Using Unannounced Standardized Patients to Assess Residents' Competency in Asthma Severity Classification

Ozuah, Philip O.; Reznik, Marina

doi:10.1016/j.ambp.2007.11.004

Cited by 13 publications

(2 citation statements)

References 12 publications

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“…It provides a different perspective of the care received by patients and points the way to “corrective actions” [ 69 ]. Firstly, it has been used in the late 1980s to test emergency departments’ response to paediatric code, then to assess sexually transmitted disease prevention practices [ 70 ], observe clinicians’ basic patient’s assessment skills, classification of asthma severity [ 71 ], monitor telephone triage of emergency calls, and is now commonly used, with different frequency in medical institutions, to assess teams and system responses [ 72 ]. It can be considered as a quality control procedure or quality insurance policy of health systems, ensuring a total level of psychological engagement of the clinicians but is also the highest possible level of deception to reach absolute fidelity of the clinician/patient encounter.…”

Section: Presentation Of the Model And Its Elementsmentioning

confidence: 99%

Simulation-based education: deceiving learners with good intent

Alinier

Oriot

2022

Adv Simul

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The level of performance of every clinician and of the overall multiprofessional team relies on the skills and expertise they have individually and collectively acquired through education, training, self-directed learning, and reflection. Simulation-based education (SBE) is playing an increasingly important role in that respect, and it is sometimes said that it is an art to facilitate. Many explanations can justify this assertion. Although there is generally an emphasis on making everything as realistic or “high-fidelity” as possible, it is often futile and this is where the art of simulation comes into play with an element of modulation of realism linked to the intended learning objectives. The atmosphere created by the educators; how the learners are made to engage and interact; how physical, technical, and contextual elements are simulated or represented; and what type of technology is used need to be appropriately adapted to contribute to the immersiveness of any SBE activity. Although it inevitably carries a negative connotation, some form of “deception” is more commonly used than one may think for the benefit of learners during SBE. High levels of realism are sometimes achieved by making learners believe something works or reacts as would be expected in real life, whereas it is achieved in a totally different manner. Learners do not need to know, see, or understand these “tricks of the trade”, shortcuts, or artistic or technological aspects, and this can be considered a form of benevolent deception. Similarly, information may be withheld to recreate a realistic situation and push learners to demonstrate specific learning outcomes, but it needs to be practised with caution and be justifiable. These forms of “positive” deception are part of most SBE activities and are used to help learners bridge the reality gap so they can suspend disbelief more easily, exercise critical thinking, and treat the simulation more realistically without damaging the trust they place in their educators. This article will discuss how aspects of SBE activities are often manipulated, modified, or hidden from learners to facilitate the learning experience and present a simulation fidelity model encompassing the environmental, patient, semantical, and phenomenal dimensions.

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Section: Presentation Of the Model And Its Elementsmentioning

confidence: 99%

Simulation-based education: deceiving learners with good intent

Alinier

Oriot

2022

Adv Simul

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“…The simulated patient (SP) method was developed by Barrows in 1968 for teaching purposes to assess the competence of medical doctors in a safe setting by means of a person trained to represent a disease [14,15]. It has been used in studies to assess the quality of care and decision-making in common clinical settings in several countries [16][17][18][19][20][21][22][23][24][25][26][27][28][29], and there are also useful guidelines for the reporting of research works in which this methodology is used [21].…”

Section: Introductionmentioning

confidence: 99%

The Real Practice Prescribing Antibiotics in Outpatients: A Failed Control Case Assessed through the Simulated Patient Method

et al. 2023

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The first level of medical care provides the largest number of consultations for the most frequent diseases at the community level, including acute pharyngitis (AP), acute diarrhoea (AD) and uncomplicated acute urinary tract infections (UAUTIs). The inappropriate use of antibiotics in these diseases represents a high risk for the generation of antimicrobial resistance (AMR) in bacteria causing community infections. To evaluate the patterns of medical prescription for these diseases in medical offices adjacent to pharmacies, we used an adult simulated patient (SP) method representing the three diseases, AP, AD and UAUTI. Each person played a role in one of the three diseases, with the signs and symptoms described in the national clinical practice guidelines (CPGs). Diagnostic accuracy and therapeutic management were assessed. Information from 280 consultations in the Mexico City area was obtained. For the 101 AP consultations, in 90 cases (89.1%), one or more antibiotics or antivirals were prescribed; for the 127 AD, in 104 cases (81.8%), one or more antiparasitic drugs or intestinal antiseptics were prescribed; for the scenarios involving UAUTIs in adult women, in 51 of 52 cases (98.1%) one antibiotic was prescribed. The antibiotic group with the highest prescription pattern for AP, AD and UAUTIs was aminopenicillins and benzylpenicillins [27/90 (30%)], co-trimoxazole [35/104 (27.6%)] and quinolones [38/51 (73.1%)], respectively. Our findings reveal the highly inappropriate use of antibiotics for AP and AD in a sector of the first level of health care, which could be a widespread phenomenon at the regional and national level and highlights the urgent need to update antibiotic prescriptions for UAUTIs according to local resistance patterns. Supervision of adherence to the CPGs is needed, as well as raising awareness about the rational use of antibiotics and the threat posed by AMR at the first level of care.

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