Survey of use and understanding of OSATS in obstetrics and gynaecology training in a UK deanery: A need for time and training

Abstract

Introduction OSATS (objective structured assessment of technical skills) is the primary means of assessing operative skills in UK obstetrics and gynaecology trainees. Specified targets are set by the curriculum and more recently by the RCOG matrix. Surveys suggested trainees were concerned that OSATS were time consuming and becoming a 'tick box' exercise. Methods An anonymous online survey was conducted over a 4 week period among trainees in the West Midlands. Results 43.4% trainees responded. All grades and years were represented. 63% reported no training in use of OSATS. Most common reasons for using OSATS were as proof of competency, as an assessment or because required. 63% however used as a surrogate logbook. Only 50% could correctly define the numbers of OSATS required for competence and 51% the numbers for continuing competence.96% trainees reported problems in getting OSATS completed with 37% reporting problems 'often' or 'always'. Main problems cited were failure of consultants to return forms, consultant not available to supervise or unit too busy to ask for OSATS. Equal numbers asked for OSATS during or after the case for their most recent OSATS (40%) - only 15% asked before the case. 16% of trainees had no feedback for most recent OSATS, 29% had structured feedback for most or all of OSATS; 35% had structured feedback for few or none of OSATS. Most trainees' comments were negative. Discussion The low levels of knowledge of OSATS requirements and how to organise OSATS is surprising. The high levels of problems in getting OSATS was also a concern. Issues with trainer engagement, knowledge or availability were highlighted. Even with likely changes in OSATS, issues with time available will remain unless trainers prioritise training of the next generation even in busy units. Quality above quantity with useful feedback should provide better assessments. The need for trainees being trained has led to embedding this into the basic regional training programme. The survey results and 'top tips' have been published on the trainee website. Use and supervision of workplace based assessments has been specifically highlighted in educational supervisor updates and training. Conclusions The survey results highlighted poor knowledge of OSATS among trainees and that many experience issues in OSATS completion. Better training for trainees and trainers has been instituted to enable trainees to meet RCOG curriculum requirements.