Experiential Faculty Development Program: Using Objective Structured Clinical Examinations (OSCEs) to Assess and Reinforce Practicing Physiciansʼ Patient-Centered Care Skills

Abstract

Introduction: Effective patient-centered communication in a physician-patient relationship is challenging, and these skills may need reinforcement as faculty progress in their career. Formal curricula to assess and enhance patient-centered care skills are lacking for practicing physicians. Methods: Eight GI faculty participated in an IRB-approved pilot program which included a four-station OSCE: 1) “Breaking Bad News” - a fatalistic patient undergoes a screening colonoscopy and is found to have a likely malignancy; 2) “Apologizing for a Complication” - a patient who mistrusts the medical system has a perforation during a screening colonoscopy; 3) “Geriatric IBD Case” - an elderly patient newly diagnosed with IBD requires complex outpatient care at the time of discharge; 4) “Giving Sign-Out” - a clinically depressed colleague with alcohol dependence is in crisis upon arrival for her shift. Trained standardized patients/physicians (SPs) assessed the faculty's performance using a previously validated behaviorally anchored checklist. Immediately following each case, the SP provided verbal feedback to the participant. Faculty completed a survey after each encounter about the relevance of the scenarios. Each station was videotaped, and faculty reviewed and assessed their videotaped performance using checklists. All participants completed pre- and post-OSCE surveys. Results: 25% of faculty participants have been in practice for 10+ years, 25% for 6-10 years, and 50% for 1-5 years. 5/8 participants strongly agreed that faculty development program initiatives are a worthwhile endeavor prior to the OSCE, compared with 8/8 post-OSCE. Pre-OSCE, 75% strongly agreed that faculty development programs serve a personal and professional benefit, compared with 100% postintervention. Pre-OSCE, only 2/8 agreed that OSCEs are a worthwhile method of learning, compared with 7/8 strongly agreeing with this attestation post-OSCE. Close to 90% would recommend this faculty development OSCE to their colleagues. Data on the SPs' assessment of faculty performance, and the faculty's self-assessment, are pending. Conclusion: This experiential faculty development pilot program using performance-based assessment and self-review was very well-received, and has potential to be expanded as a formal curriculum for all faculty in clinical academic practice.