Original Publication
Open Access

Geriatric Oncology OSCE: Using Geriatric Assessment Tools to Guide Patient Treatment Decisions

Published: July 28, 2014 | 10.15766/mep_2374-8265.9860

Included in this publication:

  • Instructor's Guide.docx
  • Core Entrustable Professional Activities #0.doc
  • Needs Assessment Survey Faculty #0.docx
  • Needs Assessment Survey Fellows #0.docx
  • Case Development Blueprint Case 1 #0.docx
  • Case Development Blueprint Case 2 #0.docx
  • Assessment Tools Session Agenda #1.docx
  • Assessment Tool Session PPT #1.pptx
  • Assessment Tools Session Evaluation #1.docx
  • SP Training Session Agenda #2.docx
  • SP Training Session Agenda with faculty notes #2.docx
  • SP Directions OSCE Case 1 ,#2.docx
  • SP Directions OSCE Case 2, #2.docx
  • OSCE Session Agenda #3.docx
  • Door Sign Case 1, #3.docx
  • Door Sign Case 2, #3.docx
  • OSCE Debrief Session#3.docx
  • OSCE Session Evaluation #3.docx
  • Barthel Scale Assessment Tool #1,#2,#3.pdf
  • Lawton Tool #1, #2, #3.pdf
  • MoCA Tool #1, #2, #3.pdf
  • Mini-Cog Tool #1, #2, #3.pdf

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

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 learner performance. At the Medical College of Wisconsin (MCW), geriatricians and oncologists worked together to create and implement a geriatric oncology educational OSCE for oncology fellows. Key curriculum content gaps (geriatric cognitive, functional, and psychosocial assessment) were identified through oncology fellow and faculty knowledge/performance gaps on a needs assessment survey/pretest. Methods: Curriculum content, intended to introduce geriatric assessment tools, was delivered using an initial one hour didactic presentation/demonstration session. The second session, one week later, was a two case OSCE session followed by a debrief session, designed to give learners practice using the tools with standardized patients as both an educational/assessment method. Fellows assessed their competency level in those initial EPAs both pre- and postOSCE curriculum intervention (1 = cannot perform, 5 = teach others). This MedEdPORTAL submission contains all materials for the geriatric oncology OSCE regarding geriatric oncology patient assessment, including materials for the initial didactic/demonstration session, standardized patient training session, two sets of OSCE station educational materials, debrief session, pre-/postEPA surveys and session evaluation form. There are four geriatrics assessment tools used, which are included as attachments. Results: Results of the post OSCE session evaluations showed fellows (N = 9) rating "The OSCEs were an effective method for increasing my confidence and skills in caring for elderly patients" and "The OSCE cases were believable and applicable to clinical practice" with means of 4.6 and 4.8 (1 = poor, 5 = excellent), respectively. Session strengths included, "This is a great reminder of the need to do functional and cognitive assessment," "Very realistic patient cases and scenarios," and "Discussion session at the end solidified it all." Pre- and postEPA ratings revealed a shift to competence. The EPA item, "I can apply geriatric assessment tools to better prognosticate/understand treatment risk and benefit in elderly cancer patients" shifted from a mean of 2.5 to 5.0 (1 = cannot perform, 5 = teach others). The item, "I can identify risks and benefit of cancer treatment versus non-treatment outcomes for elderly patients (life expectancy, treatment side effects, complications, quality of life) showed pre- to posttest change from a mean of 3.2 to 4.8. Discussion: This curriculum was successfully implemented in the oncology fellowship core curriculum but could also be implemented with other levels and types of learners (residents, medical students). Resource limitations may include space and standardized patients.


Educational Objectives

By the end of the module, the learner will be able to:

  1. Assess the patient's cognition using history taking and cognitive examination tools.
  2. Determine the patient's functional status using geriatric screening tools.
  3. Discuss treatment options and provide a recommendation based upon the overall assessment of the patient.
  4. Determine the patient's understanding of the risks and benefits of three treatment options.


Author Information

  • Kathryn Denson, MD: Medical College of Wisconsin
  • Gabriel Manzi: Medical College of Wisconsin
  • Patrick Foy: Medical College of Wisconsin
  • Thomas Giever: Medical College of Wisconsin
  • Judith Rehm: Medical College of Wisconsin

Disclosures
None to report.

Funding/Support
None to report.



Citation

Denson K, Manzi G, Foy P, Giever T, Rehm J. Geriatric oncology OSCE: using geriatric assessment tools to guide patient treatment decisions. MedEdPORTAL. 2014;10:9860. https://doi.org/10.15766/mep_2374-8265.9860