scholarly journals Incorporating Interactive Workshops into Bedside Teaching: Completion of a Multi- Modal Rheumatology Rotation Significantly Increases Internal Medicine Residents’ Competency and Comfort with Comprehensive Knee Examinations

2021 ◽  
Author(s):  
Alysia Kwiatkowski ◽  
Najia Shakoor ◽  
Augustine Manadan ◽  
Joel A. Block ◽  
Sonali Khandelwal
Keyword(s):  
Internal Medicine ◽  
Educational Research ◽  
Clinical Examination ◽  
Objective Structured Clinical Examination ◽  
Diagnosis And Treatment ◽  
Bedside Teaching ◽  
Traditional Methods ◽  
Modal Approach ◽  
Internal Medicine Residents ◽  
Interactive Models

Abstract Background: Studies have elucidated the lack of competency in musculoskeletal (MSK) examination skills amongst trainees. Various modalities have been studied, however, there remains a dearth of literature regarding the effectiveness of bedside teaching versus dedicated workshops. Our aim was to determine if incorporating a workshop into a rheumatology rotation would be effective in increasing medicine residents’ competency and comfort with knee examinations when compared to the rotation alone.Methods: Over 16 months, rotators were randomized to workshop plus rotation versus rotation alone. Participants were tested on their knee examination skills using an objective structured clinical examination (OSCE). Surveys were administered assessing to what degree the rotation was beneficial. Comfort and helpfulness were measured using a 5-point Likert scale. Paired and independent samples t-tests were used for comparisons. Results: Fifty-seven residents participated. For both groups, there were improvements between pre and post OSCE scores (workshop p < 0.001, no workshop p = 0.003), and levels of comfort with examination (workshop p < 0.001, no workshop p < 0.001). When comparing groups, there were differences favoring the workshop in post OSCE score (p = < 0.001), mean change in OSCE score (p < 0.001) and mean change in comfort with knee examination (p = 0.025).Conclusion: An elective in rheumatology augmented residents’ MSK competency and comfort. Incorporation of a workshop further increased knowledge, skills and comfort with diagnosis and treatment. Current educational research focuses on alternatives to traditional methods. This study provides evidence that a multi-modal approach, combining traditional bedside and interactive models, is of benefit.

scholarly journals Improving Residents' Safe Opioid Prescribing for Chronic Pain Using an Objective Structured Clinical Examination

2016 ◽  
Vol 8 (3) ◽  
pp. 390-397 ◽  
Author(s):  
Daniel P. Alford ◽  
Brittany L. Carney ◽  
Belle Brett ◽  
Sharon J. Parish ◽  
Angela H. Jackson
Keyword(s):  
Internal Medicine ◽  
Chronic Pain ◽  
Clinical Examination ◽  
Academic Medical Center ◽  
Objective Structured Clinical Examination ◽  
Opioid Prescribing ◽  
Internal Medicine Residents ◽  
Number Of Patients ◽  
Safe Opioid Prescribing ◽  
And Control

ABSTRACT  Internal medicine residents care for a sizable number of patients with chronic pain. Programs need educational strategies to promote safe opioid prescribing.Background  To describe a safe opioid prescribing education program utilizing an objective structured clinical examination (OSCE) and report the resulting impact on residents' knowledge, confidence, and self-reported practices.Objective  Using a quasi-experimental design, 39 internal medicine residents from an urban academic medical center were assigned to 1 of 4 groups: 1-hour lecture only, lecture followed by immediate OSCE, lecture followed by 4-month delayed OSCE, and control. Safe opioid prescribing knowledge, confidence, and self-reported practices were assessed at baseline and at 8 months.Methods  At 8 months, knowledge, confidence, and self-reported practices improved in the control and in all 3 intervention groups. The immediate OSCE group had the greatest improvements in combined confidence scores within group (0.74, P = .01) compared to controls (0.52, P = .05), using a 5-point scale. This group also had the greatest improvement in self-reported practice changes (1.04, P = .04), while other groups showed nonsignificant improvements—delayed OSCE (0.43, P = .44), lecture only (0.66, P = .24), and control (0.43, P = .19).Results  Safe opioid prescribing education that includes a lecture immediately followed by an OSCE had an impact on residents' confidence and self-reported practices greater than those for delayed OSCE or lecture only groups. There was no difference in knowledge improvement among the groups. Lecture followed by an OSCE was highly regarded by residents, but required additional resources.Conclusions

scholarly journals ОБГРУНТУВАННЯ ОБ’ЄКТИВНОСТІ СЕМЕСТРОВОГО КОМПЛЕКСНОГО ТЕСТОВОГО ТА ОБ’ЄКТИВНОГО СТРУКТУРОВАНОГО КЛІНІЧНОГО ІСПИТІВ ДЛЯ ОЦІНЮВАННЯ ЗНАНЬ I ВМІНЬ З ПРОПЕДЕВТИКИ ВНУТРІШНЬОЇ МЕДИЦИНИ

2012 ◽  
Author(s):  
V. P. Martsenyuk ◽  
P. R. Selskyi
Keyword(s):  
Internal Medicine ◽  
Clinical Examination ◽  
Assessment Methods ◽  
Objective Structured Clinical Examination ◽  
Practical Skills ◽  
Innovative Teaching ◽  
The Subject ◽  
Medical University

<p>The article deals with an experience of implementing innovative teaching and assessment methods, as well as learning practical skills, while conducting Internal Medicine Propedeutics in I. Ya. Horbachevsky Ternopil State Medical University. According to the subject evaluation results, the objectivity of semester exam test and objective structured clinical examination has been substantiated.</p>

scholarly journals Feedback Credibility in a Formative Postgraduate Objective Structured Clinical Examination: Effects of Examiner Type

2018 ◽  
Vol 10 (2) ◽  
pp. 185-191 ◽  
Author(s):  
Lynfa Stroud ◽  
Matthew Sibbald ◽  
Denyse Richardson ◽  
Heather McDonald-Blumer ◽  
Rodrigo B. Cavalcanti
Keyword(s):  
Clinical Examination ◽  
Objective Structured Clinical Examination ◽  
General Internist ◽  
Critical Element ◽  
Immediate Feedback ◽  
Perceived Credibility ◽  
Internal Medicine Residents ◽  
Proportional Odds Models ◽  
Feedback Delivery ◽  
To Receive

ABSTRACT Background  Resident perspectives on feedback are key determinants of its acceptance and effectiveness, and provider credibility is a critical element in perspective formation. It is unclear what factors influence a resident's judgment of feedback credibility. Objective  We examined how residents perceive the credibility of feedback providers during a formative objective structured clinical examination (OSCE) in 2 ways: (1) ratings of faculty examiners compared with standardized patient (SP) examiners, and (2) ratings of faculty examiners based on alignment of expertise and station content. Methods  During a formative OSCE, internal medicine residents were randomized to receive immediate feedback from either faculty examiners or SP examiners on communication stations, and at least 1 specialty congruent and either 1 specialty incongruent or general internist faculty examiner for clinical stations. Residents rated perceived credibility of feedback providers on a 7-point scale. Results were analyzed with proportional odds models for ordinal credibility ratings. Results  A total of 192 of 203 residents (95%), 72 faculty, and 10 SPs participated. For communication stations, odds of high credibility ratings were significantly lower for SP than for faculty examiners (odds ratio [OR] = 0.28, P &lt; .001). For clinical stations, credibility odds were lower for specialty incongruent faculty (OR = 0.19, P &lt; .001) and female faculty (OR = 0.45, P &lt; .001). Conclusions  Faculty examiners were perceived as being more credible than SP examiners, despite standardizing feedback delivery. Specialty incongruency with station content and female sex were associated with lower credibility ratings for faculty examiners.

scholarly journals Resident Evaluations: The Use of Daily Evaluation Forms in Rheumatology Ambulatory Care

2009 ◽  
Vol 36 (6) ◽  
pp. 1298-1303 ◽  
Author(s):  
SUSAN HUMPHREY-MURTO ◽  
NADER KHALIDI ◽  
C. DOUGLAS SMITH ◽  
ELZBIETA KAMINSKA ◽  
CLAIRE TOUCHIE ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Clinical Competence ◽  
Clinical Skills ◽  
Faculty Members ◽  
Objective Structured Clinical Examination ◽  
Validity And Reliability ◽  
Point Scale ◽  
Good Reliability ◽  
Evaluation Report ◽  
Internal Medicine Residents

Objective.The in-training evaluation report (ITER) is widely used to assess clinical skills, but has limited validity and reliability. The purpose of our study was to assess the feasibility, validity, reliability, and effect on feedback of using daily evaluation forms to evaluate residents in ambulatory rheumatology clinics.Methods.An evaluation form was developed based on the Royal College of Physicians and Surgeons of Canada CanMEDS roles. There were 12 evaluation items including overall clinical competence. They were rated on a 5-point scale from unsatisfactory to outstanding. All internal medicine residents rotating on rheumatology were strongly encouraged to provide the form to their preceptor at the end of each clinic. A questionnaire was administered to residents and faculty.Results.Seventy-three internal medicine residents completed a 1-month rotation at University of Ottawa (n = 26) and McMaster University (n = 47). Faculty members completed a total of 637 evaluation forms. The number of evaluation forms ranged from 2 to 16 (mean 8.73) per resident. At an average of 8.73 forms per resident the reliability was 0.71 for the composite score. Fourteen forms would be required for a reliability of 0.8. The correlation between the objective structured clinical examination scores and the forms was 0.48 (p = not significant). Faculty and residents reported increased feedback following implementation of the forms.Conclusion.The use of daily evaluation forms is feasible and provides very good reliability. Use of the evaluation forms increases feedback to residents on their performance. The forms were well received by faculty and residents.

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