Objective Structured Clinical Examination Research Articles

Virtual Learning and Assessment in Rheumatology Fellowship Training: Objective Structured Clinical Examination Revisited.

With the onset of the COVID-19 pandemic, an annual multi-institutional face-to-face rheumatology objective structured clinical examination (ROSCE) was transformed into a virtual format. The educational goals of the virtual ROSCE (vROSCE) were to reproduce the educational value of the previous in-person ROSCE, providing a valuable formative assessment of rheumatology training activities encompassing the 6 Accreditation Council for Graduate Medical Education (ACGME) core competencies for fellows-in-training (FITs). This article describes the novel design, feasibility, and stakeholder value of a vROSCE. Through an established collaboration of 5 rheumatology fellowship training programs, in February 2021, a vROSCE was created and conducted using a Zoom platform. Station development included learning objectives, FIT instructions, faculty proctor instructions, and a checklist by which to provide structured formative feedback. An anonymous, optional web-based survey was sent to FIT participants to evaluate the experience. Twenty-three rheumatology FITs from 5 institutions successfully rotated through 6 stations in the vROSCE. Immediate feedback was given to each FIT using standardized rubrics structured around ACGME core competencies. A total of 65% of FITs (15 of 23) responded to the survey, and 93% of survey respondents agreed or strongly agreed that the vROSCE was a helpful educational activity and identified individualized opportunities for improvement. A vROSCE is an innovative, feasible, valuable, and well-received educational technology tool. The vROSCE enriched rheumatology FITs' education and offered collaborative learning experiences across institutions.

A pilot clinical skills coaching program to reimagine remediation: a cohort study.

Background New approaches are needed to improve and destigmatize remediation in undergraduate medical education (UME). The COVID-19 pandemic magnified the need to support struggling learners to ensure competency and readiness for graduate medical education (GME). Clinical skills (CS) coaching is an underutilized approach that may mitigate the stigma of remedial learning. Methods A six-month CS coaching pilot was conducted at Harvard Medical School (HMS) as a destigmatized remedial learning environment for clerkship and post-clerkship students identified as 'at risk' based on objective structured clinical examinations (OSCE). The pilot entailed individual and group coaching with five faculty, direct bedside observation of CS, and standardized patient encounters with video review. Strengths-based coaching principles and appreciative inquiry were emphasized. Results Twenty-three students participated in the pilot: 14 clerkship students (cohort 1) and 9 post-clerkship students (cohort 2). All clerkship students (cohort 1) demonstrated sustained improvement in CS across three OSCEs compared to baseline: at pilot close, at 6-months post pilot, and at 21-24 months post-pilot all currently graduating students (10/10, 100%) passed the summative OSCE, an HMS graduation requirement. All post-clerkship students (cohort 2) passed the HMS graduation OSCE (9/9,100%). Feedback survey results included clerkship students (9/14; 64%) and post-clerkship students (7/9; 78%); all respondents unanimously agreed that individual coaching was "impactful to my clinical learning and practice". Faculty and leadership fully supported the pilot as a destigmatized and effective approach to remediation. Conclusion Remediation has an essential and growing role in medical schools. CS coaching for remedial learning can reduce stigma, foster a growth mindset, and support sustained progress for 'at risk' early clerkship through final year students. An "implementation template" with suggested tools and timelines can be locally adapted to guide CS coaching for UME remediation. The CS coaching pilot model is feasible and can be generalized to many UME programs.

Applying a validated scoring rubric to pre-clerkship medical students’ standardized patient notes: a pilot study

BackgroundWith the elimination in 2021 of the United States Medical Licensing Examination Step 2 Clinical Skills test, it is incumbent upon U.S. medical schools to develop local validated assessments of clinical reasoning. While much attention has been paid to summative exams for graduating students, formative exams for pre-clerkship students have not been well studied.MethodsWe applied the University of Illinois at Chicago College of Medicine (UIC-COM) Patient Note (PN) Scoring Rubric to templated PNs written by 103 pre-clerkship students for two cases in an objective structured clinical examination (OSCE) at the Yale School of Medicine. The rubric consists of four section scores (Documentation, Differential Diagnosis, Justification, and Workup, each scored 1 to 4) and a composite score (scaled 23 to 100). We calculated item discrimination for each section score and Cronbach’s alpha for each case. We surveyed students about their experience writing the templated PN.ResultsMean Documentation, Differential Diagnosis, Justification, Workup, and composite scores for case A were 2.16, 1.80, 1.65, 2.29, and 47.67, respectively. For case B, the scores were 2.13, 1.21, 1.60, 1.67, and 40.54, respectively. Item discrimination ranged from 0.41 to 0.80. Cronbach’s alpha for cases A and B was 0.48 and 0.25, respectively. A majority of the students felt that the exercise was useful and appropriate to their level of training.ConclusionsDespite performing poorly, pre-clerkship students found the note-writing task beneficial. Reliability of the scoring rubric was suboptimal, and modifications are needed to make this exercise a suitable measure of clinical reasoning.

Nursing education institutions' readiness to use online objective structured clinical examination scoring management system

Introduction: The Objective Structured Clinical Examination (OSCE) is an acceptable measure to assess nursing students' skill competencies. To date, rapid changes in the education system, technology information, and pandemic enforced the need to develop and implement an online OSCE scoring management system, an online system to score the student during the OSCE. Although the satisfaction of the online OSCE scoring management system has been studied, the study to assess readiness to implement the online OSCE scoring management system is still lacking. This study aimed to identify the nursing education institution readiness level in implementing an online OSCE scoring management system named ON-OSCE. Methods: The online survey involved 144 nursing lecturers across Indonesia. The survey consisted of 30 questions with a 5-point Likert scale that entails technology, innovation, people, and self-development dimensions. Each dimension was constructed by the questions related to resources, skills, and attitudes. The readiness levels were categorized into not ready (average score of 1-3.39) and ready (average score of 3.40-5.00). Results: Mostly, the participants worked at a private institution (93%) with an accreditation level of B level (75.5%) and implemented an e-Learning system (85.4%). However, the common OSCE scoring management system was paper-based/hardcopy (73.2%). About two third of participants (67.4%) were ready to implement an online OSCE scoring management system (Mean = 3.57, SD = 0.57). Conclusion: Most participants perceived that their institution was ready to implement an online OSCE scoring management system. Further study is needed to pilot an online OSCE scoring management system in a nursing education institution and explore the student and examiner's satisfaction before implementing an online OSCE scoring management system.

Implementation of the national antimicrobial stewardship competencies for UK undergraduate healthcare professional education within undergraduate pharmacy programmes: a survey of UK schools of pharmacy.

Pharmacists play a key role in antimicrobial stewardship (AMS). Consensus-based national AMS competencies for undergraduate healthcare professionals in the UK reflect the increasing emphasis on competency-based healthcare professional education. However, the extent to which these are included within undergraduate pharmacy education programmes in the UK is unknown. To explore which of the AMS competencies are delivered, including when and at which level, within UK undergraduate MPharm programmes. A cross-sectional online questionnaire captured the level of study of the MPharm programme in which each competency was taught, the method of delivery and assessment of AMS education, and examples of student feedback. Ten institutions completed the survey (33% response rate). No institution reported covering all 54 AMS competencies and 5 of these were taught at half or fewer of the institutions. Key gaps were identified around taking samples, communication, outpatient parenteral antimicrobial therapy and surgical prophylaxis. The minimum time dedicated to AMS teaching differed between institutions (range 9-119 h), teaching was generally through didactic methods, and assessment was generally through knowledge recall and objective structured clinical examinations. Feedback from students suggests they find AMS and antimicrobial resistance (AMR) to be complex yet important topics. UK schools of pharmacy should utilize the competency framework to identify gaps in their AMS, AMR and infection teaching. To prepare newly qualified pharmacists to be effective at delivering AMS and prescribing antimicrobials, schools of pharmacy should utilize more simulated environments and clinical placements for education and assessment of AMS.

Impact of a Digital Tool on Pharmacy Students' Ability to Perform Medication Reviews: A Randomized Controlled Trial.

Digital Medication Review Tools (DMRTs) are increasingly important in pharmacy practice. To ensure that young pharmacists are sufficiently competent to perform medication reviews after graduation, the introduction of DMRTs teaching in academic education is necessary. The aim of our study was to demonstrate the effect of DMRTs use on pharmacy students' performance when conducting a medication review (MR) in a randomized controlled pre-post design. Forty-one pharmacy students were asked to complete a MR within 60 min, followed by a 10-min consultation with (intervention group) and without a DMRT (control group). The MR performance was subdivided into four categories: communication skills, subjective and objective patient data, assessment, and plan. Performance was assessed using objective structured clinical examinations (OSCEs) and analytical checklists. With the use of DMRTs, the overall performance was improved by 17.0% compared to the control group (p < 0.01). Improvement through DMRTs was seen in the subcategories "Assessment" and "Plan". Furthermore, pharmacy students liked using DMRTs and felt more confident overall. Our study results demonstrate that DMRTs improve the performance of MRs, hence DMRTs should become an integral part of pharmacy curriculum. Consequently, digitally enabled pharmacists using DMRTs will be better prepared for their professional careers in pharmacy practice.

Undergraduate Skills Training in Pandemic Times: Where Is the Future of Medical Education?

The COVID-19 pandemic forced medical programs to rapidly switch to remote teaching from scratch, impacting hands-on skills training. This study compared the efficacy of a hybrid online format to a regular in-person session for a mandatory surgical skills class. Third-year undergraduate medical students attending the surgical skills class in the winter semester of 2020/21 at the Medical University of Graz were randomly assigned to either the hybrid or in-person class, depending on their course schedule and government regulations. The hybrid class involved online videos, one-on-one peer tutoring, and an Objective Structured Clinical Examination (OSCE). Pre- and post-class self-assessments were conducted to evaluate their theoretical and practical knowledge of a single interrupted suture. The study included 85 students in the regular in-person class and 50 in the hybrid class. A pre-class assessment revealed higher self-assessments in the hybrid class for theoretical and practical knowledge, but a post-class assessment showed no significant difference. The advantages and disadvantages of both modalities were identified, providing valuable insights for future curriculum development. Both teaching modes were effective for undergraduate surgical skills training. This study recommends implementing positive aspects of both the hybrid and in-person formats while recognizing their respective limitations.

Assessment of Antimicrobial Stewardship through objective structured clinical examination in pharmacy education.

To describe the implementation and assess whether an objective structured clinical examination (OSCE) is a viable assessment tool for testing Antimicrobial Stewardship (AMS) principles. A three-station OSCE set in a hospital and community pharmacy was designed and mapped to the World Health Organisation's AMS intervention practical guide. This OSCE comprised 39 unique cases and was implemented across two campuses (Malaysia and Australia) at one institute. Stations were 8 min long and consisted of problem-solving and applying AMS principles to drug therapy management (Station 1), counselling on key antimicrobials (Station 2) or managing infectious diseases in primary care (Station 3). Primary outcome measure to assess viability was the proportion of students who were able to pass each case. Other than three cases with pass rates of 50, 52.8 and 66. 7%, all cases had pass rates of 75% or more. Students were most confident with referral to medical practitioner cases and switching from intravenous to oral or empirical to directed therapy. An AMS-based OSCE is a viable assessment tool in pharmacy education. Further research should explore whether similar assessments can help improve students' confidence at recognising opportunities for AMS intervention in the workplace.

Experience of introducing electronic health records station in an objective structured clinical examination to evaluate medical students' communication skills in Canada: a descriptive study.

There is limited literature related to the assessment of electronic medical record (EMR)-related competencies. To address this gap, this study aims to explore the feasibility of EMR objective structured clinical examination (OSCE) station to evaluate the medical students' communication skills by psychometric study and standardized patients' (SPs) perspectives on EMR use in OSCE. An OSCE station that incorporated the use of an EMR was developed and pilot-tested in March 2022. Students' communication skills were assessed by SPs and physician examiners. Student's score in EMR station was compared with that of other 9 stations. Psychometric analysis, including item total correlation was done. SPs participated in a post-OSCE focus group to discuss their perception of EMRs' effect on communication. Ninety-nine 3rd year medical students participated in a 10-station OSCE that included the use of the EMR station. The EMR station had an acceptable item total correlation (0.217). Students who leveraged graphical displays in counseling received higher OSCE station scores from the SPs (P -value). Thematic analysis of the SP perception of students' EMR use from the focus group revealed the following domains of themes: technology, communication, case design, ownership of health information, and timing of EMR usage. This study demonstrated the feasibility of incorporating EMR in assessing learner communication skills in an OSCE. The EMR station had acceptable psychometric characteristics. Some medical students were able to efficiently use the EMRs as an aide in patient counseling. Teaching students how to be patient-centred even in the presence of technology may help with engagement.

The Qualified Lawyers Transfer Scheme: The Objective Structured Clinical Examination (OSCE) 2014–2022

The Qualified Lawyers Transfer Scheme: The Objective Structured Clinical Examination (OSCE) 2014–2022

Implementation of Automated Information System to Increase Administration Efficiency of Objective Structured Clinical Examinations

&lt;p&gt;客觀結構式臨床技能測驗（Objective Structured Clinical Examination, OSCE）需大量人力物力支持，本品質改善專案意在藉由資訊自動化、線上化，提升OSCE管理效率。活動中藉由建置OSCE網站、運用資訊自動化概念設定評分自動換算彙整模組、擬定並執行考官培訓計畫，大幅改善管理效率。品質改善活動後籌備時間自184小時減少至132小時，紙張耗費量從1224張紙減少至696張紙，考官成員數量自26位增加至31位。整體而言，品質改善專案的執行達成預定的目標，未來除持續執行之外，也將加強文件管理與備份，以專用帳號管理OSCE網站與雲端硬碟文件，定期下載備份資料以確保資料完整性。&lt;/p&gt; &lt;p&gt;&amp;nbsp;&lt;/p&gt;&lt;p&gt;Objective Structured Clinical Examinations (OSCEs) require substantial investments in terms of human and material resources. Thus, this Quality Enhancement Project aims to increase the efficiency of OSCE administration through the automation of online access to information.In this project, an OSCE website was established to substantially improve management efficiency, information automation was achieved by implementing a module for automatic score conversion and aggregation, and an examiner training plan was designed and implemented.Through various quality improvement activities, the preparation time for OSCE was reduced from 184 to 132 h, paper consumption was reduced from 1,224 sheets to 696 sheets, and the number of examiners was increased from 26 to 31. Thus, the overall objective of the Quality Enhancement Project was achieved.In the future, the project should be continued, file management and backup processes should be enhanced by managing the files on the OSCE website and cloud storage platforms through a dedicated account, and data should be regularly backed up to ensure data integrity.&lt;/p&gt; &lt;p&gt;&amp;nbsp;&lt;/p&gt;

Assessment of Factors That Students Perceive to Affect Their Virtual Learning of Clinical Skills for OSCE.

Objective Structured Clinical Examination (OSCE) is a vital examination that must be passed to graduate as a qualified doctor. The delivery of OSCE teaching was changed to an online format to accommodate COVID-19 restrictions. Therefore, this study evaluates factors that students perceive to affect their virtual learning of clinical skills for OSCE. In this cross-sectional study, all medical students from across the world who attended "The Respiratory Station" session delivered by OSCEazy (a medical student organization providing free online medical education) in the academic year 2020-2021 received an online questionnaire about their perceptions of this learning opportunity. The survey was created on Google™ forms and consisted of 5-point Likert scales as well as free-text boxes. A total of 556 responses were received (mean age: 24, female: 76.6%). Most students agreed that online OSCE teaching offers more flexibility and convenience (median: 5, IQR: 4-5) but their likeliness to ask questions in either format was similar (median: 4, IQR: 3-5 vs median: 4, IQR: 3-4, p value: 0.94). The use of visual aids (median: 5, IQR: 4-5) and breakout rooms (median: 3, IQR: 2-4) were thought to enhance the quality of virtual OSCE teaching. The biggest concern about online teaching was access to a stable internet connection (69.1%). The flexibility and convenience of virtual OSCE teaching enables the sharing of knowledge and skills to a wider audience and thus may be a very useful adjunct to face-to-face OSCE teaching in the future.

A Telehealth Module and Virtual Objective Structured Clinical Examination of Health Literacy in Pharmacy Education

ObjectiveTo implement an online health literacy (HL) module and evaluate its impact through virtual Objective Structured Clinical Examination (OSCE) on students’ abilities to manage patients with low HL. MethodsStudents virtually engaged in several learning activities related to HL, including practicing using HL assessment tools, designing an information booklet suitable for low HL patients, using readability formulas to lower text readability level to ≤ sixth grade, role-playing scenarios related to HL, and undergoing a virtual OSCE. Student performance on course assessments was tested using Spearman’s rank-order. Students evaluated their OSCE experience in terms of case content, virtual assessment, and logistics; and effectiveness of the HL module and confidence related to HL. ResultsA total of 90 students completed the virtual OSCE; the mean score was 8.8 out of 10 (88%), which correlated with similar course assessments. The average score was 3.46 out of 3.7 for the “gathering information” domain (recognizing risk factors and behaviors, assessing HL and adherence, etc.), and 4.06 out of 4.9 for the “patient management” domain (counseling patients on taking medications, focusing on repeating key messages, offering adherence interventions, etc.). Students responded positively regarding case content and virtual assessment, but less favorably regarding logistics. Feedback on effectiveness of the HL module and confidence in managing patients with low HL was positive. ConclusionAn HL module delivered online was effective in improving student knowledge, abilities, and confidence related to HL. Students achieved high scores in all items in the virtual OSCE, and considered it a measure of communication and clinical skills that is comparable to traditional in-room assessments.

A study to assess the effectiveness of OSCE (Objective structured clinical examination) method on cardiopulmonary resuscitation (CPR) among B.Sc. Nursing 2nd Year Students of Government College of Nursing, Ujjain (M.P.)

A study to assess the effectiveness of OSCE (Objective structured clinical examination) method on cardiopulmonary resuscitation (CPR) among B.Sc. Nursing 2nd Year Students of Government College of Nursing, Ujjain (M.P.)

Effect of blended-learning in promoting clinical skills of nursing students

Background and aims: Before the COVID-19 epidemic, the main part of university education was presented in traditional form, but nowadays, E-learning and blended learning evolve in students’ education. This study was conducted to determine the effectiveness of blended learning in promoting the clinical skills of nursing students. Methods: In this quasi-experimental study, 76 nursing students in the Sirjan School of Medical Sciences were entered through the census method in 2019 and 2020. They were allocated to intervention (n=36) and control (n=40) groups based on their academic year. Those who entered university in 2017 (control group) revived standard education, while the students of 2018 (intervention group) received blended clinical training, which included podcasts, vodcasts (40%), and standard training in the clinical courses of adult-geriatric nursing three and critical care nursing. Students’ performance was evaluated through an Objective Structured Clinical Examination (OSCE) method. Data were collected using a researcher-made checklist after assessing its validity and reliability. Data were analyzed using descriptive and analytical statistics (chi-square, independent sample t test, and paired t test) by SPSS-19. Results: There was not any significant difference between the scores of clinical skills in the control group before (2.15±0.48) and after (2.44±0.29) the intervention (P=0.58), but there were significant differences between the scores of clinical skills in the intervention group before (2.28±0.31) and after (3.22±0.16) the intervention and also between the scores of the two groups, in all subscales after the intervention (P&lt;0.001). Conclusion: The study results highlighted the need for using blended-learning methods and appropriate technology to help nursing students achieve their clinical skill learning goals in clinical settings.

A comprehensive medical Spanish curriculum model: the Vida Medical Spanish Curriculum

IntroductionRacial and language disparities in the United States healthcare system have long undermined the quality of care provided to minority patients. With the projected growth of the Hispanic population, there is an urgent need for medical schools to integrate high-quality medical Spanish and cultural competency content. We propose a comprehensive medical Spanish curriculum aligned with the preclinical curriculum as a solution to these issues. The primary goal of this study is to demonstrate the effectiveness of a clinically focused, culturally competent medical Spanish program and advocate for its widespread adoption in medical institutions nationwide.MethodsThe study utilized the Kirkpatrick Model to evaluate the success of the medical Spanish curriculum. A total of 111 medical students voluntarily enrolled in the medical Spanish course. Out of these students, 47 completed the final evaluation, which included a Spanish Objective Structured Clinical Examination and a 40-question Multiple-Choice Exam assessing the integration of Spanish language skills and cultural competency. Both assessment methods took place in clinical skills facilities. Descriptive statistics summarized exam results, and two-tailed t-tests compared mean exam scores between students of different proficiency levels.Results and discussionStudents achieved a mean score of over 80% on all components of the Spanish Objective Structured Clinical Examination and the Multiple-Choice Exam. Survey data suggest that students felt able to communicate in Spanish with patients after completing the course series. The study also provides a model for a medical Spanish curriculum that applies expert-recommended best practices to meet the needs of Hispanic patient populations.Limitations and conclusionsStudents who sat for the OSCE and MCE were self-selected. Baseline data on student perceptions and Spanish competency are not sufficient for making comparisons.

Reliability in performance assessment creates a potential application of artificial intelligence in veterinary education: evaluation of suturing skills at a single institution.

To evaluate suturing skills of veterinary students using 3 common performance assessments (PAs) and to compare findings to data obtained by an electromyographic armband. 16 second-year veterinary students. Students performed 4 suturing tasks on synthetic tissue models 1, 3, and 5 weeks after a surgical skills course. Digital videos were scored by 4 expert surgeons using 3 PAs (an Objective Structured Clinical Examination [OSCE]- style surgical binary checklist, an Objective Structured Assessment of Technical Skill [OSATS] checklist, and a surgical Global Rating Scale [GRS]). Surface electromyography (sEMG) data collected from the dominant forearm were input to machine learning algorithms. Performance assessment scores were compared between experts and correlated to task completion times and sEMG data. Inter-rater reliability was calculated using the intraclass correlation coefficient (ICC). Inter-rater agreement was calculated using percent agreement with varying levels of tolerance. Reliability was moderate for the OSCE and OSATS checklists and poor for the GRS. Agreement was achieved for the checklists when moderate tolerance was applied but remained poor for the GRS. sEMG signals did not correlate well with checklist scores or task times, but features extracted from signals permitted task differentiation by routine statistical comparison and correct task classification using machine learning algorithms. Reliability and agreement of an OSCE-style checklist, OSATS checklist, and surgical GRS assessment were insufficient to characterize suturing skills of veterinary students. To avoid subjectivity associated with PA by raters, further study of kinematics and EMG data is warranted in the surgical skills evaluation of veterinary students.

Objective Structured Clinical Examination Laboratory Learning Management for Nursing Students University of Muhammadiyah Malang

Objective Structured Clinical Examination (OSCE) is used at the end of the skill lab learning to determine students’ success in learning a skill taught by a lecturer. This research aimed to identify nursing student values regarding OSCE Laboratory learning in UMM Nursing Students. This research was descriptive. The sample of 2016 PSIK students in Classes A and B of the University of Muhammadiyah Malang in the BLOK KMB 1 course was 84 respondents. Sampling was done using value blanks from the OSCE results for the BLOK KMB 1 course. Data analysis used a univariate analysis test. The results showed that nursing students who took part in the OSCE had good average scores when viewed by category. The results of OSCE laboratory learning for nursing students in the 2016 BLOCK KMB 1 course were very good, where the distribution of average scores, grades by category, and grades and categories show that more students get ‘very good’ and ‘good’ grades.&#x0D; Keywords: Learning Outcomes, OSCE, Nursing Students

Time for change? Feasibility of introducing micromodules into medical student education: a randomised controlled trial.

Didactic lectures have been the foundation of learning for many medical students. However, in recent years, the flipped classroom model has become increasingly popular in medical education. This approach enhances pre-class learning, allowing the limited contact time between clinicians and medical students to be focused on practical issues. This study evaluated the effectiveness and non-inferiority of online micromodule teaching in terms of knowledge transfer concerning specific urology topics. Medical students without prior exposure to the urology subspecialty were enrolled in the study, then randomised to a traditional didactic lecture group or an online micromodule group. Knowledge transfer was assessed by pre-intervention and post-intervention multiple-choice questions and objective structured clinical examinations that involved the acquisition of medical histories from real patients. In total, 45 medical students were enrolled (22 in the traditional didactic group and 23 in the online micromodule group). In terms of knowledge transfer (assessed by objective structured clinical examinations), the efficacy of online micromodules was comparable to traditional didactic lectures, although the difference was not statistically significant (P=0.823). There were no significant differences in terms of knowledge acquisition, retention, or clinical application between the two groups. In terms of acquiring, retaining, and applying foundational urological knowledge, online micromodules can help medical students to achieve outcomes comparable with the outcomes of didactic lectures. Online micromodules may be a viable alternative to traditional didactic lectures in urology education.

Shedding Light on the Hidden Curriculum: A Systematic Review of Ethics Education during General Surgery and Subspecialty Training

Ethics education in surgical residencies is often delivered in an informal and nonstructured manner as part of a "hidden curriculum", leading to few residencies routinely including it in their core curriculum. This systematic review aimed to summarize the delivery modes, curriculum, structure, and effectiveness of ethics educational interventions for surgical trainees. We performed a comprehensive database search including MEDLINE, Embase, Scopus and CENTRAL to search for articles describing the implementation of ethics educational interventions for general surgery or subspecialty trainees. A total of 14 studies were included. Only 2 centers performed targeted needs assessment. Curricula covered included informed consent, the doctor-patient relationship, breaking bad news, decision-making, end-of-life care, conflicts of interest, considering patients' personal contexts, and surgical research ethics. Modes of delivery varied across studies, including case-based learning, group discussions, didactic lectures, reading material, role-playing, simulated patients, and ethics morbidity and mortality (M&M) meetings. Evaluations were most commonly via surveys exploring knowledge and self-reported confidence, with only 3 studies measuring actual trainee performance using objective structured clinical examinations. In general, the educational interventions increased trainees' confidence/preparedness in handling ethical dilemmas. We recommend comprehensive local needs assessment to guide curricular development and designing specific learning objectives and measurable milestones to ensure evaluation. Educational interventions are best delivered in a graduated manner with the complexity of the topic mirroring residents' real-life clinical responsibilities and experiences. Teaching modalities should be tailored according to the nature of the curricular content being taught to make the learning experience more interactive and effective.