Impact of Observed Structured Teaching Exercises (OSTE) on Teaching Skills and Behavioral Change in a Clinician Educator Track Program

University of Nebraska Medical Center

Introduction: OSTEs are the gold standard for programmatic evaluation of clinician educator tracks (CETs). However, most CETs only evaluate Kirkpatrick level 1 outcomes. We assessed the impact of OSTE on teaching skills and behavioral change in learners within our 2-year, interdisciplinary CET program. Methods: In October 2023, 17 post-graduate trainees from Internal Medicine (n=8), Pediatrics (n=3), Emergency Medicine (n=2), General Surgery (n=1), Family Medicine (n=1), Pathology (n=1), and Physiatry, (n=1) participated in three recorded OSTE experiences playing the following roles: 1) Resident providing bedside teaching to an M3, 2) Chief Resident giving corrective feedback to an intern, and 3) Observer providing feedback to CET peers during the first two encounters. Volunteer M4s played the standardized roles of M3 and interns. After encounters #1 and #2, learners engaged in self-assessment and received feedback from both M4 and CET peers. Program evaluation included Likert-scale and open-ended questions. Results: Of the 16 learners who replied, a majority strongly agreed that the OSTE improved their teaching skills (94%), was an appropriate development activity for residents (87.5%), helped identify areas for additional training (81.3%), and helped identify practices in teaching that they would like to change (62.5%). The OSTE was noted as a “low stakes but high yield learning opportunity.” Self-rated performance in the bedside teaching scenario was higher than the corrective feedback scenario. More objective analyses from the video-recorded OSTEs are in progress. Conclusions: We successfully implemented the first OSTE in our longitudinal CET program. This innovation leverages the Community of Practice in offering reciprocal peer feedback and video-based coaching once yearly. We hope practical lessons learned are informative for others who plan high fidelity simulation of teaching encounters at their institutions.