Geisel School of Medicine at Dartmouth On Doctoring Year Two OSCEs Checklist 1.31.2013

• 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: Physical Exam Components
  Part IV: Oral Presentation of History
  Part V: Clinical Competencies

• 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 two student.
  
  Explanation of Scores:
  NC=Not Completed or observed
  Poor= May need remediation before promotion. Inadequate performance for the end of year two. Not ready to move on to year three.
  Fair= Making progress towards expectations. Fair performance in this area, but would benefit from a bit more practice before beginning year three.
  Good= Meets expectations. Good solid performance at a level of mastery expected for the end of year two.
  Very Good= Exceeds expectations. Better than average for a year two student. This student displays proficiency for a year two student and is already performing in this area at a level comparable to a novice year three 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)

  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)

  NC

  Poor

  Fair

  Good

  Very Good

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

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

• II.A.1. PMH of chronic diseases

  No

  Yes

• II.A.2. PMH of similar problems

  No

  Yes

• II.A.3. Fully characterize the CC; asked OLDCARTS questions

  No

  Yes

• What questions were asked if any? Please provide feedback.

• II.A.4. Any associated symptoms

  No

  Yes

• II.A.4.a. List relevant symptoms the student asks about:

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

  No

  Yes

• II.A.6. Patient's adherence to medication regimen

  No

  Yes

• II.A.7. Any medication side effects

  No

  Yes

• II.A.8. Any relevant risk factors

  No

  Yes

• II.A.8.a. Smoking

  No

  Yes

• II.A.8.b. Hypertension

  No

  Yes

• II.A.8.c. Diabetes

  No

  Yes

• II.A.8.d. Hyperlipidemia

  No

  Yes

• II.A.8.e. Family Hx of early CAD

  No

  Yes

• II.A.9. Associated ROS

  No

  Yes

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

• Part III Instructions:
  Evaluate the student at their level of training as a year two 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. Some answers of "No" may require further explanation in a drop-down menu.

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

  No

  Yes

• III.A.2. Re-check any abnormal vital signs

  No

  Yes

• III.A.3. Perform the relevant exam parts accurately

  No

  Yes

• What was inaccurate? Please provide feedback.

• III.B. General Comments on Patient Interaction:

• III.C. Specific Comments on Data Gathering & Physical:

PART IV: ORAL PRESENTATION OF HISTORY A. Did the student's presentation include the following:

• Part IV Instructions:
  Evaluate the student at their level of training as a year two 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. Some answers of "No" will require further explanation in a drop-down menu if it appears.

• IV.A.1. Organization

  No

  Yes

• Please provide feedback.

• IV.A.2. Relevant ROS, PMH, FH and Habits

  No

  Yes

• IV.A.3. Pertinent vitals and physical exam

  No

  Yes

• IV.A.4. Summary Statement

  No

  Yes

• IV.A.5. Assessment that includes a brief differential diagnosis and plan

  No

  Yes

• IV.A.6. Please provide any additional comments on the oral presentation.

PART V: CLINICAL COMPETENCIES

• Part V Instructions:
  Evaluate the student at their level of training as a year two student. Students are to be evaluated as to level of performance achieved at the end of On Doctoring.
  
  Explanation of Scores:
  Not Observed (N/A)=Student did not complete this task during the OSCEs.
  Novice (N)=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 Year 3 clerkship; student is not yet ready to move on to Year 4 clerkships or SubInternships.
  *(ONLY USE THE FOLLOWING IN AREAS OF EXCEPTIONAL PERFORMANCE) Advanced Beginner (AB)= Student performs this clinical skill with increased dexterity, speed, independence, and accuracy; expected level of performance at the end of a Year 3 clerkship; student is ready to continue on to the greater independence and responsibilities of Year 4 clerkships and SubInternships.

• Professional Manner and Rapport

  N

  AB

  N/A

• Please explain the reasoning for this score.

• Please initial by selecting "Sign"

  Sign

• Interview: HPI relevant for case

  N

  AB

  N/A

• Please explain the reasoning for this score.

• Please initial by selecting "Sign"

  Sign

• Counsel: Shared Decision Making

  N

  AB

  N/A

• Please explain the reasoning for this score.

• Please initial by selecting "Sign"

  Sign

• Counsel: Smoking Cessation

  N

  AB

  N/A

• Please explain the reasoning for this score.

• Please initial by selecting "Sign"

  Sign

• PE: Focused exam based on specified case

  N

  AB

  N/A

• Please explain the reasoning for this score.

• Please initial by selecting "Sign"

  Sign

• Communication: Oral Presentation of Patient

  N

  AB

  N/A

• Please explain the reasoning for this score.

• Please initial by selecting "Sign"

  Sign

• Comments: