THE ENT OSCE: HOW WELL PRIMARY CARE RESIDENTS PERFORM?

Ear, nose and throat (ENT) problems are common in Primary Care (PC). Studies about the competence of PC residents to diagnose and manage ENT problems are lacking. The objective is to assess the competence to diagnose and manage prevalent ENT problems in medical residents of PC. We identified the prevalent ENT problems with a “Delphi” method including ten experts. A blueprint was defined to design the stations with standardized patients and simulators. The OSCE included 2 six-station circuits: one in Paediatrics and the other, in Adults. Two stations, with adolescent ENT problems, were used in both circuits. Standard setting was calculated by the borderline group method. A post examination meeting was planned to provide feedback. A total of 25 PGY 3 and 4 residents from Family Medicine (n= 8), General Internal Medicine (n=10) and Paediatrics (n=7) voluntarily participated. The global Cronbach´s alpha coefficient was 0.70. In the paediatric circuit, the mean score of FM residents was 63.21% and paediatrics residents´, 67.38% (p= ns); in the adult circuit, FM residents mean score was 64.22%, and GIM´s, 55.80% (p=0.02). A passing score of 55.77 % was obtained for the paediatric circuit and, 55.55 %, for the adult circuit. Six GIM residents did not pass the adult circuit. All FM and paediatrics residents passed the OSCE. The lowest scores were obtained in the procedural station of epistaxis and sinusitis (failure rate= 68% and 36%, respectively). The ENT OSCE is feasible and reliable. Family Medicine and Paediatrics Residents perform better than General Internal medicine Residents in diagnosing and treating ENT in Primary Care.