Application of an objective structured clinical examination to evaluate and monitor interns’ proficiency in hand hygiene and personal protective equipment use in the United States

Abstract

Purpose: This study was conducted to determine whether an objective structured clinical examination (OSCE) could be used to evaluate and monitor hand hygiene and personal protective equipment (PPE) proficiency among medical interns in the United States.Methods: Interns in July 2015 (N=123, cohort 1) with no experience of OSCE-based contact precaution evaluation and teaching were evaluated in early 2016 using an OSCE for hand hygiene and PPE proficiency. They performed poorly. Therefore, the new interns entering in July 2016 (N=151, cohort 2) were immediately tested at the same OSCE stations as cohort 1, and were provided with feedback and teaching. Cohort 2 was then retested at the OSCE station in early 2017. The Mann-Whitney U-test was used to compare the performance of cohort 1 and cohort 2 on checklist items. In cohort 2, performance differences between the beginning and end of the intern year were compared using the McNemar chi-square test for paired nominal data.Results: Checklist items were scored, summed, and reported as percent correct. In cohort 2, the mean percent correct was higher on the posttest than on the pretest (92% vs. 77%, P<0.0001), and the passing rate (100% correct) was also significantly higher on the posttest (55% vs. 16%). At the end of intern year, the mean percent correct was higher in cohort 2 than in cohort 1 (95% vs. 90%, P<0.0001), and 55% of cohort 2 passed (a perfect score) compared to 24% in cohort 1 (P<0.0001).Conclusion: An OSCE can be utilized to evaluate and monitor hand hygiene and PPE proficiency among interns in the United States.