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The dialysis orders objective structured clinical examination (OSCE): a formative assessment for nephrology fellows.
Prince, Lisa K; Campbell, Ruth C; Gao, Sam W; Kendrick, Jessica; Lebrun, Christopher J; Little, Dustin J; Mahoney, David L; Maursetter, Laura A; Nee, Robert; Saddler, Mark; Watson, Maura A; Yuan, Christina M.
Afiliación
  • Prince LK; Nephrology Division, Walter Reed National Military Medical Center, Bethesda, MD, USA.
  • Campbell RC; Nephrology Division, Medical University of South Carolina, Charleston, SC, USA.
  • Gao SW; Nephrology Division, Portsmouth Naval Medical Center, Portsmouth, VA, USA.
  • Kendrick J; Department of Renal Diseases and Hypertension, University of Colorado, Denver, CO, USA.
  • Lebrun CJ; Department of Internal Medicine, Baptist Memorial Hospital, Golden Triangle, Columbus, MS, USA.
  • Little DJ; Nephrology Division, Walter Reed National Military Medical Center, Bethesda, MD, USA.
  • Mahoney DL; Nephrology Associates, Fairfax, VA, USA.
  • Maursetter LA; Nephrology Division, University of Wisconsin, Madison, WI, USA.
  • Nee R; Nephrology Division, Walter Reed National Military Medical Center, Bethesda, MD, USA.
  • Saddler M; Nephrology Associates, Mercy Regional Medical Center, Durango, CO, USA.
  • Watson MA; Nephrology Division, Walter Reed National Military Medical Center, Bethesda, MD, USA.
  • Yuan CM; Nephrology Division, Walter Reed National Military Medical Center, Bethesda, MD, USA.
Clin Kidney J ; 11(2): 149-155, 2018 Apr.
Article en En | MEDLINE | ID: mdl-29644053
BACKGROUND: Few quantitative nephrology-specific simulations assess fellow competency. We describe the development and initial validation of a formative objective structured clinical examination (OSCE) assessing fellow competence in ordering acute dialysis. METHODS: The three test scenarios were acute continuous renal replacement therapy, chronic dialysis initiation in moderate uremia and acute dialysis in end-stage renal disease-associated hyperkalemia. The test committee included five academic nephrologists and four clinically practicing nephrologists outside of academia. There were 49 test items (58 points). A passing score was 46/58 points. No item had median relevance less than 'important'. The content validity index was 0.91. Ninety-five percent of positive-point items were easy-medium difficulty. Preliminary validation was by 10 board-certified volunteers, not test committee members, a median of 3.5 years from graduation. The mean score was 49 [95% confidence interval (CI) 46-51], κ = 0.68 (95% CI 0.59-0.77), Cronbach's α = 0.84. RESULTS: We subsequently administered the test to 25 fellows. The mean score was 44 (95% CI 43-45); 36% passed the test. Fellows scored significantly less than validators (P < 0.001). Of evidence-based questions, 72% were answered correctly by validators and 54% by fellows (P = 0.018). Fellows and validators scored least well on the acute hyperkalemia question. In self-assessing proficiency, 71% of fellows surveyed agreed or strongly agreed that the OSCE was useful. CONCLUSIONS: The OSCE may be used to formatively assess fellow proficiency in three common areas of acute dialysis practice. Further validation studies are in progress.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Qualitative_research Idioma: En Revista: Clin Kidney J Año: 2018 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Qualitative_research Idioma: En Revista: Clin Kidney J Año: 2018 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Reino Unido