scholarly journals Assessment of Clinical Communication Skills of Medical Students Through the Simulated Patient Approach

2020 ◽  
Vol 19 (3) ◽  
Author(s):  
Nilesh Chavda ◽  
Priti Solanky ◽  
Jatin V Dhanani ◽  
Aashal Shah ◽  
Nirav Patel ◽  
...  

Background: Good communication skill is as crucial for the medical practitioner as medical knowledge for better patient outcome. Incorporating simulated patients for teaching communication skills and assessment can be beneficial for the learners as it gives them learning opportunities under a controlled environment. Objectives: 1. To assess the improvement in communication skills with the use of simulated patients after communication skills training. 2. To obtain feedback from simulated patients about patient satisfaction. 3. To obtain feedback from students and faculties about communication skills training intervention and simulated patients for assessment. Methods: After a thorough introduction and explanation of the study, out of total of 139 students from the fifth-semester bachelor of medicine and bachelor of surgery (MBBS), 44 students gave the willingness to participate. Students were divided into two groups of 22 students; one group acted as doctors, and the other group acted as a standardized patient group. Each simulated patient was randomly assigned to one doctor to make a pair; thus, 22 random pairs of doctor and patients were formed. Before and after giving communication skills training, each doctor-patient pair's consultation was analyzed for clinical communication skills using the Kalamazoo scale adapted version by trained observers. After each consultation, each patient was given a patient satisfaction questionnaire to fill. Results: In this study, students were improved significantly in each competency of the Kalamazoo scale after communication skills training. Before giving this training, the total mean communication skills score of students was 49.86 (SD=10.73), and after training, it significantly improved to 75.45 (SD=15.78) (P < 0.05). Before the training, the mean patient's satisfaction score was 48.95 (SD=12.18), which significantly improved after training to 60.36 (SD=3.99) (P < 0.05). Students as well as observers, found the Kalamazoo scale very useful for communication skills training and assessment. In feedback, they mentioned that the simulated patient approach for the assessment of communication skills was useful. Conclusions: This study showed that the clinical communication skills training with a structured scale was helpful for medical students. Students were found interested in learning such new skills; thus, clinical communication skills training should be an integral part of medical education. Simulated patients were found useful and can be used for the assessment of other clinical skills in medical education.

2021 ◽  
Vol 16 (3) ◽  
Author(s):  
Grace Peters

Simulated patients (also known as standardized patients) are commonly employed by institutions of medical education to train medical students and assess their communication skills. This article demonstrates that such patients are not translational devices that enact prima facie standards of communication skills as laid out by the institutions that use them, but rather metadiscursively transform communication practices. This is shown via a case study that closely examines a series of interactions between a simulated patient and a third-year medical student during a practice exam designed for the United States Medical Licensing Examination Step 2 Clinical Skills. I use discourse analysis to show how communication skills are transformed in three practices: (1) simulated consultations between standardized patients and medical students; (2) spoken evaluations offered by standardized patients after simulated consultations between standardized patients and medical students; and (3) written evaluations offered by standardized patients in assessment forms. In particular, by attending to how a simulated patient makes the act of draping the patient a relevant communication skill, I explicate the material elements and moral implications of clinical communication. Finally, I consider the instructive role simulated patients play in medical education and how their standards build on and often stand in contrast to communication skills techniques. I conclude by making practical suggestions for communication skills training with simulated patients in medical education.


Author(s):  
Silas Taylor ◽  
Matthew Haywood ◽  
Boaz Shulruf

Purpose: Optimal methods for communication skills training (CST) are an active research area, but the effects of CST on communication performance in objective structured clinical examinations (OSCEs) has not been closely studied. Student roleplay (RP) for CST is common, although volunteer simulated patient (SP) CST is cost-effective and provides authentic interactions. We assessed whether our volunteer SP CST program improved OSCE performance compared to our previous RP strategy. Methods: We performed a retrospective, quasi-experimental study of 2 second-year medical student cohorts’ OSCE data in Australia. The 2014 cohort received RP-only CST (N=182) while the 2016 cohort received SP-only CST (N=148). The t-test and analysis of variance were used to compare the total scores in 3 assessment domains: generic communication, clinical communication, and physical examination/procedural skills. Results: The baseline characteristics of groups (scores on the Australian Tertiary Admission Rank, Undergraduate Medicine and Health Sciences Admission Test, and medicine program interviews) showed no significant differences between groups. For each domain, the SP-only CST group demonstrated superior OSCE outcomes, and the difference between cohorts was significant (P<0.01). The superiority of volunteer SP CST over student RP CST in terms of OSCE performance outcomes was found for generic communication, clinical communication, and physical examination/procedural skills. Conclusion: The better performance of the SP cohort in physical examination/procedural skills might be explained by the requirement for patient compliance and cooperation, facilitated by good generic communication skills. We recommend a volunteer SP program as an effective and efficient way to improve CST among junior medical students.


2021 ◽  
Vol 24 (4) ◽  
pp. 63
Author(s):  
L.V. Sakhno ◽  
V.I. Orel ◽  
I.V. Koltuntseva ◽  
A.G. Rykachevskaya ◽  
T.V. Mishkina ◽  
...  

2018 ◽  
Vol 8 (3) ◽  
pp. 363.3-364
Author(s):  
Hannah Costelloe ◽  
Alice Copley ◽  
Andrew Greenhalgh ◽  
Andrew Foster ◽  
Pratik Solanki

Evidence demonstrates that medical students have limited experience in developing ‘higher-order communication skills’ (Kaufman et al. 2000). Anecdotally many do not feel confident in their ability to conduct difficult conversations often due to a lack of exposure to such scenarios in practice or a pervasive notion that these scenarios are inappropriate for students and beyond the scope of a junior doctor’s role and thus not a focus of curriculums (Noble et al. 2007). There is however a correlation between level of clinical experience and improved confidence for medical students (Morgan and Cleave-Hogg 2002).We surveyed a group of final year medical students to assess their confidence using a 10-point Likert scale in tackling common palliative and end of life care scenarios. Our intervention comprised a study day of 10 practical small-group teaching simulation and OSCE-style stations designed to provide exposure to common experiences in a controlled setting. We reassessed the confidence of students after delivery and objectively explored the impact of the day by asking participants to complete a validated assessment before and after the course. All results showed significant improvement on t-testing: confidence in end of life communication in an OSCE setting improved by 42.2% and assessment marks improved by 24.7% (p=0.039).Palliative care is an area in which students approaching the end of undergraduate training feel underprepared. Our findings demonstrate that small group sessions improve confidence by facilitating communication practice in a controlled environment and providing crucial exposure to common palliative care scenarios they will face as doctors.References. Kaufman D, Laidlaw T, Macleod H. Communication skills in medical school: Exposure confidence and performance. Academic Medicine [online] 2000;75(10):S90–S92. Available at https://journals.lww.com/academicmedicine/Fulltext/2000/10001/Communication_Skills_in_Medical_School__Exposure.29.aspx [Accessed: 30 May 2018]. Morgan P, Cleave-Hogg D. Comparison between medical students’ experience confidence and competence. Medical Education [online] 2002;36(6):534–539. Available at https://doi.org/10.1046/j.1365-2923.2002.01228.x [Accessed: 30 May 2018]. Noble L, Kubacki A, Martin J, Lloyd M. The effect of professional skills training on patient-centredness and confidence in communicating with patients. Medical Education [online] 2007;41(5):432–440. Available at https://doi.org/10.1111/j.1365-2929.2007.02704.x [Accessed: 30 May 2018]


2020 ◽  
Vol 103 (11) ◽  
pp. 2384-2387
Author(s):  
Roger Ruiz Moral ◽  
Cristina Andrade-Rosa ◽  
Juan D Molina Martín ◽  
Emilio Cervera Barba ◽  
Luis Pérula de Torres ◽  
...  

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Cristina Bagacean ◽  
Ianis Cousin ◽  
Anne-Helene Ubertini ◽  
Mohamed El Yacoubi El Idrissi ◽  
Anne Bordron ◽  
...  

Abstract Background Verbal and non-verbal communication, as well as empathy are central to patient-doctor interactions and have been associated with patients’ satisfaction. Non-verbal communication tends to override verbal messages. The aim of this study was to analyze how medical students use verbal and non-verbal communication using two different educational approaches, student role play (SRP) and actor simulated patient (ASP), and whether the non-verbal behaviour is different in the two different poses. Methods Three raters evaluated 20 students playing the doctor role, 10 in the SRP group and 10 in the ASP group. The videos were analyzed with the Calgary-Cambridge Referenced Observation Guide (CCG) and, for a more accurate evaluation of non-verbal communication, we also evaluated signs of nervousness, and posture. Empathy was rated with the CARE questionnaire. Independent Mann Whitney U tests and Qhi square tests were performed for statistical analysis. Results From the 6 main tasks of the CCG score, we obtained higher scores in the ASP group for the task ‘Gathering information’ (p = 0.0008). Concerning the 17 descriptors of the CCG, the ASP group obtained significantly better scores for ‘Exploration of the patients’ problems to discover the biomedical perspective’ (p = 0.007), ‘Exploration of the patients’ problems to discover background information and context’ (p = 0.0004) and for ‘Closing the session – Forward planning’ (p = 0.02). With respect to non-verbal behaviour items, nervousness was significantly higher in the ASP group compared to the SRP group (p < 0.0001). Concerning empathy, no differences were found between the SRP and ASP groups. Conclusions Medical students displayed differentiated verbal and non-verbal communication behaviour during the two communication skills training methodologies. These results show that both methodologies have certain advantages and that more explicit non-verbal communication training might be necessary in order to raise students’ awareness for this type of communication and increase doctor-patient interaction effectiveness.


2010 ◽  
Vol 8 (4) ◽  
pp. 441-447 ◽  
Author(s):  
Michelle N. Grainger ◽  
Sue Hegarty ◽  
Penelope Schofield ◽  
Vicki White ◽  
Michael Jefford

AbstractObjective:Discussing the transition from active anti-cancer treatment to palliative care can be difficult for cancer patients and oncology health professionals (OHP). We developed a brief communication skills workshop to assist OHP with these conversations, and examined satisfaction with the workshop and perceived confidence regarding these discussions.Method:Interactive workshops were conducted by trained facilitators and included cognitive, behavioral, and experiential components. The major component of the workshop involved role-plays with trained actors (simulated patients). Participants completed an evaluation questionnaire.Results:Sixty-two OHP participated in workshops. Overall, participants were highly satisfied with the workshop content and format. All participants felt the workshop provided relevant practical information, and >80% thought that participation benefited their work. Over 98% said that the workshop had increased confidence in their communication skills.Significance of results:Participants were very satisfied with the workshop, and thought that participation increased confidence in communicating about the transition to palliative care. Dissemination of this model of communication skills training seems warranted.


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