Geisel School of Medicine at Dartmouth On Doctoring Year One OSCEs Checklist Updated 3.10.2014

• Checklist Instructions:
  Please read through all questions carefully before selecting an answer. Rate the student on each of the listed competencies. The parts of the checklist are:
  
  Part I: General Interview
  Part II: Detailed History
  Part III: Motivational/Counseling Skills Components
  Part IV: Physical Exam Components
  Part V: Clinical Competencies
  Part VI: OSCEs Student Code of Conduct

• Student Full Name (Last, First)

• OSCE Evaluator Full Name

• Patient Safety Simulation & Training Center; Dartmouth-Hitchcock Medical Center

  Date

PART I: GENERAL INTERVIEW

• Part I Instructions:
  Evaluate the student at their level of training as a year one student.
  
  Explanation of Scores:
  (0) NC=Not Completed or observed
  (1) Poor= May need remediation before promotion. Inadequate performance for a year one student at their current level of training.
  (2) Fair= Making progress towards expectations. Fair performance in this area for a year one student at their current level of training, but would benefit from more practice.
  (3) Good= Meets expectations. Good solid performance at a level of mastery expected for a year one student.
  (4) Very Good= Exceeds expectations. Better than average for a year one student. This student displays proficiency for a year one student and is already performing in this area at a level comparable to a novice year two student.

• I.A. BUILDS A RELATIONSHIP (Greets and shows interest in patient; Uses words that show care and concern; Uses correct tone, pace, eye contact, and posture)

  NC

  Poor

  Fair

  Good

  Very Good

• I.B. OPENS THE DISCUSSION (Allows patient to complete opening statement without interruption; Elicits full set of concerns by asking if there are other concerns besides the chief complaint; Sets an agenda)

  NC

  Poor

  Fair

  Good

  Very Good

• I.C. GATHERS INFORMATION (Begins asking open-ended questions; Clarifies details as necessary with more specific yes or no questions; Summarizes, gives patient opportunity to correct or add information)

  NC

  Poor

  Fair

  Good

  Very Good

• I.D. UNDERSTANDS THE PATIENT'S PERSPECTIVE (Asks about life events, circumstances, other health factors; Elicits patient's beliefs, concerns, and expectations about illness and treatment; Responds explicitly to patient's statements about ideas and feelings)

  NC

  Poor

  Fair

  Good

  Very Good

• I.E. SHARES INFORMATION (Assesses the patient's understanding of problem and desire for more information; Explains without using jargon; Asks if patient has any questions)

  NC

  Poor

  Fair

  Good

  Very Good

• I.F. PROVIDES CLOSURE (Asks if patient has any further concerns; Summarizes; Clarifies follow-up or contact arrangements)

  NC

  Poor

  Fair

  Good

  Very Good

PART II: DETAILED HISTORY A. Did the student specifically do or ask the patient about:

• Part II Instructions:
  Evaluate the student at their level of training as a year one student.
  
  Any= At least one item of that question was asked by the student.
  
  Explanation of Scores:
  Some answers may require further explanation in a drop-down menu.
  Yes= The student completed the task.
  No= The student did not complete the task, or did not complete the task with enough accuracy to be excusable.

• II.A.1. Introduce self, set an agenda, did not use jargon.

  No

  Yes

• Which of these were not performed? Please provide feedback.

• II.A.2. Characterize the CC

  No

  Yes

• II.A.2.a. Asked OLDCARTS questions

  No

  Yes

• Onset

  No

  Yes

• Location

  No

  Yes

• Duration

  No

  Yes

• Character

  No

  Yes

• Aggravating/Alleviating factors

  No

  Yes

• Radiation

  No

  Yes

• Timing

  No

  Yes

• Severity

  No

  Yes

• II.A.3. PMH of similar problems.

  No

  Yes

• II.A.4. Any of the following associated symptoms (ROS: fevers, chills, sweats, malaise, weight loss, exertional cp, sob, cough, reflux, n/v/d/c, blood in stool or emesis, h/o abdominal surgery)

  No

  Yes

• II.A.5. Patient's treatments for symptoms

  No

  Yes

• II.A.6. Any medications or allergies.

  No

  Yes

• II.B. Any relevant risk factors

  No

  Yes

• II.B.1. Smoking history.

  No

  Yes

• II.B.2. Alcohol history.

  No

  Yes

• II.B.2.a. Give brief advice about importance of alcohol cessation.

  No

  Yes

• II.B.2.b. Impact of drinking on home or work life.

  No

  Yes

• II.B.2.c. Any CAGE questions. (Cut down, Annoyed, Guilt, Eye opener)

  No

  Yes

• Cut down

  No

  Yes

• Annoyed

  No

  Yes

• Guilty

  No

  Yes

• Eye opener

  No

  Yes

• II.B.2.d. Family history of alcoholism.

  No

  Yes

• II.C. Comments regarding history components.

PART III: MOTIVATIONAL/COUNSELING SKILLS COMPONENTS A. Did the student specifically perform the following:

• Part III Instructions:
  Evaluate the student at their level of training as a year one student.
  
  Explanation of Scores:
  Some answers may require further explanation in a drop-down menu.
  Yes= The student completed the task.
  No= The student did not complete the task, or did not complete the task with enough accuracy to be excusable.

• III.A.1. Assess the patient's readiness to change.

  No

  Yes

• III.A.2. Use reflection.

  No

  Yes

• III.A.3. Counsel the patient on cessation.

  No

  Yes

• III.A.4. Convey respect for the patient and problem.

  No

  Yes

• III.B. Comments regarding motivational/counseling skills components.

PART IV: PHYSICAL EXAM COMPONENTS III.A. Did the student's physical exam contain the following:

• Part IV Instructions:
  Evaluate the student at their level of training as a year one student.
  
  Explanation of Scores:
  Yes= The student completed the task.
  No= The student did not complete the task, or did not complete the task with enough accuracy to be excusable.

• IV.A.1. Wash or sanitize their hands prior to the exam

  No

  Yes

• IV.A.2. Use stethoscope diaphragm to listen to chest anteriorly and posteriorly.

  No

  Yes

• IV.A.3. Auscultate the heart in the four cardinal positions.

  No

  Yes

• IV.A.4. Auscultate the abdomen in at least one quadrant.

  No

  Yes

• IV.A.5 Percuss the liver to assess size.

  No

  Yes

• IV.A.6. Palpate abdomen.

  No

  Yes

• IV.B. Comments regarding physical exam components.

PART V: CLINICAL COMPETENCIES Did the student perform the following competencies at a novice level during the OSCE:

• Part V Instructions:
  Geisel School of Medicine at Dartmouth has designated a specific set of clinical skills to be directly and carefully observed by OSCE evaluators during the On Doctoring course. Students are to be evaluated as to the level of performance achieved at the end of year one On Doctoring. Please see the competency scores below for a longer explanation of levels of performance expected of our students at the end of the course.
  
  NOVICE= Student is learning this clinical skill, but is often not accurate or able to perform independently; performance is slow and deliberate, often following a written outline or template. Expected level of performance at the end of On Doctoring, or during the first few weeks of an early Y3 Clerkship. Student is not yet ready to move on to Y4 Clerkships or Sub-internships.
  
  *Please select Novice for every skill presented that was observed during the OSCE, and initial. If students did not perform the skill, select Not Observed.

• Interview: HPI & PMH relevant for case

  Novice

  Not Observed

• Please sign your initials by clicking "Sign" on the right.

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• Physical Exam: Focused exam based on specified case

  Novice

  Not Observed

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• Counsel: Motivational Interviewing

  Novice

  Not Observed

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• Professional Manner and Rapport

  Novice

  Not Observed

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• Comments:

PART VI: OSCES STUDENT CODE OF CONDUCT

• Part VI Instructions:
  At the end of the encounter, please ask the student to read the statement and sign their name to agree to the contract.

• I promise to abide by the Geisel School of Medicine Honor Code Policy, which states in brief that students will not do any of the following: violate the principles of the DHMC Code of Professional Conduct, give or receive aid in examinations or prohibited aid in class assignments including discussing the content of the OSCE case with other students.
  
  In addition to the above, I will take an active role in ensuring that I uphold the spirit and letter of the Honor Code, and have the responsibility to participate in the enforcement of this code when appropriate to do so; take appropriate action I believe a breach of the Honor Code has occurred as outlined in this policy.
  
  Note that no code can explicitly enumerate all conceivable instances of prohibited conduct. In situations where the boundaries of proper conduct are unclear, the student accepts the responsibility to seek clarification from his or her peers and appropriate faculty members.
  
  By signing your name below, you agree to the policy and its terms.

• Please type your name in the box below and click "Sign" to sign your full name electronically using your finger or a stylus.

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