SP-3-02-C-01
Sarno, Martha Taylor, Professor Clinical Rehabilitation Medicine
New York University School of Medicine, New York, NY U.S.A.
LIVING WITH APHASIA - PSYCHOSOCIAL CONSIDERATIONS
It is generally agreed that, except for the mildest cases, the presence of aphasia produces a profoundly altered state. High levels of depression, social isolation and anxiety are reported with great frequency. Yet studies which address the psychosocial sequelae of aphasia are rare. Clinicians are aware that the impact of psychosocial sequelae in aphasia often persists well beyond the termination of rehabilitation, independent of the severity of the disorder or associated physical dysfunction. These sequelae may represent the most significant deterrents to maximizing recovery and achieving an acceptable quality of life. From a patient and family perspective, the psychosocial impact on everyday life can be overwhelming, if not devastating, leading some to call aphasia a personal, familial, and social catastrophe. As a result, aphasia can be conceptualized as a communication disorder which leads to a disorder of person. Implications for aphasia rehabilitation and theoretical models which help to account for the psychosoical sequelae of aphasia are reviewed and discussed.
EL-3-03-01
OBJECTIVE STRUCTURED CLINICAL EXAMINATION (OSCE)
Joel A. DeLisa, MD, Sudesh S. Jain, MD, Scott Nadler, DO, Mary Eyles, RN, Steve Kirshblum, MD
Clinical competency is poorly measured by knowledge-based written examinations. A five-station, four-interstations objective structured clinical examination (OSCE) has been developed in consultation with the National Board of Medical Examiners as a pilot study to standardize assessment methods that serve to evaluate the clinical competency of senior physical medicine and rehabilitation residents. Various stations demonstrating musculoskeletal and neurologic conditions commonly encountered in physiatric practice were included, incorporating the use of standardized patients into the OSCE format. This is a descriptive study of individual stations-evaluated history-taking, physical examination, and communication skills, whereas the inter-stations measured the residents' ability to write therapy and prosthetic/orthotic prescriptions, as well as interpret x-ray and electrodiagnostic data. The OSCE program development including case background, principal tasks, time allotment, evaluation objectives, performance criteria, therapeutic plan, standardized patients case descriptions, and assessment checklists as well as the training procedure is discussed. Additionally, cost analysis and scheduling issues are reviewed. This information should aid other training programs or consortiums in developing similar clinical evaluation tools.
