The use of standardized patients to teach medical students clinical skills in ambulatory care settings

Myung, Sun Jung; Kang, Seok Hoon; Kim, Yon Su; Lee, Eun Bong; Shin, Jwa Seop; Shin, Hee Young; Park, Wan Beom

doi:10.3109/0142159x.2010.507713

Cited by 23 publications

(25 citation statements)

References 14 publications

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“…Standardized patients are also important tools for dissemination and implementation research outcome assessments, as the control provided by standardized patients allows for efficient and strategic testing of key skills in response to patient presentations that are unpredictable and variable in actual encounters [95]. That said, one limitation is that simply repeated exposure to the Black standardized patients, each presenting a different racial challenge, may have resulted in expectancy effects, reduction in tension and improved performance from Time 2 to Time 3 [96]. However, data from our control participantswho evidenced no changes in behavioral performance from Time 2 to Time 3 while experiencing the same standardized patientsmitigates this concern.…”

Section: Limitationsmentioning

confidence: 99%

Addressing microaggressions in racially charged patient-provider interactions: a pilot randomized trial

et al. 2020

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Background: Racial bias in medical care is a significant public health issue, with increased focus on microaggressions and the quality of patient-provider interactions. Innovations in training interventions are needed to decrease microaggressions and improve provider communication and rapport with patients of color during medical encounters. Methods: This paper presents a pilot randomized trial of an innovative clinical workshop that employed a theoretical model from social and contextual behavioral sciences. The intervention specifically aimed to decrease providers' likelihood of expressing biases and negative stereotypes when interacting with patients of color in racially charged moments, such as when patients discuss past incidents of discrimination. Workshop exercises were informed by research on the importance of mindfulness and interracial contact involving reciprocal exchanges of vulnerability and responsiveness. Twenty-five medical student and recent graduate participants were randomized to a workshop intervention or no intervention. Outcomes were measured via provider self-report and observed changes in targeted provider behaviors. Specifically, two independent, blind teams of coders assessed provider emotional rapport and responsiveness during simulated interracial patient encounters with standardized Black patients who presented specific racial challenges to participants. Results: Greater improvements in observed emotional rapport and responsiveness (indexing fewer microaggressions), improved self-reported explicit attitudes toward minoritized groups, and improved self-reported working alliance and closeness with the Black standardized patients were observed and reported by intervention participants. Conclusions: Medical providers may be more likely to exhibit bias with patients of color in specific racially charged moments during medical encounters. This small-sample pilot study suggests that interventions that directly intervene to help providers improve responding in these moments by incorporating mindfulness and interracial contact may be beneficial in reducing racial health disparities.

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Section: Limitationsmentioning

confidence: 99%

Addressing microaggressions in racially charged patient-provider interactions: a pilot randomized trial

et al. 2020

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“…Standardized patients have been used to teach clinical skills to medical students in ambulatory care settings [29]. They have been widely used to assess communication skills among both medical and nursing students [30].…”

Section: Discussionmentioning

confidence: 99%

Feedback on and knowledge, attitude, and skills at the end of pharmacology practical sessions

Shankar

Jha

Bajracharya

et al. 2011

J Educ Eval Health Prof

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Concern has been raised about inadequate pharmacology teaching in medical schools and the high incidence of prescribing errors by doctors in training. Modifications in pharmacology teaching have been carried out in many countries. The present study was carried out using a semi-structured questionnaire to obtain students' perceptions of their knowledge, attitudes, and skills with regard to different subject areas related to rational prescribing at the end of two-year activity-based pharmacology practical learning sessions in a private medical school in Nepal. The effectiveness of the sessions and strengths and suggestions to further improve the sessions were also obtained. The median total knowledge, attitude, skills and overall scores were calculated and compared among different subgroups of respondents. The median effectiveness score was also calculated. Eighty of the 100 students participated; 37 were male and 43 female. The median knowledge, attitude, and skills scores were 24, 39, and 23, respectively (maximum scores being 27, 45, and 36). The median total score was 86 (maximum score being 108). The effectiveness score for most subject areas was 3 (maximum 4). The strengths were the activity-based nature of the session, use of videos and role-plays, and repeated practice. Students wanted more sessions and practice in certain areas. They also wanted more resources and an internet connection in the practical room. The skills scores were relatively low. The immediate impact of the sessions was positive. Studies may be needed to assess the long term impact. Similar programs should be considered in other medical schools in Nepal and other developing countries.

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“…In developed settings SPs have been shown to play an important role where access to patients is a challenge, for example if patients are not suitable for undergraduate teaching, patients are too ill or unwilling to be examined, or staff are not available to teach in these settings. 2 The question was raised whether a local SP programme could address these challenges with similar success. This programme -potentially called Partners in Clinical Training -would also need to be embedded in the PHC approach, with explicit emphasis on patientcentredness and patients' human rights.…”

Section: Local Context and Backgroundmentioning

confidence: 99%

Developing a standardised patient programme in a primary healthcare curriculum: A needs analysis

Draper¹,

Moller²,

Aubin³

et al. 2012

AJHPE

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Background and objectives. The use of standardised patients (SPs) in medical education is well documented, mostly in developed settings. The aim of this study was to conduct a needs analysis for the development of a patient-centred SP programme within a primary healthcare (PHC)-led curriculum at the University of Cape Town (UCT) in South Africa, and to make recommendations for its development. Methods. A mixed methods study was conducted which included focus groups with fourth-year medical students (n=17), a questionnaire for thirdyear medical students (n=181), a questionnaire for patients who were examined by students (n=28), and quantitative tracking of patient-student encounters. Results. While students experienced significant challenges in sourcing suitable patients for interviewing and examination, the majority placed such value on the interaction with real patients that benefits outweighed the challenges. For students, challenges included seeing patients who had minor or no clinical signs in order to complete their portfolio tasks. For patients (especially those with clinical signs) it included being examined multiple times by students. Despite this, most patients expressed a desire to play a role in students' education. The study revealed areas of tension and inconsistency with the philosophies of a PHC curriculum, specifically in the areas of patients' rights and the role of patients as 'active teachers' .Conclusions. An SP programme at UCT could help with the skills development in second year. However, this role should include exploring the doctor-patient-student power relations with students, with a view to encouraging a more patient-centred professional identity for students.

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The use of standardized patients to teach medical students clinical skills in ambulatory care settings

Cited by 23 publications

References 14 publications

Addressing microaggressions in racially charged patient-provider interactions: a pilot randomized trial

Addressing microaggressions in racially charged patient-provider interactions: a pilot randomized trial

Feedback on and knowledge, attitude, and skills at the end of pharmacology practical sessions

Developing a standardised patient programme in a primary healthcare curriculum: A needs analysis

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