overview of phase iii - squ.edu.om 1/assess… · in phase iii of new curriculum ... • mcq/saq...

Teaching & Assessment in Phase III of New Curriculum

Ikram A Burney

Senior Consultant in Medicine

Member Curriculum & Examination committee, SQU

Co-ordinator Phase III (clinical Years)

agenda

√ 1. Assessment principles

in new curriculum

2. What methods have been chosen

3. Why were those chosen

× 1. What exactly are these

methods

2. Why they work

3. How they work

Feb 14, 2012 Assessment Workshop 2

PHASE III

Behavioral Medicine, Communication Skills, History Taking,

Physical Examination Skills, Ethics, Prescribing, Medical Records, HIS

Medicine (7)

Child Health

(6)

Surgery (6)

Behavioral

Medicine (7)

Ophthalmology

(3)

FAMCO (5)

Orthopedics,

Rehab and Pain

Management

(4)

Clinical

Genetics &

Counseling (2)

SLT (Anes) (1)

Dermatology(2)

SLT (Lab) (1) SLT (Stats) (1)

SLT Forensic

Medicine (1)

SLT (Geriatrics)

(1) Oral Health (1)

Break (1 week)

Junior Clerkship Exams (1 week)

Buffer (3 weeks)

Medicine (7)

Child Health

(3) Surgery (3)

Obs/Gyne (8) Elective (8)

A&E (4)

FAMCO (3)

ICU (1)

ENT (2)

Hematology (2)

SLT (Lab) (2) Radiology (2) Selective (2) SLT (Therap) (1)

Break (1 week)

Senior Clerkship Exams (1 week)

Buffer (3 weeks)

Pre-Internship

Medicine

(3 weeks)

Surgery

(3 weeks)

Child Health

(3 weeks)

Obs/Gyn

(3 weeks)

Buffer (2 weeks)

FINAL MD EXAM (2 weeks)

Pre

-cle

rksh

ip

(10

wee

ks)

Pre

-Int

erns

hip

(12

wee

ks)

S

enio

r C

lerk

ship

(48

wee

ks)

Ju

nio

r C

lerk

ship

(48

wee

ks)

Feb 14, 2012 3 Assessment Workshop

Clinical years

Old New


5th year

6th year

7th year

Junior Clerkship

Senior Clerkship

Pre-Internship

Pre-clerkship

Early Clinical Exposure?

5

Integrated Modules (3 semesters)

History & Physical (10/52)

Junior Clerkship (52/52)

Senior Clerkship (52/52)

Pre-Internship (12/52) Feb 14, 2012 Assessment Workshop

In summary, the curriculum is …

• Outcome-based

• Presentation-based

• Integrated

– Horizontally

– Vertically

• Provides early clinical exposure


Assessment principles in new curriculum

1. Integration

1. ‘Blocks’ rather than ‘Rotations’

2. End-of-Clerkship exams

3. In-rotation End-of-Clerkship

2. Progression block at stage 1

3. Final mark = Ph II + Ph III + FMD


Medicine & Allied Week A B C D E F

1 Med CH Surgery

Ophthal

BM

FAMCO

2 Med CH Surgery Ophthal BM FAMCO


4 Med

CH

Surgery

Orthopedics

BM

FAMCO

5 Med

CH

Surgery

Orthopedics

BM

FAMCO

6 Med

CH

Surgery

Orthopedics

BM

Dermatol

7 Med

Genetics

Anesthesia Orthopedics

BM

Dermatol

8 Lab

Genetics

EBM

Geriatrics

Forensic

Oral Health


Surgery & Allied Week A B C D E F

1 Med CH Surgery

Ophthal

BM

FAMCO



4 Med

CH

Surgery

Orthopedics

BM

FAMCO

5 Med

CH

Surgery

Orthopedics

BM

FAMCO

6 Med

CH

Surgery

Orthopedics

BM

Dermatol

7 Med

Genetics


BM

Dermatol

8 Lab

Genetics

EBM

Geriatrics

Forensic

Oral Health


Ambulatory Medicine Week A B C D E F

1 Med CH Surgery

Ophthal

BM

FAMCO



4 Med

CH

Surgery

Orthopedics

BM

FAMCO

5 Med

CH

Surgery

Orthopedics

BM

FAMCO

6 Med

CH

Surgery

Orthopedics

BM

Dermatol

7 Med

Genetics


BM

Dermatol

8 Lab

Genetics

EBM

Geriatrics

Forensic

Oral Health


PHASE III



Medicine (7)

Child Health

(6)

Surgery (6)

Behavioral

Medicine (7)

Ophthalmology

(3)

FAMCO (5)

Orthopedics,

Rehab and Pain

Management

(4)

Clinical

Genetics &

Counseling (2)

SLT (Anes) (1)

Dermatology(2)


SLT Forensic

Medicine (1)

SLT (Geriatrics)

(1) Oral Health (1)

Break (1 week)


Buffer (3 weeks)

Medicine (7)

Child Health

(3) Surgery (3)


A&E (4)

FAMCO (3)

ICU (1)

ENT (2)

Hematology (2)


Break (1 week)


Buffer (3 weeks)

Pre-Internship

Medicine

(3 weeks)

Surgery

(3 weeks)

Child Health

(3 weeks)

Obs/Gyn

(3 weeks)

Buffer (2 weeks)


Pre

-cle

rksh

ip

(10

wee

ks)

Pre

-Int

erns

hip

(12

wee

ks)

S

enio

r C

lerk

ship

(48

wee

ks)

Ju

nio

r C

lerk

ship

(48

wee

ks)


PHASE III



Medicine (7)

Child Health

(6)

Surgery (6)

Behavioral

Medicine (7)

Ophthalmology

(3)

FAMCO (5)

Orthopedics,

Rehab and Pain

Management

(4)

Clinical

Genetics &

Counseling (2)

SLT (Anes) (1)

Dermatology(2)


SLT Forensic

Medicine (1)

SLT (Geriatrics)

(1) Oral Health (1)

Break (1 week)


Buffer (3 weeks)

Medicine (7)

Child Health

(3) Surgery (3)


A&E (4)

FAMCO (3)

ICU (1)

ENT (2)

Hematology (2)


Break (1 week)


Buffer (3 weeks)

Pre-Internship

Medicine

(3 weeks)

Surgery

(3 weeks)

Child Health

(3 weeks)

Obs/Gyn

(3 weeks)

Buffer (2 weeks)


Pre

-cle

rksh

ip

(10

wee

ks)

Pre

-Int

erns

hip

(12

wee

ks)

S

enio

r C

lerk

ship

(48

wee

ks)

Ju

nio

r C

lerk

ship

(48

wee

ks)


Stage 1

Stage 2

Final Mark

• Pre-clinical 3.3 10% 0.33

• Stage 1 2.41 20% 0.482

• Stage 2 2.58 20% 0.516

• Final MD C- 1.70 50% 1.70

• Overall GPA 2.18


What methods have been chosen

In-rotation

• Observed long case

• Mini-CEX

• SAQ/MEQ/KFQ

• Portfolio – Seminars

– Ward round presentations

– Bedside procedures

– Extra-curricular activities

End-of-clerkship

• MCQ/SAQ

• OSCE


Final MD

•MCQ/SAQ •OSPE •PACES style Short Cases

Why were those chosen


Validity

Feasibility Reliability



Validity


Assess all outcomes

Work-place based

Allow integration

Formative



Validity


Assess all outcomes

Work-place based

Allow integration

Formative

X Resource-intense

X Expensive

? Numbers



Validity


Assess all outcomes

Work-place based

Allow integration

Formative

X Resource-intense

X Expensive

? Numbers

Between 12 an 14

patient encounters are

sufficient to achieve a

reliability of 0.8

Norcini et al 1995; Holmboe et al 2003

Pre-Clerkship

1 2 3 4 5 6 7 8 9

GPE Mini-CEX

Abd Mini-CEX

Chest Mini-CEX

CVS Mini-CEX

CNS Mini-CEX

MSS Mini-CEX

HEENT Mini-CEX

CH Mini-CEX

Obs/Gy Mini-CEX

MCQ/SAQ


Junior Clerkship Week A B C D E F

1 Med X

CH X

Surgery X

Ophthal X

BM X

FAMCO X

2 Med x

CH x

Surgery x

Ophthal Mini-CEX

BM x

FAMCO x

3 Med Mini-CEX

CH Mini-CEX

Surgery Mini-CEX

Ophthal Mini-CEX

BM Mini-CEX

FAMCO Mini-CEX

4 Med OLC

CH Mini-CEX

Surgery OLC

Orthopedics X

BM OLC

FAMCO Mini-CEX

5 Med Mini-CEX

CH Mini-CEX

Surgery Mini-CEX

Orthopedics Mini-CEX

BM Mini-CEX

FAMCO OLC

6 Med Mini-CEX

CH OLC

Surgery OLC


BM Mini-CEX

Dermatol KFQ

7 Med OLC

Genetics SAQ

Anesthesia Mini CEX


BM OLC

Dermatol KFQ

8 Lab SAQ

Genetics SAQ

EBM MEQ

Geriatrics SAQ

Forensic MEQ

Oral Health KFQ


Numbers

OLC miniCEX Written Total

Medicine 3 6 3 12

Surgery 2 8 2 12

Ambulatory 4 5 3 12

Total 7 19 8 36


Challenges

Change vs Status quo

People seem to want to follow the

beaten path; the difficulty is that

the beaten path does not seem

to lead anywhere


SQUH RH AFH KH NH IbneS LHC

Med X X X

Lab X

CH X X X X

Genetics X

Surgery X X X

Anesth X X X

EBM X

Opthal X X

Orthop X

Geriatric X

BM X X

FM X

FAMCO X XXXX

Derma X X

OH X X


Communication


Conclusions

• New curriculum

• Challenges

• New methods of assessment

• Faculty Development

• Horse before the cart ??

• Principles vs Practice


overview of phase iii - squ.edu.om 1/assess… · in phase iii of new curriculum ... • mcq/saq...

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