RESUMO
The Medical College of Wisconsin (MCW) and the Wisconsin Geriatric Education Center (WGEC) are committed to developing educational materials for primary care physicians in training. In response to the opportunity created by the Accreditation Council for Graduate Medical Education (ACGME) competency mandate, an MCW-led interdisciplinary working group has developed competency-linked video-based assessment tools for use in primary care residency training programs. Modeled after the Objective Structured Clinical Examinations (OSCE), used as part of the medical licensing examination process, we created geriatric-focused Objective Structured Video Examinations (OSVEs) as a strategy to infuse geriatrics into residency training. Each OSVE tool contains a 1-3 minute video trigger that is associated with a series of multiple choice and/or constructed response questions (e.g., fill in the blank). These questions assess residents' understanding of video-demonstrated ACGME competencies including professionalism, systems-based practice, communication, and practice-based learning. An instructor's guide and scoring key are provided for each tool. Response to the OSVEs has been overwhelmingly enthusiastic including greater than 90% commitment by statewide faculty to use the tools in residency training.
Assuntos
Competência Clínica , Educação de Pós-Graduação em Medicina/normas , Avaliação Educacional/métodos , Tecnologia Educacional/instrumentação , Geriatria/educação , Internato e Residência/normas , Atenção Primária à Saúde/métodos , Gravação em Vídeo , Idoso , Educação Baseada em Competências/métodos , Educação Baseada em Competências/normas , Currículo , Educação de Pós-Graduação em Medicina/métodos , Escolaridade , Docentes de Medicina , Humanos , Internato e Residência/métodos , Licenciamento em Medicina , Faculdades de Medicina , WisconsinRESUMO
An elderly female patient with major depression and incidental atrial fibrillation received electroconvulsive therapy (ECT). Minutes after two different treatments on two separate occasions, she converted to a normal sinus rhythm. Although atrial fibrillation itself is associated with an increased risk of thromboembolic stroke, cardioversion without anticoagulation in individuals with nonacute atrial fibrillation is associated with a 1-2% incidence of embolization. Cardioversion during ECT may be infrequent but its possibility should alert clinicians to the consideration of prophylactic anticoagulation for some patients undergoing ECT.
