Abstract
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.
Original language | English (US) |
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Pages (from-to) | 350-355 |
Number of pages | 6 |
Journal | Substance Abuse |
Volume | 34 |
Issue number | 4 |
DOIs | |
State | Published - Oct 1 2013 |
Keywords
- Heroin addiction
- Objective Structured Clinical Examination (OSCE)
- substance abuse
ASJC Scopus subject areas
- Medicine (miscellaneous)
- Psychiatry and Mental health