A Primer for Objective Structured Teaching Exercises

Abstract

The objective structured teaching exercise (OSTE) is a high-fidelity training method for advancing the teaching and interpersonal communication skills of faculty members and preceptors. This paper is a primer for implementation of OSTEs as part of a comprehensive faculty development program. This primer addresses teaching and precepting skills that can be most effectively enhanced and assessed by the OSTE method. Development of case scenarios, recruitment and training of standardized students, OSTE session implementation processes, and OSTE evaluation methods are discussed. The experience of the authors as well as recommendations from a review of the literature and discussions with educators with OSTE experience are included.Keywords: faculty development, standardized student, professional competence INTRODUCTIONThe objective structured teaching exercise (OSTE) is a high-fidelity training and assessment method for advancing the teaching and interpersonal communication skills of faculty members, preceptors, and residents.1 First introduced in the medical literature in the early 1990s, OSTE engages learners in performance-based teaching activities with a standardized student. The OSTE method not only provides a unique and innovative way to teach, enhance, and evaluate educational skills, but also presents an ideal platform for future scholarship.The body of OSTE literature is primarily descriptive in nature and not as robust as the literature regarding standardized patients in health profession curricula. However, interest in the OSTE technique stems from the postulation that standardized student interactions will provide benefits to teachers similar to those that standardized patient interactions provide to students. In the 1960s, neurologist Dr. Howard Barrows was seeking a better method than traditional clinical observations to assess the clinical skills of his medical residents. He developed the concept and first used standardized patients by tapping into an available pool of actors in Southern California.2 Using cases of actual neurology patients, Barrows trained the actors to present the same signs, symptoms, history, emotional state, and, in some cases, physical examination findings to learners. Using the standardized patient, he could then educate, observe, and assess each learner in a safe and controlled environment. Standardized patients are now used extensively throughout health professional education and the technique has been adapted for use with individuals portraying students for faculty development. Standardized student encounters can be used for instruction and practice of skills, performance evaluation, program assessment, and research. These encounters allow for repeated experiences in which the learner can attend to the critical aspects of a situation and improve performance in response to feedback. The learner is an active participant in the experience rather than a passive observer. Standardized student encounters enable expert educators to observe and improve the interaction of the participa...

A unique approach to faculty development using an Observed Structured Teaching Encounter (OSTE)

“…There is good evidence that OSTEs serve as an effective tool to assess the benefits of faculty development projects that address various core competencies [4,10,11]. Our OSTE was developed in response to poor attending HCAHPS scores and lower than average resident evaluations of attendings.…”

“…They were given two common clinical scenarios which incorporated detailed information about the patient’s medical history, physical examination findings, and laboratory/imaging results and instructed on the learning objectives and evaluation tools. They also received clear instructions regarding responses to potential questions the faculty member may ask and, more specifically, how much information the MS4 could disclose [4]. …”

Assessment of Learning and Program Evaluation in Health Professions Education Programs

“…The assessment method that will most likely provide evidence that the learner accomplished the learning objective is an authentic assessment in which learners are asked to perform real‐world tasks that demonstrate meaningful application of essential knowledge and skills (Wiggins, 1998). For example, if a learning objective stated that an HPE student should be able to design and implement a curricular intervention, they should be provided with opportunities to: practice designing and implementing a curricular intervention for virtual learners and simulated learners in an OSTE (Objective Structured Teaching Examination) setting (Sturpe & Schaivone, 2014), and then learners in a preclinical and/or clinical setting; receive feedback on each practice episode from knowledgeable educators, starting with direct observation and continuing with reporting to a mentor. …”

Summative Evaluations When Using an Objective Structured Teaching Exercise

“…1 The article cogently pointed out notable needs for effective improvements in faculty development and many "how-to" OSTE elements for pedagogical faculty development. Building off these ideas, we would like to add to the conversation by expanding on reliability needs (ie, consistency and fairness) with this type of assessment.…”