Introduction: In attempt to reinforce skills that are necessary and relevant to the practice of geriatric medicine, we designed this 22-station objective structured clinical examination (OSCE) for first-year geriatric medicine fellows. It is designed to assess competency in common geriatric assessment tools and interactions, as well as in interpersonal and communication skills and clinical reasoning in common geriatric syndromes. Methods: Intended as a formative assessment tool, this OSCE utilizes real clinical situations, standardized patient encounters, and computer-based clinical vignettes. Scores are pass/fail, and two independent geriatric medicine attendings use a standardized checklist to score each fellow's performance. Fellows also complete a self-evaluation using the same checklist. Formative feedback and remediation takes place for all failed stations. This facilitator's manual presents the procedures to implement the OSCE as well as the resources required, guidelines for assessment, and lessons learned from our 2-year experience. Results: Regarding the effectiveness of the OSCE experience, our fellows reported that the exam was well-organized, fair, and had a good balance of cases. In general, they believed they learned a great deal from participating in the OSCE and considered it a worthwhile and valuable exercise (especially the feedback and remediation sessions). They felt the OSCE tested skills relevant to geriatrics that they will incorporate into their future practices. Discussion: Given that there are no specific, defined learning outcomes for geriatric fellowship programs, the educational experience varies among institutions. Some fellowships stress palliative medicine, for example, whereas others offer more exposure to inpatient-geriatric medicine consult services. The competencies covered in the OSCE comprise the minimum skills we feel graduating fellows should possess. When used as a formative assessment tool, the OSCE could serve to standardize the educational experience across various institutions.
- Reinforce skills that are necessary and relevant to the practice of geriatric medicine.
- Allow fellows to identify personal weaknesses or gaps in their knowledge and application of geriatric medicine.
- Provide individualized, targeted feedback to fellows who fail any station.
- Supply educational materials for fellows to review.
- Ensure a comfortable learning environment where fellows can improve upon their knowledge and/or skills of geriatric medicine before completion of the fellowship.
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