Integrated OSCE Prep

Question 1

My complexity definition

Answer 1

‘Complexity exists when there is a situation that has multiple parts that act in ways that are not always predictable. These parts interact with each other, and the interconnected actions change the context of the other parts.’

Question 2

Where is complexity found? (6 points)

Answer 2

• Individuals
• Society
• Health and wellbeing
• Healthcare
• Communication and swallowing
• Speech pathology profession

Question 3

Name a complexity model and what is the gist of it?

Answer 3

The Glouberman Framework is about looking at a situation from many perspectives (lenses)

Question 4

What are the lenses adapted from the Glouberman framework? (9 points)

Answer 4

• Do I have the facts right & am I aware of my biases?
• Am I respecting histories, cultures, & diverse viewpoints ?
• EBP?
• Are my clients making informed decisions?
• Legal and ethical considerations
• Measureable?
• Strengths based?
• Does it make good business sense?
• Reality check – am I missing anything, where can I get help?

Question 5

What are clinical schemas?

Answer 5

Frameworks that allow us to understand, assess and treat clients. Eg:
* Collect background info
* Assess with appropriate tasks/measures
* Discuss goals with client/family
* Plan therapy based on goals and assessment results
* Provide therapy
* Document and follow-up

Question 6

What is the ICF? (6 points)

Answer 6

• Impairment/health condition (which assessment or treatment first or together, differential diagnosis, comorbidities of note)
• Body functions and structure (attention, cognition, memory, mood etc.)
• Activities (ADLs, working, shopping etc.)
• Participation (social relationships, community activities, recreation etc.)
• Environmental factors (QoL, social rules, health services, economic factors etc.)
• Personal factors (cultural norms, age, gender etc.)

Question 7

What are mental models?

Answer 7

The images (attitudes and assumptions) we carry in our minds about ourselves, other people, institutions and the world.

Question 8

What needs to be sorted to move forward with regards to the presenting clinical issues? (3 questions and how to answer the question?)

Answer 8

• What do I know?
• What do I NOT know?
• How will I find out potentially?
  “Three things I would need to consider clinically, would be … 1… 2… 3…“

Question 9

What is Quality Improvement?

What are the benefits?

Answer 9

A set of principles that:
* Solves problems in healthcare
* Improves services
* Leads to better outcomes for clients/patients
* Provides opportunitites for clinicians to lead and deliver change

Question 10

What are the principles of QI?

Answer 10

Primary Intent: Aim for measurable improvements in specific healthcare delivery aspects.
* Iterative Testing Process: Adopt a theory of change focused on continuous planning, testing, studying outcomes, and adapting hypotheses based on previous results.
* Consistent Methodology: Use a selected QI methodology (e.g., Model for Improvement, Lean, Six Sigma) consistently; success is tied to adherence rather than the specific method.
* Empowerment: Engage front-line staff and service users, enabling them to contribute to and take ownership of improvement initiatives.
* Data-Driven Improvement: Utilize data to measure the impact of changes over time, focusing on narrative understanding rather than perfect data accuracy.
* Scale-Up and Spread: As effective interventions are identified, adapt them for new contexts and audiences, promoting wider adoption through iterative testing.

Question 11

What needs to be addressed, why, and how might you go about the cycle of QI (3 points)

Answer 11

• Identify the issue in the system
• Explain the consequences and why it needs to be addressed
• How will you approach addressing the issue? (PDSA)

Question 12

What is PDSA

Answer 12

A model for improvement - A systematic process for gaining valuable learning and knowledge for the continual improvement of a product, process or service.
* Plan: involves identifying a goal or purpose, formulating a theory, defining success metrics and putting a plan into action.
* Do: the components of the plan are implemented, such as making a product.
* Study: outcomes are monitored to test the validity of the plan for signs of progress and success, or problems and areas for improvement.
* Act: closes the cycle, integrating the learning generated by the entire process, which can be used to adjust the goal, change methods, reformulate a theory altogether, or broaden the learning – improvement cycle from a small-scale experiment to a larger implementation Plan.
The steps can be repeated over and over in a continual cycle of improving

Question 13

What documents guide us with ethical considerations?

Answer 13

• SPA code of conduct
• SPA Code of ethics
• Plus some more general ones such NDIS code of conduct, Fair work Australia, NSW Health code of conduct

Question 14

What does the SPA code of conduct guide us with?

Answer 14

The Code of Conduct says that practitioners must: (the most relevant ones… there are more)
* provide services in a safe and ethical manner
* obtain consent
* report concerns about treatment or care provided by other health care workers
* take appropriate action in response to adverse events
* not make claims to cure certain serious illnesses
* not misinform their clients
* comply with relevant privacy laws
* keep appropriate records
* be covered by appropriate insurance

Question 15

What does the SPA code of ethics guide us with?

Answer 15

The SPA Code of Ethics guides and informs our everyday professional practice and should be used in a proactive manner.
Members are bound to comply with the code.

Question 16

What are the relevant ethical values outlined in the SPA code of ethics?

Answer 16

Ethical Values: underpin our interactions, drive and inform how we behave
* Respect and dignity – promote a professional culture embodying kindness, taking time to value, listen and show compassion to others. Provide person- and relationship-centred care. Recognise and respect diversity.
* Responsiveness – collaborate, engage, advocate and partner with individuals, families, colleagues, other professionals and community to respond to their needs. Promote accessible communities.
* Quality and safety – provide quality and competent professional services which follow EBP principles. Work within QI and safety frameworks. Manage our personal health and wellbeing to effectively fulfil our personal responsibilities.
* Professionalism and integrity – uphold the reputation of the profession. Act in an objective manner, be transparent, accountable and keep commitments

Question 17

What are the relevant ethical principles outlined in the SPA code of ethics?

Answer 17

Ethical Principles: guide us when making decisions in our everyday practice. These principles are of equal value and are interrelated.
* Autonomy– respects the rights of others to self-determination and to make free and informed decisions. Support client autonomy.
* Beneficence – seek to benefit others through our activities.
* Non-maleficence – act to prevent harm and do not knowingly cause harm.
* Truth and veracity – act honestly and demonstrate respect.
* **Justice and fairness** – our professional decision-making is fair and equitable. Consider the context and needs of the person and wider community.

Question 18

How would you go about directly telling the relevant person involved in the case your answer to their request?

Answer 18

1. Active listening -reflect back what they are saying
2. Focus their underlying driver and how you can help with that in an ethical way and align with their purpose
3. Provide clear but sensitive reasoning on why you may not be able to meet their specific request and show concern for the potential consequences for them and yourself.
4. Bring it back around to a positive statement understanding their needs and your commitment to meeting that in an ethical way.