Evaluating the Informed Consent Objective Structured Clinical Exam (OSCE) Using a Minimum Standard Assessment Tool...

To evaluate the feasibility and descriptive performance of a modified minimum-standard informed consent (IC) assessment tool when implemented during a transition-to-residency IC objective structured clinical exam (OSCE).

We conducted a single-center retrospective cohort analysis of IC OSCE recordings from fourth-year medical students enrolled in a transition-to-residency course in Academic Year (AY) 2023 and AY2024. Facilitators scored recordings using a modified Spatz minimum-standard tool. Minimum standard was considered addressing either quantitative or qualitative risk in addition to the domains of "What," "Why," "How," "Benefits," "Alternatives," and "Timeframe." Each domain was worth one point for a total minimum standard score of seven. Data sources and analytic sample: Primary data was collected during March/April 2023 (AY2023) and March/April 2024 (AY2024) using the modified Spatz assessment tool completed by facilitators while watching IC OSCE recordings.

In 2023 and 2024, 158 (98.75%) and 155 (96.87%) OSCEs were graded, respectively. A greater proportion of AY2024 students met the minimum standard compared with AY2023 students (87.1% vs 51.9%, p < 0.001). Higher AY2024 domain-level performance was observed for "Alternatives" and "Timeframe" as well as in "Quantitative Risk." A high proportion of students met expectations on the "What," "Why," "How," and "Benefits" sections in both years. Students in specialty subgroups with procedural predominance maintained high performance. Non-procedural specialty students improved significantly from AY2023 to AY2024.

The modified Spatz assessment tool was feasible to implement in a transition-to-residency IC OSCE and identified specific consent-content domains in which students did and did not meet a minimum standard.