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

Area of Science:

• Medical Education
• Clinical Skills Assessment
• Informed Consent

Background:

• Informed consent (IC) is a critical component of patient care and medical ethics.
• Assessing the quality of IC communication during clinical encounters is essential for training physicians.
• Objective Structured Clinical Exams (OSCEs) provide a standardized method for evaluating clinical skills.

Purpose of the Study:

• To evaluate the feasibility and descriptive performance of a modified minimum-standard informed consent (IC) assessment tool.
• To assess the tool's utility during a transition-to-residency IC OSCE.
• To identify specific domains of IC where students meet or do not meet a minimum standard.

Main Methods:

• A single-center retrospective cohort analysis of IC OSCE recordings from fourth-year medical students (AY2023 and AY2024).
• Facilitators used a modified Spatz minimum-standard tool to score recordings.
• The minimum standard included assessing quantitative/qualitative risk and seven core IC domains.

Main Results:

• A significantly greater proportion of AY2024 students met the minimum IC standard compared to AY2023 students (87.1% vs 51.9%, p < 0.001).
• Improved performance was noted in AY2024 for "Alternatives," "Timeframe," and "Quantitative Risk."
• Students consistently met expectations for "What," "Why," "How," and "Benefits" domains; non-procedural specialty students showed significant improvement.

Conclusions:

• The modified Spatz assessment tool is feasible for implementation in transition-to-residency IC OSCEs.
• The tool effectively identified specific consent-content domains needing improvement.
• This assessment method can guide targeted educational interventions for enhancing IC communication skills.