Small Group Case Considerations Questions

Seven AOA Core Competencies:

Competency 1: Osteopathic Philosophy and Osteopathic Manipulative Medicine: Residents are expected to demonstrate and apply knowledge of accepted standards in Osteopathic Manipulative Treatment (OMT) appropriate to their specialty. The educational goal is to train a skilled and competent osteopathic practitioner who remains dedicated to life-long learning and to practice habits in osteopathic philosophy and manipulative medicine.

Competency 2: Medical Knowledge: Residents are expected to demonstrate and apply knowledge of accepted standards of clinical medicine in their respective specialty area, remain current with new developments in medicine, and participate in life-long learning activities, including research.

Competency 3: Patient Care: Residents must demonstrate the ability to effectively treat patients, provide medical care that incorporates the osteopathic philosophy, patient empathy, awareness of behavioral issues, the incorporation of preventive medicine, and health promotion.

Competency 4: Interpersonal and Communication Skills: Residents are expected to demonstrate interpersonal and communication skills that enable them to establish and maintain professional relationships with patients, families, and other members of health care teams.

Competency 5: Professionalism: Residents are expected to uphold the Osteopathic Oath in the conduct of their professional activities that promote advocacy of patient welfare, adherence to ethical principles, collaboration with health professionals, life-long learning, and sensitivity to a diverse patient population. Residents should be cognizant of their own physical and mental health in order to care effectively for patients.

Competency 6: Practice-Based Learning and Improvement: Residents must demonstrate the ability to critically evaluate their methods of clinical practice, integrate evidence-based medicine into patient care, show an understanding of research methods, and improve patient care practices.

Competency 7: System-Based Practice: Residents are expected to demonstrate an understanding of health care delivery systems, provide effective and qualitative patient care within the system, and practice cost-effective medicine.

Other Questions:

- Psychosocial, evidence based medicine, health policy, risk management, Core Competencies, or cultural competencies….

The Nine Questions currently used:

1. Construct a differential diagnostic list of clinical conditions that can present as (FILL IN SICKNESS).

Differential Diagnosis of Disease/Condition

2. List (patient’s name)’s symptoms and identify the significant abnormalities in (his/her) physical exam. Explain the underlying pathological processes (i.e. molecular, cellular, and organ/tissue) of each sign or symptom.

Symptom/Sign

Underlying Pathology

3. Using information from the history and the physical examination to justify your choices, identify those clinical conditions in your differential diagnostic list that are supported by this patient's clinical presentation, and discard those entities that lack substantial support. Explain your choices.

Condition/Disease

Supportive Correlation

Absent Correlation

4. List the diagnostic tests you would order for (patient’s name). Explain the reasons for your choices.

Diagnostic Test

Rationale

5. The CBL facilitator will provide results of the diagnostic tests for this case. Interpret the results and explain any abnormal values in terms of underlying molecular, cellular, or anatomical (tissue/organ) pathologies.

Diagnostic Test

Interpretation

Explanation

6. Construct a management plan for Mr./Ms. (patient’s name), including patient education and treatment options. Explain the rationale for your recommendations, including the mechanism of any medications.

Treatment	Explanation
Supportive
Medication
OMM
Surgery
Exercise
Nutrition/Diet
Patient Education
Diagnostic Follow-up
Follow-Up Care
Community Resources
Other

7. Describe the role of osteopathic manipulative treatment for (patient’s name)’s condition.

OR

Discuss the goals of osteopathic manipulative treatment in (patient’s name)’s case.

OR

Describe osteopathic manipulative treatments that may improve (patient’s name)’s condition.

OMT Treatment

How Treatment will improve condition

8. List the risk factor(s) from (patient name)’s that influence the development of this condition.

OR

List the risk factors that can contribute to (patient name)’s condition(s), and rank them in relative importance to this case. Explain your rankings.

OR

(Patient Name) asks why he/she developed this condition and wonders what he/she can do to prevent recurrences. Discuss the incidence and epidemiology of this condition. Identify the common risk factors associated with his/her malady, and outline some steps he/she could take to prevent a recurrence.

Risk Factors related to this condition

How the risk factor influences the condition

Steps patient can take to reduce the impact of the risk factor

9. Discuss the impact of this (patient name)’s disease on his/her lifestyle/quality of life. Outline the physician’s priorities in address his/her quality of life needs.

OR

What elements of (patient name)’s history suggest the impact of his/her symptoms on his/her quality of life. Suggest ways a health care practitioner may choose to address these.

OR

What elements of (patient name)’s history suggest the impact of his/her symptoms on his/her quality of life. Suggest resources that may be available to help his/her family cope with his/her illness.

Symptoms / conditions impacting quality of life

How the symptom/ condition may impact quality of life of the patient and those around him/her

Ways to address the impact of the symptom/ condition on quality of life of the patient and those around him/her

Other considerations:

Evidence Based Medicine, insurance, Core Competencies (Osteopathic Philosophy and Osteopathic Manipulative Medicine (3 elements), Medical Knowledge (2 elements), Patient Care (3 elements), Interpersonal and Communication Skills (2 elements), Professionalism (3 elements), Practice-Based Learning and Improvement (3 elements), Systems-Based Practice (2 elements)), and Cultural Competencies.