Altshuler Lisa, Kachur Elizabeth, Krinshpun Shifra, Sullivan Deborah
Developmental & Behavioral Pediatrics, Maimonides Infants & Children's Hospital of Brooklyn, Brooklyn, New York 11219, USA.
Acad Med. 2008 Nov;83(11):1088-93. doi: 10.1097/ACM.0b013e31818902e5.
In 2003, the Maimonides Infants & Children's Hospital received a Title VII Residency Training in Primary Care grant to integrate genetic-specific competencies into postgraduate pediatrics education. As part of that endeavor, mandatory yearly genetics objective structured clinical exams (OSCEs) were instituted for third-year residents. This article reports on the first three years of experience with this innovative educational tool.After an overview of genetic concepts, dysmorphology, and communication styles, residents complete a five-station OSCE and receive feedback from standardized patients and from the faculty who observe them. After this clinical exercise, the residents participate in a small-group debriefing session to share strategies for effective communication and clinical case management and to discuss the ethical issues that arise with these genetic cases.In three years, 60 residents have completed the genetics OSCE program. Evaluation data demonstrate that the program has been effective in both introducing genetic-specific challenges and assessing residents' clinical skills. It has helped trainees self-identify both strengths and further training needs. Pre- and postsurveys among the trainees show increased comfort levels in performing 5 of 12 genetic-related clinical tasks.We conclude that genetics OSCEs are an enriching educational tool. Merely providing trainees and practicing physicians with the latest scientific information is unlikely to prepare them for counseling patients about complex genetic issues. Developing proficiency requires focused practice and effective feedback.This article is part of a theme issue of Academic Medicine on the Title VII health professions training programs.
2003年，迈蒙尼德婴幼儿医院获得了一项初级保健领域的住院医师培训拨款（《民权法案》第七章），旨在将特定的遗传学能力融入研究生阶段的儿科学教育。作为该项工作的一部分，针对三年级住院医师设立了强制性的年度遗传学客观结构化临床考试（OSCE）。本文报告了使用这一创新教育工具的头三年经验。在对遗传学概念、畸形学和沟通方式进行概述之后，住院医师完成一个由五个站点组成的OSCE，并从标准化病人以及观察他们的教员那里获得反馈。在这项临床练习之后，住院医师参加一个小组汇报会，分享有效沟通和临床病例管理的策略，并讨论这些遗传学病例中出现的伦理问题。三年来，60名住院医师完成了遗传学OSCE项目。评估数据表明，该项目在引入特定遗传学挑战和评估住院医师临床技能方面均行之有效。它帮助学员自我识别自身优势和进一步的培训需求。学员的课前和课后调查显示，在12项与遗传学相关的临床任务中，有5项任务的操作舒适度有所提高。我们得出结论，遗传学OSCE是一种丰富的教育工具。仅仅为学员和执业医师提供最新的科学信息，不太可能让他们为就复杂的遗传学问题向患者提供咨询做好准备。培养熟练程度需要有针对性的练习和有效的反馈。本文是《学术医学》关于《民权法案》第七章卫生专业培训项目主题特刊的一部分。
