Using Objective Structured Clinical Exams (OSCEs) To Streamline Dermatoethics Education - A New Approach

Sep 20, 2026

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Proposes using Objective Structured Clinical Exams (OSCEs) to streamline dermatoethics education for dermatology training within ACGME milestones. Identifies an ethics curriculum practice gap, noting few accredited residencies offer formal ethics instruction. Outlines OSCE modalities including live standardized patient encounters and online or oral examination formats. Provides an ethics OSCE example on iPledge, contraception adherence, and response to prescription requests, with checklist-based performance assessment, objective evaluation, and debrief through group discussion and grand rounds. Recommends expert consensus, resident feedback, scenario banks, validity testing, and pilot study before and after ethics curriculum implementation.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages10

Reading Time25 min

AccessFree to download

Using Objective Structured Clinical Exams (OSCEs) To Streamline Dermatoethics Education

ACGME Milestones

Proposed OSCE Modalities

Ethics OSCE: Example

Performance Assessment

Evaluation and Follow-up

Next Steps

References

NEOMED TEMPLATE Using Objective Structured Clinical Exams (OSCEs) To Streamline Dermatoethics Education A New Approach Gowri Kabbur, BS (MS-IV) Eliot Mostow, MD, MPH ACGME MILESTONES PROF1 . Practices medicine ethically • Practice gap in dermatology residency training • Few accredited residencies with formal ethics curriculum – Brown University – University of Connecticut PROPOSED OSCE MODALITIES Objective Structured Clinical Exams (OSCE) • Live, standardized patient encounter – Two to Three 15-minute stations – Could be videotaped – Based on cases from individual departments • Online simulation programs • Oral examination – Verbal case provided, step-by-step prompted questions on how to proceed through the encounter ETHICS OSCE: EXAMPLE • Case – You receive an email from an established 17-year old female patient who is on her second round ofisotretinoin for treatment of severe acne. – She forgot to get her monthly labs and wants you to fill her prescription anyways. She is eager to complete treatment before prom season. – She says that she’s been using birth control pills and abstinence as her 2 forms of contraception . – At her last in-office visit, she mentioned that she has anew boyfriend. Inquiries about sexual activity were not asked because her mother was also present. – She only has 3 more months of treatment left. What is your response? • Prompt 1: Patient sends back an angry response and demands prescription to be filled. PERFORMANCE ASSESSMENT • Possible Checklist Items 􀂉 Clarifies exact patient request 􀂉 Asks patient about contraception adherence 􀂉 Educates patient on risks surrounding request 􀂉 Informs patient of ethical conflict 􀂉 Counsels patient on proper course of action (iPledge) 􀂉 Acknowledges patient’s frustration 􀂉 Maintains a calm, professional tone in email/phone encounter 􀂉 Offers up alternative options for upcoming visit • Debrief encounter with short resident assessment of perceived performance EVALUATION • Objective data – Number of clinical competencies completed on OSCE checklist • Internal consistency reliability of OSCE domains can be assessed • Analysis of variance – Results of post-encounter resident assessment • Track resident perception of ethical competency – Standardized patient assessment scores of resident (if applicable) SUBJECTIVE FOLLOW-UP • Focused Group Discussion – Program-wide debrief meeting on OSCE experiences – Troubleshooting on how to improve practices and flow of the exercise – Interactive discussion to identify ethical conflictsand appropriate clinical responses • Ethical Grand Rounds NEXT STEPS • Expert consensus (dermatology faculty) • Feedback from individual programs on areas of interest/concern. Elicit resident experiences with ethical conflict. • Promote regular ethics seminars for open discussion with residents and faculty • Use subjective data to compile a bank of Dermatoethics OSCEs scenarios – Test OSCEs on volunteer faculty for face/content validity – Begin pilot study on incoming residency class before and after ethics curriculum implementation REFERENCES 1. Aldrich N, Mostow E. Incorporating teaching dermatoethics in a busy outpatient clinic. J Am Acad Dermatol. 2011;65(2):423-4. 2. Bercovitch L, Long TP. Ethics education for dermatology residents. Clin Dermatol. 2009;27(4):405-10. 3. The Accreditation Council for Graduate Medical Education and The American Board of Dermatology. The Dermatology Milestone Project. [https://www.acgme.org/Portals/0/PDFs/Milestones/DermatologyMilestones.pdf](https://www.acgme.org/Portals/0/PDFs/Milestones/DermatologyMilestones.pdf). Updated July 2015. Accessed August 2016. 4. Hochberg MS, Berman RS, Kalet AL, Zabar S, Gillespie C, Pachter HL. Professionalism Training For Surgical Residents: Documenting the Advantages of a Professionalism Curriculum. Ann Surg. 2016;264(3):501-7. 5. Singer PA, Cohen

FAQs

What practice gap in dermatology residency training does the presentation address?

It identifies a gap in dermatoethics education, noting few accredited residencies provide a formal ethics curriculum.

What OSCE modalities are proposed to deliver ethics training?

The proposal includes live standardized patient encounters with short stations, online simulation programs, and oral examinations with step-by-step prompted questioning.

How is performance assessed in the ethics OSCE example?

Assessment uses possible checklist items covering clarification of the patient request, contraception adherence questions, risk education, ethical conflict identification, counseling on proper action, professionalism, and maintaining a calm tone.

Sep 20, 2026

Upload by Bulrr