ABSTRACT
Background: We developed an app (UfaceME) which simultaneously allows patient and clinician to be viewed on a split screen, then replayed and rated on a series of semantic differential scales and the ratings of the clinician of their own response to the interview, and the patient's response, displayed on a graph. Method: We evaluated the app with trials with 14 medical student volunteers who alternated the roles of patient and clinician, using 2 randomly allocated sexual case histories. Semantic differentials for 10 adjectives were examined pre- and post-exercise. There were significant differences in 8 of the 10 adjectives. A focus group with the 14 subjects was also carried out and transcribed. The exercise was repeated with all 175 first-year medical students taking a sexual history. Results: Qualitative data indicated themes of being surprised and educated by non-verbal and verbal responses; seeing how the patient rated their responses; rating and watching discomfort; differences in clinician/patient perceptions and response; and the advantage of feedback. Quantitative data comparing self vs "patient" showed low correlations between perceptions of being "at ease", moderate for appearing "distracted", and high for appearing "engaged". Conclusion: UfaceME was easily understood and used, and the opportunity to replay and rate performance on key semantic scales, and watch and assess verbal and non-verbal performance, including patient rating, provided valuable insight.
ABSTRACT
Background: Internal medicine physicians and trainees are increasingly using, and seeking training in, diagnostic point of care ultrasound (POCUS). Numerous internal medicine training programs have described their curricula, but little has been written about how learners should be assessed, supervised, and allowed to progress toward independent practice, yet these practices are imperative for safe and effective use. Entrustable professional activities (EPAs) offer a practical method to assess observable units of professional work and make supervision decisions. Methods: An EPA for POCUS is used as a framework to assess and determine appropriate levels of supervision in an internal medicine residency program. Results: All learners have been able to advance to level 2 with a mandatory introductory boot camp course. Learners have been able to advance to higher levels of independence, often after taking formal elective programmatic coursework. However, not all learners taking the same coursework have been granted the same level of independence. Conclusions: It is feasible to assess and supervise internal medicine residents' ability to use diagnostic point of care ultrasound using an EPA.
