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A Competency Based Osteopathic Internship

A Competency Based Osteopathic Internship. Bruce Dubin, DO The Edward Via – Virginia College of Osteopathic Medicine. Interns. Study basic areas of: Internal Medicine Surgery Obstetrics Pediatrics Family Practice Emergency Medicine. Model Rotating Osteopathic Internship.

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A Competency Based Osteopathic Internship

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  1. A Competency Based Osteopathic Internship Bruce Dubin, DO The Edward Via – Virginia College of Osteopathic Medicine

  2. Interns • Study basic areas of: • Internal Medicine • Surgery • Obstetrics • Pediatrics • Family Practice • Emergency Medicine

  3. Model Rotating Osteopathic Internship • No less than two months of exposure in general internal medicine • One month exposure in emergency medicine • One month in family practice

  4. Progression has been time based

  5. Interns • Do not progress at the Same Rate • The schedule expects/requires everyone to move at the same rate • Tends to be teacher centered

  6. Performance • Restraints of time • Measures are frequently pre and then post-rotation • Individual assistance in problem areas is minimized

  7. Time based education is an ineffective and inefficient system when the goal is to train individuals to perform specific, job related skills

  8. Pilot Training

  9. Competent Clinician One who is able to perform clinical skills to a satisfactory standard

  10. Competency Based Training

  11. CBT The unit of progression is mastery of specific knowledge and skills to a specific standard

  12. Two Key Components of CBT

  13. Skill A task or group of tasks performed to a specific level of proficiency which use motor functions and typically require manipulation of instruments and equipment • Central Line, ABG • Counseling

  14. Competency A skill performed to a specific standard and under specific conditions

  15. CBT Competencies to be achieved are carefully: 1. Identified 2. Verified 3. Made publicin advance

  16. CBT Assessment criteria are: 1. Explicitly stated 2. Made public in advance

  17. CBT Instructional program provides for individual development and evaluation of each of the competencies specified.

  18. CBT Actual performance of the competency as the primary source of evidence is required (take into account knowledge and attitude of participant)

  19. CBT Participants progress through the instructional program at their own rate by demonstrating the attainment of the specified competencies

  20. Characteristics of a CBT Curriculum

  21. Characteristics of a CBT Curriculum • Competencies are carefully selected • Essential knowledge is learned to support skill performance • Detailed training materials are keyed to the competencies to be achieved and are designed to support the acquisition of knowledge and skills

  22. Characteristics of a CBT Curriculum • Premise that all participants can master the required knowledge or skill, provided sufficient time and appropriate training methods are used. • Knowledge and skills are assessed as interns enter a program and those with satisfactory knowledge and skills may bypass training or competencies already attained.

  23. Characteristics of a CBT Curriculum • Learning should be self paced • Use flexible training methods • Large and small group activities • Individual study components • Use a variety of support materials • Print • Audiovisual • Simulations

  24. Characteristics of a CBT Curriculum • Satisfactory completion of training is based on achievement of all specified competencies

  25. Advantages of CBT • Achieve competencies required in clinical job performance • Build confidence as success is demonstrated and measured in mastering specific competencies • Interns receive a transcript or list of competencies achieved

  26. Advantages of CBT • More efficient use of training time • Trainer is a facilitator of learning rather than a provider of information • More time devoted to interns individually or in small groups • More time devoted to evaluation and an individuals ability to perform essential job skills

  27. Disadvantages of CBT • Need to train the trainers (tendency to “teach as we were taught). • CBT is only as effective as the process used to identify competencies

  28. CBT A course may be called CBT, but unless specific CBT materials and training approaches are designed and used, it is unlikely that the resulting course will be truly competency-based.

  29. Use of Models and Simulations

  30. The Cave at Virginia Tech

  31. The Cave

  32. Student Inside a DNA Molecule

  33. Suturing inside the Cave

  34. Laser Surgery

  35. It’s All About Education

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