title: Expanding the role of objectively structured clinical examinations in nephrology training.
abstract: Objectively structured clinical examinations (OSCEs) are widely used in medical education, but we know of none described that are specifically for nephrology fellowship training. OSCEs use simulation to educate and evaluate. We describe a technically simple, multidisciplinary, low-cost OSCE developed by our program that contains both examination and training features and focuses on management and clinical knowledge of rare hemodialysis emergencies. The emergencies tested are venous air embolism, blood leak, dialysis membrane reaction, and hemolysis. Fifteen fellows have participated in the OSCE as examinees and/or preceptors since June 2010. All have passed the exercise. Thirteen responded to an anonymous survey in July 2013 that inquired about their confidence in managing each of the 4 tested emergencies pre- and post-OSCE. Fellows were significantly more confident in their ability to respond to the emergencies after the OSCE. Those who subsequently saw such an emergency reported that the OSCE experience was somewhat or very helpful in managing the event. The OSCE tested and trained fellows in the recognition and management of rare hemodialysis emergencies. OSCEs and simulation generally deserve greater use in nephrology subspecialty training; however, collaboration between training programs would be necessary to validate such exercises.
authors.affiliation: Nephrology Service, Department of Medicine, Walter Reed National Military Medical Center, Bethesda, MD.
authors.forename: Lisa K
authors.initials: LK
authors.lastname: Prince
authors.affiliation: Nephrology Service, Department of Medicine, Walter Reed National Military Medical Center, Bethesda, MD.
authors.forename: Kevin C
authors.initials: KC
authors.lastname: Abbott
authors.affiliation: Nephrology Service, Department of Medicine, Walter Reed National Military Medical Center, Bethesda, MD.
authors.forename: Felicidad
authors.initials: F
authors.lastname: Green
authors.affiliation: Nephrology Service, Department of Medicine, Walter Reed National Military Medical Center, Bethesda, MD.
authors.forename: Dustin
authors.initials: D
authors.lastname: Little
authors.affiliation: Nephrology Service, Department of Medicine, Walter Reed National Military Medical Center, Bethesda, MD.
authors.forename: Robert
authors.initials: R
authors.lastname: Nee
authors.affiliation: Nephrology Service, Department of Medicine, Walter Reed National Military Medical Center, Bethesda, MD.
authors.forename: James D
authors.initials: JD
authors.lastname: Oliver
authors.affiliation: Organ Transplant Service, Department of Surgery, Walter Reed National Military Medical Center, Bethesda, MD.
authors.forename: Erin M
authors.initials: EM
authors.lastname: Bohen
authors.affiliation: Nephrology Service, Department of Medicine, Walter Reed National Military Medical Center, Bethesda, MD. Electronic address: christina.m.yuan@health.mil.
authors.forename: Christina M
authors.initials: CM
authors.lastname: Yuan
mesh_terms: D000328:Adult; D003162:Competency-Based Education / Q000458:organization & administration*; D004503:Education, Medical, Graduate / Q000592:standards*; D004521:Educational Measurement / Q000379:methods; D004630:Emergencies; D006801:Humans; D009398:Nephrology / Q000193:education*; D011361:Professional Competence / Q000706:statistics & numerical data; D006435:Renal Dialysis
keywords: Objective structured clinical examination (OSCE); hemodialysis emergencies; nephrology fellowship; nephrology training; simulation