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Bußenius L, Harendza S. Development of an instrument for medical students' self-assessment of facets of competence for patient-centred care. PATIENT EDUCATION AND COUNSELING 2023; 115:107926. [PMID: 37536112 DOI: 10.1016/j.pec.2023.107926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 07/25/2023] [Accepted: 07/26/2023] [Indexed: 08/05/2023]
Abstract
OBJECTIVE To develop a facets of competence self-assessment instrument (FOCSI) with operationalised items for ten competence facets required for patient-centred care at the beginning of residency. METHODS We conducted focus groups and cognitive interviews with final-year medical students to develop items that match students' clinical experience. We tested 50 items in two samples and analysed model fit and internal consistency of all possible combinations to identify the optimal ten-item-solution. Item analysis was performed as well as correlation with six personality traits. RESULTS An optimal ten-item solution for the self-assessment instrument emerged for sample 1 (n = 101, 27.2 ± 3.5 years, 75.2 % female). We validated the model fit with sample 2 (n = 135, 27.7 ± 3.9 years, 66.7 % female): χ2(35) = 49.3, p = .055, CFI = .94, RMSEA = .055, SRMR = .058, Cronbach's alpha = .78. The personality factors 'Conscientiousness' and 'Extraversion' correlate positively with most FOCSI items. CONCLUSION The operationalised FOCSI items support undergraduate medical students close to graduation in realistic self-assessment of facets of competences for patient-centred care in their transition to residency. PRACTICE IMPLICATIONS Realistic self-assessment of facets of competence will provide medical students with the opportunity to monitor their competence development as part of self-directed learning for gaining adaptive expertise in professional, patient-centred care.
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Affiliation(s)
- Lisa Bußenius
- III. Department of Internal Medicine, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany.
| | - Sigrid Harendza
- III. Department of Internal Medicine, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
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Bos-van den Hoek DW, Smets EMA, Ali R, Baas-Thijssen MCM, Bomhof-Roordink H, Helsper CW, Stacey D, Tange D, van Laarhoven HWM, Henselmans I. A blended learning for general practitioners and nurses on skills to support shared decision-making with patients about palliative cancer treatment: A one-group pre-posttest study. PATIENT EDUCATION AND COUNSELING 2023; 112:107712. [PMID: 37004502 DOI: 10.1016/j.pec.2023.107712] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 03/14/2023] [Accepted: 03/17/2023] [Indexed: 05/09/2023]
Abstract
OBJECTIVE To evaluate a newly developed blended learning programme for general practitioners (GPs) and nurses in supporting shared decision making (SDM) about palliative cancer treatment in a simulated setting. METHODS In a pre-posttest study, healthcare professionals (HCPs) participated in the blended learning (i.e. e-learning and (online) training session). HCPs filled out surveys (T0 (baseline), T1 (after e-learning) and T2 (after full blended learning)) and engaged in simulated consultations at T0 and T2. The primary outcome was observed SDM support (Triple-S; DSAT-10 for validation). Secondary outcomes included satisfaction, knowledge about and attitude towards SDM support. Repeated measures General Linear Models were conducted. RESULTS 33 HCPs (17 GPs and 16 nurses) participated. SDM support significantly improved after training (Triple-S; medium effect). Observers' overall rating of SDM support (medium effect) as well as HCPs' knowledge (large effect) and beliefs about their capabilities (medium effect) improved after training. There was no difference in decision support skills (DSAT-10), HCPs' other clinical behavioural intentions and satisfaction. HCPs evaluated the training positively. CONCLUSION Blended learning for HCPs on supporting SDM in palliative cancer care improved their skills, knowledge and confidence in simulated consultations. PRACTICE IMPLICATIONS These first findings are promising for evaluating interprofessional SDM in clinical practice.
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Affiliation(s)
- Danique W Bos-van den Hoek
- Amsterdam UMC location University of Amsterdam, department of Medical Psychology, Meibergdreef 9, Amsterdam, the Netherlands; Amsterdam Public Health research institute, Quality of Care program, Amsterdam, the Netherlands; Cancer Center Amsterdam, Cancer Treatment and Quality of Life, Amsterdam, the Netherlands.
| | - Ellen M A Smets
- Amsterdam UMC location University of Amsterdam, department of Medical Psychology, Meibergdreef 9, Amsterdam, the Netherlands; Amsterdam Public Health research institute, Quality of Care program, Amsterdam, the Netherlands; Cancer Center Amsterdam, Cancer Treatment and Quality of Life, Amsterdam, the Netherlands
| | - Rania Ali
- Amsterdam UMC location University of Amsterdam, department of Medical Psychology, Meibergdreef 9, Amsterdam, the Netherlands
| | | | - Hanna Bomhof-Roordink
- Amsterdam UMC location Vrije Universiteit Amsterdam, Department of Public and Occupational Health, Boelelaan 1117, Amsterdam, the Netherlands
| | - Charles W Helsper
- Julius Center, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Dawn Stacey
- School of Nursing, University of Ottawa, Ottawa, Canada; Centre for Implementation Research, Ottawa Hospital Research Institute, Ottawa, Canada
| | - Dorien Tange
- Dutch Federation of Cancer Patient Organizations (NFK), Godebaldkwartier 365, Utrecht, the Netherlands
| | - Hanneke W M van Laarhoven
- Cancer Center Amsterdam, Cancer Treatment and Quality of Life, Amsterdam, the Netherlands; Amsterdam UMC Location University of Amsterdam, Department of Medical Oncology, Meibergdreef 9, Amsterdam, the Netherlands
| | - Inge Henselmans
- Amsterdam UMC location University of Amsterdam, department of Medical Psychology, Meibergdreef 9, Amsterdam, the Netherlands; Amsterdam Public Health research institute, Quality of Care program, Amsterdam, the Netherlands; Cancer Center Amsterdam, Cancer Treatment and Quality of Life, Amsterdam, the Netherlands; Amsterdam UMC Location University of Amsterdam, department of General Practice, Meibergdreef 9, Amsterdam, the Netherlands
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Bußenius L, Harendza S. A simulation-based OSCE with case presentation and remote rating - development of a prototype. GMS JOURNAL FOR MEDICAL EDUCATION 2023; 40:Doc12. [PMID: 36923319 PMCID: PMC10010768 DOI: 10.3205/zma001594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Figures] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 12/14/2022] [Accepted: 01/10/2023] [Indexed: 06/18/2023]
Abstract
Simulation-based examination formats improve the possibility to assess medical students' competences during their performance. Additionally, videotaping of simulations allows for remote rating, providing advantages for raters, students, and exam organizers. We describe a simulation-based OSCE prototype with remote rating of students' competences, developed to replace a conventional OSCE at Hamburg Medical Faculty. The assessment consists of two phases: a consultation phase with four simulated patient encounters and a case presentation phase where four students present two cases each. All encounters from the consultation and the presentation phase are to be videotaped and remotely rated by clinical raters. Advanced medical students (year 4) are to be assessed regarding their clinical knowledge as well as physician-patient-communication, clinical reasoning competence, and patient management competence. We provide detailed schedules for the simulation-based OSCE procedure and a roster for organization. When piloting the assessment, we encountered two major obstacles with respect to legal obligations regarding examination time and videotaping which allowed us to provide tips on how to successfully implement this assessment prototype. Remote rating will, when successfully implemented, help students to concentrate on their consultation or presentation tasks, reduce raters' time constraints and also allow for randomized rating. Using established instruments for competence-rating rather than OSCE checklists provides an additional feature for this simulation-based OSCE prototype. Legal issues can be avoided by using the prototype for formative assessment but should be addressed in advance when it is planned to be used as summative assessment.
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Affiliation(s)
- Lisa Bußenius
- Universitätsklinikum Hamburg-Eppendorf, III. Medizinische Klinik, Hamburg, Germany
| | - Sigrid Harendza
- Universitätsklinikum Hamburg-Eppendorf, III. Medizinische Klinik, Hamburg, Germany
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