1. Objective Structured Clinical Exam (OSCE) By: Stephanie Joinvil Maimonides Medical Center Mentor: Dr. Lisa Altshuler Co-Mentor: Ibsen Vargas

2. Vocabulary  OSCE- Objective Structured Clinical Exam  Cultural- relating to the civilization, and achievements of a particular time or people.  Competence- ability; adequately qualified or capable  Observer- a representative sent to observe but not participate officially in an activity.

3. What is OSCE?  OSCE (Objective Structured Clinical Exam) is a growing training program in a number of hospitals. This program was developed to residents the opportunity to practice different situations on real life experiences.  It allows for skills practice and feedback.

4. Maimonides Medical Center  Implemented the OSCE program in the Pediatrics Department.  Realized there was a growing need for appropriate training models in the area of cultural competence  Since 1999 the first formative Culture OSCE at MMC was developed.

5. Residents  Communication OSCE- 1st year residents  Culture OSCE- 2nd year residents  Genetics OSCE- 3rd year residents

6. Communication OSCE  1st year residents  Residents are beginning to be in contact with patients.  It will offer them practice in communicating with patients.

7. Culture OSCE  2nd year residents  these residents have some experience with communicating with patients.  MMC serves a diverse population. They serve them with respect and understand why they treat them or respond to them in another way.

8. Genetic OSCE  3rd year resident- Advanced group.  Be able to convey genetic information to the public in nontechnical terms.  Since genetics is much more complicated it is give to the advanced group.  For example explaining Done Syndrome, giving a visual Diagnosis and genetic referrals.

9. Ethnicity and Religion (Parents’ Report) Other White (Non-Hispanic) 56% African-Am. 3% * Categories used by MMC Jewish 41% Other 7% Christian Catholic 35% Muslim 14% Practice Hallal 11% 3% 7% Middle East Indian 4% Asian 11% White (Hispanic) 21% Child’s Ethnicity Parent’s Religion Kosher home 38% 3% Not Kosher No Hallal 3%

10. Culture scenario Lost in Translation – addressing the language barrier in a Bengali family where only the father speaks English.

11. Overall Evaluation of Culture OSCE

12. Conclusion  OSCE(Objective Structured Clinical Exam) is a post resident training program which will improve residents performance skills in the office.  Improves skilld, gives a more one-on-one interaction, feedback, communication and helps residents acquire th eknowledge that they didn't receive or understand inmedical school.

13. Bibliography ACGME Outcome Project http://www.acgme.org/outcome/comp/compFull.asp Accessed from ACGME on Aug 2, 2006 http://www.acgme.org/outcome/comp/compFull.asp ALTSHULER, L., Kachur, E. (2001). A Culture OSCE: Teaching residents to bridge different worlds. Academic Medicine, 76, 514. HARDEN, R.M., STEVENSON, M., DOWNIE, W.W., WILSON, G. M. (1975). Assessment of clinical competence using objective structured clinical examinations. British Medical Journal, 1, 447-51. ALTSHULER, L., Kachur, E. ( 2004). Cultural competence is everyone's responsibility! Medical Teacher, 26, 101-5 INSTITUTE OF MEDICINE ( 2002). Unequal treatment: confronting racial and ethnic disparities in healthcare. Washington (DC): National Academy Press. ROBINS,L.S., WHITE, C.B., ALEXANDER, G.L., GRUPPEN, L.C., GRUM, C.M. (2001). Assessing medical students’ awareness of and sensitivity to diverse health beliefs using a standardized patient station. Academic Medicine, 76, 76-80. SINGER, P.A., COHEN, R., ROBB, A., ROTHMAN, A. (1993). The ethics objective structured clinical examination. Journal of General Internal Medicine, 81, 23-8

14. Acknowledgements  Thank you to:  Harlem Children Society Internship Program In Science, Medicine, Technology & Allied Sciences  Dr. Sat  Dr. Lisa Altshuler  Ibsen Vargas  Everyone in the audience