ABSTRACT
Purpose@#Peer-assisted learning (PAL) promotes the development of communication, facilitates improvements in clinical skills, and is a way to provide feedback to learners. We utilized PAL as a conceptual framework to explore the feasibility of peer-assisted feedback (PAF) to improve note-writing skills without requiring faculty time. The aim was to assess whether PAL was a successful method to provide feedback on the United States Medical Licensing Exams (USMLE)-style clinical skills exam notes by using student feedback on a survey in the United States. @*Methods@#The University of Florida College of Medicine administers clinical skills examination (CSEs) that include USMLE-like note-writing. PAL, in which students support the learning of their peers, was utilized as an alternative to faculty feedback. Second-year (MS2) and third-year (MS3) medical students taking CSEs participated in faculty-run note-grading sessions immediately after testing, which included explanations of grading rubrics and the feedback process. Students graded an anonymized peer’s notes. The graded material was then forwarded anonymously to its student author to review. Students were surveyed on their perceived ability to provide feedback and the benefits derived from PAF using a Likert scale (1–6) and open-ended comments during the 2017–2018 academic year. @*Results@#Students felt generally positively about the activity, with mean scores for items related to educational value of 4.49 for MS2s and 5.11 for MS3s (out of 6). MS3s perceived peer feedback as constructive, felt that evaluating each other’s notes was beneficial, and felt that the exercise would improve their future notes. While still positive, MS2 students gave lower scores than the MS3 students. @*Conclusion@#PAF was a successful method of providing feedback on student CSE notes, especially for MS3s. MS2s commented that although they learned during the process, they might be more invested in improving their note-writing as they approach their own USMLE exam.
ABSTRACT
Purpose@#This study was conducted to determine whether an objective structured clinical examination (OSCE) could be used to evaluate and monitor hand hygiene and personal protective equipment (PPE) proficiency among medical interns in the United States. @*Methods@#Interns in July 2015 (N=123, cohort 1) with no experience of OSCE-based contact precaution evaluation and teaching were evaluated in early 2016 using an OSCE for hand hygiene and PPE proficiency. They performed poorly. Therefore, the new interns entering in July 2016 (N=151, cohort 2) were immediately tested at the same OSCE stations as cohort 1, and were provided with feedback and teaching. Cohort 2 was then retested at the OSCE station in early 2017. The Mann-Whitney U-test was used to compare the performance of cohort 1 and cohort 2 on checklist items. In cohort 2, performance differences between the beginning and end of the intern year were compared using the McNemar chi-square test for paired nominal data. @*Results@#Checklist items were scored, summed, and reported as percent correct. In cohort 2, the mean percent correct was higher on the posttest than on the pretest (92% vs. 77%, P<0.0001), and the passing rate (100% correct) was also significantly higher on the posttest (55% vs. 16%). At the end of intern year, the mean percent correct was higher in cohort 2 than in cohort 1 (95% vs. 90%, P<0.0001), and 55% of cohort 2 passed (a perfect score) compared to 24% in cohort 1 (P<0.0001). @*Conclusion@#An OSCE can be utilized to evaluate and monitor hand hygiene and PPE proficiency among interns in the United States.