AN INNOVATIVE & INTEGRATED TESTING FORMAT COMBINING ANATOMY, PRIMARY CARE SKILLS, AND OMM IN A SIMULATED PATIENT ENCOUNTER Gail Dudley, DO, Francine Anderson, PT, PhD, Ava Stanczak, DO

Edward Via Virginia College of Osteopathic Medicine, Blacksburg, VA.

Introduction

Objective

Methods

Discussion

Abstract

PARTICIPANTS

•Core Discipline Leaders – • Anatomy, Patient Care• Osteopathic Manipulative Medicine)

•Anatomy & Clinical Faculty (Figures 5. & 6.)

•First Year Medical students

INSTRUMENTS

Standardized System Templates:

• Instructor Grading Sheet (see Figure 1.)

• Anatomy Lab Grading Sheet (see Figure 2.)

• Student (patient) Work Sheet (see Figure 3.)

• Student (physician) Work sheet (see Figure 4.)

Experimental Design

.According to the Association of American Medical

Colleges (AAMC), changes in the education of medical students has had a tremendous impact on educators in the basic sciences. Currently there is an emphasis to incorporate clinical education in the first two years of medical school. The addition of clinical content raises concerns about whether teaching in the basic sciences is being compromised or diminished and if this will negatively impact the quality of medical education and medical practice.

Methods. Discipline Leaders from each of three core disciplines (anatomy, patient care and osteopathic manipulative medicine) developed a system specific skill-set with threads from each of the three disciplines as a template for assessing student competency in a simulated patient care setting. Clinical faculty designed system specific cases that were tailored to a skill-set on which students would be tested. From this, a corresponding answer key for each case was devised. Anatomy faculty then contributed a corresponding answer key specific to the case. At the end of each block, students demonstrated their knowledge of gross anatomy, primary patient care skills, and osteopathic manipulative medicine in an integrated format. Results. By the end of the first year of medical school, in conjunction with gaining knowledge in the basic sciences, students had the opportunity to develop appropriate patient communication skills, patient evaluation skills and basic osteopathic skills in an integrated format within a nine month period. Conclusion. This model will be utilized with future first year medical students in preparation of the clinical competency component of the licensing examination for both the United States Medical Licensing Examination (USMLE) and the Comprehensive Osteopathic Medical Licensing Examination (COMLEX II).

The objective of this study is to describe the curriculum development of an innovative teaching approach integrating gross anatomy, with other first year medical courses, specifically, primary patient care skills and basic osteopathic manipulative medicine skills.

Longitudinal cohort including student observation and survey methods.

Medical training of physicians must address along with the fundamental foundation of basic science knowledge, areas of interpersonal communication, patient rapport and professionalism. Current research suggests the need for increased emphasis in these areas to improve the success of clinical practice. Integrated curriculums are designed to expose medical students to clinical education earlier (within the first two years). To develop an integrated model collaboration between the basic sciences and clinical faculty is a must.

At this institution, core faculty have collaborated to develop an innovative integrated model of teaching and evaluating student competence in a standardized manner. The model integrates basic science (gross anatomy) with, clinical skills and osteopathic skills. These disciplines reflect the foundation of clinical practice.

ResultsStandardized System-Specific Template Model

There is a growing trend to incorporate clinical education earlier in the medical school curriculum; as a result, institutions must be proactive and innovative in developing and implementing strategies to meet this objective.The teaching model described allowed clinical and basic science faculty to objectively measure student knowledge, critical thinking and performance in a standardized problem focused format. This simulated patient care environment allowed students to learn skills necessary for clinical practice early in their medical education, and to put them together to formulate a rudimentary assessment, plan and osteopathic manipulative treatment. Students were tested in the higher levels of taxonomy in the areas of basic science and cumulatively developed clinical skills through critical thinking and integration of knowledge. This integrated practical is a reflection of the changes in medical education and can provide a longitudinal evaluation of history taking and physical examination skills, correlated with anatomy knowledge.

Figure 5.

Integrated Practical Average Grade

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Block 2 Block 3 Block 4 Block 6

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Integrated Practical Highest & Lowest Grade

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Block 6

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Figure 6.

Figure 5. Clinical faculty testing students

Figure 6. Clinical faculty testing students

Figure 1. Abbreviated version of worksheet

Figure 2. Abbreviated version of worksheet