Simulated patient’s feedback to improve communication skills of clerkship students

Abstract

Background: The changing trends of the society and revisions to medical education have changed the way medical students are trained to adroitly care for patients hence, patient centered care has become need of today's society and communication skills are imperative in developing patient physician relationship. Increasingly, simulations are being used to aid medical students to incorporate theoretical knowledge into practice. There are innumerable studies regarding communication skills in terms of reliability, validity and feasibility but no such study has been documented using simulated patient's feedback in improving communication skills in Pakistan. The aim of this study is to explore whether simulated patients' feedback improves the communication skills of undergraduate medical students. Methods: During a randomized control trail a group of eighty students in the final year clerkship at Al-Nafees Medical College have participated in pre-post Objective Structured Clinical Exam (OSCE) on communication skills. The students were selected through convenience sampling technique. Four Objective Structured Clinical Exam (OSCE) stations based on different scenarios of communication skills were developed. Each station of fifteen minutes duration was assessed by both simulated patients and faculty using a validated tool LCSAS (Liverpool Communication Skills Assessment Scale). The difference between the pre and post-tests of two groups was explored by applying independent t-test. Cronbach's alpha was used to check the reliability of scores and effect size was calculated. Results: Results of this study have showed that there is significant improvement in communication skills after receiving feedback from simulated patients (p value ≤0.05) was observed. An overall Cronbach α = 0.83 on LCSAS reveal a high internal consistency and there was adequate demonstration of effect size(r = 0.8). Conclusion: The results on the scores of the students on the Liverpool Communication Skills Assessment Scale confirm that simulated patient's feedback is essential to enhance the communication skills of the medical students. This study offers significant evidence towards successful conduction of a formal communication skills development initiative at Al-Nafees Medical College using simulated patient feedback during teaching and assessments. Background Patient centered care is gaining prime importance globally [1]; it is defined as giving priority and respect to patient's desires, requests and preferences, so patient can choose the treatment plan that best fit their personal needs [2]. This egalitarian approach is unlike the doctorcentered or paternalistic approach, which encourages patient to play role of a partner [3] and makes them more accountable for their own health [4]. Communication skills have a key role in patient centered care as it influences compliance to treatment plan and patient satisfaction [5]. The modern clinical conversation has become increasingly complex, as doctors explain to the patients about drug regimes, its side eff...

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Innovative perception of literary education: Communication concept

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What is the value of simulated patient assessment in structured clinical examinations of undergraduate students, and how should it be used?

“…[18][19][20] Authentic scenarios in OSCE provide opportunities for assessment of student performance, and patient feedback on student performance can be valuable in improving student communication skills and can be used as a reliable learning tool. 4,21 Where patients are supported and trained appropriately, "they can teach and assess as reliably as doctors," and there may be no significant differences between using simulated and real patients. 8,22 Previous studies on medical students have also shown that SP ratings can have a reliable correlation with assessor ratings and, therefore, may be used formatively.…”

“…2,3 It is widely accepted that formative assessment activities and receiving feedback from patients (real or simulated) can improve clinicians' communication and that such patients will support learning in complementary domains to the clinician expert, especially enhancing the humanistic elements over the more observable checklist content. [4][5][6] Once the graduated healthcare student is in the workplace, it is likely that patients will be judging them on a daily basis, and to be fully prepared for practice perhaps this patient voice should be highlighted in their undergraduate studies. Patient involvement has been encouraged in contemporaneous medical education to reinforce patient-centred care and shared decision-making.…”