Family Medicine End of Clerkship Assessment EOCA EeeOKah

Family Medicine End of Clerkship Assessment (EOCA) [Eee-O-Kah] Irmanie Eliacin MD Christine Dalton, MD John Delzell Jr, MD Suzanne Minor, MD Marquita Samuels, BA Ebony Whisenant, MD Florida International University- Herbert Wertheim College of Medicine February 6, 2015

Disclosures • No Disclosures

Objectives • Gain knowledge on the aspects of the End of Clerkship Assessment (EOCA) including details of stations and their objectives. • Explain the different processes in developing an EOCA and implementing it into all clerkship rotations. • Correlate their students EOCA with the NBME shelf exam and other parameters.

Introductions • Irmanie Eliacin MD Assistant Clerkship Director • Christine Dalton, MD Instructor • John Delzell Jr, MD Director of Student Education • Suzanne Minor, MD Clerkship Director • Marquita Samuels, BA Clerkship Coordinator • Ebony Whisenant, MD Assistant Clerkship Director

Background • Why did we decide to develop an OSCE? – Another tool to evaluate clinical knowledge – Expanded to use more outside clinical preceptors • Ensure students were gaining an equitable learning experience consolidating core topics assessed in family medicine.

Questions we want to answer… • Does our EOCA give additional info about students (different than NBME or ASPC)? • Does a new EOCA / OSCE have reasonable validity? • Does our EOCA give additional info about students at academic sites vs community preceptor sites ?

Curriculum Design…What went into choosing the stations? • Students struggled with formulating complete problem list, thorough assessment, plan and differential diagnosis. – A Standardized Patient (SP) station • targeted several key chronic medical conditions • evaluating students ability to develop comprehensive recommendation and plans. – Post Encounter Note – Oral presentation to faculty

Curriculum Design…What went into choosing the stations? • Students had trouble with pharmacology and writing prescriptions. – Sections required mock prescription, orders, studies and recommended treatment for different acute and chronic conditions

Curriculum Design… How were the assessment tools created? • Rubrics developed for each station based on topic and assessment – Point system – Check list, etc • Research and cross reference • Time commitment

Curriculum Design EOCA Station Assessments Time 1 DM/HTN SP Station Post Encounter Note Oral Presentation EKG Station Dermatology Station Paper Cases with Knowledge Assessments q Preventative Medicine (Case A) q Pedigree ~ Hyperlipidemia (Case B) q Asthma (Case C) q UTI/Vaginitis (Case D) q HTN/DM/Hypothyroid (Case E) 15 minutes 2 3 4 5 6 15 minutes 90 minutes

Evaluation of Student Performance • Four rotations completed so far – Total of 73 students (41 more students to complete)

Evaluation of Student Performance Average Overall EOCA Overall NBME Overall ASPC (Clinical Assessment ) 86. 68 82. 77 89. 74

Evaluation of Student Performance Overall Performance 96 94 92 90 88 86 84 82 80 78 76 Group 1 Group 2 Group 3 EOCA NBME Group 4 ASPC

92 Evaluation of Student Performance : Academic Centers vs Community Preceptor ~ EOCA 90 88 86 Comm EOCA 84 Academic EOCA 82 80 78 Group 1 Group 2 Group 3 Group 4

Evaluation of Student Performance : Academic Centers vs Community Preceptor ~ NBME 85 84 83 Comm NBME 82 Academic NBME 81 80 79 Group 1 Group 2 Group 3 Group 4

Challenges • • • Time Deadlines Coordinating Accuracy/Cross Reference Technical Challenges Bias – One faculty grading all assessments/rubrics

Conclusions & Lessons Learned • Its really easy to start a new OSCE … No it’s really not! • Students complain about the amount of time for each station. . . – It’s ok

Questions? ? ?

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