Table 4 Selected Results from Scenario Checklists in the 2009 and 2011 Pediatric Rheumatology Objective Structured Clinical Examinations

1: Gluco-corticoid explanation

10/21 did not mention risk of adrenal suppression; 6/21 did not say the risk-benefit ratio favored taking steroids

16/19 did not mention risk of adrenal suppression; 4/19 did not say the risk-benefit ratio favored taking steroids

2: Joint injection preparation

11/21 did not prepare the injection sterilely; 12/21 did not buffer the lidocaine

Scenario not used

3: Joint injection explanation and simulation

All fellows were respectful of parent’s concerns; 13/21 did not mention skin hypopigmentation as a side effect

All fellows were respectful of parent’s concerns; 12/19 did not mention skin hypopigmentation as a side effect

4: Musculo-skeletal exam

Of all assessed joints, none was examined by all 21 fellows; 7/21 fellows did not check forefoot

The wrist was the only joint examined by all 19 fellows; 8/19 fellows did not check forefoot

5: Dermato-myositis diagnosis discussion

11/21 did not mention possibility of abdominal pain; 14/21 did not mention possible emotional consequences of JDM

12/18 did not mention possibility of abdominal pain; 14/18 did not mention safety precautions necessary due to muscle weakness

6: Juvenile arthritis lecture

9/21 did not mention limb growth abnormalities; 11/21 did not mention jaw disease related to oligoarticular juvenile arthritis

10/19 did not mention limb growth abnormalities; 13/19 did not mention jaw disease related to oligoarticular juvenile arthritis

7: Insurance appeal

10/21 did not cite a source correctly for the letter; 10/21 did not describe patient consequences of denied treatment

Scenario not used

8: Gait analysis

Scenario not used

Not scored

9: Bad news delivery

Scenario not used

All 18 fellows were respectful of the parent; 11/18 did not ask how much information the parent wanted to know about cancer