Geriatric Cardiology OSCE: The Hidden Curriculum, Identifying End Stage Heart Disease & Clarifying Care Goals

Abstract

OPEN ACCESSSeptember 12, 2013Geriatric Cardiology OSCE: The Hidden Curriculum, Identifying End Stage Heart Disease & Clarifying Care Goals Kathryn Denson, MD, Gabriel Manzi, Diane Brown, Catharine Malmsten Kathryn Denson, MD Medical College of Wisconsin Google Scholar More articles by this author , Gabriel Manzi Medical College of Wisconsin Google Scholar More articles by this author , Diane Brown Medical College of Wisconsin Google Scholar More articles by this author , Catharine Malmsten Medical College of Wisconsin Google Scholar More articles by this author https://doi.org/10.15766/mep_2374-8265.9526 SectionsAbout ToolsDownload Citations ShareFacebookTwitterEmail AbstractAbstract Introduction: Fellowship Programs must soon comply with the ACGME's Next Accreditation System (NAS) Milestone performance tracking and reporting requirement and consider Entrustable Professional Activities (EPAs) to measure fellow performance. At the Medical College of Wisconsin (MCW), geriatricians and cardiologists worked together to create and implement a geriatric cardiology education OSCE for cardiology fellows to asses fellow competence in relevant EPAs. This resource is an objective structured clinical exam (OSCE) on geriatric cardiology education for cardiology fellows. Methods: This resource contains all the materials necessary for the geriatric cardiology OSCE regarding end-stage heart disease and end-of-life goal setting. The resource also contains an additional agenda, timeline, and second evaluation form if it's to be combined with our other geriatric cardiology OSCE. Our evaluation tools included a session evaluation and learner self-assessment of skills pre- and postsession. As educators, our goal was to see if the learners were able to recognize that the cardiac disease was at an end-stage process, and then follow with an exploration of cognitive, functional, and social situations in the context of the patient's goals and wishes to discuss a hospice/palliative care approach. Results: Results of the post-OSCE session evaluations showed fellows rating ‘Instructional strategies advanced my learning about geriatrics” as very good (33%) and excellent (66%) and “Overall effectiveness of session” as very good (44%) and excellent (56%). Session strengths included “Patient cases are relevant to daily patient care, very realistic,” and “Excellent discussion of end of life issues.” Pre- and post-EPA ratings revealed a shift to competence. The EPA item, “I can independently identify when a patient's illness trajectory is appropriate for palliative care/hospice” showed a pre-to-post competence change from 56% to 100%. Discussion: Our curricular session demonstrates that OSCE is an effective, well-received instructional method to teach cardiology fellows geriatrics related to Accreditation Council for Graduate Medical Education competencies. Educational Objectives By the end of this OSCE, participants will be able to: Identify end stage cardiac disease in an elderly patient.Determine the patient's cognitive and functional capabilities.Elicit the patient's goals of care.Make care recommendations that are consistent with the patient's life and care goals. Sign up for the latest publications from MedEdPORTAL Add your email below FILES INCLUDEDReferencesRelatedDetails FILES INCLUDED Included in this publication: Case Development Template.doc Debrief Session Questions.doc Door Sign.doc OSCE Evaluation Form (1 OSCE version).docx OSCE Evaluation Form (2 OSCE version).docx SP Directions.doc Session Agenda & Timeline (1 OSCE version).docx Session Agenda & Timeline (2 OSCE version).docx To view all publication components, extract (i.e., unzip) them from the downloaded .zip file. Download editor’s noteThis publication may contain technology or a display format that is no longer in use. Related Geriatric Cardiology OSCE: The Hidden Curriculum, Identifying End Stage Heart Disease & Clarifying Care Goals Geriatric Cardiology OSCE: The Hidden Curriculum, Identifying Hypoactive Delirium When Obtaining Procedural Consent Copyright & Permissions© 2013 Denson et al. This is an open-access article distributed under the terms of the Creative Commons Attribution license.KeywordsTerminal CareGeriatricsEnd of Life Decision MakingGoals of CareEnd Stage Heart DiseasePatient Care PlanningStandardized PatientHeart DiseasesCardiologyOSCE Disclosures None to report. Funding/Support None to report. Loading ...