Medical Error Disclosure: An Entrustable Professional Activity During an Objective Standardized Clinical Examination for Clerkship Students
Introduction Most health care providers will be involved in a medical error during their careers. It is critical that future physicians receive formal training on error disclosure. Methods We designed a formative skills-based objective standardized clinical exam (OSCE) for fourth-year medical studen...
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| Format: | Article |
| Language: | English |
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Association of American Medical Colleges
2024-02-01
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| Series: | MedEdPORTAL |
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| Online Access: | http://www.mededportal.org/doi/10.15766/mep_2374-8265.11382 |
| _version_ | 1797302495940182016 |
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| author | Rebecca Dougherty Alice Fornari Gino Farina Doreen M. Olvet |
| author_facet | Rebecca Dougherty Alice Fornari Gino Farina Doreen M. Olvet |
| author_sort | Rebecca Dougherty |
| collection | DOAJ |
| description | Introduction Most health care providers will be involved in a medical error during their careers. It is critical that future physicians receive formal training on error disclosure. Methods We designed a formative skills-based objective standardized clinical exam (OSCE) for fourth-year medical students to assess competence in disclosing an error during a required entrustable professional activity. Faculty observed the encounter and completed a checklist evaluating students’ performance in communication skills and content knowledge. Students received immediate formative feedback. They then participated in a facilitated case-based experience, discussed the critical elements of disclosure, utilized role-play to reinforce skills, and reflected on self-care practices. Finally, students completed a survey evaluating their perception of the OSCE's impact on their disclosure knowledge, skills, and attitudes. Results Ninety-two students participated in the OSCE. Of those, 67 (73%) completed a retrospective pre/post survey assessing their disclosure knowledge, skills, and attitudes. Forty-one (62%) did not identify the error. Students who identified the error (26, 39%) were more likely to use the two-patient identifier than students who did not identify the error, χ2(1) = 13.3, p < .001. Self-reported comfort and confidence in disclosure improved, as did self-care practices (ps ≤ .005). Discussion Students agreed that health care providers should disclose an error and know how to do so. Student self-reported comfort in disclosure and knowledge of how to disclose and how to report an error all improved following the OSCE and structured debrief. The OSCE and case-based experience can be adapted for implementation in curricula about error disclosure. |
| first_indexed | 2024-03-07T23:37:48Z |
| format | Article |
| id | doaj.art-bc52afc0f6b64c0dac3c7dc5f0662227 |
| institution | Directory Open Access Journal |
| issn | 2374-8265 |
| language | English |
| last_indexed | 2024-03-07T23:37:48Z |
| publishDate | 2024-02-01 |
| publisher | Association of American Medical Colleges |
| record_format | Article |
| series | MedEdPORTAL |
| spelling | doaj.art-bc52afc0f6b64c0dac3c7dc5f06622272024-02-20T05:00:16ZengAssociation of American Medical CollegesMedEdPORTAL2374-82652024-02-012010.15766/mep_2374-8265.11382Medical Error Disclosure: An Entrustable Professional Activity During an Objective Standardized Clinical Examination for Clerkship StudentsRebecca Dougherty0Alice Fornari1Gino Farina2Doreen M. Olvet3Associate Professor, Department of Medicine and Science Education, Zucker School of Medicine at Hofstra/NorthwellProfessor, Department of Family Medicine and Science Education, Zucker School of Medicine at Hofstra/NorthwellProfessor, Department of Emergency Medicine and Science Education, Zucker School of Medicine at Hofstra/NorthwellAssociate Professor, Department of Science Education, Zucker School of Medicine at Hofstra/NorthwellIntroduction Most health care providers will be involved in a medical error during their careers. It is critical that future physicians receive formal training on error disclosure. Methods We designed a formative skills-based objective standardized clinical exam (OSCE) for fourth-year medical students to assess competence in disclosing an error during a required entrustable professional activity. Faculty observed the encounter and completed a checklist evaluating students’ performance in communication skills and content knowledge. Students received immediate formative feedback. They then participated in a facilitated case-based experience, discussed the critical elements of disclosure, utilized role-play to reinforce skills, and reflected on self-care practices. Finally, students completed a survey evaluating their perception of the OSCE's impact on their disclosure knowledge, skills, and attitudes. Results Ninety-two students participated in the OSCE. Of those, 67 (73%) completed a retrospective pre/post survey assessing their disclosure knowledge, skills, and attitudes. Forty-one (62%) did not identify the error. Students who identified the error (26, 39%) were more likely to use the two-patient identifier than students who did not identify the error, χ2(1) = 13.3, p < .001. Self-reported comfort and confidence in disclosure improved, as did self-care practices (ps ≤ .005). Discussion Students agreed that health care providers should disclose an error and know how to do so. Student self-reported comfort in disclosure and knowledge of how to disclose and how to report an error all improved following the OSCE and structured debrief. The OSCE and case-based experience can be adapted for implementation in curricula about error disclosure.http://www.mededportal.org/doi/10.15766/mep_2374-8265.11382EPAError DisclosureCase-Based LearningClinical Skills Assessment/OSCEsCompetency-Based Medical Education (Competencies, Milestones, EPAs)Professionalism |
| spellingShingle | Rebecca Dougherty Alice Fornari Gino Farina Doreen M. Olvet Medical Error Disclosure: An Entrustable Professional Activity During an Objective Standardized Clinical Examination for Clerkship Students MedEdPORTAL EPA Error Disclosure Case-Based Learning Clinical Skills Assessment/OSCEs Competency-Based Medical Education (Competencies, Milestones, EPAs) Professionalism |
| title | Medical Error Disclosure: An Entrustable Professional Activity During an Objective Standardized Clinical Examination for Clerkship Students |
| title_full | Medical Error Disclosure: An Entrustable Professional Activity During an Objective Standardized Clinical Examination for Clerkship Students |
| title_fullStr | Medical Error Disclosure: An Entrustable Professional Activity During an Objective Standardized Clinical Examination for Clerkship Students |
| title_full_unstemmed | Medical Error Disclosure: An Entrustable Professional Activity During an Objective Standardized Clinical Examination for Clerkship Students |
| title_short | Medical Error Disclosure: An Entrustable Professional Activity During an Objective Standardized Clinical Examination for Clerkship Students |
| title_sort | medical error disclosure an entrustable professional activity during an objective standardized clinical examination for clerkship students |
| topic | EPA Error Disclosure Case-Based Learning Clinical Skills Assessment/OSCEs Competency-Based Medical Education (Competencies, Milestones, EPAs) Professionalism |
| url | http://www.mededportal.org/doi/10.15766/mep_2374-8265.11382 |
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