Abstract
Background
The purpose of this study was to implement an objective structured clinical examination
for child neurology trainees for formative feedback regarding communication skills.
Effective communication skills are essential and teachable, but tools to formally
assess them are limited. An objective structured clinical examination is one such
tool, but these examinations have not been developed for child neurology residents.
Methods
We developed nine standardized scenarios that highlighted communication challenges
commonly encountered in child neurology. Child neurology trainees participated in
three objective structured clinical examination events with three scenarios each over
three academic years. Standardized patients portrayed patients or their parents. Each
trainee–standardized patient encounter was evaluated by an observing faculty member
using a modified Gap-Kalamazoo Communication Skills Assessment Form, the standardized
patient who provided direct feedback, and by the participating trainee.
Results
We refined the process of case writing, standardized patient training, and trainee
evaluation throughout the three-year pilot. Results indicated rater agreement ranging
from 32% to 56%. Trainees reported that the cases were challenging and reflective
of real life and that the experience helped improve their communication skills.
Conclusions
An objective structured clinical examination can provide a standardized setting for
formative feedback regarding communication skills in child neurology residency programs.
The communication challenges posed by common clinical scenarios involving critically
ill children, children with undetermined prognosis, and the triad of parent, child,
and physician can be realistically modeled in an objective structured clinical examination.
We developed cases and a process that were valuable and that we plan to sustain for
resident education related to communication skills.
Keywords
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Article info
Publication history
Published online: September 14, 2020
Accepted:
September 5,
2020
Received:
June 25,
2020
Footnotes
Conflicts of interest: This study was sponsored by the American Board of Psychiatry and Neurology. The authors declare that there are no conflicts of interests regarding the publication of this article.
Identification
Copyright
© 2020 Elsevier Inc. All rights reserved.
