Young Nicola, Branford Kelly, Engle Deborah L, Dotters-Katz Sarah K, Dotson Andrea
Medical Student, Duke University School of Medicine.
Clinical Skills Program Director, Duke University School of Medicine.
MedEdPORTAL. 2025 Aug 22;21:11543. doi: 10.15766/mep_2374-8265.11543. eCollection 2025.
Breastfeeding provides significant health benefits for families and cost-saving potential for health care systems. Physician support is crucial to lactation success. However, lactation education curricula across the US do not reliably meet published standards, and educators lack a standardized tool to assess student competency. We developed a breastfeeding-focused OSCE for UME learners that assesses students' application of lactation knowledge in clinical settings.
This lactation OSCE for medical students includes a patient interview, postencounter note, and evaluation by a trained standardized patient (SP). OSCE performance was compared between clerkship students who participated in a pilot lactation curriculum and students who did not participate in this curriculum. Primary outcome was correct identification of primary diagnosis. Secondary outcomes included postencounter note total score, history score, management/counseling score, and SP communication score. Data were analyzed using bivariate statistics.
Twenty-eight students completed the OSCE, of whom 15 (54%) participated in the pilot lactation curriculum. Pilot students were more likely than nonpilot students to correctly identify the primary diagnosis (73% vs. 31%, = .02), score higher on management/counseling (median 4.0 [IQR: 4.0, 6.0] vs. 4.0 [IQR: 2.0, 4.0], = .04), and communicate better (73% vs. 63%, = .002), and also nearly twice as likely to score ≥50th percentile overall (73% vs. 39%, = .06) and have higher total postencounter note scores (median 22.0 [IQR: 20.0, 26.0] vs. 19.0 [IQR: 18.0, 22.0], = .18).
This OSCE effectively assesses UME learners' ability to clinically apply lactation knowledge.
母乳喂养对家庭有显著的健康益处，对医疗保健系统有节约成本的潜力。医生的支持对哺乳成功至关重要。然而，美国各地的哺乳教育课程并不能可靠地达到已公布的标准，而且教育工作者缺乏评估学生能力的标准化工具。我们为本科医学教育（UME）学习者开发了一个以母乳喂养为重点的客观结构化临床考试（OSCE），以评估学生在临床环境中对哺乳知识的应用。
这个针对医学生的哺乳OSCE包括患者访谈、访谈后记录以及由经过培训的标准化患者（SP）进行评估。比较了参加哺乳课程试点的实习学生和未参加该课程的学生的OSCE表现。主要结果是正确识别主要诊断。次要结果包括访谈后记录总分、病史得分、管理/咨询得分和SP沟通得分。数据采用双变量统计分析。
28名学生完成了OSCE，其中15名（54%）参加了哺乳课程试点。参加试点的学生比未参加试点的学生更有可能正确识别主要诊断（73%对31%，P =.02），在管理/咨询方面得分更高（中位数4.0[四分位间距：4.0，6.0]对4.0[四分位间距：2.0，4.0]，P =.04），沟通更好（73%对63%，P =.002），总体得分≥第50百分位数的可能性也几乎是未参加试点学生的两倍（73%对39%，P =.06），并且访谈后记录总分更高（中位数22.0[四分位间距：20.0，26.0]对19.0[四分位间距：18.0，22.0]，P =.18）。
这个OSCE有效地评估了UME学习者在临床应用哺乳知识的能力。
