Medical students’ experiences of working with simulated patients in challenging communication training

Abstract

Background Physicians’ communication skills are important for patient-centered care. Although working with simulated patients (SPs) in case simulations is common for training communication skills, studies seldom include a wide range of challenging behaviors or explore students’ own experiences of learning communication skills with SPs. Therefore, this study was aimed at investigating how medical students perceive communication training involving challenging consultations with SPs and the impact on their learning experiences. Methods Twenty-three medical students from the same class were interviewed in focus groups about their experiences of simulation training with actors as SPs. In the simulation training, the students were instructed to deliver bad news, manage negative patient reactions, and encourage behavioral changes in reluctant patients. This was followed by feedback and a debriefing exercise. The interviews were analyzed with content analysis. Results Students reported that actors as SPs made the simulations more realistic and enabled them to practice various communication skills for challenging consultations in a safe way and manage their own feelings, thereby promoting new learning experiences. Elements such as actors’ flexibility in changing behaviors during role-play and exposure to different challenging behaviors, like negative emotions, were regarded as valuable. The importance of an accepting and permissive climate for the debriefing exercise was highlighted, though without taking too much time from the simulation training. Feedback directly from the SP was appreciated. Conclusions Actors as SPs were perceived as a valuable part of challenging communication training and added elements to the learning process. Future studies should include a wider range of challenging behaviors in training with SPs and evaluate the effects of such training on students’ use of communication skills.

Integrating Shared Decision-Making into Undergraduate Oncology Education: A Pedagogical Framework

“…These exercises foster effective communication, especially in conveying intricate treatment options and their implications [ 12 ]. Additionally, they offer a platform for students to cultivate empathy, a critical skill for addressing sensitive discussions inherent to oncology [ 13 , 14 ]. Through repeated practice in controlled settings, students can better prepare for real-world oncology consultations, ensuring a balanced integration of patient values and clinical evidence in medical decisions.…”

A Qualitative Study on the Experiences of Preclinical Students in Learning Clinical and Communication Skills at a Simulation Centre

“…Real-time feedback is defined as any positive or constructive statements about clinical performance shared between trainees and supervisors shortly after an observed behaviour. Real-time feedback is formative and requires setting expectations, so the learner is prepared to receive feedback in this manner [ 6 , 12 , 44 ]. This study also highlights that apart from real-time feedback, preclinical students view frequent and multiple sources of feedback (peer, near peer and faculty) as a valuable element for learning in SC.…”

“…Bugaj et al [ 6 ] explained that the positive social and cognitive congruence between students and their peers or near peers helps in learning and receiving feedback as there is shared empathy due to similar social roles and ability to share knowledge and skills at a level that is understood better, cognitive congruence. Importantly as highlighted in previous studies [ 11 , 12 , 32 ], effective feedback is a resource outcome that can motivate students especially those in preclinical years to engage more in SC: preparation for authentic clinical experience , accessibility of multiple resources for learning and support and opportunities to learn and improve .…”

“…Students’ concerns with learning at SC include insufficient resources and facilities, lack of trained staff and accessibility of simulators [ 9 ]. The scenarios used during simulation and the role of simulated patient have been highlighted as challenges by students as being unreal or too extreme [ 12 ]. Nevertheless, literature shows that clinical skills training needs to be introduced gradually from year 1 of medical training to deliver an integrated curriculum.…”