TY - JOUR
KW - Clinical Competence
KW - Education, Medical, Graduate
KW - Family Practice/education
KW - Heroin Dependence/therapy
KW - Humans
KW - Internal Medicine/education
KW - Internship and Residency
AU - S. J. Parish
AU - M. R. Stein
AU - S. R. Hahn
AU - U. Goldberg
AU - J. H. Arnsten
A1 - 
AB - BACKGROUND: Heroin-abusing patients present a significant challenge. Objective Structured Clinical Examinations (OSCEs) allow evaluation of residents' clinical skills. The objective of this study was to examine residents' OSCE performance assessing and managing heroin abuse. METHODS: Evaluation and comparison of heroin-specific communication, assessment, and management skills in a 5-station postgraduate year 3 (PGY3) substance abuse OSCE. Faculty used a 4-point Likert scale to assess residents' skills; standardized patients provided written comments. RESULTS: Two hundred sixty-five internal and family medicine residents in an urban university hospital participated over 5 years. In the heroin station, residents' skills were better (P < .001 for both comparisons) in communication (mean overall score: 316 +/- 0.51) than in either assessment (mean overall score: 2.66 +/- 0.60) or management (mean overall score: 2.50 +/- 0.73). The mean score for assessing specific high-risk behaviors was lower than the mean overall assessment score (222 +/- 1.01 vs. 2.74 +/- .59; P < .0001), and the mean score for recommending appropriate harm reduction management strategies was lower than the mean overall management score (2.39 +/- .89 vs. 2.54 +/- .74; P < .005). Standardized patients' comments reflected similar weaknessess in residents' skills. CONCLUSIONS: Assessment and management of heroin abuse were more challenging for residents than general communication. Additional training is required for residents to assess and counsel patients about high-risk behaviors.
BT - Substance abuse
C5 - Opioids & Substance Use; Education & Workforce
CP - 4
CY - United States
DO - 10.1080/08897077.2013.776658
IS - 4
JF - Substance abuse
N2 - BACKGROUND: Heroin-abusing patients present a significant challenge. Objective Structured Clinical Examinations (OSCEs) allow evaluation of residents' clinical skills. The objective of this study was to examine residents' OSCE performance assessing and managing heroin abuse. METHODS: Evaluation and comparison of heroin-specific communication, assessment, and management skills in a 5-station postgraduate year 3 (PGY3) substance abuse OSCE. Faculty used a 4-point Likert scale to assess residents' skills; standardized patients provided written comments. RESULTS: Two hundred sixty-five internal and family medicine residents in an urban university hospital participated over 5 years. In the heroin station, residents' skills were better (P < .001 for both comparisons) in communication (mean overall score: 316 +/- 0.51) than in either assessment (mean overall score: 2.66 +/- 0.60) or management (mean overall score: 2.50 +/- 0.73). The mean score for assessing specific high-risk behaviors was lower than the mean overall assessment score (222 +/- 1.01 vs. 2.74 +/- .59; P < .0001), and the mean score for recommending appropriate harm reduction management strategies was lower than the mean overall management score (2.39 +/- .89 vs. 2.54 +/- .74; P < .005). Standardized patients' comments reflected similar weaknessess in residents' skills. CONCLUSIONS: Assessment and management of heroin abuse were more challenging for residents than general communication. Additional training is required for residents to assess and counsel patients about high-risk behaviors.
PP - United States
PY - 2013
SN - 1547-0164; 0889-7077
SP - 350
EP - 355
EP - 
T1 - Teaching and assessing residents' skills in managing heroin addiction with objective structured clinical examinations (OSCEs)
T2 - Substance abuse
TI - Teaching and assessing residents' skills in managing heroin addiction with objective structured clinical examinations (OSCEs)
U1 - Opioids & Substance Use; Education & Workforce
U2 - 24159905
U3 - 10.1080/08897077.2013.776658
VL - 34
VO - 1547-0164; 0889-7077
Y1 - 2013
ER -