Sustainability of physical exam skills in a resident-led curriculum in a large internal medicine program with competency based medical education

Background: Competency Based Medical Education (CBME) designates physical examination competency as an Entrustable Professional Activity (EPA). Considerable concern persists regarding the increased time burden CBME may place on educators. We developed a novel physical examination curriculum that shi...

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Autores principales:	Don Thiwanka Wijeratne, Siddhartha Srivastava, Barry Chan, Wilma Hopman, Benjamin Thomson
Formato:	article
Lenguaje:	EN
Publicado:	Canadian Medical Education Journal 2018
Materias:	Competency Based Medical Education Physical Examination Medical Education Postgraduate education Education (General) L7-991 Medicine (General) R5-920
Acceso en línea:	https://doaj.org/article/11304422cdc646de82e65a13162a5211
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spelling	oai:doaj.org-article:11304422cdc646de82e65a13162a52112021-12-01T22:44:11ZSustainability of physical exam skills in a resident-led curriculum in a large internal medicine program with competency based medical education10.36834/cmej.432731923-1202https://doaj.org/article/11304422cdc646de82e65a13162a52112018-11-01T00:00:00Zhttps://journalhosting.ucalgary.ca/index.php/cmej/article/view/43273https://doaj.org/toc/1923-1202Background: Competency Based Medical Education (CBME) designates physical examination competency as an Entrustable Professional Activity (EPA). Considerable concern persists regarding the increased time burden CBME may place on educators. We developed a novel physical examination curriculum that shifted the burden of physical examination case preparation and performance assessment from faculty to residents. Our first objective was to determine if participation led to sustainable improvements in physical examination skills. The second objective was to determine if resident peer assessment was comparable to faculty assessment. Methods: We selected physical exam case topics based on the Objectives of Training in the Specialty of Internal Medicine as prescribed by the Royal College of Physicians and Surgeons of Canada. Internal Medicine residents compiled evidence-based physical exam checklists that faculty reviewed before distribution to all learners. Physical exam practice sessions with whole-group demonstration followed by small-group practice sessions were performed weekly. We evaluated this pilot curriculum with a formative OSCE, during which a resident peer and a faculty member simultaneously observed and assessed examinee performance by . Results: Participation in the novel curriculum practice sessions improved OSCE performance (faculty score mean 78.96 vs. 62.50, p<0.05). Peer assessment overestimated faculty scores (76.2 vs. 65.7, p<0.001), but peer and faculty assessments were highly correlated (R2 = 0.73 (95% CI 0.50-0.87). Conclusion: This novel physical examination curriculum leads to sustainable improvement of physical examination skills. Peer assessment correlated well with the gold standard faculty assessment. This resident-led physical examination curriculum enhanced physical examination skills in a CBME environment, with minimal time commitment from faculty members. Don Thiwanka WijeratneSiddhartha SrivastavaBarry ChanWilma HopmanBenjamin ThomsonCanadian Medical Education JournalarticleCompetency Based Medical EducationPhysical ExaminationMedical EducationPostgraduate educationEducation (General)L7-991Medicine (General)R5-920ENCanadian Medical Education Journal, Vol 9, Iss 4 (2018)
institution	DOAJ
collection	DOAJ
language	EN
topic	Competency Based Medical Education Physical Examination Medical Education Postgraduate education Education (General) L7-991 Medicine (General) R5-920
spellingShingle	Competency Based Medical Education Physical Examination Medical Education Postgraduate education Education (General) L7-991 Medicine (General) R5-920 Don Thiwanka Wijeratne Siddhartha Srivastava Barry Chan Wilma Hopman Benjamin Thomson Sustainability of physical exam skills in a resident-led curriculum in a large internal medicine program with competency based medical education
description	Background: Competency Based Medical Education (CBME) designates physical examination competency as an Entrustable Professional Activity (EPA). Considerable concern persists regarding the increased time burden CBME may place on educators. We developed a novel physical examination curriculum that shifted the burden of physical examination case preparation and performance assessment from faculty to residents. Our first objective was to determine if participation led to sustainable improvements in physical examination skills. The second objective was to determine if resident peer assessment was comparable to faculty assessment. Methods: We selected physical exam case topics based on the Objectives of Training in the Specialty of Internal Medicine as prescribed by the Royal College of Physicians and Surgeons of Canada. Internal Medicine residents compiled evidence-based physical exam checklists that faculty reviewed before distribution to all learners. Physical exam practice sessions with whole-group demonstration followed by small-group practice sessions were performed weekly. We evaluated this pilot curriculum with a formative OSCE, during which a resident peer and a faculty member simultaneously observed and assessed examinee performance by . Results: Participation in the novel curriculum practice sessions improved OSCE performance (faculty score mean 78.96 vs. 62.50, p<0.05). Peer assessment overestimated faculty scores (76.2 vs. 65.7, p<0.001), but peer and faculty assessments were highly correlated (R2 = 0.73 (95% CI 0.50-0.87). Conclusion: This novel physical examination curriculum leads to sustainable improvement of physical examination skills. Peer assessment correlated well with the gold standard faculty assessment. This resident-led physical examination curriculum enhanced physical examination skills in a CBME environment, with minimal time commitment from faculty members.
format	article
author	Don Thiwanka Wijeratne Siddhartha Srivastava Barry Chan Wilma Hopman Benjamin Thomson
author_facet	Don Thiwanka Wijeratne Siddhartha Srivastava Barry Chan Wilma Hopman Benjamin Thomson
author_sort	Don Thiwanka Wijeratne
title	Sustainability of physical exam skills in a resident-led curriculum in a large internal medicine program with competency based medical education
title_short	Sustainability of physical exam skills in a resident-led curriculum in a large internal medicine program with competency based medical education
title_full	Sustainability of physical exam skills in a resident-led curriculum in a large internal medicine program with competency based medical education
title_fullStr	Sustainability of physical exam skills in a resident-led curriculum in a large internal medicine program with competency based medical education
title_full_unstemmed	Sustainability of physical exam skills in a resident-led curriculum in a large internal medicine program with competency based medical education
title_sort	sustainability of physical exam skills in a resident-led curriculum in a large internal medicine program with competency based medical education
publisher	Canadian Medical Education Journal
publishDate	2018
url	https://doaj.org/article/11304422cdc646de82e65a13162a5211
work_keys_str_mv	AT donthiwankawijeratne sustainabilityofphysicalexamskillsinaresidentledcurriculuminalargeinternalmedicineprogramwithcompetencybasedmedicaleducation AT siddharthasrivastava sustainabilityofphysicalexamskillsinaresidentledcurriculuminalargeinternalmedicineprogramwithcompetencybasedmedicaleducation AT barrychan sustainabilityofphysicalexamskillsinaresidentledcurriculuminalargeinternalmedicineprogramwithcompetencybasedmedicaleducation AT wilmahopman sustainabilityofphysicalexamskillsinaresidentledcurriculuminalargeinternalmedicineprogramwithcompetencybasedmedicaleducation AT benjaminthomson sustainabilityofphysicalexamskillsinaresidentledcurriculuminalargeinternalmedicineprogramwithcompetencybasedmedicaleducation
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Sustainability of physical exam skills in a resident-led curriculum in a large internal medicine program with competency based medical education

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