title: Development of the objective structured system-interaction examination.
abstract: OBJECTIVE
  The purpose of this study was to develop an objective method of evaluating resident competency in systems-based practice.
  
  
  METHODS
  Faculty developed a 12-station examination, the Objective Structured System-Interaction Examination (OSSIE), patterned after the Objective Structured Clinical Examinations (OSCEs), to evaluate residents' ability to effectively work within the complex medical system of care. Scenarios consisted of multiple situations, such as patient hand-offs, consultations, complicated discharges, and family meetings, in which residents interacted with simulated professionals, simulated patients, and simulated family members to demonstrate the systems-based skills. Twelve second-year residents participated in the OSSIE.
  
  
  RESULTS
  Along with the standardized professionals, a faculty member provided the resident with immediate feedback and completed an evaluation form designed specifically to assess systems-based practice. Residents, faculty, and staff evaluated the OSSIE and felt it provided a rich learning experience and was a beneficial means of formative assessment. The residents' third-year learning experiences were adapted to meet their needs, and suggestions were offered for curriculum revision.
  
  
  CONCLUSIONS
  The OSSIE is unique in that it uses standardized professionals, involves scenarios in a variety of settings, and incorporates current technology, including an electronic health record and a state-of-the-art simulation laboratory, into the examination. Challenges to implementation include faculty time, scheduling of residents, and availability of resources.
  
  
  CONCLUSIONS
  By using the OSSIE, faculty are able to assess, provide constructive feedback, and tailor training opportunities to improve resident competence in systems-based practice. Reliability and validity of an instrument developed for use with the OSSIE are currently being determined.
authors: Susan
authors: S
authors: Hingle
authors: Richard B
authors: RB
authors: Rosher
authors: Sherry
authors: S
authors: Robinson
authors: Nancy
authors: N
authors: McCann-Stone
authors: Christine
authors: C
authors: Todd
authors: Michael
authors: M
authors: Clark