• J Gen Intern Med · Sep 2024

    Requested a Different Doctor: Developing and Evaluating an OSCE Assessing Core Skills in Supporting Trainees Facing Patient Discrimination.

    • Christine P Beltran, Jeffrey A Wilhite, Cristina M Gonzalez, Barbara Porter, Christian Torres, Margaret Horlick, Kevin Hauck, Colleen Gillespie, Sondra Zabar, and Richard E Greene.
    • Division of General Internal Medicine and Clinical Innovation, Department of Medicine, New York University Grossman School of Medicine, New York, NY, USA. christinedale.beltran@nyulangone.org.
    • J Gen Intern Med. 2024 Sep 30.

    BackgroundSuboptimal support for colleagues experiencing discrimination can adversely impact clinician well-being and patient care.AimTo describe resident performance and experience during an Objective Structured Clinical Examination (OSCE) case centered on supporting a trainee facing discrimination to inform enhanced, supportive learning environments.SettingFormative, internal medicine OSCE at a simulation center.Participants148 second-year residents across 2018, 2019, 2021, 2022.Program DescriptionResidents had 10 min to support a Muslim standardized intern (SI) experiencing discrimination from a patient. The SI rated resident performance across Supervision, Relationship Development, and Support domains and provided written feedback. Post-OSCE evaluations elicited resident reflections on case challenges.Program EvaluationProficient residents (≥ 80% average score across domains, n = 85) performed better in all items, except in not acting defensive and collaborating with SI to develop follow-up plan, compared to non-proficient residents (n = 65). The SI described effective approaches to feeling supported, including using empathetic statements, stating personal stance on discrimination, exhibiting supportive body language, and verbalizing support. Stating knowledge of situation upfront was an area of improvement. Residents found engaging the distressed SI difficult.DiscussionUse of an explicit discrimination OSCE case can help identify effective approaches to supporting targets of discriminatory patients to inform future training.© 2024. The Author(s), under exclusive licence to Society of General Internal Medicine.

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