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To validate an approach to measuring professional identity formation (PIF), we explore if the Professional Identity Essay (PIE), a stage score measure of medical professional identity (PI), predicts clinical communication skills.Students completed the PIE during medical school orientation and a 3-case Objective Structured Clinical Exam (OSCE) where standardized patients reliably assessed communication skills in 5 domains. Using mediation analyses, relationships between PIE stage scores and communication skills were explored.For the 351 (89%) consenting students, controlling for individual characteristics, there were increases in patient counseling (6.5%, p0.01), information gathering (4.3%, p = 0.01), organization and management (4.1%, p = 0.02), patient assessment (3.6%, p = 0.04), and relationship development (3.5%, p = 0.03) skills for every half stage increase in PIE score. The communication skills of lower socio-economic status (SES) students are indirectly impacted by their slightly higher PIE stage scores.Higher PIE stage scores are associated with higher communication skills and lower SES.PIE predicts critical clinical skills and identifies how SES and other characteristics indirectly impact future clinical performance, providing validity evidence for using PIE as a tool in longitudinal formative academic coaching, program and curriculum evaluation, and research.

Background The authors developed and evaluated an interactive, Web-based module to train medical students in screening and brief intervention (SBI) for unhealthy alcohol use. Methods First-year students were randomized to module versus lecture. Change in knowledge, attitudes, and confidence were compared. Performance was assessed by objective structured clinical examination (OSCE) and analyzed by intention to treat and treatment received. Results Of 141 consenting students, 64% ( n = 90) completed an intervention (54% lecture vs. 70% Web assigned). Knowledge, confidence, and attitudes improved in both groups, with more improvement in Advise–Assist knowledge for Web students (14% vs. −3%, p = .003). Web students outperformed their lecture peers in both general communication (65% vs. 51% items well done, p = .004) and alcohol-specific tasks (54% vs. 41%, p = .021) on OSCE. Analysis by treatment received enhanced between-group differences. Conclusion Use of a Web-based module to teach SBI is associated with greater knowledge gain and skills performance compared with a lecture covering similar content. The module provides an efficient means for training in this area.

Background Aims Objective structured clinical encounters (OSCEs) are used widely to educate and assess the competence of medical students and residents; they generally are absent from fellowship training. The Accreditation Council for Graduate Education has cited OSCEs as a best practice for assessing the 6 core competencies. This article reports on the use of an OSCE to assess the competence of second-year gastroenterology fellows in the difficult-to-assess core competencies: interpersonal and communication skills and professionalism. Methods We developed a 4-station, faculty-observed OSCE with 4 standardized patients. Information gathering, relationship development, patient education, and counseling skills were assessed. Professionalism skills assessed included obtaining informed consent, delivering bad news, managing difficult situations, and showing interdisciplinary respect. In each station, faculty and standardized patients completed an 18- to 24-item checklist evaluating fellows' performance and provided feedback to the fellows. Nine fellows and 5 faculty from 4 gastroenterology training programs in NYC participated. Results Fellows and faculty generally highly rated the realism of the OSCE and favorably rated the OSCE for its difficulty and their overall experience. Across all cases, fellows were rated as receiving "well dones" for 56.4% of the communication items (SD, 18.3%) and for 79.1% of the professionalism items (SD, 16.4%). Conclusions Integrating OSCEs into gastroenterology fellowship training may help enhance communication skills and prepare fellows for dealing with difficult clinical situations and provides mechanisms for constructive feedback. OSCEs developed collaboratively can assist in program self-evaluation and reduce costs by sharing resources, in addition to fulfilling Accreditation Council for Graduate Education mandates.

Food label use is associated with better food choices, an essential part of the management of many chronic diseases. Previous studies suggest lack of comprehension of food labels. We studied a multimedia intervention to improve food label comprehension in a sample of low income patients in New York City.This randomized study took place at Gouverneur Healthcare Services from 2005 until 2007. The intervention group (n=29) received a Nutrition Facts Label pocket card and viewed a video explaining card use. The control group (n=27) received written materials. Participants completed a 12-item pre- and post-intervention nutrition food label quiz. Quiz scores were analyzed using repeated measures analysis of variance.The intervention group had greater improvement on the quiz than the control group (p0.001). There was a three way interaction by time with health literacy and treatment group where the greatest improvement occurred in patients with adequate health literacy in the intervention group (p0.05). There was no improvement in patients with limited health literacy.A multimedia intervention is an effective way to improve short-term food label comprehension in patients with adequate health literacy. Further research is necessary to improve understanding of food labels in patients with limited health literacy.

Background: Gastroenterology training programs are mandated to give feedback to their fellows but some faculty may not feel comfortable offering feedback or identifying specific areas for improvement. Training programs are also expected to develop the skills of their faculty as educators. We use Observed Standardized Clinical Encounters (OSCEs) to assess fellows' interpersonal and communication skills as well as their professionalism. The skills checklists we created provide the faculty with specific criteria to rate the performance of the fellows. We propose that OSCEs can serve as tools for faculty development in delivering effective feedback. Methods: Faculty completed a web-based 30 minute training module on giving feedback and received written guidelines about giving feedback prior to the OSCE. Four OSCE stations (obtaining informed consent, delivering bad news, apologizing for a medical complication, and transfer to surgery) were completed by each fellow and observed by faculty. The faculty used standardized behavioral specific checklists to assess the fellows' knowledge, professionalism, and communication skills. Post OSCE faculty rated the value of each faculty development program component and assessed their current comfort level with feedback as compared to before the program. Results: 8 faculty members from 5 GI training programs in NYC observed the 4 station OSCE and 10 fellows participated. Each faculty member observed one of the 4 scenarios. Immediately following each case, feedback was provided to the fellow by both the faculty observer and the standardized patient. The faculty members completed an exit survey to assess the utility of the OSCE and how well the program addressed the proposed educational objectives. 100% of the faculty agreed that feedback is an important learning tool, should include the learner's assessment and performance and that their feedback skills could improve with practice. As compared to prior to the program, 87.5% of the faculty agreed that they focused more on specific behaviors, 75% agreed that giving negative feedback was easier for them, and 62.5% felt that giving feedback was less challenging than before the training. The components of the program: the web based module, the narrative and the practicum were also rated on a scale of 1 (poor) to 5 (excellent) and the mean scores were 4.125, 4.375, and 4.875 respectively. Conclusions: OSCEs developed collaboratively can serve as practicums for giving constructive feedback and for faculty development and can help Gastroenterology training programs fulfill ACGME mandates.