Peer to peer feedback of the pediatric residents’ performance in the osce · 2020-06-11 ·...

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‘Peer-to-Peer’ Feedback of the Pediatric Residents’ Performance in the OSCE Marina V. Martínez-Garri, MD Rosa L. Haddock-de Jesús, MD Department of Pediatrics School of Medicine University of Puerto Rico
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Transcript of Peer to peer feedback of the pediatric residents’ performance in the osce · 2020-06-11 ·...

  • ‘Peer-to-Peer’ Feedback of the Pediatric Residents’ Performance in

    the OSCE Marina V. Martínez-Garri, MD Rosa L. Haddock-de Jesús, MD

    Department of Pediatrics School of Medicine

    University of Puerto Rico

  • Objective Structured Clinical Examinations (OSCEs) are a useful educational strategy to assess ACGME clinical competencies during residency training.

    OSCEs provide an ideal opportunity for practicing feedback which has proven to be an invaluable adjunct in medical education.

    Feedback to trainees is mostly provided by faculty; more attention is being paid to peer feedback as a valuable strategy.

    Studies examining the impact of ‘peer-to-peer’ feedback on residents OSCEs’

    performance are lacking.

    Background

  • Medical Knowledge

    Patient Care

    Professionalism

    Interpersonal and Communication

    Skills

    Practice Based Learning and Improvement

    Systems Based Practice

    ACGME Core Competencies

    OSC

    E P

    ee

    r-to

    -Pe

    er

    Fee

    db

    ack

  • Our Educational Strategy

    OSCE’s stations: 1. Handoff

    2. Procedures/ Bad News

    Peer-to-peer

    feedback

    Written Debriefing

    Guide

    Discussion with Program

    Director

    ILP Activities

    This process allows residents to evaluate their peer’s styles and clinical competencies with the ultimate goal of learning

    from each other and applying that knowledge in future clinical encounters.

  • 3. Each of them evaluates their own performance, followed by their peer’s feedback on their performance.

    1. Paired with a peer resident

    2. Watch one of each other’s OSCE Station’s recording

  • PGY1 PGY2 PGY3

    Perspectives on performance

    ‘I was better than expected in terms of organization’

    ‘It was good to see improvement in my history taking skills from last year and improvement in body language’

    ‘Improved from last year but still need more organization’

    Strengths ‘Good attitude and empathy’

    ‘I could formulate a differential diagnosis an adequate plan of action’

    ‘Professional attitude’ ‘Organized’

    Opportunities for improvement

    ‘I need to improve my non-verbal gestures, communication skills, tone of voice’

    ‘Muletillas’ or tag-lines ‘Establishing priorities’

    ‘Need to be aware of hand gestures during the interaction’

    Debriefing Guide: Strengths and Opportunities for Improvement

  • Level ILP Activities

    PGY-1 “I will tell my peers and attendings the areas I want to improve for them to provide consistent feedback during my upcoming rotations.”

    PGY-2 ‘I’ll watch a fellow resident to learn about organization while taking a history and during bad news delivery to implement it in my daily duties’

    PGY-3 ‘During patient interactions, I will be more aware of my body language. Will get help from peers for feedback of my interview skills’

    ILP Activities Suggested by Residents

  • Peer-to-peer feedback through a simulated setting provides an integrated way of learning and assessing residents’ clinical competencies.

    Resident’s Competencies

    Outpatient Inpatient

    Community

    OSCE

    Resident’s Competencies

  • Next Steps …

    Evaluate residents’ perspective about this educational strategy.

    Faculty feedback session on the OSCE’s performance before the peer-to-peer feedback session.

    Develop some of the suggested activities in the ILP to refine skills identified as needed to improve

  • Thank you very much for your attention!

  • References 1. Young, Ian, et al. “The Benefits of a Peer-Assisted Mock OSCE.” The Clinical Teacher, vol. 11, no. 3, July 2014, pp. 214–218.,

    doi:10.1111/tct.12112

    2. Maloney, Stephen, et al. “The Effect of Student Self-Video of Performance on Clinical Skill Competency: a Randomized Controlled Trial.” Advances in Health Sciences Education, vol. 18, no. 1, 2012, pp. 81–89, doi: 10.1007/s10459-012-9356-1

    3. Cushing, Annie, et al. “Peer Feedback as an Aid to Learning: What Do We Want? Feedback. When Do We Want It? Now!” Medical Teacher, vol. 33, no. 2, 2011, doi:10.3109/0142159x.2011.542522.

    4. Harrison, Christopher J., et al. “How We Give Personalized Audio Feedback after Summative OSCEs.” Medical Teacher, vol. 37, no. 4, Mar. 2014, pp. 323–326., doi:10.3109/0142159x.2014.932901.

    5. Larsen, T., and D. Jeppe-Jensen. “The Introduction and Perception of an OSCE with an Element of Self- and Peer-Assessment.” European Journal of Dental Education, vol. 12, no. 1, 2008, pp. 2–7., doi:10.1111/j.1600-0579.2007.00449.x.

    6. Lefroy, Janet, et al. “Guidelines: the Do´s, Don´ts and Don´t Knows of Feedback for Clinical Education.” Perspectives on Medical Education, vol. 4, no. 6, 2015, pp. 284–299., doi:10.1007/s40037-015-0231-7.

    7. Maloney, Stephen, et al. “The Effect of Student Self-Video of Performance on Clinical Skill Competency: a Randomized Controlled Trial.” Advances in Health Sciences Education, vol. 18, no. 1, 2012, pp. 81–89., doi:10.1007/s10459-012-9356-1.

  • References 8. Maria Syl D. De La Cruz, et al. “Resident Perceptions of Giving and Receiving Peer-to-Peer Feedback.” Journal of Graduate Medical Education, vol. 7, no. 2, 2015,

    pp. 208–213., doi:10.4300/jgme-d-14-00388.1.

    9. Ohyama, Atsushi, et al. “Educative Effect of Feedback after Medical Interview in Objective Structured Clinical Examination.” The Journal Of The Stomatological Society,Japan, vol. 71and72, no. 4-1, 2005, pp. 71–76., doi:10.5357/koubyou.71and72.71.

    10. Pegram, Anne, and Carol Fordham-Clarke. “Implementing Peer Learning to Prepare Students for OSCEs.” British Journal of Nursing, vol. 24, no. 21, 2015, pp. 1060–1065., doi:10.12968/bjon.2015.24.21.1060.

    11. Perera, Jennifer, et al. “The Use of Objective Structured Self-Assessment and Peer-Feedback (OSSP) for Learning Communication Skills: Evaluation Using a Controlled Trial.” Advances in Health Sciences Education, vol. 15, no. 2, 2009, pp. 185–193., doi:10.1007/s10459-009-9191-1

    12. Ruesseler, M., et al. “The Effect of Video-Assisted Oral Feedback versus Oral Feedback on Surgical Communicative Competences in Undergraduate Training.” European Journal of Trauma and Emergency Surgery, Nov. 2016, doi:10.1007/s00068-016-0734-x

    13. Rush, Sue, et al. “Students' Perceptions of Practice Assessment in the Skills Laboratory: An Evaluation Study of OSCAs with Immediate Feedback.” Nurse Education in Practice, vol. 14, no. 6, 2014, pp. 627–634., doi:10.1016/j.nepr.2014.06.008.

    14. Snydman, Laura, et al. “Peer Observation and Feedback of Resident Teaching.” The Clinical Teacher, vol. 10, no. 1, July 2013, pp. 9–14., doi:10.1111/j.1743-498x.2012.00591.x.

    15. Young, Ian, et al. “The Benefits of a Peer-Assisted Mock OSCE.” The Clinical Teacher, vol. 11, no. 3, July 2014, pp. 214–218., doi:10.1111/tct.12112.

    16. Norman, G. R., and H. G. Schmidt. "The Psychological Basis of Problem-based Learning."Academic Medicine 67.9 (1992): 557-65. Web.

    17. Evans, Carol. "Students' Perspectives on the Role of Peer Feedback in Supporting Learning." Latest TOC RSS. Springer Publishing Company, 01 Jan. 1970. Web. 27 Mar. 2017.

    18. Glynn, Liam G., Anne Macfarlane, Maureen Kelly, Peter Cantillon, and Andrew W. Murphy. "Helping Each Other to Learn – a Process Evaluation of Peer Assisted Learning." BMC Medical Education 6.1 (2006): n. pag. Web.