A Model for a Structured Clinical Development Program for First-Year Residents: Utilizing the Entrance OSCE, Individualized Learning Plans (ILPs), and Peer Clinical Coaching

Authors

Jill M. Krapf, George Washington UniversityFollow
Sameer Aggarwal, George Washington University
Larrie Greenberg, George Washington UniversityFollow
Benjamin Blatt, George Washington UniversityFollow

Document Type

Instructional Material

Publication Date

5-11-2015

Description

Identification of incoming residents’ unique strengths and weaknesses in a clinical setting is important for developing an individualized educational curriculum and ultimately addressing specific needs. This resource presents and describes materials for a clinical development program for first year residents. The program is structured around three educational elements: an entrance Objective Structured Clinical Examination (OSCE), Individualized Learning Plan (ILP), and peer clinical coaching. The included files, which describe these three elements, are intended to serve as a resource for residency directors and/or graduate medical education faculty interested in constructing a similar program.

In the described clinical development program, first-year Obstetrics and Gynecology residents participated in an entrance OSCE as a component of their orientation to residency. Their performance was evaluated through Faculty and Self-assessment tools and scored on a nine-point scale in accordance with the ACGME core competency scoring evaluation system. These evaluations were utilized in the creation of ILPs. Stated goals were translated into discrete learning objectives and then developed further through a learning strategy and timeline using the SMART model. As a component of a research study, first-year residents were randomized into one of two groups: clinical coaching group or individual implementation group. Senior resident volunteers served as peer clinical coaches after participating in a two-hour interactive workshop. The peer clinical coaches met with first-year residents on a monthly basis for four months to develop the resident’s ILP. Exit questionnaires were completed at the conclusion of the year-long program.

The OSCE is a well-utilized tool to ensure direct observation, evaluate clinical performance in a simulated environment, and provide timely feedback. Another potential application of the OSCE is to provide a baseline evaluation of clinical performance that may be utilized in determining a starting point for clinical competencies. Utilizing the feedback from the OSCE to create an ILP may translate valuable feedback into measurable objectives and competencies, while also providing a model for reassessment and follow up. While the OSCE and the faculty mentored ILP have been well characterized in the literature, the concept of clinical coaching is relatively novel to medicine. Teaching and coaching differ in that teachers disseminate knowledge whereas coaches ensure performance. Seeking to elaborate on this relatively novel paradigm, we sought to characterize how resident’s global clinical experience was affected within this working model. Despite time constraints, both first-year residents and peer clinical coaches reported that clinical coaching improved their clinical experience. A structured clinical program incorporating an entrance OSCE, ILP, and peer clinical coaching holds promise in documentation of milestones and promoting life-long learning.

AAMC MedEdPORTAL publication ID 10084. Link to original.

Creative Commons License

This work is licensed under a Creative Commons Attribution-Noncommercial-Share Alike 4.0 License.

DOI

10.15766/mep_2374-8265.10084

Recommended Citation

Krapf J, Aggarwal S, Blatt B, Greenberg L. A model for a structured clinical development program for first-year residents: utilizing the entrance OSCE, individualized learning plans (ILPS), and peer clinical coaching. MedEdPORTAL Publications. 2015;11:10084. http://doi.org/10.15766/mep_2374-8265.10084