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Articulating and Measuring Competencies Across the Continuum of Osteopathic Medical Education.

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Presentation on theme: "Articulating and Measuring Competencies Across the Continuum of Osteopathic Medical Education."— Presentation transcript:

1 Articulating and Measuring Competencies Across the Continuum of Osteopathic Medical Education

2 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 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

3 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 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

4 How? Competency Based Education 101 Assessment Mapping OMM & Institutional Assessment Questions Discussion Competency Based Education 101 Assessment Mapping OMM & Institutional Assessment Questions Discussion

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6 INSTITUTE OF MEDICINE A Bridge to Quality

7 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 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

8 IOM Competencies Provide patient-centered care Work in interdisciplinary teams Employ evidence-based practice Apply quality improvement Utilize informatics Provide patient-centered care Work in interdisciplinary teams Employ evidence-based practice Apply quality improvement Utilize informatics

9 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 Osteopathic Philosophy and Osteopathic Manipulative Medicine Medical Knowledge Patient Care Interpersonal and Communication Skills Professionalism Practice-Based Learning and Improvement Systems-Based Practice

10 Competency Based Education Who is it for? –Not just residents! –Not just medicine! What is the difference? –Design –Explicit –Assessad Who is it for? –Not just residents! –Not just medicine! What is the difference? –Design –Explicit –Assessad

11 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 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

12 IOM Levers –Accreditation is the most potent lever for curricula reform… –CMS should take the lead in funding… –Report cards IOM Levers –Accreditation is the most potent lever for curricula reform… –CMS should take the lead in funding… –Report cards Why Should We Move to Competency Based Education??

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16 How do you design a competency based curriculum?

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18 Designing a Competency Based Curriculum Start with the finishing resident/student Identify –Knowledge –Skills –Attitudes/behaviors WHAT to learn Start with the finishing resident/student Identify –Knowledge –Skills –Attitudes/behaviors WHAT to learn

19 Management of Cervical Neoplasia Describe the pathogenesis of cervical neoplasia Assess the need for cervical screening Outline management for an abnormal pap smear Perform a pap smear Learning Objective

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21 Designing a Competency Based Curriculum Start with the finishing resident/student Identify –Knowledge –Skills –Attitudes/behaviors What HOW Start with the finishing resident/student Identify –Knowledge –Skills –Attitudes/behaviors What HOW

22 Teaching/Learning Lecture Discussion Student Directed Learning Case Based Learning Problem Based Learning Role Playing Simulated Patient Lab Electronic & Computer Simulators Web Based Lecture Discussion Student Directed Learning Case Based Learning Problem Based Learning Role Playing Simulated Patient Lab Electronic & Computer Simulators Web Based

23 Knows Knows How Linking Learning Objectives to Assessment: Millers Triangle Shows How Does

24 Knows Describe the pathogenesis of cervical neoplasia Knows How Assess the need for cervical screening Shows How Outline management for an abnormal pap smear Does Perform a pap smear Millers Triangle Learning Objective

25 The ACGME Toolbox

26 Multiple choice exam, oral exam Knows Describe the pathogenesis of cervical neoplasia Multiple choice exam, oral exam, OSCE Knows How Assess the need for cervical screening OSCE, Standardized patient Shows How Outline management for an abnormal pap smear Checklist, Record review Does Perform a pap smear Evaluation Tool Millers Triangle Learning Objective

27 Designing a Competency Based Curriculum Explicit Assessed Explicit Assessed

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29 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 Peter B. Dane, D.O. FACEP Associate Dean for Pre-doctoral Education Ohio University College of Osteopathic Medicine

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31 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

32 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

33 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.

34 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%

35 OPP Integration Project 1992 Task force named 1993 Institutional self-assessment, creation of document, curriculum committee revision & approval* 1994OPP Integration Discipline (now the Case Studies in Osteopathic Medicine Discipline) 1995First OMM Student Clinic 1996OPP Integration became standing faculty committee 1997Faculty voted to change review criteria for retention, tenure and promotion to include OPP Integration 2003Position of Associate Dean of Osteopathic Medical Education created, OPP Integrated into PBL *(

36 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%

37 Classroom/lab exposure to osteopathic philosophy was provided by: CLINICAL SCIENCES faculty

38 Classroom instruction/assistance in integration of OMT into practice was provided by: CLINICAL SCIENCES faculty

39 Classroom/lab exposure to osteopathic philosophy was provided by: BASIC SCIENCES faculty

40 Classroom instruction/assistance in integration of OMT into practice was provided by: BASIC SCIENCES faculty

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

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

43 To what extent did your clinical rotations enhance your preparation regarding OMT/OPP?

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

45 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%

46 Future planned assessments Comparison of student rating of incorporation of osteopathic concepts between WVSOM on-campus and guest faculty teaching in 1 st two years Between DO and non-DO teachers Between systems, courses and disciplines

47 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

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49 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? 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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