Four Successive Years of Trauma-Based Objective Structured Clinical Evaluations: What Have We Learned?

Abstract

Objective: We studied 4 years of data from our objective structured clinical examination (OSCE) to determine whether residents improved skills in the trauma physical examination (PE). Our hypothesis was that residents would improve with each year of training, and that resident scores would also improve over time, with each year of OSCE testing.

Design: We developed 2 polytrauma scenarios and alternated yearly. Residents were graded on PE, history taking, and professionalism. Scenarios simulated trauma cases residents could encounter during training. We compared each year for any significant (p < 0.05) changes overall and between postgraduate years.

Setting: The Ohio State University Wexner Medical Center.

Participants: Orthopedic faculty and residents.

Results: Across years 2010 to 2013, we saw no significant improvement in PE skills. History-taking skills trended upwards, but this was not significant, and communication skills significantly improved.

Conclusions: We expected after instituting a trauma OSCE that we would see an improvement in residents' PE skills, which we did not. We observed an overall improvement in ability to interact and communicate with patients and ask appropriate questions.

Keywords: Interpersonal and Communication Skills; Medical Knowledge; OSCE; Patient Care; Professionalism; physical examination; resident training; trauma.