1 / 35

Kirksville college of osteopathic medicine A T Still University of health sciences

Kirksville college of osteopathic medicine A T Still University of health sciences. A Matrix for Quality Enhancement Based upon the Seven Core Competencies of the Osteopathic Profession. Michael Lockwood, DO, FCA AACOM June 2007.

jolie-gibson
Download Presentation

Kirksville college of osteopathic medicine A T Still University of health sciences

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Kirksville college of osteopathic medicineA T Still University of health sciences

  2. A Matrix forQuality EnhancementBased upon the Seven Core Competencies of the Osteopathic Profession Michael Lockwood, DO, FCA AACOM June 2007

  3. The Matrix for quality enhancement: Comprised of five submatrixes • The Seven Core Competencies of the Osteopathic Profession • Expectations for COMLEX-USA, Dimension I and II • Domains of COMLEX-USA-PE • Physician behavior based Patient Safety concerns • The Stillian Paradigm as enunciated in the Four Tenets of Osteopathic Medicine

  4. The Matrix for Quality enhancement • Allows for tracking of core competencies • Provides basis for curriculum development • Can be applied to Standardized Patient and other case based formats • Can track First and Second year encounters • Can be employed by preceptors • Regional Deans could track undergraduate programs • Can be applied to OPTIK programs

  5. Modified Bloom’s Hierarchy of Learning and the Use of the Expanded Matrix

  6. Seven Core Competencies • Individual competencies were analyzed for expectations and requirements • Each competency or required element was subdivided according to expectations • Subdivided expectations were made into the interogative form • Responses were imposed upon the MATRIX grid for analysis

  7. AN example subdivided as to individual expectaTions CORE COMPETENCY 1: Osteopathic Philosophy and Osteopathic Manipulative Medicine Students are expected to demonstrate and apply knowledge of accepted standards in Osteopathic Manipulative Treatment (OMT).The educational goal is to train a skilled and competent osteopathic practitioner who remains dedicated to life-long learningand to practice habits in osteopathic philosophy and manipulative medicine.

  8. AN Example OF the Three expectations Changed to the interogative CORE COMPETENCY 1: Osteopathic Philosophy and Osteopathic Manipulative Medicine DOES THE LEARNING ACTIVITY HELP, ALLOW OR REQUIRE THE STUDENT TO: • Demonstrate and apply knowledge of accepted standards in OMT? • Train a skilled and competent osteopathic practitioner who remains dedicated to life-long learning? • Train a skilled and competent osteopathic practitioner who remains dedicated to practice habits of manipulative medicine?

  9. Required elements ARE ALSO CHANGED PUT INTO A QUERY FORMAT REQUIRED ELEMENT ONE • Does it demonstrate competency in the understanding and application of Osteopathic Manipulative Treatment (OMT)? • Does it integrate Osteopathic Concepts and OMT into the medical care provided to patients? • Does it advance integrating Osteopathic Principles and Philosophy into all clinical and patient care activities?

  10. Matrix for Quality Enhancement Seven Core Competencies of the Osteopathic Profession

  11. Comlex-usa

  12. COMLEX - USA • The NBOME examinations are the primary pathway by which osteopathic physicians apply for licensure to practice osteopathic medicine and surgery • A passing score on these examinations ensures that the candidate’s medical knowledge and clinical skills have met a national standard • The COMLEX-USA examination sequence is accepted for licensure in 50 states • The Osteopathic Medical Board in seven states require COMLEX for licensure

  13. COMLEX - USA • COMLEX – USA examination sequence uses a primary care approach to patient care • Distinctiveness of osteopathic medicine fully integrated throughout the examination • Approximately 20% of questions have a distinct component of Osteopathic philosophy, principles, and practice

  14. Submatrix for COMLEX – USA CLINICAL PRESENTATION • Dimension I lists patient presentations in case history format. PHYSCIAN TASKS • Dimension II ensures adequate demonstration of physician tasks.

  15. Dimension I: Patient Presentation TypesWITH DESIGNATOR ABBREVIATION

  16. Dimension II: Physician Tasks with Designator Abbreviation

  17. COMLEX-USA-Level 2-PE • COMLEX – USA Level 2 –PE is a clinical skills examination with an examination blueprint designed to assess osteopathic students • The blueprint reflects the distinctive practice of osteopathic medicine • All encounters are expected to reflect Osteopathic Principles and Philosophy • Additionally, from 25% to 50% of the encounters, the student is expected to perform appropriate osteopathic manipulative treatment • There is an emphasis on manipulative treatment and the neuromusculoskeletal system as appropriate for osteopathic medicine

  18. COMLEX -USA- PE biomechanical/boimedical domain B

  19. COMLEX-USA-PE humanistic domains

  20. medica safety issues with designator abbreviation

  21. Consider Medical Safety Errors “Never Never Use” Abbreviations- Examples

  22. Structure and Function Are reciprocally interrelated. Normal structure is essential to normal function. The body is a unit. Mind, body, spirit inseparable. The Four Tenets of Osteopathy The Four Tenets of Osteopathy The body possesses healing and self-regulating mechanisms. Rational therapy based upon understanding of body and integration of other three tenets

  23. Stillian paradigm requirements A scientific knowledge of anatomy and physiology in the hands of a person of intelligence and skill Masterful adherence to the process of astute, systematic observations Development of advanced palpatory skills Apply all skills and knowledge base for enhancement and promotion of health

  24. KCOM/ATSU C Fossum, 2006

  25. Know Systemic Drainage Patterns Potential Obstruction to Lymph Flow Myofascial, ANS, Pathological Lymphatic Somatic Dysfunction Sympathetics Para- sympathetics Thoracolumbar Outflow: T1 – L2 Craniosacral Outflow: OA, C1-2; & S1 - 4 Know Sympathetic Chain Ganglia Know Organ Segmentation Viscerosomatic considerations in osteopathic manipulative medicine

  26. Defining Criteria: Tenderness (T) Asymmetry (A) Restricted Range of Motion (R) Tissue Texture Changes (T) Somatic Dysfunction is impaired or altered function of related components of the somatic (body framework) system: skeletal, arthrodial and myofascial structures; and related vascular, lymphatic and neural elements • Palpatory Clues in Viscerosomatic Reflex Activity: • Increased temperature and sweat (sudomotor activity: moisture on skin drag) Korr, 1962, Nicholas et al 1983 • Paraspinal myofascial tissue in area of facilitation feel ‘doughy, boggy’, with predominance of bogginess in the subcutaneous tissues Denslow, 1975, Kappler, 2003 • Segmental response to ‘springing’ usually not confined to just one segment: there is a tendency for two or more segments to react ‘en-bloc’ Beal, 1985, 2004 • Restricted ROM is due to reflexively muscle activation which will give a springy or ropy quality or end-feel on passive motion testing KCOM/ATSU C Fossum2006 Viscerosomatic considerations in osteopathic manipulative medicine • Palpatory Clues to Lymphatic Involvement: • Decreased movement of rib cage and reduced diaphragmatic excursion • Myofascial tension and somatic dysfunctions in areas of transverse diaphragms and spinal junctions • Fullness and bogginess palpated in areas of regional lymphatic drainage • Presence of Chapman’s Reflexes

  27. Evidence-Based Medicine …the integration of best research evidence with clinical expertise and patient values…

  28. The Osteopathic Physician “The relationship between the Osteopath and the patient is the heart of Osteopathy”. (Podmore, 2001) Figure adapted from ACP Journal Club

  29. Evidence Search I A search for the best evidence is based upon the hierarchy of studies as shown: Elsevier Ltd. 2005. Straus et al.: Evidence Based Medicine

  30. Evidence Search II An appraisal of the osteopathic literature is critical to ensure the osteopathic paradigm is foremost in the philosophical application of information to patient care.

  31. Search Requirements Search of relevant data from the osteopathic literature • Ost Med (http://ostmed.hsc.unt.edu/ostmed/) • A.T. Still Library Online Text • ACOFP, JAOA, Journal of the AAO Systems or synopses engines: • Poems (www.infopoems.com) • Up to Date (www.uptodate.com • Family Practice Inquiry Network –(www.fpin.org) Studies, synopsis • PubMed Linkout – ATSU Kirksville – PubMed plus links to the journals owned by ATSU/KCOM • OVID, Google Scholar, others

  32. Evaluation of clinical experiences using sp’s based on seven core competencies Osteopathic Philosophy and Treatment Integration of Osteopathic Principles Expectations for OMS I Medical Microbiology OMT Applications Totals Competency One OMT Integration

  33. to whom much is given, much is expectedLUKE THE PHYSICIAN

  34. Your feedback is desired. Please submit paper or E-commentsto request templatesmlockwood@atsu.edufax660-626-2626

More Related