Objective structured teaching examination (OSTE): an underused tool developed to assess clinical teaching skills. A narrative review of the literature

ABSTRACT BACKGROUND: There are plenty of options for evaluating medical students and medical residents' clinical skills. Objective structured clinical evaluations (OSCEs) have emerged as a powerful and reliable tool for assessing multiple cognition domains of clinical expertise. In the same way as OSCEs have emerged to assess clinical skills, objective structured teaching evaluations (OSTEs) have come to light as promising and unbiased interventions for evaluating the act of clinical teaching. DESIGN AND SETTING: Narrative review developed at Universidade Federal de Uberlândia, Brazil. METHODS: We searched the literature regarding OSTEs using the MEDLINE (via PubMed) and LILACS (viaBiblioteca Virtual em Saude) databases. The SciELO library was also searched for Brazilian papers. Systematic reviews, reviews and randomized controlled trials specifically assessing how OSTEs performed in relation to development of academic staff and medical residents were then selected. RESULTS: Our search retrieved 178 papers, of which 40 were considered eligible for intensive review. Most of the studies selected reported positive effects from OSTE activities. However, there was little quantitative data to gauge the impact of OSTEs on improvement of teaching skills. CONCLUSIONS: Considering that OSCEs have become a widely used tool for assessing medical students' and residents' clinical skills, it is high time to incorporate OSTEs for evaluating teaching skills in Brazil. Encouraging data to support implementation of this assessment tool in this country is available from abroad. The net benefit from this would possibly encompass medical students, residents and academic staff, through bringing awareness about the importance of excelling in teaching skills.

Teaching skills for medical residents: are these important? A narrative review of the literature

ABSTRACT BACKGROUND: There is extensive evidence, mainly from the United States and Canada, that points towards the need to train medical residents in teaching skills. Much of the "informal curriculum", including professional values, is taught by residents when consultants are not around. Furthermore, data from the 1960s show the importance of acquiring these skills, not only for residents but also for all doctors. ­Teaching moments can be identified in simple daily situations, like discussing a clinical situation with patients and their families, planning patients' care with the healthcare team or teaching peers and medical students. The aim here was to examine the significance of resident teaching courses and estimate the effectiveness of these courses and the state of the art in Brazil. METHODS: We conducted a review of the literature, using the MEDLINE, PubMed, SciELO and LILACS databases to extract relevant articles describing residents-as-teachers (RaT) programs and the importance of teaching skills for medical residents. This review formed part of the development of a doctoral project on medical education. RESULTS: Original articles, reviews and systematic reviews were used to produce this paper as part of a doctoral project. CONCLUSIONS: RaT programs are important in clinical practice and as role models for junior learners. ­Moreover, these educational programs improve residents' self-assessed teaching behaviors and teaching confidence. On the other hand, RaT program curricula are limited by both the number of studies and their methodologies. In Brazil, there is no such experience, according to the data gathered here, except for one master's thesis.