Nguyen Laura N, Tardioli Kim, Roberts Matthew, Watterson James
Department of Surgery, Division of Urology, The Ottawa Hospital, Ottawa, ON;
The University of Ottawa Skills and Simulation Centre, University of Ottawa, Ottawa, ON.
Can Urol Assoc J. 2015 Jan-Feb;9(1-2):32-6. doi: 10.5489/cuaj.2366.
As residency training requirements increasingly emphasize a competency-based approach, novel tools to directly evaluate Canadian Medical Education Directives for Specialists (CanMEDS) competencies must be developed. Incorporating simulation allows residents to demonstrate knowledge and skills in a safe, standardized environment. We describe a novel hybrid simulation station for use in a urology resident in-training Objective Structured Clinical Exam (OSCE) to assess multiple CanMEDS competencies.
An OSCE station was developed to assess Communicator, Health Advocate, Manager, and Medical Expert (including technical skills) CanMEDS roles. Residents interviewed a standardized patient, interacted with a nurse, performed flexible cystoscopy and attempted stent removal using a novel bladder/stent model. Communication was assessed using the Calgary-Cambridge Observational Guide, knowledge was assessed using a checklist, and technical skills were assessed using a previously validated global rating scale. Video debriefing allowed residents to review their performance. Face and discriminative validity were assessed, and feasibility was determined through qualitative post-examination interviews and cost analysis.
All 9 residents (postgraduate years [PGY] 3, 4, 5) completed the OSCE in 15 minutes. Communicator and knowledge scores were similar among all PGYs. Scores in technical skills were higher in PGY-5 compared with PGY-3/4 reside nts (mean score 79% vs. 73%). Residents and exam personnel felt the OSCE station allowed for realistic demonstration of competencies. Equipment cost was $218 for the exam station.
We developed and implemented a hybrid simulation-based OSCE station to assess multiple CanMEDS roles. This approach was feasible and cost-effective; it also provided a framework for future development of similar OSCE stations to assess resident competencies across multiple domains.
随着住院医师培训要求越来越强调基于能力的方法，必须开发直接评估《加拿大专科医生医学教育指令》（CanMEDS）能力的新工具。引入模拟技术可让住院医师在安全、标准化的环境中展示知识和技能。我们描述了一种新型混合模拟站，用于泌尿外科住院医师培训客观结构化临床考试（OSCE），以评估多项CanMEDS能力。
开发了一个OSCE站，以评估沟通者、健康倡导者、管理者和医学专家（包括技术技能）等CanMEDS角色。住院医师采访一名标准化患者，与一名护士互动，进行软性膀胱镜检查，并使用新型膀胱/支架模型尝试取出支架。使用《卡尔加里 - 剑桥观察指南》评估沟通能力，使用清单评估知识，使用先前验证的整体评分量表评估技术技能。通过视频反馈让住院医师回顾自己的表现。评估了表面效度和区分效度，并通过考试后的定性访谈和成本分析确定了可行性。
所有9名住院医师（研究生第3、4、5年）在15分钟内完成了OSCE。所有研究生年级的沟通能力和知识得分相似。与研究生第3/4年的住院医师相比，研究生第5年的住院医师技术技能得分更高（平均得分79%对73%）。住院医师和考试人员认为该OSCE站能够真实地展示能力。考试站的设备成本为218美元。
我们开发并实施了一个基于混合模拟的OSCE站，以评估多项CanMEDS角色。这种方法可行且具有成本效益；它还为未来开发类似的OSCE站提供了一个框架，以评估住院医师在多个领域的能力。
