EDUCATION RESEARCH POSTER PRESENTATION ABSTRACTS
Please note: All posters will be displayed in Salons 10-12.

FRIDAY, 10:15-11:00 AM


Silverman H, Koithan M, Maizes V.

Evaluating integrative medicine competencies in mid-career providers: the usefulness of the OSCE.

University of Arizona, Program in Integrative Medicine mkoithan@nursing.arizona.edu

Competency evaluation of healthcare trainees and practitioners has gained increasing attention in recent years. As a developing discipline, Integrative Medicine needs to create credible standards and adapt /adopt competency-based measurement techniques. One technique that has gained acceptance in medical student and resident evaluation is the Objective Structured Clinical Examination (OSCE). This format utilizes standardized patients who rate the learner's actual performance on a defined list of competencies. The Program in Integrative Medicine at the University of Arizona has developed core terminal competencies for all of its educational programs and utilizes single station OSCE examinations as one method to evaluate learners' competence relative to terminal competencies. As faculty discussed this evaluation strategy, we noted that there is essentially no literature describing the use of the OSCE to evaluate skill/knowledge acquisition in mid-career healthcare providers. Therefore, we have examined whether (a) the OSCE is a meaningful and useful evaluation strategy for mid-career healthcare providers and (2) the OSCE can provide individual and aggregate competency data in an integrative medicine educational program in a small pilot study. To address these research questions, evaluation data collected from two one-station OSCEs, used as evaluation strategies in the Integrative Medicine Associate Fellowship, were analyzed. OSCE I measured competence in patient-provider relationship formation, patient-centered care techniques and the performance of a comprehensive integrative medicine assessment and health history; OSCE II measured the ability to use knowledge and skills in five key content areas to create and communicate a patient treatment plan. Evaluation data from 44 participants indicated that the OSCE was relevant to their practice (94.3%); helped them assess personal strengths and weaknesses in identified skill areas (91.2%); and would be useful in their professional lives with patients and colleagues (93.7%). Content analysis of the qualitative responses indicated that the opportunity for guided feedback, patient interaction in a safe environment and the challenge of "real" situations contributed to the usefulness of this OSCE experience. However, participants also noted that the experience was "stressful" and reminiscent of medical evaluation and 17 (38.6%) participants felt ill-prepared. Results also indicated initial support for the validity of the OSCE. In addition to participant ratings that the OSCE content was comprehensive (97.1%), accurate (96.9%), and indicative of skill ability (89.2%), individual (range 72-100%) and aggregate/group item scores (range 68-98%) indicated that the OSCE was able to differentiate individual fellows on the identified competencies as well as program competencies that require additional instruction and attention. Therefore there is support that OSCEs are meaningful and useful evaluation and teaching-learning techniques for mid-career providers.

 

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