Rhinoplasty Education Using a Standardized Patient Encounter.
BACKGROUND
Comprehensive aesthetic surgery training continues to be a challenge for residency programs. Our residency program developed a rhinoplasty-based objective structured clinical examination (OSCE) based upon validated methods as part of the residency education curriculum. We report our experience with the rhinoplasty-based OSCE and offer guidance to its incorporation within residency programs.


METHODS
The encounter involved resident evaluation and operative planning for a standardized patient desiring a rhinoplasty procedure. Validated OSCE methods currently used at our medical school were implemented. Residents were evaluated on appropriate history taking, physical examination, and explanation to the patient of treatment options. Examination results were evaluated using analysis of variance (statistical significance P<0.05).


RESULTS
Twelve residents completed the rhinoplasty OSCE. Medical knowledge assessment showed increasing performance with clinical year, 50% versus 84% for postgraduate year 3 and 6, respectively (P<0.005). Systems-based practice scores showed that all residents incorrectly submitted forms for billing and operative scheduling. All residents confirmed that the OSCE realistically represents an actual patient encounter. All faculty confirmed the utility of evaluating resident performance during the OSCE as a useful assessment tool for determining the Next Accreditation System Milestone level.


CONCLUSIONS
Aesthetic surgery training for residents will require innovative methods for education. Our examination showed a program-educational weakness in billing/coding, an area that will be improved upon by topic-specific lectures. A thoroughly developed OSCE can provide a realistic educational opportunity to improve residents' performance on the nonoperative aspects of rhinoplasty and should be considered as an adjunct to resident education.
Division of Plastic and Reconstructive Surgery, Stanford University, Palo Alto, CA, USA.
Eric J
EJ
Wright
Division of Plastic and Reconstructive Surgery, Stanford University, Palo Alto, CA, USA.
Rohit K
RK
Khosla
Division of Plastic and Reconstructive Surgery, Stanford University, Palo Alto, CA, USA.
Lori
L
Howell
Division of Plastic and Reconstructive Surgery, Stanford University, Palo Alto, CA, USA.
Gordon K
GK
Lee
Educational measurement; Internship and residency; Rhinoplasty
J Surg Educ. 2012 Mar-Apr;69(2):180-9
22365863
Cleft Palate Craniofac J. 2016 Nov;53(6):634-639
26720521
Aesthetic Plast Surg. 1996 Jul-Aug;20(4):351-4
8791578
Ann Plast Surg. 2008 Aug;61(2):127-31; discussion 132
18650601
Surgery. 1998 Aug;124(2):307-12
9706153
Plast Reconstr Surg. 2008 Nov;122(5):1570-8
18971742
Plast Reconstr Surg. 2011 Jul;128(1):291-8
21701346
Plast Reconstr Surg. 1993 Apr;91(4):642-54; discussion 655-6
8446718
Am J Surg. 2010 Jan;199(1):86-93
20103071
Laryngoscope. 2007 Nov;117(11):1938-42
17767088
Inflamm Bowel Dis. 2015 Apr;21(4):759-65
25633560
Aesthet Surg J. 2011 May;31(4):445-55
21551438
Ann Plast Surg. 2013 Apr;70(4):476-81
23486137
Ann Surg. 1995 Dec;222(6):735-42
8526580
N Engl J Med. 2012 Mar 15;366(11):1051-6
22356262
Surgery. 2006 Oct;140(4):633-8; discussion 638-9
17011911