Mark E. Archambault DHSc, PA-C Ashlyn Bruning MMS, PA-C

F123 TAKING THE STING OUT OF THE BS: B3.02 STANDARD COMPLIANCE

1. Describe attributes of effective and manageable end-of-program learning outcomes (“competencies”). 2. Integrate sample “competencies” into three common organizational schemes commonly used in medical education. 3. Discuss strategies for aligning end-of-program learning outcomes with clinical education curriculum and assessment. 4. Describe strategies for effectively and efficiently communicating to students, faculty, preceptors, and accrediting bodies the process by which the end-of-program learning outcomes are attained by students and assessed prior to graduation.

SESSION OBJECTIVES

¡ Feeling confident in our ability to align: § Program-Defined Expectations with § Supervised Clinical Practice Experience

(SCPE) Course Learning Outcomes with § SCPE Student Assessment Plan.

¡ The ability to communicate to others the above plus, how we assure students have acquired the “c”ompetencies prior to graduation.

WE ARE GOING TO LEAVE HERE TODAY…

WHAT DO YOUR LEARNING OUTCOMES

LOOK LIKE?

¡ Be careful what you borrow ¡ Use restraint ¡ Think “ALL … must” ¡ Assessment ¡ Find another home for the “keep pile”

LEARNING OUTCOMES CAN BE MANAGEABLE

Three Common Schemes used in Medical Education ¡  Knowledge, Attitudes, and Skills OR

Cognitive, Affective and Psychomotor ¡  ACGME Core Competency Headings ¡  None

ARE CATEGORIES HELPFUL?

KNOWLEDGE, ATTITUDES AND SKILLS

§ Demonstrate knowledge of biomedical and clinical sciences when applied to the care of patients.

¡ Identify cost-effective interventions for preventing disease and promoting healthy living behaviors.

KNOWLEDGE-RELATED LEARNING OUTCOMES

¡ Demonstrate sensitivity and empathy regarding the emotional, cultural and socioeconomic aspects of the patient, the patient’s condition and the patient’s family.

¡ Communicate in a patient-centered and culturally responsive manner to accurately obtain, interpret and utilize subjective information and construct a patient-centered management plan.

ATTITUDE-RELATED OUTCOMES

¡ Perform focused histories and physicals on patients across the life span and in a variety of health care delivery settings.

¡ Educate patients in health promotion and disease prevention and demonstrate a working knowledge of all tiers of preventive medicine in patient interactions.

SKILLS-RELATED OUTCOMES

CORE COMPETENCY EXAMPLE

¡ Medical Knowledge ¡ Interpersonal & Communication Skills ¡ Patient Care ¡ Professionalism ¡ Practice-based Learning and Improvement ¡ Systems-based Practice

CORE COMPETENCIES

¡ Be careful what you borrow ¡ Use restraint ¡ Think “ALL … must” ¡ Assessment ¡ Find another home for the “keep pile”

THE CORE COMPETENCY OUTCOMES MUST BE MODIFIED

“SHM”ATEGORIES

1.  Perform focused histories and physicals on patients across the life span and in a variety of health care delivery settings. (P)

2.  Formulate a differential diagnosis based upon the patient history and physical exam and recommend the proper diagnostic studies. (C)

3.  Diagnose common medical and behavioral problems likely to be seen in a primary care setting. (C)

4.  Diagnose potentially life- or function-threatening medical and behavioral problems likely to be seen in a primary care setting. (C)

“SHM”ATEGORIES EXAMPLE

5.  Develop, implement and monitor management plans for emergent, acute, chronic or ongoing conditions including pharmacological and non-pharmacological approaches, surgery, counseling, therapeutic procedures and/or rehabilitative therapies. (C)

6.  Accurately and concisely communicate the findings of a given patient encounter in written and oral forms to all members of the health care team. (P)

See: http://www.highpoint.edu/physicianassistant/ for the full list of 13 Program Learning Outcomes

LEARNING OUTCOMES FOR SCPES

WHERE ARE YOU GOING WITH THIS?

¡ End-of-Program Learning Outcomes = students prepared for entry into clinical practice

¡ Goal of SCPE: to prepare students for entry into clinical practice

SO WHY NOT…

¡ Have Program Learning Outcomes = Learning Outcomes for SCPEs

¡ SCPE Core Syllabus ¡ Individual SCPE Rotation syllabi

WHAT’S UNIQUE?

¡ Provide Rotation-Specific Learning Objectives which guide student learning and sets expectations of each rotation

¡ Learning Objectives are “c”ompetency based ¡ Ultimately, learning objectives facilitate

attainment of Learning Outcomes

COMMUNICATION, COMMUNICATION, COMMUNICATION!

IS EVERYONE ON THE SAME PAGE?

¡ Using the Syllabi to their full potential

ASSESSMENT TOOL   OUTCOME CATEGORY   PERCENTAGE OF GRADE  

Clinical Performance Evaluations (75 Points)  

1-13   23  

Specialty Subject Examinations  (100 Points)  

2, 3, 4, 5, 11, 12   31%  

Miscellaneous Assignments:  Typhon logging (10 Points)  Mid-rotation evaluation (5 Points)  Student evaluation of Preceptor/Site (5 Points)  

1-10, 12, 13   6%  

Written Case (65 points)   2-13   20%  Oral Case  (65 Points)  

2-13   20%  

ASSESSMENT MATCHED TO OUTCOMES

¡ K-A-S § Knowledge § Attitude § Skills

¡ “Shm”ategories

§ Cognitive § Affective § Psychomotor

¡ Medical Knowledge ¡ Interpersonal

communication ¡ Patient Care ¡ Professionalism ¡ Practice-Based

Learning and Improvement

¡ Systems-Based Practice

ASSESSMENT METHODS SHOULD MATCH OUTCOME DOMAINS

¡ Syllabi Template § Include Standards addressed by course § Include End-of-Program Learning Outcomes

in course design § Show how student assessment aligns with

learning outcomes

EXPLICIT AND CONSISTENT COMMUNICATION MAKES IT CLEAR

¡ Course Name, Number, Credits ¡ Course Description ¡ Course Goals ¡ ARC-PA Standards Addressed in this Course ¡ Program Learning Outcomes Supported by

this Course ¡ Course Outcomes ¡ Course Objectives ¡ Assessment of Learning Outcomes

HPU SYLLABI TEMPLATE

¡ ARC-PA STANDARDS ADDRESSED IN THIS COURSE  § B1.06 provide medical care to patients from

diverse populations. § B2.06 care across the life span - preventive § B2.10 search, interpret and evaluate the

medical literature. § B2.12 concepts of public health as they

relate to the role of the practicing PA

POPULATION HEALTH COURSE EXAMPLE

High Point University Department of Physician Assistant Studies Graduates will possess the knowledge, skills, and attitudes necessary to demonstrate entry-level proficiency in the following program learning outcomes.  § 12. Educate patients in health promotion and

disease prevention and demonstrate a working knowledge of all tiers of preventive medicine in patient interactions. (P)

PROGRAM LEARNING OUTCOMES SUPPORTED BY THIS COURSE

7.  Discuss the major primary preventive medicine strategies including immunization, screening, behavior change counseling, and preventive therapeutics.

8.  Describe how to prioritize preventive medicine screening and interventions based on individual patient risk profiles and the principles of primary, secondary and tertiary prevention.

PREVENTIVE MEDICINE COURSE OUTCOMES

¡  Describe basic concepts of epidemiology as they relate to clinical prevention and health promotion practices, including risk factor assessment, risk stratification, and testing features (e.g., sensitivity, specificity, positive and negative predictive value).

¡  Differentiate between and identify examples of primary, secondary and tertiary preventive services.

¡  Reconcile conflicting recommendations and guidelines among expert organizations in order to select appropriate gender and age-specific disease prevention and health promotion practices.

¡  Describe patient, physician and systems-based barriers to delivery of preventive care services and postulate methods to address/overcome these barriers.

¡  Develop a list of quality resources for self-use and use by patients to promote healthy living behaviors and provide education on preventive health topics.

PREVENTIVE MEDICINE OBJECTIVES

ASSESSMENT OF COURSE LEARNING OUTCOMES

ARE YOUR STUDENTS COMPETENT WHEN THEY

GRADUATE?

¡ “expects the program to demonstrate compliance with Standards”

¡ “expects the program to define expectations” ¡ “expects competencies to be tied to objectives

and to assessment” ¡ “expects the program to let students in on the

expectations” ¡ “Clearly outline its expectations to students and

preceptors.” ¡ “Explain the above to the ARC-PA.”

YOU CAN MET ARC-PA DEFINED EXPECTATIONS

ARC-PA. What is Expected? Program Defined Expectations. Accessed September 4, 2014 available at http://www.arc-pa.com/documents/Program%20Defined%20Expectaions%204.2014.pdf

QUESTION AND ANSWER

1. What is “Expected?” Program Defined Expectations. Accreditations Review Commission on Education for the Physician Assistant website. http://www.arc-pa.com/documents/Program%20Defined%20Expectaions%204.2014.pdf Published October, 2013. Accessed May 23, 2014.  2. Syllabi, Instructional Objectives and Learning Outcomes. Standards 4th Edit ion. A Guide for PA Program Faculty. Accreditation Review Commission on Education for the Physician Assistant website. http://www.arc-pa.com/documents/SyllabiandObjectivesManualStandards%204th_edition_9.16.2010.pdf Published September, 2010. Accessed May 23, 2014.  3. Recommendations for Clinical Skil ls Curricula for Undergraduate Medical Education. Task Force on the Clinical Skil ls Education of Medical Students. Association of American Medical Colleges (AAMC) website.https://members.aamc.org/eweb/upload/Recommendations%20for%20Clinical%20Skil ls%20Curricula%202005.pdf Published 2005. Accessed May 28, 2014.  4. Education Physicians for the 21st Century. ACGME Outcome Project. ACGME website. https://dconnect.acgme.org/outcome/e-learn/e_powerpoint.asp Published 2006. Accessed May 28, 2014.

REFERENCES