Teaching the competencies: using objective structured clinical encounters for gastroenterology fellows.

Area of Science:

• Medical Education
• Gastroenterology Fellowship Training
• Clinical Skills Assessment

Background:

• Objective structured clinical encounters (OSCEs) are standard for medical students/residents but rare in fellowships.
• Accreditation Council for Graduate Education mandates OSCEs for core competencies.
• Assessing interpersonal, communication, and professionalism skills in fellows is challenging.

Purpose of the Study:

• To report on the implementation of an OSCE for second-year gastroenterology fellows.
• To assess core competencies, specifically interpersonal/communication skills and professionalism.
• To evaluate the feasibility and effectiveness of OSCEs in fellowship training.

Main Methods:

• A 4-station, faculty-observed OSCE was developed with standardized patients.
• Key skills assessed included information gathering, relationship development, patient education, counseling, informed consent, delivering bad news, and interdisciplinary respect.
• Faculty and standardized patients used checklists for evaluation and provided feedback; 9 fellows and 5 faculty participated.

Main Results:

• Fellows and faculty rated the OSCE highly for realism, difficulty, and overall experience.
• Fellows achieved "well-done" ratings for 56.4% of communication items and 79.1% of professionalism items.
• The OSCE provided a structured method for assessing and giving feedback on critical skills.

Conclusions:

• Integrating OSCEs into gastroenterology fellowship training can improve communication skills and preparedness for complex clinical scenarios.
• OSCEs offer a mechanism for constructive feedback and program self-evaluation.
• Collaborative OSCE development can reduce costs and fulfill accreditation requirements.