Summative assessment tools for undergraduate students

1. Summative assessment tools for undergraduate students EURACT 15th INTERNATIONAL COURSE LEARNING AND TEACHING ABOUT COMORBIDITY IN GENERAL/FAMILY PRACTICE.

2. Group 3: Jaime Correia de Sousa • Darinka Klančar • Gerry Wheeler • Igor Švab • Marko Kocijan • Matilda Vojnović • Nathalie Bentov • Nena Kopčavar-Guček • VlastaVodopivec-Jamšek • Vojislav Ivetić

3. AIMS • To devise summative assessment tools for final year medical students. • To assess students’ competence in using an holistic approach for managing comorbidity.

4. TOOLS • MEQ (Modified Essay Question) • OSCE (Objective Structured Clinical Examination)

5. MEQ QUESTION 1 A 64 year old woman who has recently remarried, has moved to the area. She comes to visit you for the first time. She complains of dysuria for 3 days. She also tells you that she has had Type 2 Diabetes Mellitus since the birth of the last of her 3 children 25 years ago. A What symptoms and signs will you ask for? (Limit your answer to a maximum of 20 items). B What examinations and investigations would you do today? (Maximum of 7 items) C Outline a brief plan of management for the next 7 days (Maximum 7 items).

6. MEQ MARKING GRID

7. MEQ 1A. Marking Schedule -SYMPTOMS AND SIGNS (ACUTE- 40 POINTS)

8. MEQ 1A. (BACKGROUND- 25 POINTS). *essential

9. MEQ 1B. EXAMINATION, INVESTIGATIONS AND REFERRALS (20 POINTS)

10. MEQ 1C. PLAN (15 POINTS)

11. MEQ QUESTION 2 You invite her for a double time consultation a week later. When she returns, her symptoms have cleared. She now admits to urinary incontinance for 10 years and dyspareunia since her recent remarriage. She brings her file which shows: • HbA1C 6.9 • BP 130/80 • ECG Normal • Eye examination; no retinopathy A. What issues will you address today? B. Outline your management plan for the next 3 months

12. MEQ Question 3 On her next visit, she tells you that she is worried about her 30 year-old son, who has moved in with her and her husband. She confesses to difficulties with her husband. List the factors that might be impacting on their relationship.

13. OSCE Information for the candidate (student) You are Dr. B, a GP/FP in a practice / health centre. Mrs. A is a 75 year old woman that has recently registered with you. You haven’t seen her previously and you have a blank clinical file in front of you. Mrs. A’s previous file has not yet been transferred to you. All you have is her name, age and address. Your task will be to interview this patient, write SOAP notes on the consultation and deal with her problems and requests.

14. OSCE Information for the role player (patient) Mrs A, a 75 year old woman has recently registered with Dr. B. Dr.B doesn’t know much about Mrs. A’s previous health problems. When Mrs. A enters the consulting room coughing, she informs her family physician (FP) that she would like to have her celecoxib prescription renewed and, by the way, “could you also write down my other usual prescriptions”? She gives the doctor a paper with the list of regular medication. Mrs. A, when asked, informs Dr. B. that she has chronic low back pain, was seen by an orthopaedist in the emergency service two weeks ago and was prescribed celecoxib. This new drug is helping her. If asked, Mrs. A. should confess that she sometimes takes both diclofenac and celecoxib. When asked, Mrs.A. will inform the Dr. that she has been taking paroxetine during her husband’s terminal disease and since his death she feels lonely and sad. Her feelings are alleviated somewhat by the paroxetine and she is sleeping better. The only thing she complains about is her weight loss of about 5 kg in the last month which she attributes to her sadness and depression. When Dr. B. asks Mrs. A about the reasons for taking salmeterol she will inform her that she was given that for her COPD and that she feels much better from using it. She was seen by a lung specialist 3 months ago and had a chest X-ray and everything was OK. If asked, she will confess smoking 20 cigarettes a day and she has thought about quitting but it is her only comfort in here loneliness / sadness.

15. OSCE • Information for the examiner • The student is expected to write SOAP notes on the consultation. The different elements of these notes will be used for the assessment of the OSCE station. The consultation will be video recorded. The observers will use a classification form to mark the student’s performance. • During the interview, the doctor should review the medication together with the patient and the reasons why she’s taking them. • There will be marks for: • Identification of the problems • Management and prioritisation • Follow-up • Empathy

16. OSCE APPENDIX 1OBJECTIVE (EXAMINATION)

17. OSCEAPPENDIX 2LIST OF MEDICATION

18. OSCEAPPENDIX 3LAB tests

19. OSCE • Information for the candidate (student) • You are Dr. B, a GP/FP in a practice / health centre. • Mrs. A is a 75 year old woman that has recently registered with you. • You haven’t seen her previously and you have a blank clinical file in front of you. Mrs. A’s previous file has not yet been transferred to you. All you have is her name, age and address. • Your task will be to interview this patient, write SOAP notes on the consultation and deal with her problems and requests.

20. OSCE Marking Schedule

21. OSCE Marking ScheduleA. Identification of the problems(10 points; from SOAP written by the student)

22. OSCE Marking ScheduleB. Management and prioriatisation (10 points; from video observation)

23. OSCE Marking Schedule C. FOLLOW UP (5 points; from SOAP) D. CANDIDATE’S ATTITUDE (5 points; from video)