‘Peer-to-Peer’ Feedback of the Pediatric Residents’ Performance in

the OSCE Marina V. Martínez-Garri, MD Rosa L. Haddock-de Jesús, MD

Department of Pediatrics School of Medicine

University of Puerto Rico

Objective Structured Clinical Examinations (OSCEs) are a useful educational strategy to assess ACGME clinical competencies during residency training.

OSCEs provide an ideal opportunity for practicing feedback which has proven to be an invaluable adjunct in medical education.

Feedback to trainees is mostly provided by faculty; more attention is being paid to peer feedback as a valuable strategy.

Studies examining the impact of ‘peer-to-peer’ feedback on residents OSCEs’

performance are lacking.

Background

Medical Knowledge

Patient Care

Professionalism

Interpersonal and Communication

Skills

Practice Based Learning and Improvement

Systems Based Practice

ACGME Core Competencies

OSC

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Our Educational Strategy

OSCE’s stations: 1. Handoff

2. Procedures/ Bad News

Peer-to-peer

feedback

Written Debriefing

Guide

Discussion with Program

Director

ILP Activities

This process allows residents to evaluate their peer’s styles and clinical competencies with the ultimate goal of learning

from each other and applying that knowledge in future clinical encounters.

3. Each of them evaluates their own performance, followed by their peer’s feedback on their performance.

1. Paired with a peer resident

2. Watch one of each other’s OSCE Station’s recording

PGY1 PGY2 PGY3

Perspectives on performance

‘I was better than expected in terms of organization’

‘It was good to see improvement in my history taking skills from last year and improvement in body language’

‘Improved from last year but still need more organization’

Strengths ‘Good attitude and empathy’

‘I could formulate a differential diagnosis an adequate plan of action’

‘Professional attitude’ ‘Organized’

Opportunities for improvement

‘I need to improve my non-verbal gestures, communication skills, tone of voice’

‘Muletillas’ or tag-lines ‘Establishing priorities’

‘Need to be aware of hand gestures during the interaction’

Debriefing Guide: Strengths and Opportunities for Improvement

Level ILP Activities

PGY-1 “I will tell my peers and attendings the areas I want to improve for them to provide consistent feedback during my upcoming rotations.”

PGY-2 ‘I’ll watch a fellow resident to learn about organization while taking a history and during bad news delivery to implement it in my daily duties’

PGY-3 ‘During patient interactions, I will be more aware of my body language. Will get help from peers for feedback of my interview skills’

ILP Activities Suggested by Residents

Peer-to-peer feedback through a simulated setting provides an integrated way of learning and assessing residents’ clinical competencies.

Resident’s Competencies

Outpatient Inpatient

Community

OSCE

Resident’s Competencies

Next Steps …

Evaluate residents’ perspective about this educational strategy.

Faculty feedback session on the OSCE’s performance before the peer-to-peer feedback session.

Develop some of the suggested activities in the ILP to refine skills identified as needed to improve

Thank you very much for your attention!

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