OSTEOPATHIC PHILOSOPHY AND OSTEOPATHIC MANIPULATIVE MEDICINE: | | |
Demonstrate and apply knowledge of accepted standards in OMT. | 2 | No OMT was applied or expected during the SP encounter though it was an expected element of the SOAP Note “Plan.” |
Train a skilled and competent osteopathic practitioner who remains dedicated to life-long learning. | 4 | Part of the exercise required students to access an NIH database to use DNA sequence data to identify the agent of infection. |
Train a skilled and competent osteopathic practitioner who remains dedicated to practice habits in osteopathic philosophy and manipulative medicine. | 5 | The physical examination aspect of the exercise required students to use their palpatory skills to search for sympathetic and lymphatic involvement. |
Demonstrate competency in the understanding and application of OMT. | 1 | No OMT was applied or expected during the SP encounter though it was an expected element of the SOAP Note “Plan.” |
Integrate osteopathic concepts and OMT into the medical care provided to patients as appropriate. | 2 | No OMT was applied or expected during the SP encounter though it was an expected element of the SOAP Note “Plan.” |
Advance the understanding and integration of osteopathic principles and philosophy into all clinical and patient care activities. | 5 | The physical examination aspect of the exercise required students to use their palpatory skills to search for sympathetic and lymphatic involvement. |
MEDICAL KNOWLEDGE: | | |
Demonstrate and apply knowledge of accepted standards of clinical medicine. | 5 | Students learned to use The Sanford Guide to Antimicrobial Therapy to determine appropriate treatment. Students wrote a medical record including Assessment and Plan portions of SOAP Note, which was graded with comments and returned. |
Remain current with new developments in medicine. | 4 | Student knowledge was derived from annually updated lectures, class handouts, and the most recent edition of The Sanford Guide to Antimicrobial Therapy. |
Encourage participation in life-long learning activities. | 4 | Part of the exercise required students to access an NIH database to use DNA sequence data to identify the agent of infection. The course also includes a general, open-book medical informatics exercise, which benefits students in writing their SOAP Notes. |
Encourage development of research. | 3 | Part of the exercise required students to access an NIH database to use DNA sequence data to identify the agent of infection. The course also includes a general, open-book medical informatics exercise, which benefits students in writing their SOAP Notes. |
Demonstrate competency in the understanding of clinical medicine to patient care. | 4 | The SP encounters required students to develop an assessment with a minimum of three diagnoses. |
Demonstrate competency in the application of clinical medicine to patient care. | 4 | The SP encounters required students to develop an assessment with a minimum of three diagnoses and associated plans to verify and treat. |
Aid knowledge and applications of the foundations of clinical and behavioral medicine. | 4 | Many of the SP encounters involved patients with behavioral issues (eg, alcohol, drugs, smoking, unsafe sexual practice) that students were expected to recognize and address through counseling. |
PATIENT CARE: | | |
Demonstrate the ability to effectively treat patients. | 5 | After writing their SOAP Notes, students were provided additional information from which they were to confirm diagnosis. They were then to submit an evidence-based therapy for the patient via an addendum to the SOAP Note. |
Demonstrate the ability to provide medical care that incorporates the osteopathic philosophy. | 5 | The physical examination aspect of the exercise required students to use their palpatory skills to search for sympathetic and lymphatic involvement. Many of the SP encounters involved patients with behavioral issues (eg, alcohol, drugs, smoking, unsafe sexual practice) that students were expected to recognize and address through counseling. |
Demonstrate the ability to provide patient empathy. | 5 | Students were evaluated for a list of items categorized as patient-centered skills, which are based in empathy for the patient. |
Demonstrate the ability to provide awareness of behavioral issues. | 5 | Many of the SP encounters involved patients with behavioral issues (eg, alcohol, drugs, smoking, unsafe sexual practice) that students were expected to recognize and address through counseling. |
Demonstrate the ability to provide the incorporation of preventive medicine. | 4 | As all of these SP encounters are based on infectious disease, students were evaluated on hand-washing behaviors and wearing gloves at appropriate times during the examination. Patient counseling was to include recognition of contagiousness. |
Demonstrate the ability to provide health promotion. | 5 | Many of the SP encounters involved patients with behavioral issues (eg, alcohol, drugs, smoking, unsafe sexual practice) that students were expected to recognize and address through counseling. Patient counseling was to include recognition of contagiousness. |
Gather accurate, essential information from all sources. | 5 | In the open-book phase of writing the SOAP Notes, students were invited to refer to lecture notes, class handouts, and textbooks, as well as online sources of information. |
Develop medical interview skills. | 5 | Students were evaluated three ways; orally immediately postencounter by the SP and peer observer and then in writing by faculty evaluator via SP encounter checklist. Any identified problems required remediation (ie, assessment and discussion) with faculty evaluator. |
Develop physical examination skills. | 5 | Students were evaluated three ways; orally immediately postencounter by the SP and peer observer and then in writing by faculty evaluator via SP encounter checklist. Any identified problems required remediation (ie, assessment and discussion) with faculty evaluator. |
Develop medical record-keeping skills. | 4 | Students were required to produce a SOAP Note with one addendum. |
Develop diagnostic/therapeutic plans and treatments. | 5 | Students were required to produce a SOAP Note with one addendum. Diagnostic, therapeutic, and treatment plans were required. |
Validate competency in the performance of diagnosis. | 4 | The SOAP Note is graded on the logic of the diagnoses. |
Validate competency in the performance of treatment. | 4 | The SOAP Note is graded on the logic of the treatment plan. |
Validate competency in the performance of procedures. | 2 | No clinical procedures were performed. Some medical microbiology procedures were performed and graded. |
Demonstrate ability to provide healthcare services consistent with osteopathic philosophy. | 5 | Many of the SP encounters involved patients with behavioral issues (eg, alcohol, drugs, smoking, unsafe sexual practice) that students were expected to recognize and address through counseling. Patient counseling was to include recognition of contagiousness. |
Demonstrate ability to provide preventive medicine and health promotion services that are based on current scientific evidence. | 4 | Comments regarding preventive medicine and health promotion were to be based on class handouts and reference materials. |
INTERPERSONAL AND COMMUNICATION SKILLS: | | |
Develop and demonstrate interpersonal and communication skills that enable students to establish and maintain professional relationships with patients. | 5 | Multiple videos have been used to demonstrate or model professional and effective communication skills. Students were assessed and remediated on their communication skills in the SP encounters. |
Develop and demonstrate interpersonal and communication skills that enable students to establish and maintain professional relationships with patients' families. | 1 | Not addressed |
Develop and demonstrate interpersonal and communication skills that enable them to establish and maintain professional relationships with other members of patient's healthcare team. | 1 | Not addressed |
Demonstrate effectiveness in developing appropriate doctor-patient relationships. | 5 | Teaching/assessment/remediation of patient-centered care was central to SP encounters. |
Develop effective listening skills in professional interactions with patients. | 5 | Teaching/assessment/remediation of listening skills was part of the SP encounters. |
Develop effective written communication skills in professional interactions with patients. | 4 | Teaching/assessment/remediation of writing skills was central to SP encounters. |
Develop effective oral communication skills in professional interactions with patients. | 5 | Teaching/assessment/remediation of communication skills was central to SP encounters. |
Develop effective oral communication skills with patients' families. | 1 | Not addressed |
Develop effective oral communication skills with other health professionals. | 4 | Students were required to discussed their performance immediately postencounter with the SP and peer observer. Any identified problems required remediation (ie, assessment and discussion) with faculty evaluator. |
PROFESSIONALISM: | | |
Enhance expectations to uphold the osteopathic oath in the conduct of professional activities. | 2 | Although the osteopathic oath is not specifically addressed in the SP encounter model, behaviors addressed in the oath are part of expected behaviors for this exercise. |
Promote advocacy of patient welfare. | 1 | Not addressed |
Promote adherence to ethical principles. | 4 | Ethics and integrity were discussed and assessed during the SP encounter. |
Promote collaboration with health professionals. | 4 | The peer observer in the SP encounter may collaborate with the student “physician” in recording data gathered during the interview. The observer is required to provide the “physician” with constructive feedback designed to improve performance in future encounters. |
Promote life-long learning. | 4 | Students were referred to select sources and asked to use computer searches to answer clinical questions. |
Promote sensitivity to a diverse patient population. | 4 | After each encounter, students received feedback from their SPs, who represented a variety of demographic groups (eg, age, gender, economic diversity). |
Promote avenues of the student's physical and mental health in order to effectively care for patients. | 1 | Not addressed |
Demonstrate respect for patients. | 5 | Students were assessed directly and indirectly in terms of their respect for the patient. |
Demonstrate respect for patients' families. | 1 | Not addressed |
Advocate for the primacy of patient welfare and autonomy. | 1 | Not addressed |
Adhere to ethical principles in the practice of medicine. | 4 | We discussed and assessed the ethics of accurate SOAP Note records. |
Demonstrate awareness and proper attention to issues of culture, religion, age, gender, sexual orientation, and mental and physical disabilities. | 4 | Many of the issues listed were embedded in the SP cases, sometimes with direct application to understanding disease etiology. |
PRACTICE-BASED LEARNING AND IMPROVEMENT: | | |
Demonstrate the ability to critically evaluate their methods of clinical practice. | 1 | Not addressed |
Demonstrate the ability to integrate evidence-based medicine into patient care. | 4 | Students were required to seek data from NIH databases for their SOAP Note addenda. |
Demonstrate the ability to show an understanding of research methods. | 4 | Students were required to seek data from NIH databases for their SOAP Note addenda. |
Demonstrate the ability to improve patient care practices. | 1 | Not addressed |
Treat patients in a manner consistent with the most up-to-date information on diagnostic and therapeutic effectiveness. | 5 | Students were encouraged to seek data from current source of therapies for infectious disease (eg, The Sanford Guide to Antimicrobial Therapy, online resources). |
Perform self-evaluations of clinical practice patterns and practice-based improvement activities using a systematic methodology. | 4 | Students were required to write a self-reflection piece that focused on their performance and included any issues identified during peer (observer) assessment. |
Understand research methods as applied to the practice of medicine. | 4 | Students were given instructions to use an NIH database for genomic information and assessed on their performance through the graded SOAP Note and addendum. |
Understand medical informatics as applied to the practice of medicine. | 5 | One of the foundation experiences in the course is a medical informatics exercise, which the student is required to master. |
Understand technology as applied to the practice of medicine. | 4 | Both the medical informatics exercise and the NIH database search were designed around clinical questions. |
SYSTEMS-BASED PRACTICE: | | |
Provide an understanding of healthcare delivery systems. | 1 | Not Adressed |
Provide an understanding of effective and qualitative patient care within the healthcare system. | 1 | Not Adressed |
Provide an understanding of cost-effective medicine. | 1 | Not Adressed |
Promote understanding of national and local healthcare delivery systems and how they impact patient care. | 1 | Not Adressed |
Promote understanding of national and local healthcare delivery systems and how they impact professional practice. | 1 | Not Adressed |
Advocate for quality healthcare on behalf of patients. | 1 | Not Adressed |
Advance and assist patients in their interactions with the complexities of the medical system.
| 1 | Not Adressed |