Standardisierte und qualitätsgesicherte Video-Prüfung: Aufklärungsgespräch vor der Operation

Standardisierte und qualitätsgesicherte Video-Prüfung: Aufklärungsgespräch vor der Operation

Standardized and quality-assured video-recorded examination: informed consent prior to surgery

Christoph Kiehl

Doctoral thesis

Date of Examination: 2019-07-24

Date of issue: 2019-07-04

Advisor: König, Sarah Prof. Dr.

Referee: König, Sarah Prof. Dr.

Referee: Kauffmann, Philipp PD Dr.

Persistent Address: http://hdl.handle.net/21.11130/00-1735-0000-0003-C156-2

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Abstract

English

Background: Communication skills combined with specialized knowledge are fundamental to a good and trust-based doctor/patient relationship. Our aim was to develop a quality-assured video-recorded objective structured clinical examination (V-OSCE), where students were tasked with obtaining informed consent. Methods: 155 students in their fifth year of medical school participated in a summative VOSCE within the teaching module “Operative Medicine.” They were asked to video record their obtaining informed consent from simulated patients for one of three clinical scenarios and the surgical procedures involved. Students were assessed by two independent raters. Results were statistically tested to diverse quality-assuring items (e.g. Cronbach's α) using SPSS. Results: Students’ scores were averaging 91.0% (± 4.0%), 88.4% (± 4.4%), and 87.0% (± 4.7%) for the three clinical szenarios appendectomy, cholecystectomy and inguinal hernia repair. Most items for the individual checklists were found to have fair to excellent discrimination values and the Cronbach’s α values ranged with passable scores between 0.565 and 0.605. Interrater agreement was strong with a Pearson correlation coefficient of 0.80 and intraclass correlation coefficient (ICC 2.1) of 0.78, despite the fact only one of the rater had an surgical background and the other was a dentist. Conclusions: The VOSCE is a feasible and reliable method of assessing student communication skills to create a good and trust-based doctor/patient relationship prior to surgery. In addition, its efficiency is remarkable, since non-specialist physicians can be used as an examiner and it reduces the organizational effort.

Keywords: informed consent; osce; video recorded examination