A core competence-based objective structured clinical examination (OSCE) in evaluation of clinical performance of postgraduate year-1 (PGY1) residents

Yang, Ying‐Ying; Lee, Fa Yauh; Hsu, Hui‐Chun; Huang, Chin Chou; Chen, Jaw Wen; Lee, Wen-shin; Chuang, Chiao Lin; Chang, Ching Chih; Chen, Hao Min; Huang, Chia Chang

doi:10.1016/j.jcma.2011.03.003

Cited by 15 publications

(11 citation statements)

References 18 publications

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“…Notably, video and SP simulations were used in our course to enhance the effectiveness of PE training. In the objective structured clinical observation (OSCE) of final-year medical students and postgraduate year 1 residents, as for the results of the United States Medical Licensing Examination (USMLE) step 2, the PE scores were significantly lower (59.6%) than the scores for history-taking [11,12]. Therefore, in this study, we provided repeated hands-on PE practice for each medical student in different sessions of the core and cluster parts of the course.…”

Section: Discussionmentioning

confidence: 99%

Dreyfus scale-based feedback increased medical students’ satisfaction with the complex cluster part of a interviewing and physical examination course and improved skills readiness in Taiwan

Huang

Yang

et al. 2019

J Educ Eval Health Prof

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PurposeIn contrast to the core part of the clinical interviewing and physical examination (PE) skills course, corresponding to the basic, head-to-toe, and thoracic systems, learners need structured feedback in the cluster part of the course, which includes the gastrointestinal, neuromuscular, and musculoskeletal systems. This study evaluated the effects of using Dreyfus scale-based feedback, which has elements of continuous professional development, instead of Likert scale-based feedback in the cluster part of training in Taiwan.MethodsInstructors and final-year medical students in the 2015–2016 classes of National Yang-Ming University, Taiwan comprised the regular cohort, whereas those in the 2017–2018 classes formed the intervention cohort. In the intervention cohort, Dreyfus scale-based feedback, rather than Likert scale-based feedback, was used in the cluster part of the course.ResultsIn the cluster part of the course in the regular cohort, pre-trained standardized patients rated the class climate as poor, and students expressed low satisfaction with the instructors and course and low self-assessed readiness. In comparison with the regular cohort, improved end-of-course group objective structured clinical examination scores after the cluster part were noted in the intervention cohort. In other words, the implementation of Dreyfus scale-based feedback in the intervention cohort for the cluster part improved the deficit in this section of the course.ConclusionThe implementation of Dreyfus scale-based feedback helped instructors to create a good class climate in the cluster part of the clinical interviewing and PE skills course. Simultaneously, this new intervention achieved the goal of promoting medical students’ readiness for interviewing, PE, and self-directed learning.

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Section: Discussionmentioning

confidence: 99%

Dreyfus scale-based feedback increased medical students’ satisfaction with the complex cluster part of a interviewing and physical examination course and improved skills readiness in Taiwan

Huang

Yang

et al. 2019

J Educ Eval Health Prof

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“…The objective structured clinical examination (OSCE) setting was similar to that used in our previous studies and was conducted at the beginning (1 st month) and at the end (3 rd month) of the follow-up period for comparison of the effects of the 3-month MR-based clinical skills training between senior (PGY 1 residents) and junior (intern and clerk) attendees of the regular and TA MRs. 12,13 The MR-assessed OSCE consisted of six stations [history taking (HT), physical examination (PE), DD, laboratory and images (data) ordering and interpretation, problem solving/decision making, and skills of dealing with controversial/professional issues] that evaluated the seven clinical skills being taught in MRs. A faculty rater graded each medical student and resident according to a set of 10e12 predetermined items presented in the form of a checklist. The attendees' summary scores of individual station and average rater-assessed scores of six MRbased OSCE stations were converted into percentage values for final analysis.…”

Section: Objective Structured Clinical Examinationsmentioning

confidence: 99%

Self- and rater-assessed effectiveness of “thinking-aloud” and “regular” morning report to intensify young physicians’ clinical skills

Hsu

Lee

Yang

et al. 2015

Journal of the Chinese Medical Association

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“…Several studies have published and discussed the achievement of objectives goals assessed through various methods. [1,2,3] Further research on the effectiveness of speci c rotations like community medicine in the program was discussed in the literature. [4,5] Experience in EM is considered a critical part of medical education, [6] EM rotation provides excellent primary care training opportunities by encountering a signi cant breadth of the patient population and managing a diversity of clinical presentation.…”

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confidence: 99%

The role of emergency medicine for postgraduate year one undifferentiated physician: a qualitative analysis of trainees' perspective

Shen

Huang

Tsai

et al. 2020

Preprint

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Background PGY1 program was initiated in 2003 for undifferentiated physicians in Taiwan, the program aimed to improve the general competency gap exposed during the SARS epidemic breakout in physicians. Many published studies discussed the effectiveness of the program. We were interested in the learning impacts gained from the physicians' perspectives during EM rotation in the PGY1 program, and little was known regarding this subject. Methods This retrospective study used grounded theory data analysis methods. 201 PGY1 physicians rotated in the emergency department from August 2014 to July 2017 answered three open-ended post-rotation survey questions and resulted in a dataset of 603 comments. A three-member team for code development reviewed all comments and established the code themes with the consensus of the team members. A four-member coding team coded applicable comments accordingly. Results We coded 563 (96%) comments and sorted 32 themes essential to characterize the clinical experiences into two categories. Twenty-six codes were relevant to professional development; 6 were related to the emotional issue. In the professional development category, patient care (33%) was the most frequently coded domains in the sub-level of six core competencies, followed by system-based practice (25%) and interpersonal and communication skills (19%). Senses of growth and improvement were the most frequently coded theme in the emotional issue category, followed by pressure at the workplace and on-the-spot-feedback. The top 3 lessons learned by physicians' perception were decision-making, team and patient communication, and prioritize tasks. Conclusions EM rotation had a productive role in professional development for undifferentiated physicians before receiving specialty discipline training. Gaining experiences on clinical judgment and communication were the strengths of the EM PGY1 program. This model of analysis might be used as a novel way of assessment on the achievement of learning objectives from the trainee's perspective. However, a prospective standardized study protocol is needed for a further affirmative conclusion.

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A core competence-based objective structured clinical examination (OSCE) in evaluation of clinical performance of postgraduate year-1 (PGY1) residents

Abstract: By using a structured development process, the authors were able to create reliable evaluation items for determining PGY(1) residents' acquisition of the ACGME core competencies.

Cited by 15 publications

References 18 publications

Dreyfus scale-based feedback increased medical students’ satisfaction with the complex cluster part of a interviewing and physical examination course and improved skills readiness in Taiwan

Dreyfus scale-based feedback increased medical students’ satisfaction with the complex cluster part of a interviewing and physical examination course and improved skills readiness in Taiwan

Self- and rater-assessed effectiveness of “thinking-aloud” and “regular” morning report to intensify young physicians’ clinical skills

The role of emergency medicine for postgraduate year one undifferentiated physician: a qualitative analysis of trainees' perspective

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