Using the Objective Structured Clinical Exam (OSCE) to Assess ACGME Competencies in Pediatric Gastroenterology Fellows.

Background: The Accreditation Council for Graduate Medical Education (ACGME) has described six core competencies with which trainees should demonstrate proficiency. Using the Objective Structured Clinical Exam (OSCE), we aimed to assess four of these competencies among Pediatric GI fellows (PG). Methods: Eight first-year PG's from six medical centers in the New York area participated in a four-station OSCE with trained standardized patient (SP) actors. The cases included an "ED Consult" for lower GI bleeding; "Breaking Bad News" focusing on CF nutritional complications; "Second Opinion" for abdominal pain; "Transition of Care" for inflammatory bowel disease. At each station, attending faculty (FO) observed the encounters behind a one-way mirror. SPs and FOs provided immediate feedback to the examined fellows. Previously validated OSCE checklists were used to assess performance. On completion, fellows attended debriefing sessions and completed surveys about the educational value. Results: Median overall milestone competency scores were 6.9 (PC1), 4.8 (PC2), 5.9(MK1), 5.7(MK2), 6.4(ICS1), 6.9(Prof1), 6.7(Prof3). Overall, fellows score highest (7/9) on the IBD "Transition of Care" case, found the "Breaking Bad News" Cystic Fibrosis OSCE to be the most challenging, and were most comfortable with the "ED Consult" OSCE, as a commonly encountered scenario. Overall, the fellows rated the educational value of the program highly. Conclusions: To our knowledge, while the OSCE has been validated in other medical fields, this is the first OSCE program developed for Pediatric GI fellows. These OSCEs have included ACGME competencies, serving to assess fellows' skills in these areas while exposing them to challenging medical and psychosocial cases that they may not frequently encounter. (C) 2016 by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology,

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