Development and Pilot Testing of an Objective Structured Clinical Examination for Obstructive Sleep Apnea

Objective: Our aim was (1) to develop an objective structured clinical examination (OSCE) for obstructive sleep apnea (OSA) and (2) to test the reliability and evaluate the feasibility of this OSCE while assessing residents’ clinical skills in multiple core competencies via the standardized patient methodology. Study Design: Development of assessment tool. Setting: Johns Hopkins Medicine Simulation Center. Subjects and Methods: Residents of the Department of Otolaryngology–Head and Neck Surgery at The Johns Hopkins University School of Medicine were invited to participate. A 2-station OSCE was developed. The first station used a standardized patient, and the encounter was videotaped for later evaluation by medical faculty not familiar with the participants being tested. The second was a computer-based station developed per a modified Delphi technique, based on feedback from otolaryngology and sleep medicine faculty involved in the care of patients with OSA. Checklists were developed for each station to standardize the evaluation of each trainee’s performance. Results: The OSCE that we developed is a feasible tool for assessing residents’ performance and skills to diagnose and manage a patient with OSA. Internal consistency, as assessed by Krippendorff’s alpha, was 0.699 for station 1 and 0.95 for station 2. Conclusion: This OSCE was found to be feasible for assessment of clinical competency in OSA. Our model provides targeted assessment of multiple competencies and opportunity to improve clinical knowledge and skills.