First-year medical students are often challenged by the rapid pace and large volume of content that must be learned. Peer teaching has emerged as a supportive educational strategy. However, the most ...effective strategies for training peer tutors (PTs) for their role are not known. This paper examines the use of an Objective Structured Teaching Exercise (OSTE) to augment PT training sessions. Applying deliberate practice as a conceptual framework, an OSTE was used to provide tutors with an opportunity to practice their skills and receive feedback about their performance when meeting with a student presenting with a challenge. The newly trained PTs were required to assess a standardized student, determine challenge(s) being experienced, and present options to address the challenge(s). Standardized students evaluated the tutors' performance and a pre- and post-OSTE questionnaire was used to determine whether the OSTE was effective in increasing the confidence level of PTs to effectively assess and support students seeking help. Participants reported an increase in confidence in their ability to assess areas requiring improvement, understand the active learning strategies, and suggest appropriate active learning study strategies. Evaluations completed by standardized students documented that newly trained PTs accurately diagnosed the challenge presented in the OSTE and in most cases PTs asked all relevant questions to assess. Increased self-efficacy promotes PT's capacity to perform their work and feedback during an OSTE can further advance required skills. Aggregate OSTE results can also inform efforts to enhance the PT training program.
This novel application of the Objective Structured Teaching Exercise (OSTE) was done to enhance tutors' skills as valued members of our integrated academic support program. The OSTE provided feedback to the tutors and enabled us to identify a need for enhanced tutor training in active learning strategies. The OSTE can be adapted for use in other health science educational programs to enhance their training programs and to assess tutor's skills in preparation for their role.
New emphasis on the assessment of health professions educators' teaching competence has led to greater use of the Objective Structured Teaching Encounter (OSTE). The purpose of this study is to ...review and further describe the current uses and learning outcomes of the OSTE in health professions education.
PubMed, MEDLINE, and CINAHL (March 2010 to February 2022) were searched for English-language studies describing the use of an OSTE for any educational purpose within health professions education.
Of the 29 articles that met inclusion criteria, over half of the studies (17 of 29, 58.6%) were published during or after 2017. Seven studies described OSTE use outside of the traditional medical education context. These new contexts included basic sciences, dental, pharmacy, and Health Professions Education program graduates. Eleven articles described novel OSTE content, which included leadership skills, emotional intelligence, medical ethics, inter-professional conduct, and a procedural OSTE. There is increasing evidence supporting the use of OSTEs for the assessment of clinical educators' teaching skills.
The OSTE is a valuable tool for the improvement and assessment of teaching within a variety of health professions education contexts. Further study is required to determine the impact of OSTEs on teaching behaviors in real-life contexts.
Competency-based training should be paired with objective assessments. To date, there has been limited objective assessment of resident-as-teacher curricula (RATC). We sought to assess the impact of ...a longitudinal RATC on postgraduate year-1 (PGY1) resident teaching competency using Observed Structured Teaching Encounters (OSTEs) for the skills of 1) brief didactic teaching DT, 2) feedback FB, and 3) precepting PR.
A controlled, prospective, educational study was conducted from May 2015 to June 2016. The RATC consisted of a workshop series with reinforcement of key skills (DT, FB) during clinical rotations. Intervention residents participated in the RATC and completed OSTEs at the beginning and end of the academic year. A control group, PGY1 residents that matriculated the year previously, completed the OSTEs before starting their PGY2 year. OSTEs were reviewed by 2 blinded study personnel. We assessed reliability between raters via intraclass correlation coefficients and differences in OSTE scores via least squared mean differences (LSMD).
In total, 92.5% (n = 37) of eligible control and 100% (n = 41) of eligible intervention residents participated. The OSTEs demonstrated excellent agreement between reviewers (DT: 0.99, FB: 0.89, PR: 0.98). A significant pre-post difference was demonstrated in the intervention group for DT (LSMD 95% confidence interval, 3.14 2.49-3.79, P < .0001), FB (0.93 0.49–1.37, P < .0001), and PR (0.64 0.09–1.18, P < .022). A significant difference between the control and intervention groups was demonstrated for DT (3.00 2.05–3.96, P < .0001).
Skill-based OSTEs can be used to detect changes in residents’ teaching competency and may represent a potential component of programmatic evaluation of resident-as-teacher curricula.
Interprofessional education (IPE) is important in the education of all health care students, yet limited IPE training has been provided to preceptors who train these students in the clinical setting. ...Simulation using the standardized student model has been used to train health care preceptors in medicine. To our knowledge, there are no reports utilizing interprofessional objective structured teaching exercises (iOSTE) to train pharmacy preceptors. The primary objectives of this pilot study were to evaluate the effects of iOSTE on the pharmacy preceptors’ perceived importance of the Interprofessional Education Collaborative (IPEC) core competencies and confidence in precepting interprofessional students. Additionally, data were collected regarding pharmacy preceptors' prior experiences in simulation and debriefing.
Preceptors (n=23) participated in an iOSTE and debriefed with trained standardized nursing and pharmacy students caring for a trained standardized asthma patient.
Pre- versus post-iOSTE survey data showed statistically significant improvements in all self-confidence related items, including the following abilities: precept students from different disciplines (p=0.004), facilitate a simulation activity (p=0.001), conduct the debriefing process (p<0.001), and discuss with students the IPE core competencies (p=0.001). Additionally, responses to post-iOSTE survey questions assessing the learning activity showed high ratings (median=5, interquartile range=4 to 5). Pharmacy preceptors increased their teaching ability and confidence level in communicating with students from other health care professions.
These findings indicate that iOSTE is a useful and well-received method for preceptor development.
Introduction
Teaching is an important competency in graduate medical education (GME). Many residency programs have implemented curricula to develop residents’ teaching skills and observed structured ...teaching experiences (OSTEs) have been used to assess these skills. There is an increasing focus on building teaching skills earlier in the medical education continuum, however, there is limited literature on assessing medical students’ teaching skills. The authors developed an OSTE for medical students enrolled in a students-as-teachers course to address this gap and provide formative feedback on teaching skills.
Materials and Methods
OSTEs were conducted for fourth-year medical students (M4s) enrolled in a Students as Teachers Advanced Elective at a US medical school. An M4 observed a first-year medical student (M1) during a simulated encounter with a standardized patient. The M4 gave feedback and a chalk talk. A physician observer assessed the M4’s teaching using the modified Stanford Faculty Development Program (SFDP) questionnaire. The M1s and M4s also completed the SFDP. The M4 completed pre- and post-OSTE self-efficacy surveys (score range 6-30) and a post-OSTE acceptability survey.
Results
All (30/30) M4s completed the OSTE. The SFDP identified common teaching strengths and areas for growth. ANOVA tests demonstrated significant differences between the mean (SD) scores from physician assessors, M1s, and M4s 4.56 (0.63) vs. 4.87 (0.35) vs. 4.08 (0.74), p<0.001. There was a statistically significant difference in mean (SD) self-efficacy scores pre- and post-OSTE 18.72 (3.39) vs. 23.83 (3.26), p<0.001. All M4s (30/30) somewhat or strongly agreed with all three OSTE acceptability questions.
Lessons Learned
The authors successfully conducted an OSTE in an M4 advanced elective. The OSTE was highly acceptable to participants, and M4s demonstrated improved teaching self-efficacy. Further research should explore the validity of the OSTE to measure medical students’ teaching skills and the long-term impact of developing teaching skills in medical school.
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