Elizabeth Carroll1, Aaron Nelson2, Arielle Kurzweil3, Sondra Zabar4, Ariane Lewis5. 1. Department of Neurology, NYU Langone Medical Center, 530 1st Ave, HCC-5A, New York 10016, NY, United States. Electronic address: Elizabeth.carroll@nyulangone.org. 2. Department of Neurology, NYU Langone Medical Center, New York, NY, United States. Electronic address: Aaron.nelson@nyulangone.org. 3. Department of Neurology, NYU Langone Medical Center, New York, NY, United States. Electronic address: Arielle.kurzweil@nyulangone.org. 4. Department of Medicine, NYU Langone Medical Center, New York, NY, United States. Electronic address: Sondra.Zabar@nyulangone.org. 5. Department of Neurology, NYU Langone Medical Center, New York, NY, United States; Department of Neurosurgery, NYU Langone Medical Center, New York, NY, United States. Electronic address: Ariane.Kansas.Lewis@gmail.com.
Abstract
BACKGROUND: Neurologists need to be adept at disclosing prognosis and breaking bad news. Objective structured clinical examinations (OSCE) allow trainees to practice these skills. METHODS: In 2017, in conjunction with the NYU School of Medicine Simulation Center, neurology faculty designed an OSCE case in which a resident had to inform a standardized patient (SP) her father had severe global hypoxic ischemic injury. The residents were surveyed on the experience using a Likert scale from 1 (worst) to 5 (best). The SP completed a behavioral anchored checklist and marked items as "not done," "partly done," or "well done". RESULTS: 57 third and fourth year neurology residents completed the case from 2018 to 2020, 54 (95%) of whom completed the post-OSCE survey. Residents reported feeling moderately prepared for the simulation (mean Likert score 3.7/5), and thought their performance was average (3.4/5). Overall, they found the case to be very helpful (4.6/5). The residents performed well in the realms of maintaining professionalism (64% rated "well done"), developing a relationship (62% rated "well done"), and information gathering (61% rated "well done"). There was room for improvement in the realms of providing education and presenting the bad news (39% and 37% rated "partly/not done," respectively). CONCLUSIONS: OSCE cases can be used to teach neurology trainees how to discuss prognosis and break bad news. Feedback about this simulation was positive, though its efficacy has yet to be evaluated and could be a future direction of study.
BACKGROUND: Neurologists need to be adept at disclosing prognosis and breaking bad news. Objective structured clinical examinations (OSCE) allow trainees to practice these skills. METHODS: In 2017, in conjunction with the NYU School of Medicine Simulation Center, neurology faculty designed an OSCE case in which a resident had to inform a standardized patient (SP) her father had severe global hypoxic ischemic injury. The residents were surveyed on the experience using a Likert scale from 1 (worst) to 5 (best). The SP completed a behavioral anchored checklist and marked items as "not done," "partly done," or "well done". RESULTS: 57 third and fourth year neurology residents completed the case from 2018 to 2020, 54 (95%) of whom completed the post-OSCE survey. Residents reported feeling moderately prepared for the simulation (mean Likert score 3.7/5), and thought their performance was average (3.4/5). Overall, they found the case to be very helpful (4.6/5). The residents performed well in the realms of maintaining professionalism (64% rated "well done"), developing a relationship (62% rated "well done"), and information gathering (61% rated "well done"). There was room for improvement in the realms of providing education and presenting the bad news (39% and 37% rated "partly/not done," respectively). CONCLUSIONS: OSCE cases can be used to teach neurology trainees how to discuss prognosis and break bad news. Feedback about this simulation was positive, though its efficacy has yet to be evaluated and could be a future direction of study.
Authors: Jeffrey A Wilhite; Sondra Zabar; Colleen Gillespie; Kevin Hauck; Margaret Horlick; Richard E Greene; Kathleen Hanley; Jennifer Adams Journal: J Gen Intern Med Date: 2022-06-16 Impact factor: 6.473