Standardized Patient Encounters Periodic Versus Postencounter Evaluation of Nontechnical Clinical Performance

Introduction: Standardized patients are a beneficial component of modern healthcare education and training, but few studies have explored cognitive factors potentially impacting clinical skills assessment during standardized patient encounters. This study examined the impact of a periodic (vs. traditional postencounter) evaluation approach and the appearance of critical verbal and nonverbal behaviors throughout a standardized patient encounter on scoring accuracy in a video-based scenario. Methods: Forty-nine standardized patients scored either periodically or at only 1 point in time (postencounter) a healthcare provider\u27s verbal and nonverbal clinical performance during a videotaped standardized patient encounter. The healthcare provider portrayed in this study was actually a standardized patient delivering carefully scripted verbal and nonverbal behaviors in their portrayal of an actual physician. The encounter itself was subdivided into 3 distinct segments for the purpose of supporting periodic evaluation, with the expectation that both verbal and nonverbal cues occurring in the middle segment would be more challenging to accurately report for participants in the postscenario evaluation group as a result of working memory decay. Results: Periodic evaluators correctly identified a significantly greater number of critical verbal cues midscenario than postencounter evaluators (P \u3c 0.01) and correctly identified a significantly greater number of critical nonverbal cues than their postscenario counterparts across all 3 scenario segments (P \u3c 0.001). Further, postscenario evaluations exhibited a performance decrement in terms of midscenario correct identifications that periodic evaluators did not (P \u3c 0.01). Also, periodic evaluators exhibited fewer verbal cue false-positives during the first segment of the scenario than postscenario evaluators (P \u3c 0.001), but this effect did not extend to other segments regardless of the cue type (ie, verbal or nonverbal). Discussion: Pausing lengthier standardized patient encounters periodically to allow for more frequent scoring may result in better reporting accuracy for certain clinical behavioral cues. This could enable educators to provide more specific formative feedback to individual learners at the session\u27s conclusion. The most effective encounter design will ultimately depend on the specific goals and training objectives of the exercise itself

Human Factors and Simulation in Emergency Medicine

This consensus group from the 2017 Academic Emergency Medicine Consensus Conference Catalyzing System Change through Health Care Simulation: Systems, Competency, and Outcomes held in Orlando, Florida, on May 16, 2017, focused on the use of human factors (HF) and simulation in the field of emergency medicine (EM). The HF discipline is often underutilized within EM but has significant potential in improving the interface between technologies and individuals in the field. The discussion explored the domain of HF, its benefits in medicine, how simulation can be a catalyst for HF work in EM, and how EM can collaborate with HF professionals to effect change. Implementing HF in EM through health care simulation will require a demonstration of clinical and safety outcomes, advocacy to stakeholders and administrators, and establishment of structured collaborations between HF professionals and EM, such as in this breakout group

A Longitudinal Analysis of Stress in African American Youth: Predictors and Outcomes of Stress Trajectories

Few researchers have studied trajectories of stress over time in relation to psychosocial outcomes and behaviors among adolescents. A sample of African American adolescents were assessed longitudinally on perceived stress, psychological well-being, support, antisocial behaviors, and academic success. Patterns of stress over 4 time points were developed using a cluster-analytic approach. Differences among the trajectory clusters were examined using psychosocial outcomes and behaviors. Adolescents with chronic levels of stress reported more anxiety and depression, engaged in antisocial behaviors, and reported less active coping than youth in other trajectories. Adolescents with low levels of stress over time reported fewer psychological problems, perceived more social support, and were more likely to graduate from high school than those with higher stress levels over time. We also found that an increase in stress coincided with a lack of support and more psychological problems over time.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/45295/1/10964_2004_Article_465298.pd