michael jibson , m.d., ph.d. david kaye , m.d. sandra sexson , m.d

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Clinical Skills Verification Rater Training MODULE 4 Strategies for Clinical Skills Assessment: Models and Best Practices Michael Jibson, M.D., Ph.D. David Kaye , M.D. Sandra Sexson , M.D.

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Clinical Skills Verification Rater Training MODULE 4 Strategies for Clinical Skills Assessment: Models and Best Practices. Michael Jibson , M.D., Ph.D. David Kaye , M.D. Sandra Sexson , M.D. Module 4 Pre-Test. - PowerPoint PPT Presentation

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Page 1: Michael  Jibson , M.D., Ph.D. David Kaye , M.D. Sandra  Sexson  , M.D

Clinical Skills Verification Rater TrainingMODULE 4

Strategies for Clinical Skills Assessment:Models and Best Practices

Michael Jibson, M.D., Ph.D.David Kaye , M.D.

Sandra Sexson , M.D.

Page 2: Michael  Jibson , M.D., Ph.D. David Kaye , M.D. Sandra  Sexson  , M.D

Module 4 Pre-Test

1. The strength of a Clinical Skills Verification Examination stems from its ability to serve as a forum for all of the following except:

A. A high stakes examination

B. direct observation of clinical skillsC. provision of immediate feedback on performanceD. repeated administrations during residency

Page 3: Michael  Jibson , M.D., Ph.D. David Kaye , M.D. Sandra  Sexson  , M.D

2. Which of the following models for CSV exam is the least standardized?

A. Workshop Model

B. Mock Board Model

C. Clinical Evaluation Model

Module 4 Pre-Test

Page 4: Michael  Jibson , M.D., Ph.D. David Kaye , M.D. Sandra  Sexson  , M.D

Module 4 Pre-Test

3. Which of the following models for the CSV exam makes the greatest use of resident peer feedback?

A. Workshop Model

B. Mock Board ModelC. Clinical Evaluation Model

Page 5: Michael  Jibson , M.D., Ph.D. David Kaye , M.D. Sandra  Sexson  , M.D

Module 4 Pre-Test

4. Within a program, consistency of faculty expectations and rating of residents on the CSV exam can be maximized by:

A. All raters using the same evaluation model

B. Limiting assessment to the three competency areas outlined by the ABPN

C. Using standardized patientsD. Monitoring inter-rater reliability

Page 6: Michael  Jibson , M.D., Ph.D. David Kaye , M.D. Sandra  Sexson  , M.D

Clinical Skill Verification (CSV)

Strengths of Clinical Skills Verification• Direct observation of clinical skill• Multiple observations and observers• Defined areas for evaluation• Specific anchors for performance• Immediate feedback• Ample opportunity for remediation

Page 7: Michael  Jibson , M.D., Ph.D. David Kaye , M.D. Sandra  Sexson  , M.D

Evaluation Model

We recommend that the evaluation:• Be done early in residency and repeated

frequently• Include immediate feedback • Avoid the “high-stakes exam” model

Page 8: Michael  Jibson , M.D., Ph.D. David Kaye , M.D. Sandra  Sexson  , M.D

Evaluation Model

Mock Board Model• Use the CSV for the current practice of

“Mock Board” exams• Prearranged patients • Scheduled interviews

Page 9: Michael  Jibson , M.D., Ph.D. David Kaye , M.D. Sandra  Sexson  , M.D

Mock Board Model

Advantages• Familiar format• Highly standardized

Disadvantages• Retains high-stakes exam format• Narrow patient selection• Difficult to schedule

Page 10: Michael  Jibson , M.D., Ph.D. David Kaye , M.D. Sandra  Sexson  , M.D

Evaluation Model

Workshop Model• Use the CSV form for a workshop or class

on interviewing• Involve peer resident observers • Videotape the encounter

Page 11: Michael  Jibson , M.D., Ph.D. David Kaye , M.D. Sandra  Sexson  , M.D

Workshop Model

Advantages• Multiple residents

involved• Highly

standardized• Excellent

feedback (if videotaped)

Disadvantages• Few opportunities

for each resident to interview

• Narrow patient selection

Page 12: Michael  Jibson , M.D., Ph.D. David Kaye , M.D. Sandra  Sexson  , M.D

Evaluation Model

Clinical Model• Use the CSV form for any initial clinical

encounter with supervising faculty• Inpatient admission• Emergency room evaluation• Outpatient assessment

Page 13: Michael  Jibson , M.D., Ph.D. David Kaye , M.D. Sandra  Sexson  , M.D

Clinical Model

Advantages• Broad range of

patients• Many

opportunities to interview

• Easy to schedule

Disadvantages• Moderately

standardized• Faculty buy-in

essential

Page 14: Michael  Jibson , M.D., Ph.D. David Kaye , M.D. Sandra  Sexson  , M.D

Evaluation Model

We recommend that the evaluation:• Occur during regularly scheduled clinical

rotations• Involve the standard interview used in that

clinical setting• Involve randomly selected patients• Be done as part of the routines of clinical

care

Page 15: Michael  Jibson , M.D., Ph.D. David Kaye , M.D. Sandra  Sexson  , M.D

Additional Issues

Programs may want to consider:• Using the exam to test additional

competencies for their own purposes• Requiring residents to pass the examination

before advancing through training

Page 16: Michael  Jibson , M.D., Ph.D. David Kaye , M.D. Sandra  Sexson  , M.D

Additional Competencies

CSV requirements may be combined with other clinical competencies:• Case formulation• Diagnostic assessment• Treatment planning

Page 17: Michael  Jibson , M.D., Ph.D. David Kaye , M.D. Sandra  Sexson  , M.D

Faculty Training

We recommend that programs:• Offer training to faculty in how to conduct

and score the examination• Make an effort to standardize scoring on the

examination• Monitor inter-rater reliability internally• Consider credentialing faculty as evaluators

Page 18: Michael  Jibson , M.D., Ph.D. David Kaye , M.D. Sandra  Sexson  , M.D

Post-Test Module 4

1. The strength of a Clinical Skills Verification Examination stems from its ability to serve as a forum for all of the following except:

A. A high stakes examination

B. direct observation of clinical skillsC. provision of immediate feedback on performanceD. repeated administrations during residency

Page 19: Michael  Jibson , M.D., Ph.D. David Kaye , M.D. Sandra  Sexson  , M.D

Post-Test Module 4

1. The strength of a Clinical Skills Verification Examination stems from its ability to serve as a forum for all of the following except:

A. A high stakes examination

The in –residency CSV exam allows programs to administer repeatedly and avoid the high-stakes aspect.

Page 20: Michael  Jibson , M.D., Ph.D. David Kaye , M.D. Sandra  Sexson  , M.D

Post-Test Module 4

2. Which of the following models for CSV exam is the least standardized?

A. Workshop Model

B. Mock Board ModelC. Clinical Evaluation Model

Page 21: Michael  Jibson , M.D., Ph.D. David Kaye , M.D. Sandra  Sexson  , M.D

Post-Test Module 4

2. Which of the following models for CSV exam is the least standardized?

C. Clinical Model

The clinical model utilizes patients seen on regular clinical services without pre-selection of patients

Page 22: Michael  Jibson , M.D., Ph.D. David Kaye , M.D. Sandra  Sexson  , M.D

Post-Test Module 4

3. Which of the following models for the CSV exam makes the greatest use of resident peer feedback?

A. Workshop Model

B. Mock Board ModelC. Clinical Evaluation Model

Page 23: Michael  Jibson , M.D., Ph.D. David Kaye , M.D. Sandra  Sexson  , M.D

Post-Test Module 4

3. Which of the following models for the CSV exam makes the greatest use of resident peer feedback?

A. Workshop Model

Page 24: Michael  Jibson , M.D., Ph.D. David Kaye , M.D. Sandra  Sexson  , M.D

Post-Test Module 4

4. Within a program, consistency of faculty expectations and rating of residents on the CSV exam can be maximized by:

A. All raters using the same evaluation model

B. Limiting assessment to the three competency areas outlined by the ABPN

C. Using standardized patientsD. Monitoring inter-rater reliability

Page 25: Michael  Jibson , M.D., Ph.D. David Kaye , M.D. Sandra  Sexson  , M.D

Post-Test Module 4

4. Within a program, consistency of faculty expectations and rating of residents on the CSV exam can be maximized by:

D. Monitoring inter-rater reliability

Along with faculty training on how to conduct and score the examination, tracking inter-rater reliability among faculty after observing the same performance and giving feedback to faculty regarding their ratings compared to others is a very effective way of standardizing ratings.