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Postdoctoral Core Competencies in the Predoctoral Curriculum
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     Kirksville (Mo) College of Osteopathic Medicine of A.T. Still University of Health Sciences

    The Kirksville (Mo) College of Osteopathic Medicine of A.T. Still University of Health Sciences (KCOM/ATSU) in Kirksville, Mo, is undergoing accreditation for the North Central Association of Colleges and Schools and the American Osteopathic Association (AOA). A self-study report comprises a significant portion of the documentation that must be provided for review.1,2 With regard to the curricular elements of this report, we elected (and received permission) to adapt the AOA core competency requirements for postdoctoral training into a suitable grid for evaluating predoctoral medical education.3

    Because the AOA competency standards are inclusive, it was necessary to change only the performance expectation and the scope of function to make the standard applicable for medical students. However, we also needed to develop a method to determine the extent to which our undergraduate medical education curriculum matched the core competencies by linking the learning activities our students were engaged in to the specific core competencies. Therefore, we created a database of our entire 4-year curriculum based on the core competencies and sub-elements. The database included the course name and its department of origin, learning objectives, quarter(s) in the academic calendar in which the objective is taught, as well as methods of teaching and assessment. A collection tool was sent to all course directors and curriculum committee members, and informational forums were held with course directors and instructors to explain the purpose of the project and to ensure consistency of data collection. Course directors placed their educational goals and/or learning objectives into the database by course. The faculty response to the effort was good. Nearly all course directors had clearly defined learning objectives, which made data collection relatively easy.

    This database has allowed KCOM to better analyze its medical education curriculum and to assess the teaching and testing of the core competencies during the 4 years of its program. We have found that some important skills, such as communication with patients, develop over time and are assessed at different levels along the continuum of the curriculum. We have also found that in some courses, learning activities relating to the development of interpersonal and communication skills and professionalism were not formally recognized in the course objectives. These learning activities occurred in laboratory and other small group activities.

    Based on the benefits we found by comparing our curricular content and course goals with the (adapted) AOA core competency standards, we are extending our evaluation to include our "exit objectives." These objectives, which have been used at KCOM/ATSU for about a decade, are the learning objectives for the entire medical school curriculum. We expect this review to be completed by late fall 2006.

    References

    1. Seven Core Competencies of the Osteopathic Profession. Chicago, Ill: American Osteopathic Association; 2004. Available at: http://www.acoi.org/CoreComp.pdf. Accessed August 10, 2006.(Julia E. Mcnabb, DO, MLS;)