Small-scale OSCE is Useful for Evaluation of the ACGME General Competencies of PGY1 Residents in Internal Medicine

10.6145/jme201413

Jiun-Lu Lin；Yung-Wei Hsu；Rong-Luh Lin；Cheng-Hsin Chu；Chiu-Ping Kuo；Tseng-Yu Huang；Min-Shu Wang；Chun-Chih Peng；Shou-Chuan Shih；His-Hsien Hsu；Ching-Chung Lin

objective structured clinical examination (OSCE) ； postgraduate medical education ； core competency ； PGY1 ； clinical skills

Journal of Medical Education

18卷3期（2014 / 09 / 01）

22 - 31

英文

Background: Evaluating the clinical skills of medical students by objective structured clinical examination (OSCE) is the current trend in the world. However, no consensus exists of the validity of OSCE to evaluate the general competencies of postgraduate year one (PGY1) residents. Objectives: The purpose of this study was to determine the validity of using a small-scale OSCE to test the Accreditation Council for Graduate Medical Education (ACGME) clinical competences of PGY1 residents in internal medicine. Methods: Five stations of simulated scenarios that PGY1 trainees may encounter in their clinical practice of internal medicine were built in a small-scale feedback type OSCE, to assess the PGY1 trainees' core competencies as defined by the Accreditation Council for Graduate Medical Education (ACGME). A total of 23 PGY1 trainees, 10 examiners and 18 standardized patients participated in this OSCE. Results: The candidates' overall pass rate was 87%. Most of the test stations were moderately difficult with an excellent identification rate. The highest average score was in interpersonal and communication skill, up to 74, and the average score of the other core competencies was 64-68. The reliability of Cronbach's alpha was 0.74. The overall satisfaction rate for this OSCE was 4.4 of 5, and the trainees could compare their learning outcomes scores with their peers. The test revealed that internal medicine PGY1 trainees have generally acceptable interpersonal communication skills, but other core competencies, including patient care and systems-based practice (pass rate 74%), require further improvement. Conclusion: The ACGME core competency-based small-scale OSCE allows a global, patient-centered assessment of PGY1 trainees' learning outcomes and may provide a reference for future improvements in PGY1 internal medicine training.

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