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Cultural- relating to the cultivation of the mind or manners. ... ROBINS,L.S., WHITE, C.B., ALEXANDER, G.L., GRUPPEN, L.C., GRUM, C.M. (2001) ... – PowerPoint PPT presentation

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Title: Objective%20Structured%20Clinical%20Exam


1
Objective Structured Clinical Exam
  • By Roslyn Joinvil
  • Maimonides Medical Center
  • Mentor Dr. Lisa Altshuler
  • Ibsen Vargas

2
Vocabulary
  • OSCE- Objective Structured Clinical Exam
  • Cultural- relating to the cultivation of the mind
    or manners.
  • Culture- the customs, civilization, and
    achievements of a particular time or people.
  • Competence- ability adequately qualified or
    capable.
  • Standardized Patients- people who are recruited
    for the relevant cultural groups or trained to
    understand specific cultural issues.
  • Observer- a representative sent to observe but
    not participate officially in an activity.

3
What is OSCE?
  • OSCE ( Objective Structured Clinical Exam) is a
    growing training program in a number of
    hospitals. This program was developed to give
    residents the opportunity to practice different
    situations on real life experiences.
  • It allows for skills practice and feedback.

4
History
  • OSCEs have been used in the United States since
    1975.
  • ACGME (Accreditation Council for Graduate Medical
    Education ) realized that there was a gap in the
    residents learning and training skills.
  • Came up with the one of the first OSCEs.
  • This program gave residents feedback on their
    performance.
  • The feedback targets and identifies if the
    resident will require any further mediation for
    training.

5
(contd) History
  • ACGME care specialist came about with 6 core
    steps to teach and evaluate the residents which
    are
  • Patient Care
  • Medical Knowledge
  • Practice- based learning and improvement
  • Interpersonal and communication skills
  • Professionalism
  • Systems-based practice

6
General Competencies for 6 Core Areas
  • Patient Care
  • Provide patient care that is compassionate,
    appropriate, and effective for the treatment of
    healthcare problems and the promotion of health.
  • Medical Knowledge
  • must demonstrate knowledge about established and
    evolving biomedical, clinical, and cognate
    sciences and applying this knowledge to patient
    care.
  • Practice-Based Learning and Improvement
  • able to investigate and evaluate their patient
    care practices, appraise and assimilate
    scientific evidence to improve their patient care
    practices.
  • http//www.acgme.org/outcome/comp/compFull.asp

7
(contd) General Competencies for 6 Core Areas
  • Interpersonal and Communication Skills
  • able to demonstrate interpersonal and
    communication skills that result in effective
    information exchange teaming with patients,
    patients families, and professional associates.
  • Professionalism
  • a commitment to carrying out professional
    responsibilities, adherence to ethical
    principles, and sensitivity to a diverse patient
    population.
  • Systems-Based Practice
  • demonstrate an awareness of and responsiveness
    to the larger context and system of healthcare
    and the ability to effectively call on system
    resources to provide care that is optimal value.
  • http//www.acgme.org/outcome/comp/compFull.asp

8
Maimonides Medical Center
  • Implemented the OSCE program in the Pediatrics
    Department.
  • Realized there was a growing need for appropriate
    training models in the area of cultural
    competence.
  • Since 1999 the first formative Culture OSCE at
    MMC was developed.

9
MMC OSCE Curriculum
  • Communication OSCE- 1st year Residents
  • Culture OSCE- 2nd year Residents
  • Genetics OSCE- 3rd year Residents
  • 5 Scenarios or stations are present in all three
    areas.
  • All OSCEs involve communication skills.

10
Communication OSCE
  • 1st year residents
  • Residents are beginning to be in contact with
    patients.
  • It will offer them practice in communicating with
    patients.

11
Culture OSCE
  • 2nd year residents
  • These residents have some experience with
    communicating with patients.
  • MMC serves a diverse population. They serve them
    with respect and understand why they treat them
    or respond to them in another way.

12
Ethnicity and Religion
13
Genetic OSCE
  • 3rd year resident - Advanced group
  • Be able to convey genetic information to the
    public in nontechnical terms.
  • Since genetics is much more complicated it is
    given to the advanced group.
  • For example explaining Down Syndrome, giving a
    visual diagnosis and genetic referrals.

14
Purpose of Stations
  • Developed scenarios that would teach cultural
    awareness and how culture has an impact on
    healthcare.
  • Goal is to assist the residents to explore the
    patients point of view.
  • All stations give realtime feedback
  • At the end of each scenario residents receive
    comments from the faculty observer and the
    standardized patients (if the station includes
    them).
  • What is done well, quote on what is said, could
    be improved on body language, verbally and in
    writing.

15
Culture scenario
Lost in Translation addressing the language
barrier in a Bengali family where only the father
speaks English.
16
Overall Evaluation of Culture OSCE
17
Conclusion
  • OSCE (Objective Structured Clinical Exam) is a
    post resident training program which will improve
    residents performance skills in the office.
  • Improves skills, gives a more one-on-one
    interaction, feedback, communication and helps
    residents acquire the knowledge that they didnt
    receive or understand in medical school.

18
Bibliography
  • ACGME Outcome Project
  • http//www.acgme.org/outcome/comp/compFull.asp
    Accessed from ACGME on Aug 2, 2006
  • ALTSHULER, L., Kachur, E. (2001). A Culture OSCE
    Teaching residents to bridge different worlds.
    Academic Medicine, 76, 514.
  • HARDEN, R.M., STEVENSON, M., DOWNIE, W.W.,
    WILSON, G. M . (1975). Assessment of clinical
    competence using objective structured clinical
    examinations. British Medical Journal, 1, 447-51.
  • ALTSHULER, L., Kachur, E. ( 2004). Cultural
    competence is everyone's responsibility! Medical
    Teacher, 26, 101-5
  • INSTITUTE OF MEDICINE ( 2002). Unequal treatment
    confronting racial and ethnic disparities in
    healthcare. Washington (DC) National Academy
    Press.
  • ROBINS,L.S., WHITE, C.B., ALEXANDER, G.L.,
    GRUPPEN, L.C., GRUM, C.M. (2001). Assessing
    medical students awareness of and sensitivity to
    diverse health beliefs using a standardized
    patient station. Academic Medicine, 76, 76-80.
  • SINGER, P.A., COHEN, R., ROBB, A., ROTHMAN, A.
    (1993). The ethics objective structured clinical
    examination. Journal of General Internal
    Medicine, 81, 23-8

19
Acknowledgements
  • Thank You to
  • Harlem Childrens Society
  • Dr. Sat
  • Dr. Lisa Altshuler
  • Ibsen Vargas
  • Gateway Program
  • Everyone in the audience
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