During their training, neurology residents have to acquire communication skills, in addition to diagnostic and therapeutic competences. The announcement of a chronic neurological disorder is most often made in clinic by a senior neurologist and rarely in the presence of a neurology resident in training. To date, informing patients and their families about a diagnosis remains a daunting task for any physician, either because of a poor prognosis or the absence of curative treatment or because the patient is young, with significant changes in their life. For instance, multiple sclerosis (MS) involves very young patients who will need lifelong follow-up and treatment. In Alzheimer's disease (AD), the patient may be unable to understand the announcement and the neurologist must establish a relationship of trust with the main caregiver as well. Currently, there is little agreement on how to make a diagnosis announcement of severe neurological disease and existing guidelines are dedicated to one disease in particular [1], [2]. Residents may be insufficiently trained for this task and yet will have to manage it in their future practice. At present, there is no consensus on how to evaluate residents on the communication skills required to make a diagnosis announcement [3].
The Objective Structured Clinical Examination (OSCE) was developed more than 40 years ago, and is used to assess clinical skills in medical education. Since, OSCEs are considered to be the ideal modality of evaluation of clinical skills and they have become a frequently used method to assess medical students in France [4], [5]. Other medical specialties such as medical oncology have developed assessment methods similar to OSCEs to address the issue of diagnosis announcement [6], [7]. Following the recent reform of the second cycle of medical studies in France (R2C in France) [8], the OSCE will become an integral part of the national examination before residency (Examen dématérialisé national [EDN] in French) from may 2024 [9]. In France, all neurology residents have to validate their residency in their final year of training, however the modality of assessment is decided by the local department of neurology.
Given the different skills required to make a diagnosis announcement (scientific knowledge but also communication skills), it seemed interesting to develop an OSCE combined with a more theoretical course to address this issue and further evaluate our residents in their final year of training. Here we aimed to evaluate the acceptability, feasibility and validity in routine practice of an OSCE combined with a theoretical course focused on diagnosis announcement in neurology.
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