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POGOe Editor's Choice Archives
Aging Q3 Curriculum to Improve Discharge Summary Quality: Product of the Year at the 2011 Reynolds Grantees Meeting (2nd Place)
Dr. Atul Gawande, a surgeon at Brigham and Women’s Hospital in Boston and associate professor at Harvard School of Public Health, told the New York Times in 2009 that: “There’s been a drastic decline in the number of geriatricians — and just 300 new ones are being trained each year — yet the number of people over 65 will double in the next 20 years.” Unfortunately, 3 years later, the numbers have not budged. Physicians who specialize in treating older adults - a challenging field where doctors treat patients who have multiple, complex issues - are becoming scarce.
Educators must therefore strive to develop effective and efficient strategies to improve medical trainees’ Geriatrics education. Aging Q3, an innovative educational and practice-based program from the Medical University of South Carolina (MUSC), incorporates the Assessing Care of Vulnerable Elders (ACOVE) paradigm and, quite uniquely, the principles of educational outreach or academic detailing. The three Qs signify: Quality of Education, Quality of Care, Quality of Life. It is designed to improve internal medicine residents’ clinical competencies in Geriatrics and improve the quality of care and quality of life for older adults. The program uses content development to improve the quality of geriatrics education, demonstration of appropriate clinical skills required for caring for older adults, and the application of that knowledge and skill during patient care activities.
Aging Q3 is developing curricula on 16 different topics for teaching residents to provide quality care to elderly patients. The program uses a sequence of interventions where residents learn and experience the practice of clinical Geriatrics with limited interruption to the process of patient care. As such, the Aging Q3 program emphasizes learning during clinical rotations rather than through lectures. Each ACOVE indicator, or area, is featured for 3 months. ACOVE areas in the schedule since 2009 include: Vision, Falls and Mobility, Dementia, Medication Use and Safety, Screening/Prevention, Hospital Care/Prevention, End of Life Care, Osteoporosis, Pain Management, Pressure Ulcers/Malnutrition, Osteoarthritis, Depression, Urinary Incontinence, Hearing Loss and Continuity of Care. The POGOe Product Information page provides the URL to access the full Aging Q3 website: http://mcintranet.musc.edu/agingq3/hospitalcareacove.htm. When you reach the site, the navigation panel on the left gives access to the content areas. The home page shows the Aging Q3 ACOVE area currently being featured in the curriculum, useful clinical tools, an introductory video to the Aging Q3 Program, and a direct link to POGOe.
The product being highlighted in this Editor’s Choice is the Continuity of Care Aging Q3 ACOVE Area. This product is by Kimberly Davis, MD, Neal Axon MD, Amy Thompson PharmD and Vanessa Spearman MD. This product provides a simple, innovative and useful way to get learners used to providing properly detailed discharge summaries. Some of the materials provided for the faculty and residents include a detailing handout for educators, a one-pager that emphasizes important points for the faculty to raise during resident teaching. There are different outpatient and inpatient detailing sheets that highlight differences in approach when seeing the discharged patient in these clinical settings. An editable poster can be displayed strategically in resident areas of the hospital and clinic; a pocket card designed to be printed back-to-back describes the salient features of the ACOVE area for quick access of this information, Blue Sheets that "cue" residents to address the featured issue with older adult patients contain a few brief questions on the ACOVE area that a nurse may have discussed with the patient during intake, and a References list links to an Article Linker on the MUSC website – although it would have been better if it linked to PubMed so non-MUSC users can get journal access through their own institutional log-in. Some ACOVE areas may also have Patient Education Materials, Local Provider Contact List, and an ACOVE Video Summary.
Given the differences in residents’ schedules and learning styles, the Continuity of Care working group developed a multipronged educational approach because one intervention cannot reach all residents. This appears to be a consistent theme throughout all of the Aging Q3 ACOVE areas.
Overall, this is an exciting product that covers knowledge and skills that medical trainees need to care for vulnerable adults. The program’s overall goals, concept and implementation strategies are outlined in the recent journal of Academic Medicine (Vol. 87, No. 5 / May 2012). If you are interested in this product access POGOe now or go to the MUSC website!
Educators must therefore strive to develop effective and efficient strategies to improve medical trainees’ Geriatrics education. Aging Q3, an innovative educational and practice-based program from the Medical University of South Carolina (MUSC), incorporates the Assessing Care of Vulnerable Elders (ACOVE) paradigm and, quite uniquely, the principles of educational outreach or academic detailing. The three Qs signify: Quality of Education, Quality of Care, Quality of Life. It is designed to improve internal medicine residents’ clinical competencies in Geriatrics and improve the quality of care and quality of life for older adults. The program uses content development to improve the quality of geriatrics education, demonstration of appropriate clinical skills required for caring for older adults, and the application of that knowledge and skill during patient care activities.
Aging Q3 is developing curricula on 16 different topics for teaching residents to provide quality care to elderly patients. The program uses a sequence of interventions where residents learn and experience the practice of clinical Geriatrics with limited interruption to the process of patient care. As such, the Aging Q3 program emphasizes learning during clinical rotations rather than through lectures. Each ACOVE indicator, or area, is featured for 3 months. ACOVE areas in the schedule since 2009 include: Vision, Falls and Mobility, Dementia, Medication Use and Safety, Screening/Prevention, Hospital Care/Prevention, End of Life Care, Osteoporosis, Pain Management, Pressure Ulcers/Malnutrition, Osteoarthritis, Depression, Urinary Incontinence, Hearing Loss and Continuity of Care. The POGOe Product Information page provides the URL to access the full Aging Q3 website: http://mcintranet.musc.edu/agingq3/hospitalcareacove.htm. When you reach the site, the navigation panel on the left gives access to the content areas. The home page shows the Aging Q3 ACOVE area currently being featured in the curriculum, useful clinical tools, an introductory video to the Aging Q3 Program, and a direct link to POGOe.
The product being highlighted in this Editor’s Choice is the Continuity of Care Aging Q3 ACOVE Area. This product is by Kimberly Davis, MD, Neal Axon MD, Amy Thompson PharmD and Vanessa Spearman MD. This product provides a simple, innovative and useful way to get learners used to providing properly detailed discharge summaries. Some of the materials provided for the faculty and residents include a detailing handout for educators, a one-pager that emphasizes important points for the faculty to raise during resident teaching. There are different outpatient and inpatient detailing sheets that highlight differences in approach when seeing the discharged patient in these clinical settings. An editable poster can be displayed strategically in resident areas of the hospital and clinic; a pocket card designed to be printed back-to-back describes the salient features of the ACOVE area for quick access of this information, Blue Sheets that "cue" residents to address the featured issue with older adult patients contain a few brief questions on the ACOVE area that a nurse may have discussed with the patient during intake, and a References list links to an Article Linker on the MUSC website – although it would have been better if it linked to PubMed so non-MUSC users can get journal access through their own institutional log-in. Some ACOVE areas may also have Patient Education Materials, Local Provider Contact List, and an ACOVE Video Summary.
Given the differences in residents’ schedules and learning styles, the Continuity of Care working group developed a multipronged educational approach because one intervention cannot reach all residents. This appears to be a consistent theme throughout all of the Aging Q3 ACOVE areas.
Overall, this is an exciting product that covers knowledge and skills that medical trainees need to care for vulnerable adults. The program’s overall goals, concept and implementation strategies are outlined in the recent journal of Academic Medicine (Vol. 87, No. 5 / May 2012). If you are interested in this product access POGOe now or go to the MUSC website!
Product Link:
Click here to view - 76 reads
Geriatric Gems & Palliative Pearls Mobile App: Product of the Year at the 2011 Reynolds Grantees Meeting (3rd Place)
We currently live in a Web 2.0 world where many learners find Facebook, Twitter and text messaging to be the preferred channels for delivering information and communicating ideas. In his book, The World Is Open, Curtis Bonk (2011) captures the essence of this new age of technology by stating that “anyone can now learn anything from anyone at anytime.” In the midst of this explosion of digitized information, there has been an increasing availability of electronic information access for health care providers at the point-of-care. The development of electronic health records, computers, mobile devices and other technology tools within the care environment is proving to be vital in improving the quality of care delivery and the provider’s productivity. This month’s POGOe Editor’s Choice highlights one of these technologies – The University of Texas Medical School at Houston’s Gems & Pearls Mobile App Lite v1. This “app” which is actually a website optimized for use on mobile devices running iOS, Apple’s mobile operating system, is designed to enhance clinician knowledge and skills in the care of older adults. This is a fully functional beta version that contains a limited selection of the gems and pearls in geriatrics and palliative care. It has been released primarily to test functionality and ease of use.
After accessing the website on the browser of your mobile device, the user is able to navigate through various areas and links by multi-touch gestures that touch-screen users are quite familiar with. The content is divided into general topic areas: Current Issues in Aging, Approach to the Patient, Care Systems, Syndromes, Psychiatry and Disease. Each topic area has 2 to 6 sub-topics that start with a gem (for geriatrics) or pearl (for palliative care) followed by a short summary and a list of references. The summaries are very short and focus on fundamental biomedical aspects of aging, geriatric assessment, and care coordination. These concise summaries are akin to a pocket card. Pages can be swiped sideways to navigate and pages scroll vertically with up/down swiping. Supplementary page navigation is available by using the ‘continue’ or ‘next/previous’ buttons. The layout appears to be elastic as one can change the text size display, although one cannot use the pinch/spread gestures. Several helpful hyperlinks direct the user to other pertinent content/topic areas.
However as this is a beta version it comes with some technical issues. The app takes a long time to load when first accessed, but once inside the app, content seems to load pretty quickly. It can be confusing to determine which items on the display can be swiped for navigation. The layout on the screen can be challenging when viewing on a smart phone, especially in landscape. The large image that accompanies each pearl or gem reduces the space for the actual summary to appear. The app appears to be best suited for viewing on a tablet.
These are minor quibbles about this innovative and very current method of information delivery of AAMC/ACMGE competencies on geriatric and/or palliative topics. This was voted as the 3rd Best Educational Product by over 200 geriatrics educators from 46 US medical schools in our October 2011 Reynolds Grantees Meeting. POGOe is looking forward to this app’s release version but for now, you can get the app right here for FREE!
References:
Bonk, C. J. (2011, June). The World Is Open: How Web Technology Is Revolutionizing Education. San Francisco, CA: Jossey-Bass.
After accessing the website on the browser of your mobile device, the user is able to navigate through various areas and links by multi-touch gestures that touch-screen users are quite familiar with. The content is divided into general topic areas: Current Issues in Aging, Approach to the Patient, Care Systems, Syndromes, Psychiatry and Disease. Each topic area has 2 to 6 sub-topics that start with a gem (for geriatrics) or pearl (for palliative care) followed by a short summary and a list of references. The summaries are very short and focus on fundamental biomedical aspects of aging, geriatric assessment, and care coordination. These concise summaries are akin to a pocket card. Pages can be swiped sideways to navigate and pages scroll vertically with up/down swiping. Supplementary page navigation is available by using the ‘continue’ or ‘next/previous’ buttons. The layout appears to be elastic as one can change the text size display, although one cannot use the pinch/spread gestures. Several helpful hyperlinks direct the user to other pertinent content/topic areas.
However as this is a beta version it comes with some technical issues. The app takes a long time to load when first accessed, but once inside the app, content seems to load pretty quickly. It can be confusing to determine which items on the display can be swiped for navigation. The layout on the screen can be challenging when viewing on a smart phone, especially in landscape. The large image that accompanies each pearl or gem reduces the space for the actual summary to appear. The app appears to be best suited for viewing on a tablet.
These are minor quibbles about this innovative and very current method of information delivery of AAMC/ACMGE competencies on geriatric and/or palliative topics. This was voted as the 3rd Best Educational Product by over 200 geriatrics educators from 46 US medical schools in our October 2011 Reynolds Grantees Meeting. POGOe is looking forward to this app’s release version but for now, you can get the app right here for FREE!
References:
Bonk, C. J. (2011, June). The World Is Open: How Web Technology Is Revolutionizing Education. San Francisco, CA: Jossey-Bass.
Product Link:
Click here to view - 312 reads
Distinguishing Delirium, Dementia, and Depression
In clinical practice, differentiating among the “three Ds” - Delirium, Dementia, and Depression - can be difficult because these disorders may co-exist in the same patient. Clinical pearls are needed in an educational session to assist learners with this clinical challenge. “Distinguishing Delirium, Dementia, and Depression” module, part of the GeriaFlix series, from the Carver College of Medicine at the University of Iowa, has been designed to address that and can be used “anytime, anywhere” by a wide spectrum of learners, from clinical students to practicing clinicians. The educational goals are to improve the learner’s ability to screen, diagnose, treat and increase their appreciation for the co-occurrence of the 3 D’s in the elderly patient.
The educational product is a streaming digital video format with synchronized PowerPoint presentation slides lasting approximately one hour. The lecture presentation, delivered by Dr. Gerald Jogerst, Professor of Family Medicine at the Carver College of Medicine at the University of Iowa, is divided up into three sections (one for each “D”). Each section includes a clinical case report as well as an image of a typical patient with the disorder. Dr. Jogerst is a skilled teacher and has a witty and engaging delivery. He does an excellent job of explaining concepts at a level appropriate to a broad spectrum of learners. He also makes it clear what is evidence-based and what is anecdotal in his recommendations. His presentation slides include a variety of figures, tables, and multiple-choice questions. Simple screening tools are also described that could be easily implemented immediately after watching the presentation. These screening tools are available for download on the University of Iowa website. In addition, the initial pharmacologic and non-pharmacologic therapeutic interventions of the delirious patient are reviewed.
Overall, the material is well-organized and easy to follow. Its ease of use and broad scope of information has allowed it to be embedded within curricula of multiple training programs at the University of Iowa Geriatric Education Center. Data provided by the authors at University of Iowa showed that, 96% of learners felt confident that they have achieved the four learning objectives. Many also commented that it provided materials and tools that they would use as teaching tools for their own professional/academic endeavors.
However, it would be helpful if a learner viewing the presentation could go directly to specific parts of the video presentation rather than an ordered approach. Another limitation is that the dementia section draws heavily on Alzheimer’s disease without distinguishing among other diagnostic possibilities such as vascular, frontal lobe or Lewy body. Some materials are also not adequately referenced so learners could not refer to the primary source for additional information. Most importantly, watching a digitized presentation can be a passive learning experience so the product should be an adjunct to a planned blended learning educational session.
This month’s Editor’s Choice, “Distinguishing Delirium, Dementia and Depression,” will help learners recognize and diagnose these conditions as they occur and co-exist in the geriatric patient population. Practical clinical tools for assessment are given and appear easy to employ. And this product is available here – for FREE - on POGOe.
Guest Reviewers: Andrew B. Rosenzweig, MD, Clinical Assistant Professor of Medicine and Margot I. Boigon, MD, Clinical Associate Professor of Medicine, Drexel University College of Medicine and Abington Memorial Hospital.
The educational product is a streaming digital video format with synchronized PowerPoint presentation slides lasting approximately one hour. The lecture presentation, delivered by Dr. Gerald Jogerst, Professor of Family Medicine at the Carver College of Medicine at the University of Iowa, is divided up into three sections (one for each “D”). Each section includes a clinical case report as well as an image of a typical patient with the disorder. Dr. Jogerst is a skilled teacher and has a witty and engaging delivery. He does an excellent job of explaining concepts at a level appropriate to a broad spectrum of learners. He also makes it clear what is evidence-based and what is anecdotal in his recommendations. His presentation slides include a variety of figures, tables, and multiple-choice questions. Simple screening tools are also described that could be easily implemented immediately after watching the presentation. These screening tools are available for download on the University of Iowa website. In addition, the initial pharmacologic and non-pharmacologic therapeutic interventions of the delirious patient are reviewed.
Overall, the material is well-organized and easy to follow. Its ease of use and broad scope of information has allowed it to be embedded within curricula of multiple training programs at the University of Iowa Geriatric Education Center. Data provided by the authors at University of Iowa showed that, 96% of learners felt confident that they have achieved the four learning objectives. Many also commented that it provided materials and tools that they would use as teaching tools for their own professional/academic endeavors.
However, it would be helpful if a learner viewing the presentation could go directly to specific parts of the video presentation rather than an ordered approach. Another limitation is that the dementia section draws heavily on Alzheimer’s disease without distinguishing among other diagnostic possibilities such as vascular, frontal lobe or Lewy body. Some materials are also not adequately referenced so learners could not refer to the primary source for additional information. Most importantly, watching a digitized presentation can be a passive learning experience so the product should be an adjunct to a planned blended learning educational session.
This month’s Editor’s Choice, “Distinguishing Delirium, Dementia and Depression,” will help learners recognize and diagnose these conditions as they occur and co-exist in the geriatric patient population. Practical clinical tools for assessment are given and appear easy to employ. And this product is available here – for FREE - on POGOe.
Guest Reviewers: Andrew B. Rosenzweig, MD, Clinical Assistant Professor of Medicine and Margot I. Boigon, MD, Clinical Associate Professor of Medicine, Drexel University College of Medicine and Abington Memorial Hospital.
Product Link:
Click here to view - 588 reads
Numb and Number:A Practical Approach to Periperhal Neuropathy: Product of the Year at the 2011 Reynolds Grantees Meeting (1st Place)
Peripheral neuropathy is a common complication of systemic diseases such as diabetes mellitus. Although the exact cause remains unknown, peripheral neuropathy can cause significant health concerns and decrease the quality of life for those with this condition. Although a prevalent problem in the clinical setting, instruction in this debilitating process is quite poor or even lacking. Drs. Vivyenne Roche, Mike Singer and Lindsay Oksenberg from The University of Texas Southwestern Medical Center have certainly filled a curricular gap with their POGOe product: Numb and Number: A Practical Approach to Peripheral Neuropathy. Attendees of the Reynolds Grantees’ Meeting with over 40 medical schools represented have acknowledged this and have rightly chosen it as the 2011 Product of the Year.
Numb and Number: A Practical Approach to Peripheral Neuropathy is a self-directed interactive instructional web-based module, which comprehensively reviews the approach to peripheral nerve disorders. As described by its authors, it will tune up your anatomy skills (including the brachial plexus and lumbosacral plexus) and is presented within a clinical framework. It includes key aspects of history-taking, a step-wise clinical exam, etiologies, evaluation, management, a quiz, references and even the Texas Plexus Game to test your new skills.
The flash-based module is divided into sections: 1) an instructional module focusing on data gathering (history and physical exam), a detailed review of the upper and lower limb plexuses, common etiologies and management utilizing both non-pharmacologic and pharmacologic approaches; 2) a 5-item multiple choice type pre- and post-test; 3) a game/quiz (Texas Plexus Game) that tests one’s knowledge of the brachial and lumbosacral plexuses and their associated dysfunctions by rolling over their diagrammatic representations; 4) a summary pocket card; 5) further readings and references.
Highlights include a brief tutorial at the start of the module that introduces the user to specific navigation tools. The flash-animation and illustrations are of high quality. The navigation buttons allow you to control the instructional pace of the module giving the user the ability to advance or review materials. The post-test allows the users to review their submitted answers and see what they got correct. However, it does not give the rationale for the incorrect choices. One other limitation is the audio quality, which can sound muffled and difficult to understand. This improves with increasing the volume or using headphones. However, if one sets the volume while listening, it seems to reset to default volume setting as soon as you hit ‘Continue’ thus forcing the user to readjust the volume control each time. The pocket card would be more useful if it also included the important nerve distributions emphasized thoroughly in the module.
These are definitely minor quibbles on this well-designed and conceived POGOe product. Try this 2011 Product of the Year at POGOe.org! It’s FREE!
Numb and Number: A Practical Approach to Peripheral Neuropathy is a self-directed interactive instructional web-based module, which comprehensively reviews the approach to peripheral nerve disorders. As described by its authors, it will tune up your anatomy skills (including the brachial plexus and lumbosacral plexus) and is presented within a clinical framework. It includes key aspects of history-taking, a step-wise clinical exam, etiologies, evaluation, management, a quiz, references and even the Texas Plexus Game to test your new skills.
The flash-based module is divided into sections: 1) an instructional module focusing on data gathering (history and physical exam), a detailed review of the upper and lower limb plexuses, common etiologies and management utilizing both non-pharmacologic and pharmacologic approaches; 2) a 5-item multiple choice type pre- and post-test; 3) a game/quiz (Texas Plexus Game) that tests one’s knowledge of the brachial and lumbosacral plexuses and their associated dysfunctions by rolling over their diagrammatic representations; 4) a summary pocket card; 5) further readings and references.
Highlights include a brief tutorial at the start of the module that introduces the user to specific navigation tools. The flash-animation and illustrations are of high quality. The navigation buttons allow you to control the instructional pace of the module giving the user the ability to advance or review materials. The post-test allows the users to review their submitted answers and see what they got correct. However, it does not give the rationale for the incorrect choices. One other limitation is the audio quality, which can sound muffled and difficult to understand. This improves with increasing the volume or using headphones. However, if one sets the volume while listening, it seems to reset to default volume setting as soon as you hit ‘Continue’ thus forcing the user to readjust the volume control each time. The pocket card would be more useful if it also included the important nerve distributions emphasized thoroughly in the module.
These are definitely minor quibbles on this well-designed and conceived POGOe product. Try this 2011 Product of the Year at POGOe.org! It’s FREE!
Product Link:
Click here to view - 290 reads
Mini Clinical Evaluation Exercise (Mini-CEX)
Primarily utilized to monitor learning progress during patient encounters, the Mini Clinical Evaluation Exercise (Mini-CEX) is a formative assessment method that simultaneously assesses clinical skills and offers feedback to the learner. It has been extensively evaluated in the context of internal medicine and found to be a reliable assessment tool of workplace performance for medical housestaff. A 2009 systematic review by Kogan et al in JAMA found that medical student programs have extensively utilized this assessment tool for various skills domains. This may partially be in response to the Liaison Committee on Medical Education (LCME) standard which requires that medical education programs include ongoing assessment activities that ensure that medical students have acquired, and can demonstrate on direct observation, the core clinical skills, behaviors, and attitudes that have been specified in the program's educational objectives.
This month’s Editor’s Choice highlights three mini-CEXs in our product library. They are the Health Care Proxy (HCP) Mini-CEX and Mini-Cog Mini-CEX from Albert Einstein College of Medicine and the MMSE CEX from UCSF. Commonalities include the delineation of the specific tasks the learner should perform, summary assessments of competency in both performing the task and the relevant ACGME competency, sections for comments, satisfaction questions for both student and faculty, and faculty guides. Although each is designated as appropriate for learners from medical students to fellows, only the MMSE Mini-CEX gives suggestions for the level at which these tasks should be mastered by each.
The HCP Mini-CEX (click here) developed by Drs. Amy Ehrlich and Hannah Lipman assesses 5 specific steps important in setting the stage and discussing HCPs with patients. Examiners are asked to judge whether the learner has completed each step. The Mini-Cog Mini-CEX (click here) by Drs. Ehrlich and Kim Freeman similarly assesses 12 steps when conducting the Mini-Cog, however it does not require the student to interpret the test results. Both tools ask the examiner to judge overall competency in Interpersonal and Communication skills using a 9 point scale. This scale is similar to that used in ABIM evaluations, however the scale’s anchors differ- with a score of 2 considered passable (compared with 4 on the ABIM).
The MMSE Mini-CEX (click here) by Dr. C. Bree Johnston from UCSF assesses both the performance and the scoring of each of 11 items. Interpretation of the score, humanistic qualities, counseling performance, and a summary score are evaluated using the ABIM 9-point scale with 4 as the lowest satisfactory rating. Examiners are also asked to note things that were done particularly well. The faculty guide is comprehensive, providing examples of what is considered incorrect for certain items.
In this day where we are being asked to document not just that learners were exposed to, but that they actually achieved competency in specific areas, it is important that we have a shared mental model of what that competency looks like. These 3 Mini-CEXs provide examples of this that you may wish to use ‘off-the-shelf’ or modify for your learners. They allow you to provide feedback based on direct observation, improving your skills in observation and increasing the likelihood that all learners will learn the same key points in how to perform these tasks.
So try out these Mini-CEXs today! They are available for free in POGOe.org! (You can find all of them under the following link or by searching for "mini-CEX")
This month’s Editor’s Choice highlights three mini-CEXs in our product library. They are the Health Care Proxy (HCP) Mini-CEX and Mini-Cog Mini-CEX from Albert Einstein College of Medicine and the MMSE CEX from UCSF. Commonalities include the delineation of the specific tasks the learner should perform, summary assessments of competency in both performing the task and the relevant ACGME competency, sections for comments, satisfaction questions for both student and faculty, and faculty guides. Although each is designated as appropriate for learners from medical students to fellows, only the MMSE Mini-CEX gives suggestions for the level at which these tasks should be mastered by each.
The HCP Mini-CEX (click here) developed by Drs. Amy Ehrlich and Hannah Lipman assesses 5 specific steps important in setting the stage and discussing HCPs with patients. Examiners are asked to judge whether the learner has completed each step. The Mini-Cog Mini-CEX (click here) by Drs. Ehrlich and Kim Freeman similarly assesses 12 steps when conducting the Mini-Cog, however it does not require the student to interpret the test results. Both tools ask the examiner to judge overall competency in Interpersonal and Communication skills using a 9 point scale. This scale is similar to that used in ABIM evaluations, however the scale’s anchors differ- with a score of 2 considered passable (compared with 4 on the ABIM).
The MMSE Mini-CEX (click here) by Dr. C. Bree Johnston from UCSF assesses both the performance and the scoring of each of 11 items. Interpretation of the score, humanistic qualities, counseling performance, and a summary score are evaluated using the ABIM 9-point scale with 4 as the lowest satisfactory rating. Examiners are also asked to note things that were done particularly well. The faculty guide is comprehensive, providing examples of what is considered incorrect for certain items.
In this day where we are being asked to document not just that learners were exposed to, but that they actually achieved competency in specific areas, it is important that we have a shared mental model of what that competency looks like. These 3 Mini-CEXs provide examples of this that you may wish to use ‘off-the-shelf’ or modify for your learners. They allow you to provide feedback based on direct observation, improving your skills in observation and increasing the likelihood that all learners will learn the same key points in how to perform these tasks.
So try out these Mini-CEXs today! They are available for free in POGOe.org! (You can find all of them under the following link or by searching for "mini-CEX")
Product Link:
Click here to view - 793 reads