Abstract: SA-PO190
Development and Preliminary Validation of a Formative Peritoneal Dialysis Objective Structured Clinical Examination
Session Information
- Educational Research
October 27, 2018 | Location: Exhibit Hall, San Diego Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Educational Research
- 800 Educational Research
Authors
- Y'Barbo, Brian C., Walter Reed National Military Medical Center, Bethesda, Maryland, United States
- Yuan, Christina M., Walter Reed National Military Medical Center, Bethesda, Maryland, United States
- Gao, Sam W., Naval Medical Center Portsmouth, Virginia Beach, Virginia, United States
- LeBrun, Christopher J., Nephrology Associates PC, Columbus, Mississippi, United States
- Nee, Robert, Walter Reed National Military Medical Center, Bethesda, Maryland, United States
- Oliver, David K., Walter Reed National Military Medical Center, Bethesda, Maryland, United States
- Saddler, Mark C., Durango Nephrology Associates, Durango, Colorado, United States
- Watson, Maura A., Walter Reed National Military Medical Center, Bethesda, Maryland, United States
- Prince, Lisa K., Walter Reed National Military Medical Center, Bethesda, Maryland, United States
Group or Team Name
- Nephrology Education Research & Development Consortium
Background
Only about 10% of incident end-stage renal disease patients beginning renal replacement therapy select peritoneal dialysis (PD) in the US. One reason may be limited PD experience during Nephrology fellowship training. Training programs often use simulation to boost experience in the absence of clinical opportunities. Structured test questions can provide this simulation, help to assess fellow knowledge in this area, and aid in determining program level practice patterns.
Methods
We devised a formative objective structured clinical examination (OSCE) focusing on the management of a PD patient with peritonitis and ultrafiltration dysfunction. After blueprint development and identification of key objectives (based on the International Society for Peritoneal Dialysis Peritonitis practice guideline), the case and the scoring rubric were constructed based on a real-life example. After review by 2 subject experts, it was evaluated by a 9-member test committee consisting of 8 board-certified nephrologists (4 academic, 4 clinical) and one experienced PD nurse. The final case consisted of 10 free response questions (total 22 points) and required written orders for PD exchanges and antibiotic management.
Results
The final OSCE was sent to two groups (test and validation committees) to determine the passing threshold. The test committee set the passing threshold using Ebel’s method. The passing score was set at 16 of 22. Median relevance was essential or important for all questions with a content validity index of 91%. The validation committee (16 board-certified practicing nephrologist a median of 5 years (IQR 9) post-graduation) took the test. Mean score was 19 (SD 2). 94% of the validators passed the test and scored 85% on evidence based questions. Median time to take the test was 33 minutes (IQR 19).
Conclusion
Preliminary validation is now complete, and the next phase will involve testing of nephrology fellows who have just completed their first year of fellowship training.
Disclaimer: The views expressed are those of the authors and do not reflect the official policy of the Department of the Army/Navy/Air Force, the Department of Defense, National Institutes of Health, or the United States Government.
Funding
- Other U.S. Government Support