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The Observed Clinical Encounter: Lessons Learned on the Way to Best Practice 

02-19-2019 12:37

The Liaison Committee on Medical Education (LCME) requires that medical schools employ a variety of measures, including direct observation, to assess a medical student’s core clinical skills.  Medical students spend the majority of the time on their family medicine clerkship in the office setting, working one-on-one with a family physician.  Clerkship directors work to balance needing a valid, “real world” assessment of the student’s patient care skills with minimizing on the much-needed and often over-burdened community faculty. Students crave observation and feedback, both of which are difficult to implement in a busy clinic environment1.  Direct observation allows for observation and assessment of actual clinical care, but variability in the skill of the evaluator and the validity of the assessment tool can lead to wide variation in final grade assignment. Some schools use standardized patients with medical school faculty observers to simulate an actual clinical environment and provide a more standardized assessment and valid feedback.  Others use a separate clinical environment to complete the observed history and physical.  We will present on the strategies used to provide direct observation of clinical skills at six different institutions, including the tool used, strategies to ensure valid assessment, and weight placed on the assessment.  We will work with symposia attendees to develop best practices for the observed clinical encounter in the family medicine clerkship, be it in the clinic setting or in a simulated environment.

This attachment includes notes taken during the meeting.

Author(s):Miranda Huffman, Jennifer Clem, Brandy Deffenbacher, Kelly Fedoriw, Hannah Maxfield
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Observed Clinical Encounter Presentation   894 KB   1 version
Uploaded - 02-19-2019
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Observed Clinical Encounter Form - UNC   230 KB   1 version
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Credit to Patient-Centered Observation Form created at the University of Washington
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Observed Clinical Encounter Form - MSK Exam   222 KB   1 version
Uploaded - 02-19-2019
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Observed Clinical Encounter Form - UMKC   290 KB   1 version
Uploaded - 02-19-2019
Credit to Patient-Centered Observation Form created at the University of Washington
pdf file
Observed Clinical Encounter Form - KU   248 KB   1 version
Uploaded - 02-19-2019
pdf file
Observed Clinical Encounter Form - Diabetic Foot Exam   226 KB   1 version
Uploaded - 02-19-2019
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Observed Clinical Encounter Form - UC Denver   125 KB   1 version
Uploaded - 02-19-2019