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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 education

Articulating and Measuring Competencies Across the Continuum of Osteopathic Medical Education

articulating and measuring competencies across the continuum of osteopathic medical education2
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

objectives
Objectives

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
slide4
How?
  • Competency Based Education 101
  • Assessment Mapping
  • OMM & Institutional Assessment
  • Questions
  • Discussion
slide6
INSTITUTE OF MEDICINE

A Bridge to Quality

iom crossing the quality chasm
IOM Crossing the Quality Chasm
  • “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
iom competencies
IOM Competencies
  • Provide patient-centered care
  • Work in interdisciplinary teams
  • Employ evidence-based practice
  • Apply quality improvement
  • Utilize informatics
seven core competencies of the osteopathic profession
Seven Core Competencies of the Osteopathic Profession
  • Osteopathic Philosophy and Osteopathic Manipulative Medicine
  • Medical Knowledge
  • Patient Care
  • Interpersonal and Communication Skills
  • Professionalism
  • Practice-Based Learning and Improvement
  • Systems-Based Practice
competency based education
Competency Based Education
  • Who is it for?
    • Not just residents!
    • Not just medicine!
  • What is the difference?
    • Design
    • Explicit
    • Assessad
why should we move to competency based education
Why Should We Move to Competency Based 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”

why should we move to competency based education12
Why Should We Move to Competency Based Education??
  • IOM Levers
    • “Accreditation is the most potent lever for curricula reform…”
    • CMS should take the lead in funding…”
    • Report cards
designing a competency based curriculum
Designing a Competency Based Curriculum
  • Start with the finishing resident/student
  • Identify
    • Knowledge
    • Skills
    • Attitudes/behaviors
  • WHAT to learn
management of cervical neoplasia
Management of Cervical Neoplasia

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

designing a competency based curriculum21
Designing a Competency Based Curriculum
  • Start with the finishing resident/student
  • Identify
    • Knowledge
    • Skills
    • Attitudes/behaviors
  • What
  • HOW
teaching learning
Teaching/Learning
  • Lecture
  • Discussion
  • Student Directed Learning
  • Case Based Learning
  • Problem Based Learning
  • Role Playing
  • Simulated Patient Lab
  • Electronic & Computer Simulators
  • Web Based
slide24
Learning Objective

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

the acgme toolbox
The ACGME Toolbox

http://www.acgme.org

slide26
Learning Objective

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

outline a method of competency assessment and documentation
Outline a method of competency assessment and documentation
  • Peter B. Dane, D.O. FACEP

Associate Dean for Pre-doctoral Education

Ohio University College of Osteopathic Medicine

slide31

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

goal of opp integration project
Goal of OPP Integration Project
  • “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

aoa core competency 1
AOA Core Competency #1
  • 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.
needs assessment 1993
Needs assessment, 1993
  • 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%
opp integration project
OPP Integration Project
  • 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)

assessment 2003
Assessment 2003
  • 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%
classroom lab exposure to osteopathic philosophy was provided by clinical sciences faculty
“Classroom/lab exposure to osteopathic philosophy was provided by:CLINICAL SCIENCES” faculty
slide38
“Classroom instruction/assistance in integration of OMT into practice was provided by: CLINICAL SCIENCES” faculty
classroom lab exposure to osteopathic philosophy was provided by basic sciences faculty
“Classroom/lab exposure to osteopathic philosophy was provided by:BASIC SCIENCES” faculty
slide40
“Classroom instruction/assistance in integration of OMT into practice was provided by: BASIC SCIENCES” faculty
slide41
“At the end of your sophomore year, how well prepared were you to diagnose and treat a patient regarding OMT/OPP?”
for rotations with dos instruction assistance in integration of omt into practice was provided by
“For rotations with DOs, instruction/assistance in integration of OMT into practice was provided by:
slide44
“OVERALL, by graduation, did you feel that you were adequately prepared to diagnose and treat a patient regarding OMT/OPP?”
slide45
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%
future planned assessments
Future planned assessments
  • 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
conclusion
Conclusion
  • 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
questions for discussion
Questions for Discussion
  • 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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