Proficiency in identifying, managing and communicating medical errors: feasibility and validity study assessing two core competencies

BMC Medical Education

Research Article

Amanda K. Lovett¹  Mark W. Steffen¹  Lawrence W. Steinkraus¹  Richard D. Newcomb¹  William G. Buchta¹  Abd Moain Abu Dabrh²  Mohammad Hassan Murad²  Zhen Wang³ 

[1] Division of Preventive, Occupational, and Aerospace Medicine, Mayo Clinic, 200 First Street SW, 55905, Rochester, MN, USA;Division of Preventive, Occupational, and Aerospace Medicine, Mayo Clinic, 200 First Street SW, 55905, Rochester, MN, USA;The Evidence-based Practice Center, Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Rochester, MN, USA;The Evidence-based Practice Center, Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Rochester, MN, USA;

关键词: Communication skills;    Professionalism;    Core competencies;    Medical training;    Medical errors;    ACGME;   

DOI  :  10.1186/s12909-016-0755-5

 received in 2016-04-06, accepted in 2016-08-24,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundCommunication skills and professionalism are two competencies in graduate medical education that are challenging to evaluate. We aimed to develop, test and validate a de novo instrument to evaluate these two competencies.MethodsUsing an Objective Standardized Clinical Examination (OSCE) based on a medication error scenario, we developed an assessment instrument that focuses on distinctive domains [context of discussion, communication and detection of error, management of error, empathy, use of electronic medical record (EMR) and electronic medical information resources (EMIR), and global rating]. The aim was to test feasibility, acceptability, and reliability of the method.ResultsFaculty and standardized patients (SPs) evaluated 56 trainees using the instrument. The inter-rater reliability of agreement between faculty was substantial (Fleiss k = 0.71) and intraclass correlation efficient was excellent (ICC = 0.80). The measured agreement between faculty and SPs evaluation of resident was lower (Fleiss k = 0.36). The instrument showed good conformity (ICC = 0.74). The majority of the trainees (75 %) had satisfactory or higher performance in all six assessed domains and 86 % found the OSCE to be realistic. Sixty percent reported not receiving feedback on EMR use and asked for subsequent training.ConclusionAn OSCE-based instrument using a medical error scenario can be used to assess competency in professionalism, communication, using EMRs and managing medical errors.

【 授权许可】

CC BY   
© The Author(s). 2016