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The Ottawa Resident Observation Form for Nurses (O-RON): Does it work in different specialties?

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ePoster Presentation

2:20 pm

27 February 2024

Exhibition Hall (Poster 1)

Selection and other transitions between levels and settings of education

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Presentation Description

Hedva Chiu1
Timothy Wood1, Adam Garber1, Wade Gofton1, Samantha Halman1, Janelle Rekman1 and Nancy Dudek1
1 The University of Ottawa 



Background:
Workplace-based assessment (WBA) is a recognized assessment method for competence in post-graduate medical education.1,2 Most WBA relies on physician supervisors. However, in a complex training environment where supervisors are unavailable to observe certain aspects of a trainee’s performance, nurses are well-positioned to do so. The Ottawa Resident Observation Form for Nurses (O-RON) was developed to capture nurses’ assessment of trainee performance and results have demonstrated strong evidence for validity in Orthopaedic Surgery. However, different clinical settings can impact a tool’s performance. This project studied the use of the O-RON in three different specialties at the University of Ottawa (UO). 


Summary of work:
O-RON forms were distributed on the Internal Medicine, General Surgery, and Obstetrical wards at UO over nine months. Validity evidence related to quantitative data was collected. Exit interviews with nurse managers were performed and content was thematically analyzed. 

Results: 179 O-RONs were completed on 30 residents. With four forms per resident, the ORON’s reliability was 0.82. Global judgement response and frequency of concerns was correlated (r = 0.627, P<0.001). Exit interviews identified factors impacting form completion, which included heavy clinical workloads and larger volumes of residents. 


Discussion:
Consistent with the original study, the findings demonstrated strong evidence for validity. However, the total number of forms collected was less than expected. This appears due to environmental factors. 


Conclusion:
The O-RON is a useful tool to capture nurses’ assessment of trainee performance and demonstrated reliable results in various clinical settings. However, understanding the assessment environment and ensuring it has the capacity to perform this assessment is crucial for successful implementation. 


Implications for future research:
Input from nurses on resident performance is valuable and the O-RON captures this assessment. Future research should focus on how we can create conditions whereby implementing this tool is feasible from the perspective of nurses. 




References (maximum three) 

1. Epstein RM, Hundert EM. Defining and assessing professional competence. JAMA. 2002;287(2):226-235. doi:10.1001/jama.287.2.226 

2. Prentice S, Benson J, Kirkpatrick E, Schuwirth L. Workplace-based assessments in postgraduate medical education: A hermeneutic review. Medical Education. 2020;54(11):981- 992. doi:10.1111/medu.14221 

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