title: Proficiency in identifying, managing and communicating medical errors: feasibility and validity study assessing two core competencies.
abstract: BACKGROUND
  Communication skills and professionalism are two competencies in graduate medical education that are challenging to evaluate. We aimed to develop, test and validate a de novo instrument to evaluate these two competencies.
  
  
  METHODS
  Using an Objective Standardized Clinical Examination (OSCE) based on a medication error scenario, we developed an assessment instrument that focuses on distinctive domains [context of discussion, communication and detection of error, management of error, empathy, use of electronic medical record (EMR) and electronic medical information resources (EMIR), and global rating]. The aim was to test feasibility, acceptability, and reliability of the method.
  
  
  RESULTS
  Faculty and standardized patients (SPs) evaluated 56 trainees using the instrument. The inter-rater reliability of agreement between faculty was substantial (Fleiss k = 0.71) and intraclass correlation efficient was excellent (ICC = 0.80). The measured agreement between faculty and SPs evaluation of resident was lower (Fleiss k = 0.36). The instrument showed good conformity (ICC = 0.74). The majority of the trainees (75 %) had satisfactory or higher performance in all six assessed domains and 86 % found the OSCE to be realistic. Sixty percent reported not receiving feedback on EMR use and asked for subsequent training.
  
  
  CONCLUSIONS
  An OSCE-based instrument using a medical error scenario can be used to assess competency in professionalism, communication, using EMRs and managing medical errors.
authors: Division of Preventive, Occupational, and Aerospace Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA. AbuDabrh.AbdMoain@mayo.edu.|The Evidence-based Practice Center, Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Rochester, MN, USA. AbuDabrh.AbdMoain@mayo.edu.
authors: Abd Moain
authors: http://orcid.org/0000-0002-2481-483X
authors: AM
authors: Abu Dabrh
authors: Division of Preventive, Occupational, and Aerospace Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA.|The Evidence-based Practice Center, Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Rochester, MN, USA.
authors: Mohammad Hassan
authors: MH
authors: Murad
authors: Division of Preventive, Occupational, and Aerospace Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA.
authors: Richard D
authors: RD
authors: Newcomb
authors: Division of Preventive, Occupational, and Aerospace Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA.
authors: William G
authors: WG
authors: Buchta
authors: Division of Preventive, Occupational, and Aerospace Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA.
authors: Mark W
authors: MW
authors: Steffen
authors: The Evidence-based Practice Center, Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Rochester, MN, USA.
authors: Zhen
authors: Z
authors: Wang
authors: Division of Preventive, Occupational, and Aerospace Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA.
authors: Amanda K
authors: AK
authors: Lovett
authors: Division of Preventive, Occupational, and Aerospace Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA.
authors: Lawrence W
authors: LW
authors: Steinkraus
mesh_terms: D002983:Clinical Competence / Q000592:standards*; D003142:Communication; D003479:Curriculum; D004503:Education, Medical, Graduate; D004521:Educational Measurement; D005240:Feasibility Studies; D000068156:Formative Feedback; D006801:Humans; D019300:Medical Errors / Q000523:psychology; D008910:Minnesota; D010820:Physicians; D011315:Preventive Medicine / Q000193:education*; D011361:Professional Competence / Q000592:standards*; D011634:Public Health / Q000193:education*; D015203:Reproducibility of Results; D014342:Truth Disclosure
keywords: ACGME; Communication skills; Core competencies; Medical errors; Medical training; Professionalism