Adding debriefing to objective structured clinical examinations to enhance disability cultural sensitivity in pharmacy students

Debriefing was added to the design of an objective structured clinical examination (OSCE) after second-year pharmacy students performed poorly at considering patient disability in planning for patient care. This mixed-methods study examines secondary data to explore whether and how the addition of a debriefing to an OSCE impacted pharmacy students' cultural sensitivity (CS). CS scores that rate students' consideration of disability in written SOAP notes improved significantly with the addition of debriefing. Overall performance of assessing the case and planning for care did not change significantly. Debriefing transcripts were examined for supplemental instruction they afforded students about patient care and CS. Segments of debriefing discussions were devoted to discussing the patient disability. Students' concerns in debriefings dealt largely with reviewing their interactions with patients, in particular the procedure of physical examinations, to improve in future practice. Surveys of students' experience with debriefings, using the Debriefing Experience Scale (Reed, 2012) had nearly full participation. Results suggest high student satisfaction with debriefing and slight improvement from fall to spring with the same students. However, survey results were weakly correlated with students' scores. Results from this study suggest that debriefing added to OSCEs did improve students' CS performance of CS in developing care plans for disabled patients. Longitudinal studies could determine transfer from such debriefings to practice, but existing literature suggests hopeful results. Despite apparent success of adding debriefing to an OSCE, more simulated experience and performance-based assessment besides summative OSCEs are needed to develop CS and other patient-care abilities.