Bradley Benson

Comparing rural-trained medical students with their peers: Performance in a primary care OSCE

Background: Although it is well-established and considered successful, there is limited data on how the graduates of a Minnesota rural medical education program (Rural Physician Associate Program [RPAP]) compare with their peers. Purpose: To compare the performance of RPAP students with their peers on a primary care observed structured clinical examination (OSCE). Methods: The performances of RPAP students and a group of non-RPAP Year 4 medical students were compared on the same OSCE. Results: RPAP students performed at least as well as their peers on stations assessing performance on common primary care clinical scenarios but not as well on a small number of stations that assessed applied knowledge of specific content taught in the traditional clerkship curriculum. Conclusions: We provide evidence that rurally trained students at this institution performed at least as well as their peers on OSCE stations testing performance in common primary care scenarios. The broader implications of this study are that medical students may receive high-quality training in rural communities, as documented by their performance on an objective structured clinical examination.

Domain of Competence: Practice-Based Learning and Improvement

From the Wright State University Boonshoft School of Medicine, Dayton, Ohio (Dr Burke); Department of Internal Medicine and Pediatrics, University of Minnesota Medical School, Minneapolis, Minn (Dr Benson); Association of American Medical Colleges, Washington, DC (Dr Englander); Competency-Based Assessment, The American Board of Pediatrics, Chapel Hill, NC (Dr Carraccio); and Department of Pediatrics, Childrens Hospital of Philadelphia, Philadelphia, Pa (Dr Hicks) The views expressed in this report are those of the authors and do not necessarily represent those of the Accreditation Council for Graduate Medical Education, the American Board of Pediatrics, the Association of Pediatric Program Directors, or the Academic Pediatric Association. The authors declare that they have no conflict of interest. Publication of this article was supported by the American Board of Pediatrics Foundation and the Association of Pediatric Program Directors. Address correspondence to Ann E. Burke, MD, Wright State University Boonshoft School of Medicine, One Children’s Plaza, Dayton Children’s Hospital, Department of Pediatrics, Dayton, OH 45404 (e-mail: ann.burke@wright.edu).

Pediatrics milestones: a developmental approach to the competencies.

n 2009, the Accreditation Council for Graduate Medical Education (ACGME) and the American Board of Pediatrics (ABP) partnered to create the Pediatric Milestone Project. One of the goals of this project was to reframe the 6 competencies in the context of the specialty, identifying markers of achievement (ie, milestones) along the path of residency training. They invited Carol Carraccio, MD, to be the project leader, and her first task was to establish an Advisory Board and a Working Group. Advisory Board members were recruited from the parent organizations as well as from the pool of national leaders in medical education, both from within and outside of pediatrics. The selected Working Group, composed of members of the Association of Pediatric Program Directors (APPD), one member of the Medicine Pediatrics Program Directors’ Association, two representatives of the ACGME, and a resident member, was charged with the following tasks: (1) redefine the competencies within the context of pediatrics; (2) set performance standards by level of training for achievement of the milestones; and (3) identify tools that could be embraced by the whole of the pediatric community to assess performance. The purpose of this report is to briefly describe the process used by the Working Group to accomplish the first charge of developing the milestones. We highlight some of the key lessons learned throughout the past year and outline future steps on the path to completion of our charge. We hope that other specialty groups will find this approach useful in their own work toward the ultimate goal of the Milestone Project: the ability to assess achievement of educational/curricular goals and program effectiveness.

Domain of Competence: Interpersonal and Communication Skills

From the Departments of Internal Medicine and Pediatrics, University of Minnesota Medical School, Minneapolis, Minn The views expressed in this report are those of the authors and do not necessarily represent those of the Accreditation Council for Graduate Medical Education, the American Board of Pediatrics, the Association of Pediatric Program Directors, or the Academic Pediatric Association. The author declares that he has no conflict of interest. Publication of this article was supported by the American Board of Pediatrics Foundation and the Association of Pediatric Program Directors. Address correspondence to Bradley J. Benson, MD, Department of Internal Medicine and Pediatrics, University of Minnesota Medical School, MMC 741, D-653 Mayo Memorial Building, 420 Delaware St SE, Minneapolis, MN 55455 (e-mail: benso040@umn.edu).

The pediatrics milestones: a continuous quality improvement project is launched-now the hard work begins!

From the Association of American Medical Colleges, Washington, DC (Dr Englander); Department of Pediatrics, Dayton Children’s Medical Center and the Wright State University Boonshoft School of Medicine, Dayton, Ohio (Dr Burke); Winthrop University Hospital, Winthrop, NY (Dr Guralnick); Departments of Pediatrics and Internal Medicine, University of Minnesota Amplatz Children’s Hospital and the University of Minnesota School of Medicine, Minneapolis, MN (Dr Benson); Department of Pediatrics, The Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA (Drs Hicks and Ludwig); Department of Pediatrics, Boston Children’s Hospital/Boston Medical Center and Boston University School of Medicine, Boston, Mass (Dr Schumacher); Dartmouth Institute for Health Policy and Clinical Practice Center for Leadership and Improvement, Hanover, NH (Ms Johnson); and American Board of Pediatrics, Chapel Hill, NC (Dr Carraccio) Address correspondence to Robert Englander, MD, MPH, Association of American Medical Colleges, 2450 N Street NW, Washington, DC 20037 (e-mail: renglander@aamc.org).