Utilizing Older Adult Standardized Patients to Enhance the Education of Health Professional Students

Educational Objectives 1. Identify the uses of standardized patients in geriatrics education. 2. Compare the advantages and limitations of older adult standardized patients. 3. Discuss how competencies can guide simulation development. 4. Describe methods for evaluation of learner performance when using older adult standardized patients

Standardized Patients in Occupational Therapy Education

The use of standardized patients (SPs) in occupational therapy (OT) education has greatly increased in recent years; however, there is limited research on the perceptions of student’s clinical readiness utilizing SPs and whether or not the utilization of SPs prepare students for fieldwork. The purpose of this study was to examine the perceptions of SPs in OT education and the perceived clinical readiness of students. The use of SPs has been thoroughly researched in other healthcare related fields. It is important that the same critical attention be given to their use in our own field, which emphasizes the importance of clinical readiness in the development of future professionals. A survey was given to the OT students of Dominican University of California who have had experience with the curriculum, which utilizes SPs. Students were asked to rate their own perceptions of readiness in a number of skills, which were practiced using SPs. Students were also asked to answer qualitative questions regarding their experiences in the simulated environment with SPs. Results indicated that four common themes emerged to the perceptions on the effectiveness of SPs. The use of SPs helped implement observational skills, bring classroom information to practical experience, identified the impact of secondary health conditions/comorbidity, and had effect on student performance due to anxiety. Further studies should be conducted to support this growing area of OT education

Needs Assessment in Postgraduate Medical Education:A Review

Although the concept of needs assessment in continuing medical education is well accepted, there is limited information on needs assessment in postgraduate medical education. We discuss the learning needs of postgraduate trainees and review the various methods of needs assessment such as: questionnaire surveys, interviews, focus groups, chart audits, chart-stimulated recall, standardized patients, and environmental scans in the context of post graduate medical education

A method to quantify residents\u27 jargon use during counseling of standardized patients about cancer screening

Background Jargon is a barrier to effective patient-physician communication, especially when health literacy is low or the topic is complicated. Jargon is addressed by medical schools and residency programs, but reducing jargon usage by the many physicians already in practice may require the population-scale methods used in Quality Improvement. Objective To assess the amount of jargon used and explained during discussions about prostate or breast cancer screening. Effective communication is recommended before screening for prostate or breast cancer because of the large number of false-positive results and the possible complications from evaluation or treatment. Participants Primary care internal medicine residents. Measurements Transcripts of 86 conversations between residents and standardized patients were abstracted using an explicit-criteria data dictionary. Time lag from jargon words to explanations was measured using “statements,” each of which contains one subject and one predicate. Results Duplicate abstraction revealed reliability κ = 0.92. The average number of unique jargon words per transcript was 19.6 (SD = 6.1); the total jargon count was 53.6 (SD = 27.2). There was an average of 4.5 jargon-explanations per transcript (SD = 2.3). The ratio of explained to total jargon was 0.15. When jargon was explained, the average time lag from the first usage to the explanation was 8.4 statements (SD = 13.4). Conclusions The large number of jargon words and low number of explanations suggest that many patients may not understand counseling about cancer screening tests. Educational programs and faculty development courses should continue to discourage jargon usage. The methods presented here may be useful for feedback and quality improvement efforts

Effective Learning Methods for Clinical Skills in Simulation Laboratories: High-Fidelity Mannequins and Standardized Patients

Abstract Background: Many nursing programs are utilizing simulation laboratories to teach clinical skills in a safe environment. Two modes of high-fidelity simulation—high-fidelity mannequins and standardized patients (SPs)—allow for an interactive experience that closely resembles the health care setting. Objectives: The purpose of this integrative literature review was to compare the two high-fidelity simulation methods—high-fidelity mannequins and standardized patients (SPs)—and their benefits when it comes to the development of nursing skills. Furthermore, the paper explored how skills learning laboratories can be optimized. Method: An integrative literature review of 19 research articles was conducted using databases of CINAHL, ERIC, and ProQuest. Search terms included nursing, skills, learning laboratories, undergraduate, baccalaureate, simulation, high-fidelity, mannequins, manikins, and standardized patients. Results: Three benefits were identified in the utilization of high-fidelity mannequins including effective learning and knowledge acquisition, satisfaction with the simulated experience, and improved self-confidence. Four benefits of simulations with standardized patients consisted of improved communication skills, improved clinical judgement, increased confidence, and applicability. Furthermore, common themes of the optimal environments in skill learning laboratories included discussion and engagement, approachable and innovative instructors, and opportunity for practice. Conclusion: Both high-fidelity mannequins and standardized patients give students a closely simulated health care experience. Further studies are needed to directly compare multiple attributes of high-fidelity mannequins and standardized patients. Finally, optimal learning environments were found to be supportive and engaging and led by approachable and innovative instructors

Counseling Training for Audiology Students: Using Standardized Patients

The implementation of Universal Newborn Hearing Screening (UNHS) has resulted in earlier diagnosis of hearing loss in children. Research shows that early diagnosis of hearing loss results in better outcomes in speech and language, socio-emotional, and cognitive development. Early diagnosis, however, often comes as a surprise to parents of newborns. When parents are told their child has a hearing loss, it is often before they have been able to observe behaviors that would lead to the suspicion of hearing loss. Parents are usually told about the hearing loss diagnosis by an audiologist and are often dissatisfied with how the news is delivered. Parents want someone who is compassionate, empathetic, and who will listen to them and spend time with them after the diagnosis. Audiologists often do not receive the proper training in how to deliver this news in graduate school either through coursework or practical experience. This leads to professionals who are ill-prepared to help parents with this difficult diagnosis. Medical students and other healthcare students utilize standardized patient (SP) encounters to practice counseling skills as well as clinical skills in a safe environment rich in feedback. SPs are actors trained to realistically portray a patient with varying physical symptoms and emotional reactions. The purpose of this thesis was to examine the efficacy of using SPs to train students enrolled in the Washington University Program in Audiology and Communication Sciences (PACS) Doctor of Audiology (Au.D.) program. Eight Au.D. students completed five SP encounters in which they delivered an initial diagnosis of hearing loss to a parent of a six-week old son who was referred based on his UNHS. Each encounter consisted of a parent who expressed a different emotional response to the diagnosis (tearful, contesting, guilty, and overwhelmed), with both the first and last encounters consisting of a tearful response. Students received feedback directly from the SPs following three of the encounters, as well as completed a de-briefing session with other participating students and an audiologist to discuss their experiences. Encounters were rated by two SPs and three pediatric audiologists using the Audiology Counseling Evaluation (ACE) Questionnaire. Ratings of the students as well as measurements made of video recordings of the encounters were analyzed to determine changes in behavior from the first encounter to the final encounter. Results indicated that although results were variable across and within students, improvements were made in several areas and students felt the training was worthwhile and valuable. Based on these improvements and observations made, the use of SPs could be helpful in training Au.D. students in counseling skills. Further research is necessary to quantify further these preliminary results and expand the areas in which SP encounters could be used

Improving Pharmacy Student Communication Outcomes Using Standardized Patients

Objective. To examine whether standardized patient encounters led to an improvement in a student pharmacist-patient communication assessment compared to traditional active-learning activities within a classroom setting. Methods. A quasi-experimental study was conducted with second-year pharmacy students in a drug information and communication skills course. Student patient communication skills were assessed using high-stakes communication assessment. Results. Two hundred and twenty students’ data were included. Students were significantlymore likely to have higher scores on the communication assessment when they had higher undergraduate GPAs, were female, and taught using standardized patients. Similarly, students were significantly more likely to pass the assessment on the first attempt when they were female and when they were taught using standardized patients. Conclusion. Incorporating standardized patients within a communication course resulted in improved scores as well as first-time pass rates on a communication assessment than when using different methods of active learning

Can standardized patients replace physicians as OSCE examiners?

BACKGROUND: To reduce inter-rater variability in evaluations and the demand on physician time, standardized patients (SP) are being used as examiners in OSCEs. There is concern that SP have insufficient training to provide valid evaluation of student competence and/or provide feedback on clinical skills. It is also unknown if SP ratings predict student competence in other areas. The objectives of this study were: to examine student attitudes towards SP examiners; to compare SP and physician evaluations of competence; and to compare predictive validity of these scores, using performance on the multiple choice questions examination (MCQE) as the outcome variable. METHODS: This was a cross-sectional study of third-year medical students undergoing an OSCE during the Internal Medicine clerkship rotation. Fifty-two students rotated through 8 stations (6 physician, 2 SP examiners). Statistical tests used were Pearson's correlation coefficient, two-sample t-test, effect size calculation, and multiple linear regression. RESULTS: Most students reported that SP stations were less stressful, that SP were as good as physicians in giving feedback, and that SP were sufficiently trained to judge clinical skills. SP scored students higher than physicians (mean 90.4% +/- 8.9 vs. 82.2% +/- 3.7, d = 1.5, p < 0.001) and there was a weak correlation between the SP and physician scores (coefficient 0.4, p = 0.003). Physician scores were predictive of summative MCQE scores (regression coefficient = 0.88 [0.15, 1.61], P = 0.019) but there was no relationship between SP scores and summative MCQE scores (regression coefficient = -0.23, P = 0.133). CONCLUSION: These results suggest that SP examiners are acceptable to medical students, SP rate students higher than physicians and, unlike physician scores, SP scores are not related to other measures of competence

Development of an Objective Structured Clinical Examination as a Component of Assessment for Initial Board Certification in Anesthesiology.

With its first administration of an Objective Structured Clinical Examination (OSCE) in 2018, the American Board of Anesthesiology (ABA) became the first US medical specialty certifying board to incorporate this type of assessment into its high-stakes certification examination system. The fundamental rationale for the ABA's introduction of the OSCE is to include an assessment that allows candidates for board certification to demonstrate what they actually "do" in domains relevant to clinical practice. Inherent in this rationale is that the OSCE will capture competencies not well assessed in the current written and oral examinations-competencies that will allow the ABA to judge whether a candidate meets the standards expected for board certification more properly. This special article describes the ABA's journey from initial conceptualization through first administration of the OSCE, including the format of the OSCE, the process for scenario development, the standardized patient program that supports OSCE administration, examiner training, scoring, and future assessment of reliability, validity, and impact of the OSCE. This information will be beneficial to both those involved in the initial certification process, such as residency graduate candidates and program directors, and others contemplating the use of high-stakes summative OSCE assessments

Starting a Standardized Patient Program Using a Theatre Model

The methods used to train actors can be modified to train standardized patients to simulate patient encounters with medical students. With some background in standardized patients and simulation, a member of Theatre Department can start a standardized patient program at their own institution. This is based on the pilot year of the VCU Standardized Patient Program which began in June, 2011