Development and pilot testing of an objective structured clinical examination (OSCE) on hoarseness.
OBJECTIVE
To develop a valid and reliable tool for an objective structured clinical examination (OSCE) on hoarseness. To pilot-test the feasibility by assessing residents' clinical skills in various core competencies while assessing hoarseness on a standardized patient (SP).


METHODS
Educational tool development.


METHODS
The OSCE checklists were developed using modified Delphi technique after obtaining feedback from faculty involved in providing care to hoarseness patients. SP-based and rest stations were created to assess clinical skills. Twelve Otolaryngology-Head and Neck Surgery residents participated in the study. Video recordings of residents' performance and their written documentation were rated by faculty members.


RESULTS
The OSCE that we developed is a valid method of assessing residents' clinical skills for evaluating hoarseness. Senior residents performed better in all of the tasks such as obtaining history and performing a physical exam on an SP, ability to perform flexible laryngoscopy on a mannequin, and interpretation of radiologic findings. Internal consistency assessed by Cronbach's alpha as measure of inter-item reliability was 0.92 for laryngoscopic station and 0.95 for radiology station.


CONCLUSIONS
This OSCE can be effectively used for the objective assessment of clinical competency in hoarseness. Our pilot study evaluated multiple competencies on a single occasion, including medical knowledge, patient care, professionalism, and communication and interpersonal skills. Clinical competence in history taking, physical examination, flexible fiber-optic laryngoscopy, and ability to interpret radiologic findings improved with increasing year of training. This OSCE provides targeted assessment of practice-based learning and feedback for improvement of clinical performance.
Stewart
C Matthew
CM
Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins Hospital, Baltimore, Maryland, USA.
Masood
Hamid
H
Pandian
Vinciya
V
Laeeq
Kulsoom
K
Akst
Lee
L
Francis
Howard W
HW
Bhatti
Nasir I
NI
D002983:Clinical Competence; D004503:Education, Medical, Graduate; D004504:Education, Medical, Undergraduate; D004521:Educational Measurement; D005260:Female; D006685:Hoarseness / Q000175:diagnosis*; D006801:Humans; D007396:Internship and Residency; D007828:Laryngoscopy / Q000379:methods; D008297:Male; D008348:Manikins; D008487:Medical History Taking; D009741:Nursing Staff, Hospital; D010808:Physical Examination; D010865:Pilot Projects; D015203:Reproducibility of Results