title: The patient safety OSCE for PGY-1 residents: a centralized response to the challenge of culture change.
abstract: BACKGROUND
  Accreditation and Institute of Medicine mandates require retooling of graduate medical education curriculum and assessment processes. This Objective Structured Clinical Exam (OSCE) focused on patient safety-specific skills important to stakeholders from multiple institutions.
  
  
  OBJECTIVE
  A 10-station OSCE was designed to assess patient safety-related competencies in new Postgraduate Year 1 (PGY-1) residents. The OSCE emphasized performance of essential skills and teamwork, and it provided early formative feedback to trainees and leadership.
  
  
  METHODS
  Group nominal process selected 10 final OSCE stations. Two stations were designed to assess team competencies and response to feedback. Two hundred thirty-five trainees enrolled in 64 programs participated during summer 2006. Skill-set aggregation was employed to improve the validity of individual feedback.
  
  
  RESULTS
  Significant performance deficits were noted. Trainee and administrator evaluation of the experience was positive.
  
  
  CONCLUSIONS
  Multi-institutional test development and centralized testing was well received and produced worrisome results. Early assessment can guide the development of task-specific personalized learning plans and systemwide curricular improvement. Further research is needed to determine whether such an effort directed at PGY-1 trainees can improve trainee performance and patient safety.
authors.affiliation: College of Human Medicine, Michigan State University College of Human Medicine, East Lansing, Michigan 48824, USA. wagnerd@msu.edu
authors.forename: Dianne P
authors.initials: DP
authors.lastname: Wagner
authors.forename: Ruth B
authors.initials: RB
authors.lastname: Hoppe
authors.forename: Carol Parker
authors.initials: CP
authors.lastname: Lee
mesh_terms: D003479:Curriculum; D004503:Education, Medical, Graduate; D004521:Educational Measurement; D006801:Humans; D007396:Internship and Residency; D019300:Medical Errors / Q000517:prevention & control; D015279:Organizational Culture; D011361:Professional Competence; D015397:Program Evaluation; D017751:Safety Management