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Requested a Different Doctor: Developing and Evaluating an OSCE Assessing Core Skills in Supporting Trainees Facing

Christine P Beltran1, Jeffrey A Wilhite2, Cristina M Gonzalez2,3,4

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Summary

Supporting colleagues facing discrimination is crucial for clinician well-being and patient care. An Objective Structured Clinical Examination (OSCE) case identified effective strategies for supporting trainees experiencing discrimination.

Keywords:
curriculum developmentdiscriminationexplicit biassimulation

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Area of Science:

  • Medical Education
  • Clinician Well-being
  • Healthcare Professionalism

Background:

  • Suboptimal support for colleagues experiencing discrimination negatively impacts clinician well-being and patient care.
  • Developing effective strategies to support trainees facing discrimination is essential for fostering inclusive learning environments.

Purpose of the Study:

  • To evaluate resident performance and experiences in an Objective Structured Clinical Examination (OSCE) case focused on supporting a trainee subjected to discrimination.
  • To identify effective methods for supporting trainees experiencing discrimination to enhance future training and learning environments.

Main Methods:

  • A formative internal medicine OSCE was conducted at a simulation center.
  • 148 second-year residents participated between 2018-2022.
  • Residents were tasked with supporting a standardized intern (SI) experiencing discrimination from a patient within a 10-minute timeframe, with performance evaluated across supervision, relationship development, and support domains.

Main Results:

  • Proficient residents (≥80% average score) generally outperformed non-proficient residents, with specific exceptions noted.
  • The SI identified effective support strategies including empathetic statements, stating a personal stance against discrimination, supportive body language, and verbal affirmations.
  • Residents found engaging with a distressed SI challenging, and stating knowledge of the situation upfront was identified as an area for improvement.

Conclusions:

  • An explicit discrimination OSCE case effectively highlights successful approaches to supporting individuals targeted by patient discrimination.
  • This educational tool can inform the development of future training programs aimed at improving support for clinicians facing discrimination.