Faculty Bibliography

Introduction: The objective structured clinical examination (OSCE) has been shown to not only assess but also improve the performance of trainees. Our group has previously demonstrated the benefits of OSCEs to assess gastroenterology (GI) fellows. We have successfully assessed performance across numerous milestones. Typically, OSCEs are held in person, however the COVID-19 pandemic has precipitated the need for virtual learning. We accordingly transitioned to a virtual zoom OSCE (Z-OSCE) and evaluated trainees' perception of this program.
Method(s): Fourteen first- and second-year GI fellows from five programs across multiple states participated in a four-station virtual OSCE on Zoom. Afterwards, participants answered a survey to share their perspectives and provide feedback. Learners were asked to rate the usefulness of the virtual OSCE and compare it to other in-person and virtual educational modalities. These questions were rated on a 10-point Likert scale (Figure 1). Additionally, free-text responses regarding any aspect of the OSCE were evaluated for comments on the virtual format.
Result(s): In comparing the usefulness of the virtual OSCE to other in-person modalities, trainees rated it a mean of 7.15 (range 5-10), and 31% of respondents rated it a 9 or 10. Trainees rated the virtual OSCE compared to other virtual learning modalities a mean of 8.15 (range 5-10), and 43% rated it 9 or 10. When asked whether they would recommend this OSCE as a training tool, the trainees gave a mean recommendation of 7.77 (range 5-10), and 38% gave a 9 or 10. General feedback regarding the nature of the OSCE noted the virtual format worked well, orientation to the format was important and could be improved by providing it in an email beforehand.
Conclusion(s): Virtual learning has been necessary during the COVID-19 pandemic, and it is crucial to evaluate the value of the novel Z-OSCE. Participants found the virtual OSCE may be more useful than in-person learning modalities and it compared favorably to other virtual learning modalities. One benefit of this modality was the easier inclusion of fellows from geographically disparate areas negating the need to travel for this program, a benefit given lack of universal access to simulation using standardized patients. To improve future exams, orientation prior to the day of the OSCE may improve trainees' experiences.

Introduction: gFOBT, FIT, FIT-DNA are non-invasive colorectal cancer screening tools often used inappropriately. Furthermore, clinical decisions are then predicated on these test results leading to consequences ranging from delay of healthcare to unnecessary invasive procedures. The purpose of this project was to identify misconceptions among health care providers, and to educate utilizing interventions aimed at developing life-long evidence-based practices regarding correct use, understanding and knowledge of non-invasive colorectal cancer screening tests.
Method(s): Three 1-hour long interactive lectures based on current guidelines were conducted and made available online to internal and emergency medicine residents, medical students, nurses and physician assistants. Participants completed a pre- and post-test questionnaire, with questionnaires paired to each individual. Question stems were created to focus on topics gauging ability to assess higher level of thinking, recall, and knowledge of evidence based medicine regarding gFOBT, FIT and FIT-DNA. Participants were also asked frequency in using screening tests for symptoms of abdominal pain, hematochezia or melena and if educational intervention was informative. Data was analyzed using descriptive statistics and paired T tests to assess an improvement in knowledge.
Result(s): 85 participants were involved including residents within internal (n=28) and emergency medicine (n=13), 3rd and 4th year medical students (n=24), physician assistants (n=8) and clinical nursing staff (n=12). Most common misconceptions identified were screening timeline guidelines, when and how to perform tests and next-best step following positive stool test results. (Table) The use of stool based screening tests are commonly used for symptoms such as hematochezia or melena. Pre and post-test averages showed statistically significant improvement after educational intervention in all groups. (Graph 1)
Conclusion(s): There is a gap in knowledge regarding appropriate use of stool- based testing for colorectal cancer screening. A simple educational intervention based on current guidelines showed a statistically significant increase in knowledge in medical students, residents, physician assistants and nursing staff. 100% of participants who responded found the interactive lecture and questionnaire informative. Future plans include assessing knowledge retention 3 months after initial intervention along with comparing the use of stool based tests before and after the intervention. (Table Presented)