Zoom Objective Structured Clinical Exams: Virtually the Same as the Real Thing?

OBJECTIVE: Objective structured clinical exams (OSCE) are used to train and assess resident foundational family-centered communication skills incorporating key stakeholders. In 2020 encounters were conducted virtually. We sought to compare standardized patient (SP) and family faculty (FF) assessment across OSCE and virtual OSCE (VOSCE) formats. METHODS: The intern classes of 2019 and 2020 completed a live OSCE and VOSCE respectively where they disclosed an error to an SP. The 10 minute encounter was observed by an FF and facilitator followed by a 20 minute debrief. The SP and FF completed a behavioral checklist to evaluate skill mastery. RESULTS: Eighteen (90%) of the 20 interns completed the encounter each year. Total mastery scores were significantly higher for SP assessment than for FF assessment in both OSCE [68% vs 46% (z = -3.005, P < .05)] and VOSCE formats [68% vs 53% (z = -2.105, P < .05)]. Total mastery scores of SPs across OSCE and VOSCE formats did not significantly differ, nor did FF scores based on evaluation format. CONCLUSIONS: Our current experience suggests VOSCEs are a viable alternative to in person sessions given the comparable assessment across the two modalities. The ease of participating in virtual sessions may provide a way to more easily partner with key stakeholders.

Collocational knowledge in children: a comparison of English-speaking monolingual children, and children acquiring English as an Additional Language.

Collocations, e.g., apples and pears, hard worker, constitute an important avenue of linguistic enquiry straddling both grammar and the lexicon. They are sensitive to language experience, with adult L2 learners and children learning English as an Additional Language (EAL) exhibiting poor collocational knowledge. The current study piloted a novel collocational assessment with children (mean age 6;3, 40 monolingual, 32 EAL). It investigated (1) the feasibility of a collocational assessment at this age, (2) whether collocational knowledge is associated with other language domains (receptive grammar and vocabulary), and (3) whether collocational knowledge is more affected than other domains. The assessment demonstrated good psychometric properties and was highly correlated with performance in other domains, indicating shared psycholinguistic mechanisms. Unlike adult counterparts, the EAL children performed equally poorly across domains. Given the role played by collocations in vocabulary development and reading, a focus on this domain may be beneficial for EAL children.

Teaching and Assessing Communication Skills in Pediatric Residents: How Do Parents Think We Are Doing?

OBJECTIVE: Curricula designed to teach and assess the communication skills of pediatric residents variably integrates the parent perspective. We compared pediatric residents' communication skills in an objective structured clinical exam (OSCE) case as assessed by Family Faculty (FF), parents of pediatric patients, versus standardized patients (SP). METHODS: Residents participated in an OSCE case with a SP acting as a patient's parent. We compared resident performance as assessed by FF and SP with a behaviorally-anchored checklist. Items were rated as not done, partly done or well done, with well-done indicating mastery. The residents evaluated the experience. RESULTS: 42 residents consented to study participation. FF assessed a lower percentage of residents as demonstrating skill mastery as compared to SP in 19 of the 23 behaviors. There was a significant difference between FF and SP for Total Mastery Score and Mastery of the Competency Scores in three domains (Respect and Value, Information Sharing and Participation in Care and Decision Making). The majority of residents evaluated the experience favorably. CONCLUSION: Involving parents of pediatric patients in the instructive and assessment components of a communication curriculum for pediatric residents adds a unique perspective and integrates the true stakeholders in parent-physician communication.