OSTEs are a tool in which a teacher interacts with a “standardized learner” in a scripted scenario to assess their teaching skills broadly and within a specific difficult situation as well as to improve their teaching skills by providing clear, immediate, and structured feedback. Initially, we will implement an OSTE program within the Pediatric Cardiology Fellowship Program at The University of Michigan. Using this program, we will assess and improve the teaching skills of first-year fellows, with the immediate goal of improving medical student and resident education. In addition, we will assess the role that OSTEs have in improving the education of these residents and students. Finally, we aim to more broadly implement this program as a part of the faculty development program for pediatric cardiology faculty.
An OSTE scenario for the delivery of feedback to a difficult learner was created based upon a faculty needs assessment. The OSTE was implemented within the pediatric cardiology fellowship program both as an intervention for first-year fellows as well as a faculty development tool during the faculty retreat. The faculty evaluations showed that the OSTE was realistic, well-received, valuable/useful, worth recommending to peers, and useful for trainees. Additionally, the change in faculty confidence in all domains (feedback, supervision of "difficult" learners, and good working relationships) were positive after participating in the OSTE. With the fellows, there was a significant improvement in clinical teaching scores (as evaluated by medical students and residents) after fellows participated in the OSTE. Additionally, the OSTE made a positive impact on the fellows' confidence in their teaching skills and the magnitude of this impact was more pronounced when the intervention occurred earlier.
The OSTE scenario is available for continued use and for adaptation to other clinical specialties, however our division has been exposed to the intervention, so the cost of continuing the scenario for just a few new learners is not justified at this time. Should a larger department with more turnover be interested in the program, it would be beneficial and cost-effective as a continued/ongoing intervention.
Advice to your Colleagues:
Strong divisional leadership and support to enact a culture change is very important to the success of such projects.