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Development and testing of an objective structured clinical exam (OSCE) to assess socio-cultural dimensions of patient safety competency.

Abstract：

BACKGROUND:Patient safety (PS) receives limited attention in health professional curricula. We developed and pilot tested four Objective Structured Clinical Examination (OSCE) stations intended to reflect socio-cultural dimensions in the Canadian Patient Safety Institute's Safety Competency Framework. SETTING AND PARTICIPANTS:18 third year undergraduate medical and nursing students at a Canadian University. METHODS:OSCE cases were developed by faculty with clinical and PS expertise with assistance from expert facilitators from the Medical Council of Canada. Stations reflect domains in the Safety Competency Framework (ie, managing safety risks, culture of safety, communication). Stations were assessed by two clinical faculty members. Inter-rater reliability was examined using weighted κ values. Additional aspects of reliability and OSCE performance are reported. RESULTS:Assessors exhibited excellent agreement (weighted κ scores ranged from 0.74 to 0.82 for the four OSCE stations). Learners' scores varied across the four stations. Nursing students scored significantly lower (p<0.05) than medical students on three stations (nursing student mean scores=1.9, 1.9 and 2.7; medical student mean scores=2.8, 2.9 and 3.5 for stations 1, 2 and 3, respectively where 1=borderline unsatisfactory, 2=borderline satisfactory and 3=competence demonstrated). 7/18 students (39%) scored below 'borderline satisfactory' on one or more stations. CONCLUSIONS:Results show (1) four OSCE stations evaluating socio-cultural dimensions of PS achieved variation in scores and (2) performance on this OSCE can be evaluated with high reliability, suggesting a single assessor per station would be sufficient. Differences between nursing and medical student performance are interesting; however, it is unclear what factors explain these differences.

journal_name

BMJ Qual Saf

journal_title

BMJ quality & safety

authors

Ginsburg LR,Tregunno D,Norton PG,Smee S,de Vries I,Sebok SS,VanDenKerkhof EG,Luctkar-Flude M,Medves J

doi

10.1136/bmjqs-2014-003277

subject

Has Abstract

pub_date

2015-03-01 00:00:00

pages

188-94

issue

eissn

2044-5415

issn

2044-5423

pii

bmjqs-2014-003277

journal_volume

pub_type

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Development and testing of an objective structured clinical exam (OSCE) to assess socio-cultural dimensions of patient safety competency.