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Towards a conceptual framework for the continuum of clinical competence development in an undergraduate osteopathic medical education program: An exploratory study

Journal: Unpublished PhD thesis Michigan State University, Date: 1984/01, , type of study: explorative study

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Keywords:

clinical competence [189]
explorative study [19]
medical students [402]
osteopathic medicine [1540]
undergraduate medical education [60]
USA [1086]

Abstract:

This study is an interpretation of interview data on clinical competence development. The interview data were acquired in the context of a cross-sectional study of the training of physicians at the Michigan State University College of Osteopathic Medicine. Students at three levels of training were asked to describe in detail what they were able to do in the clinical setting and why. The responses to these questions were analyzed towards answering two basic questions: (1) can unique definitions of competence be developed for each of the three levels of training? (2) what variables in the instruction/learning process should be considered when developing a competence-based medical education program? Students described doing specific clinical tasks, medical history and physical examination and medical problem solving, in ways that were unique to a given level of training. Not only what and how they did the task, but the perspective from which they viewed the task, differed for each level of training. From these descriptions were drawn four (4) continuums of competence which could provide the basis for defining clinical competence at each level of training: philosophic perspective; four aspects of cognitive development; four aspects of psychomotor development; and three aspects of attitudinal orientation. From students' explanations for why they could or could not do certain tasks were drawn six variables in the clinical competence developmental process: students' accumulated knowledge and skills; clarity of program goals and philosophy; congruity of curriculum and instruction; integration of theory and practice; instruction/role modeling; and the context of learning. Recommendations for further research were presented and implications of the findings for administrators of osteopathic medical education programs were discussed.


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