it for?

    • Not just residents!

    • Not just medicine!

  • What is the difference?

    • Design

    • Explicit

    • Assessad


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Why Should We Move to Competency Based Education?? of Osteopathic Medical Education

Institute of Medicine

“All health professionals should be educated to deliver patient centered care as part of an interdisciplinary team, emphasizing evidence-based practice, quality improvement approaches and informatics”


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Why Should We Move to Competency Based Education?? of Osteopathic Medical Education

  • IOM Levers

    • “Accreditation is the most potent lever for curricula reform…”

    • CMS should take the lead in funding…”

    • Report cards


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Why Should We Move to Competency Based Education?? of Osteopathic Medical Education


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How do you design a competency based curriculum? of Osteopathic Medical Education


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BACKWARDS of Osteopathic Medical Education


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Designing a Competency Based Curriculum of Osteopathic Medical Education

  • Start with the finishing resident/student

  • Identify

    • Knowledge

    • Skills

    • Attitudes/behaviors

  • WHAT to learn


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Management of Cervical Neoplasia of Osteopathic Medical Education

Learning Objective

Perform a pap smear

Outline management for an abnormal pap smear

Assess the need for cervical screening

Describe the pathogenesis of cervical neoplasia


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BACKWARDS of Osteopathic Medical Education


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Designing a Competency Based Curriculum of Osteopathic Medical Education

  • Start with the finishing resident/student

  • Identify

    • Knowledge

    • Skills

    • Attitudes/behaviors

  • What

  • HOW


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Teaching/Learning of Osteopathic Medical Education

  • Lecture

  • Discussion

  • Student Directed Learning

  • Case Based Learning

  • Problem Based Learning

  • Role Playing

  • Simulated Patient Lab

  • Electronic & Computer Simulators

  • Web Based


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Does of Osteopathic Medical Education

Shows How

Knows How

Knows

Linking Learning Objectives to Assessment: Millers Triangle


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Learning Objective of Osteopathic Medical Education

Millers Triangle

Perform a pap smear

Does

Outline management for an abnormal pap smear

Shows How

Assess the need for cervical screening

Knows How

Describe the pathogenesis of cervical neoplasia

Knows


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The ACGME Toolbox of Osteopathic Medical Education

http://www.acgme.org


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Learning Objective of Osteopathic Medical Education

Millers Triangle

Evaluation Tool

Perform a pap smear

Does

Checklist, Record review

Outline management for an abnormal pap smear

Shows How

OSCE, Standardized patient

Assess the need for cervical screening

Knows How

Multiple choice exam, oral exam, OSCE

Describe the pathogenesis of cervical neoplasia

Knows

Multiple choice exam, oral exam


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Designing a Competency Based Curriculum of Osteopathic Medical Education

  • Explicit

  • Assessed

BACKWARDS


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Outline a method of competency assessment and documentation of Osteopathic Medical Education

  • Peter B. Dane, D.O. FACEP

    Associate Dean for Pre-doctoral Education

    Ohio University College of Osteopathic Medicine


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Articulating & Measuring Competencies Across the Continuum of Osteopathic Medical Education: Institutional Assessment

Karen M. Steele, D.O., F.A.A.O.

Associate Dean for Osteopathic

Medical Education

West Virginia School of Osteopathic Medicine


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Goal of OPP Integration Project of Osteopathic Medical Education: Institutional Assessment

  • “to create a curriculum that will graduate physicians who utilize the osteopathic philosophy in their clinical practices and provide osteopathic manipulation to their patients.”

James R. Stookey, D.O., 1992


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AOA Core Competency #1 of Osteopathic Medical Education: Institutional Assessment

  • Residents are expected to demonstrate & apply knowledge of accepted standard in Osteopathic Manipulative Treatment (OMT) appropriate to their specialty. The educational goal is to train a skilled & competent osteopathic practitioner who remains dedicated to life-long learning and to practice habits in osteopathic philosophy & manipulative medicine.


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Needs assessment, 1993 of Osteopathic Medical Education: Institutional Assessment

  • Interviewed faculty, students, staff

  • Reviewed senior exit data, national board performance in OPP, ECOP curriculum document, etc

  • Surveyed classes of 1987 and 1988

    • last classes to have finished residency and be in practice 2 or more years prior to OPP Integration project

    • return rate 57%


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OPP Integration Project of Osteopathic Medical Education: Institutional Assessment

  • 1992 Task force named

  • 1993 Institutional self-assessment, creation of document, curriculum committee revision & approval*

  • 1994 OPP Integration Discipline (now the Case Studies in Osteopathic Medicine Discipline)

  • 1995 First OMM Student Clinic

  • 1996 OPP Integration became standing faculty committee

  • 1997 Faculty voted to change review criteria for retention, tenure and promotion to include OPP Integration

  • 2003 Position of Associate Dean of Osteopathic Medical Education created, OPP Integrated into PBL

    *(http://www.wvsom.edu/clinicalsciences/opp/OPPIntegDoc93.pdf)


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Assessment 2003 of Osteopathic Medical Education: Institutional Assessment

  • Survey of class of 1998

    • first class to have finished residency and be in practice 2 years and have had OPP Integration for 4 years of osteopathic medical education

    • return rate 38%


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“Classroom/lab exposure to osteopathic of Osteopathic Medical Education: Institutional Assessment philosophy was provided by:CLINICAL SCIENCES” faculty


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“Classroom instruction/assistance in of Osteopathic Medical Education: Institutional Assessment integration of OMT into practice was provided by: CLINICAL SCIENCES” faculty


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“Classroom/lab exposure to osteopathic of Osteopathic Medical Education: Institutional Assessment philosophy was provided by:BASIC SCIENCES” faculty


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“Classroom instruction/assistance in integration of of Osteopathic Medical Education: Institutional Assessment OMT into practice was provided by: BASIC SCIENCES” faculty


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“At the end of your sophomore year, how well prepared were you to diagnose and treat a patient regarding OMT/OPP?”


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“For rotations with DOs, instruction/assistance in integration of OMT into practice was provided by:



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“OVERALL, preparation regarding OMT/OPP?”by graduation, did you feel that you were adequately prepared to diagnose and treat a patient regarding OMT/OPP?”


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Comparison end year two and four self evaluation of preparation to diagnose and treat a patient regarding OMT/OPP

  • Class of 1988

    • End of year 2 – 80% felt well or very well prepared

    • End of year 4 – 60%

  • Class of 1998

    • End of year 2 – 95% felt well or very well prepared

    • End of year 4 – 75%


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Future planned assessments preparation to diagnose and treat a patient regarding OMT/OPP

  • Comparison of student rating of incorporation of osteopathic concepts

    • between WVSOM on-campus and guest faculty teaching in 1st two years

    • Between DO and non-DO teachers

    • Between systems, courses and disciplines


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Conclusion preparation to diagnose and treat a patient regarding OMT/OPP

  • Institutions can change in a pre-determined way, if guided by a vision and clearly defined goals

  • Assessment is a powerful tool to reinforce and guide that change

  • Create assessment tools that you can live with long term


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Questions for Discussion preparation to diagnose and treat a patient regarding OMT/OPP

  • Competencies – Important advance or the next fad?

  • Are the AOA GME competencies right for predoctoral education?

  • How do we assess professionalism?

  • Can competencies be integrated into CME?

  • How much Systems Based Practice is right for predoctoral education?


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