Abstract
BackgroundDuring their pre-clinical years, medical students are given the opportunity to practice clinical skills with simulated patients. During these formative objective structured clinical encounters (OSCEs), tutors from various backgrounds give feedback on students’ history taking, physical exam, and communication skills. The aim of the study was to evaluate whether the content and process of feedback varied according to the tutors’ profile.MethodsDuring 2013, all 2nd and 3rd year medical students and tutors involved in three formative OSCEs were asked to fill in questionnaires, and their feedback sessions were audiotaped. Tutors were divided into two groups: 1) generalists: primary care, general internist and educationalist physicians 2) specialists involved in the OSCE related to their field of expertise. Outcome measures included the students’ perceptions of feedback quality and utility and objective assessment of feedback quality.ResultsParticipants included 251 medical students and 38 tutors (22 generalists and 16 specialists). Students self-reported that feedback was useful to improve history taking, physical exam and communication skills. Objective assessment showed that feedback content essentially focused on history taking and physical exam skills, and that elaboration on clinical reasoning or communication/professionalism issues was uncommon. Multivariate analyses showed that generalist tutors used more learner-centered feedback skills than specialist tutors (stimulating student’s self-assessment (p < .001; making the student active in finding solutions, p < .001; checking student’s understanding, p < .001) and elaborated more on communication and professionalism issues (p < 0.001). Specialists reported less training in how to provide feedback than generalists.ConclusionThese findings suggest that generalist tutors are more learner-centered and pay more attention to communication and professionalism during feedback than specialist tutors. Such differences may be explained by differences in feedback training but also by differences in practice styles and frames of references that should be further explored.Electronic supplementary materialThe online version of this article (doi:10.1186/s12909-016-0815-x) contains supplementary material, which is available to authorized users.
Highlights
During their pre-clinical years, medical students are given the opportunity to practice clinical skills with simulated patients
During the 2nd and 3rd pre-clinical years, medical students are required to practice clinical skills such as history taking, physical examination and communication skills during four formative objective structured clinical examination (OSCE) which have two different formats: 1. A 20- min interaction with a simulated patient observed by a tutor, followed by a 15-min feedback session
The smaller number of 3rd year medical students is explained by the fact that the study included only 3 OSCEs out of 4 and that 3rd year students only filled in the questionnaire for one feedback session
Summary
During their pre-clinical years, medical students are given the opportunity to practice clinical skills with simulated patients. During these formative objective structured clinical encounters (OSCEs), tutors from various backgrounds give feedback on students’ history taking, physical exam, and communication skills. The objective structured clinical examination (OSCE) is designed to evaluate learners’ skills such as history taking, physical examination, communication and professionalism. Formative feedback reinforces appropriate learning and contributes to correction of deficiencies and to learners’ self-monitoring [5]. It is especially effective when information about previous performance is used to promote positive and desirable development [6]. Studies have shown that immediate feedback to students after OSCEs leads to quick and
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