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2016 ; 16
(1
): 233
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Proficiency in identifying, managing and communicating medical errors:
feasibility and validity study assessing two core competencies
#MMPMID27589949
Abu Dabrh AM
; Murad MH
; Newcomb RD
; Buchta WG
; Steffen MW
; Wang Z
; Lovett AK
; Steinkraus LW
BMC Med Educ
2016[Sep]; 16
(1
): 233
PMID27589949
show ga
BACKGROUND: Communication 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.
METHODS: Using 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. RESULTS:
Faculty 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. CONCLUSION: An OSCE-based instrument using a medical error scenario can
be used to assess competency in professionalism, communication, using EMRs and
managing medical errors.