Council on Medical Student Education in Pediatrics


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What do kids like or not like about their doctors?

What makes a good children’s doctor? Exploring the child perspective in the OSCE setting. Bardgett RJM, Darling JC, Webster E, Kime N. Medical Teacher 2016;38(5): 471-475.

Reviewed by Angela Punnett

What was the study question?
What qualities do children consider important in their doctors?

How was the study done?
Twenty-eight children age 8-10 years acted as SPs for a cranial nerve exam station in an OSCE. After each encounter, the children were asked to score their candidates on scale of 1-10 for the question ‘If you had to see a doctor again, how happy would you be to see this one?’ Children scored independently of the physician examiner. Age appropriate focus groups were held following the OSCE during which children were encouraged to describe their ideas of a ‘good doctor’ and to explain their scoring.

What were the results?
All children considered participation in the OSCE to have been a good experience. They scored a total of 256 candidates with a range in scores of 2-10 (median 9, mean 8.46) and 75% of scores >8. Attributes of a ‘good doctor’ included: friendly, funny, knowledgeable and confident. Attributes of a ‘bad doctor’ included: making mistakes, not paying attention, forgot everything, and serious. The authors conclude that children want a collaborative approach with a clear and kind explanation of process in their clinical encounters.

What are the implications?
Despite the fact that their scores were positively skewed, these children did show discrimination between candidates. It will be interesting to compare their scores with those of the physician examiners, recognizing that children and examiners may be looking at very different aspects of care. The question arises as to whether their scores should contribute to overall marks. I think this may come back to the purpose of the exam (summative vs formative) and a more in-depth understanding of the children’s decision-making.

Editor’s note: I am sure that many of us have allowed our own children to participate as standardized patients in OSCEs and that probably almost without exception it has been a positive experience, a fact that is corroborated in the literature including this paper. There is a terrific table listing attributes of “Good doctors” (caring, amazing…) and “Bad doctors” (Forgot everything, smelly, floppy[?]) according to the children (RR).

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