Implementing and evaluating a patient instructor program

Previous studies have shown that a communications program using patient instructors (PIs) facilitates data-gathering and interpersonal skills of third-year dental students. The aim of this study was to address the question of whether those skills are retained into the students' fourth year and generalized from the classroom to the clinic. In the formative training phase, three cohorts of D3 students (N=1,038) at one dental school received instruction regarding effective patient-doctor communication; interviewed three PIs and received PI feedback; and participated in a relective seminar with a behavioral science instructor. In the follow-up competency phase, fourth-year students performed two new patient interviews in the clinic that were observed and evaluated by clinical dental faculty members trained in communications. Mean scores on a standardized communications rating scale and data-gathering assessment were compared over training and follow-up sessions and between cohorts with a linear mixed model. The analysis showed that the third-year students' mean communication and data-gathering scores increased with each additional encounter with a PI (p<0.05) and that communication scores were not only maintained but increased during the fourth-year follow-up competency evaluations (p<0.05). Based on changes in the communications curriculum, prior instruction facilitated the students' clinical communication performance at baseline (p<0.05). This study suggests that the current Clinical Communications program improved students' data-gathering and interpersonal skills. Those skills were maintained and generalized through completion of the D4 students' summative competency performance in a clinical setting.

Section: Discussionsupporting

confidence: 76%

“…Criteria for the scores are provided in the ACIR manual. The ACIR has good psychometric properties with reported interjudge and intrajudge reliability ratings of 0.85 5 , 9 – 11 …”

Section: Methodsmentioning

confidence: 99%

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confidence: 98%

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confidence: 99%

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confidence: 99%

See 3 more Smart Citations

Communication Skills in Dental Students: New Data Regarding Retention and Generalization of Training Effects

Broder

Mitnick

Rodriguez

et al. 2015

Strategies for Training Standardized Patient Instructors for a Competency Exam

Amano¹,

Sano²,

Gotoh³

et al. 2004

The Common Achievement Test (CAT) in Japan, which will be implemented in 2005, involves a medical interview that is the core task to be completed by students during an Objective Structured Clinical Examination (OSCE). Standardized/ Simulated Patient instructors (SPs), posing as patients in medical interviews, are trained in standard fashion in terms of expression of symptoms as well as the emotional affect of actual patients. Institution of appropriate training programs for SP instructors in the CAT is also necessary. We trained seven individuals to function as standardized patients (in-school SPs) during a three-day SP training program described in this article. Following completion of the OSCE, we conducted a comparison study among evaluations completed by the evaluators and two types of SP instructors. We observed high correlation, according to Spearman significance testing, between scores of evaluators and those of both newly trained in-school SPs and veteran SPs who had more than five years of experience. Correlation coefficients between the veteran SPs (r=0.77) and the in-school SPs (r=0.73) were nearly identical. These results suggest that our training program for SP instructors is an effective protocol, particularly with respect to reliability and efficiency.

Promoting Interpersonal Skills and Cultural Sensitivity Among Dental Students

Broder¹,

Janal²

2006

This study evaluated interpersonal communication skills among third-and fourth-year dental students during two clinical communications training programs. Students participated in two clinical communications (CC) training sessions, each comprised of four encounters with patient instructors (PIs) who were trained to enact standardized patient scenarios. Scenarios in CC1 addressed straightforward patient care situations in dentistry (e.g., bridge adjustment), while CC2 added cultural sensitivity issues to the dental scenarios. After each encounter, patient instructors used the Arizona Clinical Interviewing Rating Scale (ACIR) to rate the students' interpersonal skills and gave the students feedback on their performance. The students also received feedback and coaching from dental school faculty in debriefings after encounters with the PIs. Students anonymously rated the program at the end of each session. To evaluate the program, students' performance was compared within and between the two training sessions. Analysis showed statistically significant increases in interpersonal communication skills within each training session (p<0.05) from unsatisfactory to above satisfactory levels. Performance scores at the start of CC2 were statistically lower than at the end of CC1, suggesting that performance wanes without practice. Student evaluations of the program were very positive. Interpersonal communication skills improved during this patient instructor program.