Original Publication
Open Access

Scenarios and Standardized Professionals From the Objective Structured System-Interaction Examinations (OSSIEs) of an Internal Medicine Residency Program

Published: January 25, 2012 | 10.15766/mep_2374-8265.9087

Included in this publication:

  • Standardized Professionals Instructor's Guide.doc
  • Final Standardized Professionals.doc
  • Appendix 1.doc
  • Appendix 2.doc
  • Appendix 3.doc
  • Appendix 4.doc
  • Appendix 5.doc
  • Appendix 6.doc
  • Appendix 7.doc
  • Appendix 8.doc
  • Appendix 9.doc
  • Appendix 10.doc
  • Appendix 11.doc
  • Appendix 12.doc
  • Appendix 13.doc

To view all publication components, extract (i.e., unzip) them from the downloaded .zip file.


Editor's Note: This publication predates our implementation of the Educational Summary Report in 2016 and thus displays a different format than newer publications.

Abstract

The purpose of this study is to make available information regarding standardized professionals, as used by the Southern Illinois University School of Medicine Internal Medicine Residency Program during the Objective Structured Systems-Interaction Examination (OSSIE). The 15 scenarios and their affiliated materials may be used by others working at institutions using standardized performance- and systems-based examinations.

The definition of a competent physician is evolving from ‘‘the doctor who possesses the right attributes’’ to ‘‘the doctor who does the right thing.’’ The public is concerned about the delivery of competent care, which can be assessed by concrete measures such as quality, safety, and cost. Competent care is provided through collaboration with the other members of the health care team and is proven by good outcomes.1 In light of this new definition of competence, the Accreditation Council for Graduate Medical Education (ACGME) has identified systems-based practice as one of the six core competencies needed by residents to practice effectively in today’s health care milieu. To be competent in systems-based practice, ‘‘residents must demonstrate an awareness of and responsiveness to the larger context and system of health care, as well as the ability to call effectively on other resources in the system to provide optimal health care.’’2

The ACGME has proposed the use of simulations, Objective Structured Clinical Examinations (OSCEs), and standardized patients (SPs) for assessing resident performance and for providing formative evaluations. These approaches place residents in circumstances that simulate real-life situations. OSCEs standardize the evaluation by controlling the variance that is inherent in real-life situations.3, 4

In contrast to the OSCE, where most standardized-patient encounters are set in the simulated clinic office, the Objective Structured System-Interaction Examination (OSSIE) cases use a variety of simulated settings. OSSIE cases are situated in simulated hospital rooms, physician offices, nurses’ stations, conference rooms, and resident lounges. These settings require using desks and other furniture instead of exam tables. In addition, charts, x-rays, and other props have to be prepared for accurate simulation. Some charts need to replicate hospital records and thus need simulated history and physicals, progress notes, lab reports, radiology reports, etc. Much time is devoted to ensure that these documents look as authentic as possible.

Previous publications have described the creation of the OSSIE as a performance-based examination and its feasibility as a measure of systems-based practice.5, 6

Educational Objectives

  1. Scenario/Appendix 1: Cost awareness and risk/benefit analysis; Residents are expected to incorporate considerations of cost awareness and risk/benefit analysis in patient and/or population-based care as appropriate.
  2. Scenario/Appendix 2: Advocate for quality care and optimal patient care systems; Residents are expected to incorporate considerations of cost awareness and risk/benefit analysis in patient and/or population-based care as appropriate.
  3. Scenario/Appendix 3: Coordinate patient care within health care delivery setting; Residents are expected to advocate for quality patient care and optimal patient care systems.
  4. Scenario/Appendix 4: Knowledge of practice and delivery systems; Residents are expected to work effectively in various health care delivery settings and systems--Residents are expected to coordinate patient care with the health care system.
  5. Residents are expected to advocate for quality patient care and optimal patient care systems.
  6. Scenario/Appendix 5: Cost awareness and risk/benefit analysis; Residents are expected to work effectively in various health care delivery settings and systems--Residents are expected to coordinate patient care with the health care system.
  7. Residents are expected to incorporate considerations of cost awareness and risk/benefit analysis in patient and/or population-based care as appropriate.
  8. Scenario/Appendix 6: Advocate for quality care & optimal systems; Residents are expected to incorporate considerations of cost awareness and risk/benefit analysis in patient and/or population-based care as appropriate.
  9. Scenario/Appendix 7: Advocate for quality care & optimal systems; Residents are expected to incorporate considerations of cost awareness and risk/benefit analysis in patient and/or population-based care as appropriate.
  10. Scenario/Appendix 8: Advocate for quality care & optimal systems; Residents are expected to incorporate considerations of cost awareness and risk/benefit analysis in patient and/or population-based care as appropriate.
  11. Scenario/Appendix 9: Coordinate patient care within health-care delivery setting; Residents are expected to work effectively in various health care delivery settings and systems--Residents are expected to coordinate patient care with the health care system.
  12. Scenario/Appendix 10: Coordinate care across settings; Residents are expected to work effectively in various health care delivery settings and systems--Residents are expected to coordinate patient care with the health care system.
  13. Scenario/Appendix 11: Knowledge of practice and delivery systems; Residents are expected to work effectively in various health care delivery settings and systems--Residents are expected to coordinate patient care with the health care system.
  14. Scenario/Appendix 12: Knowledge of practice and delivery systems; Residents are expected to work effectively in various health care delivery settings and systems--Residents are expected to coordinate patient care with the health care system.
  15. Scenario/Appendix 13: Communication, professionalism, and advocate for quality care; Residents are expected to participate in identifying systems errors and implementing potential systems solutions.
  16. Residents are expected to participate in identifying system errors and implementing potential systems solutions.

Author Information

  • Susan Thompson Hingle, MD: Southern Illinois University School of Medicine
  • Jacqueline Ferguson, MA: Southern Illinois University School of Medicine
  • Regina Kovach, MD: Southern Illinois University School of Medicine
  • Nancy McCann-Stone, MA: Southern Illinois University School of Medicine
  • Sherry Robinson, PhD, RNCS: Southern Illinois University School of Medicine
  • Richard Rosher, MD: Southern Illinois University School of Medicine
  • Christine Todd, MD: Southern Illinois University School of Medicine

Disclosures
None to report.

Funding/Support
None to report.


References

  1. Klass D. A performance-based conception of competence is changing the regulation of physician’s behavior. Acad Med. 2007;82(6):529–534. http://dx.doi.org/10.1097/ACM.0b013e31805557ba
  2. Accreditation Council for Graduate Medical Education. Common Program Requirements: General Competencies— 2/13/2007. Available at: http://www.acgme.org/outcome/comp/GeneralCompetenciesStandards21307.pdf. Accessed June 6, 2011.
  3. Accreditation Council for Graduate Medical Education, American Board of Medical Specialties. Toolbox of Assessment Methods. Accreditation Council for Graduate Medical Education and American Board of Medical Specialties. September 2000.
  4. Simpson D, Helm R, Drewniak T, et al. Objective structured video examinations (OSVEs) for geriatrics education. Gerontol Geriatr Educ. 2006;26(4):7–24. http://dx.doi.org/10.1300/J021v26n04_02
  5. Hingle, S, Rosher, R, Robinson, S, et al. Development of the Objective Structured System-Interaction Examination. J Grad Med Ed 2009:82-88. http://dx.doi.org/10.4300/01.01.0013
  6. Hingle, S, Robinson, S, Colliver, J, et al. Systems-based Practice Assessed with a Performance-based Examination Simulated and Scored by Standardized Participants in the Health Care System: Feasibility and Psychometric Properties. Teaching and Learning in Medicine 2011(23):148-154. http://dx.doi.org/10.1080/10401334.2011.561751


Citation

Thompson Hingle S, Ferguson J, Kovach R, et al. Scenarios and standardized professionals from the objective structured system-interaction examinations (OSSIES) of an internal medicine residency program. MedEdPORTAL. 2012;8:9087. https://doi.org/10.15766/mep_2374-8265.9087