In Support of Teaching Basic Diagnostics (original) (raw)
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Teaching Patient Assessment Skills to Doctor of Pharmacy Students: The TOPAS Study
American Journal of Pharmaceutical Education, 2007
Objectives. To determine the content and extent, design, and relative importance of patient assessment courses in the professional pharmacy curriculum. Methods. A 20-item questionnaire was developed to gather information pertaining to patient assessment. Pharmacy practice department chairs were mailed a letter with an Internet link to an online survey instrument. Results. Ninety-six percent of the programs indicated that patient assessment skills were taught. Fortyfive percent of respondents indicated their course was a standalone course. The most common topics covered in assessment courses were pulmonary examination, vital signs, and cardiovascular assessment. Conclusion. There is significant variability in the topics covered, depth of content, types of instruction, and evaluation methods used in patient assessment courses in US colleges of pharmacy. This survey was an initial assessment of what is being done regarding education of student pharmacists on patient assessment.
2006
Objectives. To describe the use of patient-actors as educators in a senior-level pharmacy practice course, and to contrast the value and application of ''standardized patient'' and ''simulated patient'' educational methodologies. Design. The objective structured clinical examination (OSCE) of the licensing examination were utilized during and at the end of the course along with external assessment to determine the impact of this educational methodology. Interviews with a randomly selected cohort of 14 students were undertaken 3 years after graduation and licensure to evaluate long-term impact of this course. Assessment. Overall, students responded positively to the shift from ''standardized'' patients to ''simulated'' patients, recognizing their value in teaching clinical and pharmaceutical care skills. Concerns were expressed regarding objectivity in assessment and individual grading. Over 98% of students successfully passed the OSCE component of the licensing examination. Long-term follow-up suggests students valued this approach to education and that it provided them with a foundation for better understanding of the psychosocial needs of patients in practice. Conclusions. Simulated-patient educators can play an important role in the pharmacy curriculum, and can complement practitioner-educators in providing students with a real-world context for understanding complex patient care needs.
Assessment in Medical Education
New England Journal of Medicine, 2007
A s an attending physician working with a student for a week, you receive a form that asks you to evaluate the student's fund of knowledge, procedural skills, professionalism, interest in learning, and "systems-based practice." You wonder which of these attributes you can reliably assess and how the data you provide will be used to further the student's education. You also wonder whether other tests of knowledge and competence that students must undergo before they enter practice are equally problematic. I n one way or another, most practicing physicians are involved in assessing the competence of trainees, peers, and other health professionals. As the example above suggests, however, they may not be as comfortable using educational assessment tools as they are using more clinically focused diagnostic tests. This article provides a conceptual framework for and a brief update on commonly used and emerging methods of assessment, discusses the strengths and limitations of each method, and identifies several challenges in the assessment of physicians' professional competence and performance.
Principles of Assessment: A Primer for Medical Educators in the Clinical Years
The Internet Journal of Medical Education, 2010
Whether practicing in a rural, community, or an academic setting, physicians from all clinical specialties will participate in assessment. These assessments may be for trainees, peers, and more recently, for self-assessment. Regardless of the subject, assessors may be uncomfortable making judgments because they are unfamiliar with assessment principles. This editorial review, although a primer and aimed at the novice, will also provide information for more experienced assessors when considering assessment purpose, design, and selection. Using concrete examples, these fundamental principles are illustrated so that physicians can be confident that their evaluations are accurate, insightful and meaningful.
Pharmacy Education, 2015
Introduction: Pharmacy programmes commonly use physicians, nurses, and physician assistants as instructors of patient assessment courses. These are often questioned to be physician-focused. The aim of this study was to assess pharmacy students’ attitude and perceptions towards implemented changes to the instruction of a patient assessment course. Description of Course: In a patient assessment course for undergraduate pharmacy students, we introduced a physician- pharmacist instructional strategy with a view to ensure relevance to and application in pharmacy practice. Evaluation: A significantly greater proportion of the pharmacy students rated their skills as above average to excellent after the pharmacist’s instruction when compared to prior instruction with a physician only (75%, n=18 vs. 42%, n=10, respectively; p =0.010). Similarly, most respondents (83%, n=20) rated their understanding of the importance of patient assessment skills as above average to excellent after the inclus...
African Journal of Health Professions Education
Assessment helps to determine the impact of the educational experience on students' learning. Clinical assessment decisions are informed by the practice of assessors who typically have no formal training in assessment. [1] Formal training in the theory and practice of education, including assessment, remains a rarity among the routine requirements for appointment to a clinical or academic position that typically includes teaching and assessment responsibilities in undergraduate or postgraduate medical degree programmes. [2,3] The requisite knowledge and skills are largely acquired on the job. [4,5] An unavoidable feature of this education model is that levels of knowledge and expertise among medical educators responsible for conducting assessment processes vary widely. [6,7] Gaining insight into clinicians' assessment expertise and practices is therefore essential to understand the decisions made about students' competencies. Notwithstanding the steady expansion of knowledge regarding assessment methods and best practices, little attention is devoted to educators who are responsible for assessment activities in medical training programmes. Those involved in assessment not only develop and engage in assessment processes, influencing the quality of data available for decision-making, but also use those data to make strategic decisions about performance, i.e. pass/ fail decisions. Given this responsibility, it seems reasonable to assume that medical educators should have pertinent knowledge and skills to inform their assessment practices. While the published literature provides assessors with a plethora of information regarding specific assessment methods, such as the observed structured clinical examination (OSCE) or multiple-choice questions (MCQs), [8-10] few empirical studies provide guidance on the competencies required of assessors in medical education. [11,12] Clinician educators (CEs) involved in medical education assessment are often university-employed academic staff with academic and clinical teaching responsibilities, as well as clinical staff who have a joint health service and university appointment (referred to as joint appointments). In our context, this latter group has a dual role as clinicians (70% of the time) and educators/researchers (30% of the time). These clinical staff work in a range of healthcare settings such as hospitals, community health centres and primary healthcare clinics. Assessment responsibility devolves to and rests with both academic and clinician educators. An unavoidable feature of this model is the variable levels of expertise and involvement in assessment processes. These variations among clinicians and academics with their varying levels of involvement and challenging workloads are compounded by competing interests, personal experiences and beliefs about assessment, all of which influence assessment practices. [13] Background. Medical students in their clinical years are assessed by clinician educators (CEs) with different levels of involvement and responsibilities in the assessment process. Objective. To obtain a better understanding from CEs of their involvement in assessment activities in the clinical years of a medical degree programme, their self-reported knowledge of assessment and methods of learning about assessment. This study also explored the potential association between involvement in assessment activities, self-reported knowledge of assessment and employment profile. Methods. An online cross-sectional survey was conducted among CEs involved in assessment of an undergraduate medical programme (years 4-6) at a South African university. Results. Fifty-four CEs were contacted and 30 responses (56%) were received. Assessment responsibilities included design of assessment instruments, participation in assessment activities and quality assurance of assessments. The top five assessment activities that CEs were involved in were conducting objective structured practical examinations (OSPEs)/objective structured clinical examinations (OSCEs), designing multiple-choice questions, being a clinical examiner, conducting portfolio-based oral examinations and marking written assessments. CEs (≥80%) reported having some knowledge of formative and summative assessment, and of validity and reliability. Fewer CEs reported knowledge of constructive alignment, standard setting, item analysis and blueprinting. CEs acquired knowledge of assessment predominantly through informal methods such as practical experience and informal discussion rather than through formal education processes such as attending courses. Conclusions. CEs participated extensively in assessment, but their knowledge with regard to assessment concepts varied.
Simulated Patients vs. Standardized Patients in Objective Structured Clinical Examinations
American Journal of Pharmaceutical Education, 2006
Objectives. To describe the use of patient-actors as educators in a senior-level pharmacy practice course, and to contrast the value and application of ''standardized patient'' and ''simulated patient'' educational methodologies. Design. The objective structured clinical examination (OSCE) of the licensing examination were utilized during and at the end of the course along with external assessment to determine the impact of this educational methodology. Interviews with a randomly selected cohort of 14 students were undertaken 3 years after graduation and licensure to evaluate long-term impact of this course. Assessment. Overall, students responded positively to the shift from ''standardized'' patients to ''simulated'' patients, recognizing their value in teaching clinical and pharmaceutical care skills. Concerns were expressed regarding objectivity in assessment and individual grading. Over 98% of students successfully passed the OSCE component of the licensing examination. Long-term follow-up suggests students valued this approach to education and that it provided them with a foundation for better understanding of the psychosocial needs of patients in practice. Conclusions. Simulated-patient educators can play an important role in the pharmacy curriculum, and can complement practitioner-educators in providing students with a real-world context for understanding complex patient care needs.
Journal of the …, 2006
Professional societies have called for increased geriatrics training for all medical students and physicians. A Geriatrics Standardized Patient Instructor (GSPI) was developed in which learners assess the functional status of a patient preparing for hospital discharge. Standardized patients (SPs) rate learners on functional assessment and communication skills, and provide feedback. Seventeen SPs were trained. Correlations of ratings by SPs with ratings by three geriatricians of videotaped encounters indicated good reliability (correlation coefficient 5 0.69 and 0.70 for functional assessment and communication skills, respectively). Results from two learner groups illustrated the utility and feasibility of the GSPI. First, 138 house officers in nine specialties experienced the GSPI as a formative evaluation during implementation of new geriatrics curricula. Mean scores AE standard deviation (on a 100-point scale) for functional assessment and communication skills were 78 AE 16 and 86 AE 11, respectively. House officers rated the overall experience positively (mean rating (1 5 poor, 5 5 excellent) 3.9 AE 0.8). Second, 171 first-year medical students (M1 s) encountered the GSPI as part of an intense, multimodal educational intervention. Mean scores on functional assessment and communication skills were 93 AE 10 and 93 AE 7, respectively. Mean overall rating of the experience by M1 s was 4.1 AE 0.8. After demonstrated success as a teaching tool in these two groups of learners, the GSPI has been successfully used with second-and third-year (M3) medical students and house officers from a total of 12 specialties and incorporated into multistation Objective Standardized Clinical Examination exercises for incoming house officers and M3 s. Unlike existing diagnosis-oriented SPs, the GSPI can be used to assess and teach geriatrics skills to physician learners across disciplines and levels of training.
In-training assessment - its potential in enhancing clinical teaching
Medical education, 2000
In-training assessment (ITA) has established its place alongside formative and summative assessment at both the undergraduate and postgraduate level. In this paper the authors aimed to identify those characteristics of ITA that could enhance clinical teaching. A literature review and discussions by an expert working group at the Ninth Cambridge Conference identified the aspects of ITA that could enhance clinical teaching. The features of ITA identified included defining the specific benefits to the learner, teacher and institution, and highlighting the patient as the context for ITA and clinical teaching. The 'mapping' of a learner's progress towards the clinical teaching objectives by using multiple assessments over time, by multiple observers in both a systematic and opportunistic way correlates with the incremental nature of reaching clinical competence. The importance of ITA based on both direct and indirect evidence of what the learner actually does in the real clin...