July 22, 2004
Pilot project will develop ‘core competencies’ clinical exam for health care students
Projects geared toward improving patient safety and health care by increasing understanding among health care professionals were the impetus for a newly funded program that will bring together participants from all of the health care disciplines.
Development of an interprofessional clinical exam, which received about $200,000, is one of 11 projects all over campus that were recently funded by the UW Fund for Innovation and Redesign, administered by the Office of the Provost. (See June 24 University Week.)
An interprofessional team will develop and evaluate a clinical examination aimed at students’ knowledge about what are called “core competencies,” the basic skills all health care professionals need to be able to practice. Examples are understanding what “informed consent” means, learning how to communicate about medical errors, and being able to practice in multi-cultural settings. An important element of the clinical exam will cover skills needed by health professionals from different backgrounds to work together effectively.
Dr. Lynne Robins, associate professor of medical education and biomedical informatics, is principal investigator for the project. Her co-investigators are Drs. Basia Belza, associate professor of biobehavioral nursing and health systems; Douglas Brock, assistant professor of medical education and biomedical informatics; Thomas Gallagher, assistant professor of medicine; Deborah Kartin, assistant professor of rehabilitation medicine; Taryn Lindhorst, assistant professor of social work; Thomas Morton, professor of oral biology and oral medicine; Peggy Odegard, senior lecturer in pharmacy; and Douglas Schaad, associate professor of medical education and biomedical informatics.
The exam they are developing will be an objective structured clinical examination (OSCE), which provides several “stations” where students solve problems; examine or talk with “standardized patients,” often actors or volunteers; or interact with other professionals, who might be called “standardized professionals.” The idea is to have a set of standard situations to evaluate clinical skills—something that falls between a formal written exam and evaluation in actual clinical settings with real patients. The exams are graded by observers trained to use a checklist for each scenario or problem.
“There’s an old education saying that ‘If you evaluate it, students will learn it,’” Robins said. “But up to now a core competency exam that can be used for several health professions hasn’t been developed.” The group hopes to learn what works best and make progress toward an exam that could be used as a national model.
Needless to say, setting up such exams for large numbers of students takes a lot of planning, space and people. “The logistics, including costs and time available, are always critical for this sort of effort,” Robins said. “We will take about a year to develop the stations we want for the exam and then we’ll want to gain as much information as we can afford to get. We hope to have some students from each of the schools, but right now we can’t say how many will be participating,” she added.
Some infrastructure and support for the project will come from the Center for Health Sciences Interprofessional Education. This group, led by Dr. Pamela Mitchell, associate dean of nursing, was organized seven years ago to develop and implement interprofessional activities for health sciences schools.