University of Missouri exam measures how well students deliver patient-centered care

by Lauren Dubinsky, Senior Reporter | December 31, 2014
Patient-centered care is taking center stage now that the current fee-for-service payment model is shifting to a value-based model. The University of Missouri School of Medicine has included that type of care into its curriculum since 2005 and recently developed an exam that evaluates the medical students' ability to deliver it.

Third-year students must pass The Patient-centered Care - Objective Structured Clinical Exam in order to graduate. It tests them on whether they build rapport, make good eye contact, closely listen to the patient's concerns and uncover the real reason for the visit.

During the exam, the students are placed in simulated scenarios involving standardized patients ranging from adolescents to senior citizens, family members and physicians played by trained community actors. The students must first obtain information from the patients and then create a management and care plan based on their preferences.

"They need to communicate with not only the patient, but also the family member and engage other health care providers if it's appropriate for their care," Kimberly Hoffman, associate dean for curriculum and assessment at the university, told DOTmed News.

The university found that most of the students who took the exam had strong, effective communication skills and refrained from using medical jargon, intently listened to the patient, showed empathy and took charge when they needed to lead a critical conversation.

It also showed areas where the students needed improvement. Some of the students crossed their arms, which makes them seem guarded, and they need to engage family members and other members of the health care team in the patient's care to prevent compliance problems that patients might have with their treatment plans.

Patient-centered care is also a major focus at the University of Missouri Health System. "The students need to see modeled in the clinical setting what they learn in a classroom setting," said Hoffman.

It's not required to incorporate patient-centered care in curricula to achieve accreditation but other medical schools are also putting a focus on it, including Northwestern University Feinberg School of Medicine in Chicago.

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