Adapting an Objective Structured Clinical Examination (OSCE) on Conducting Difficult Conversations Between Nephrology...

Area of Science:

• Medical Education
• Nephrology
• Telemedicine

Background:

• Previously developed a nephrology-specific Objective Structured Clinical Examination (OSCE) for assessing communication skills in scenarios involving kidney replacement therapy (KRT), acute kidney injury (AKI), and kidney biopsy (KBx).
• The need to adapt clinical skills assessments to virtual platforms has become increasingly important.

Purpose of the Study:

• To adapt the nephrology OSCE to a virtual platform simulating telemedicine encounters.
• To evaluate fellow and faculty satisfaction with the virtual OSCE format.
• To assess the utility of virtual simulations for practicing difficult conversations in nephrology.

Main Methods:

• Developed a fully virtual OSCE with three scenarios: KRT in kidney failure, urgent KRT in AKI, and KBx.
• Conducted the simulation across two academic medical centers involving nephrology fellows and faculty.
• Administered anonymous surveys to assess satisfaction with each scenario and the overall virtual format.

Main Results:

• Nearly 94% of fellows rated the virtual OSCE as a good approximation of telemedicine encounters.
• Satisfaction rates were high: 100% for AKI, 75% for kidney failure, and 75% for KBx scenarios.
• Fellows estimated a significant proportion of their recent encounters were virtual, particularly outpatient consultations.

Conclusions:

• The virtual OSCE serves as a valuable tool for nephrology fellows to practice telemedicine communication skills.
• Fellows perceived the virtual format as a realistic simulation of telehealth patient interactions.
• The study highlights the potential of virtual OSCEs for medical education in nephrology.