Breast Pain in a Lactating Person: An Objective Structured Clinical Examination for Clerkship Students

Area of Science:

• Medical Education
• Clinical Skills Assessment
• Lactation Support

Background:

• Breastfeeding offers significant health benefits and cost savings.
• Physician support is vital for breastfeeding success.
• Current lactation education lacks standardized competency assessment tools.

Purpose of the Study:

• To develop and evaluate a breastfeeding-focused Objective Structured Clinical Examination (OSCE) for undergraduate medical education (UME) learners.
• To assess students' ability to apply lactation knowledge in clinical scenarios.

Main Methods:

• Developed a lactation OSCE including patient interview, postencounter note, and standardized patient (SP) evaluation.
• Compared OSCE performance between students who participated in a pilot lactation curriculum and those who did not.
• Analyzed primary outcomes (diagnosis identification) and secondary outcomes (note scores, communication) using bivariate statistics.

Main Results:

• Pilot curriculum participants were more likely to correctly identify the primary diagnosis (73% vs. 31%, p=.02).
• Pilot students achieved higher scores in management/counseling (p=.04) and SP communication (p=.002).
• Pilot students showed a trend toward higher overall scores (p=.06) and postencounter note scores (p=.18).

Conclusions:

• The developed OSCE effectively assesses UME learners' clinical application of lactation knowledge.
• The pilot curriculum improved students' diagnostic and communication skills in lactation scenarios.
• This OSCE provides a standardized tool for evaluating lactation competency in medical education.