‘I wouldn’t get that feedback from anywhere else’: learning partnerships and the use of high school students as simulated patients to enhance medical students’ communication skills

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Abstract

Background

This article evaluates whether the use of high school students as simulated patients who provide formative feedback enhances the capacity of medical students in their fifth year of training to initiate screening conversations and communicate effectively with adolescents about sensitive health issues.

Methods

Focus group interviews with medical students (n = 52) and school students aged 15–16 (n = 107) were conducted prior to and following involvement in Learning Partnerships workshops. Prior to workshops focus groups with school students asked about attitudes to help-seeking in relation to sensitive health issues, and following workshops asked whether the workshop had made a difference to their concerns. Prior to workshops focus groups with medical students asked about their needs in relation to initiating conversations with adolescents about sensitive health issues, and following workshops asked whether the workshop had made a difference to their concerns. Surveys were also completed by 164 medical students and 66 school students following the workshops. This survey featured 19 items asking participants to rank the usefulness of the workshops out of 10 (1 = not at all useful, 10 = extremely useful) across areas such as skills and understanding, value of learning activities and overall value of the workshop. SPSS software was used to obtain mean plus standard deviation scores for each item on the survey.

Results

The Learning Partnerships workshops assisted medical students to improve their skills and confidence in communicating with adolescents about sensitive health issues such as mental health, sexual health and drug and alcohol use. They also assisted young people to perceive doctors as more likely potential sources for help.

Conclusions

These findings suggest that the innovative methods included in Learning Partnerships may assist in broader education programs training doctors to be more effective helping agents and aid the promotion of adolescent friendly health care. This research provides evidence that a new way of teaching may contribute to enhancing doctors’ capacity and willingness to initiate screening conversations and enhance adolescents’ preparedness to seek help. This has implications for educational design, content and communication style within adolescent health.

Electronic supplementary material

The online version of this article (doi:10.1186/s12909-015-0315-4) contains supplementary material, which is available to authorized users.

Related collections

Most cited references 32

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Clinical simulation is on the point of having a significant impact on health care education across professional boundaries and in both the undergraduate and postgraduate arenas. The use of simulation spans a spectrum of sophistication, from the simple reproduction of isolated body parts through to complex human interactions portrayed by simulated patients or high-fidelity human patient simulators replicating whole body appearance and variable physiological parameters. After a prolonged gestation, recent advances have made available affordable technologies that permit the reproduction of clinical events with sufficient fidelity to permit the engagement of learners in a realistic and meaningful way. At the same time, reforms in undergraduate and postgraduate education, combined with political and societal pressures, have promoted a safety-conscious culture where simulation provides a means of risk-free learning in complex, critical or rare situations. Furthermore, the importance of team-based and interprofessional approaches to learning and health care can be promoted. However, at the present time the quantity and quality of research in this area of medical education is limited. Such research is needed to enable educators to justify the cost and effort involved in simulation and to confirm the benefit of this mode of learning in terms of the outcomes achieved through this process.

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In order to assess or replicate the research findings of published reports, authors must provide adequate and transparent descriptions of their methods. We conducted 2 consecutive studies, the first to define reporting standards relating to the use of standardised patients (SPs) in research, and the second to evaluate the current literature according to these standards. Standards for reporting SPs in research were established by representatives of the Grants and Research Committee of the Association of Standardized Patient Educators (ASPE). An extensive literature search yielded 177 relevant English-language articles published between 1993 and 2005. Search terms included: 'standardised patient(s)'; 'simulated patient(s)'; 'objective structured clinical examination (OSCE)', and 'clinical skills assessment'. Articles were limited to those reporting the use of SPs as an outcome measure and published in 1 of 5 prominent health sciences education journals. Data regarding the SP encounter, SP characteristics, training and behavioural measure(s) were gathered. A random selection of 121 articles was evaluated according to 29 standards. Reviewers judged that few authors provided sufficient details regarding the encounter (21%, n = 25), SPs (16%, n = 19), training (15%, n = 15), and behavioural measures (38%, n = 44). Authors rarely reported SP gender (27%, n = 33) and age range (22%, n = 26), whether training was provided for the SPs (39%, n = 47) or other raters (24%, n = 29), and psychometric evidence to support the behavioural measure (23%, n = 25). The findings suggest that there is a need for increased rigor in reporting research involving SPs. In order to support the validity of research findings, journal editors, reviewers and authors are encouraged to provide adequate detail when describing SP methodology.

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To evaluate the effectiveness of an educational intervention in adolescent health designed for general practitioners in accordance with evidence based practice in continuing medical education. Randomised controlled trial with baseline testing and follow up at seven and 13 months. Local communities in metropolitan Melbourne, Australia. 108 self selected general practitioners. A multifaceted educational programme for 2.5 hours a week over six weeks on the principles of adolescent health care followed six weeks later by a two hour session of case discussion and debriefing. Objective ratings of consultations with standardised adolescent patients recorded on videotape. Questionnaires completed by the general practitioners were used to measure their knowledge, skill, and self perceived competency, satisfaction with the programme, and self reported change in practice. 103 of 108 (95%) doctors completed all phases of the intervention and evaluation protocol. The intervention group showed significantly greater improvements in all outcomes than the control group at the seven month follow up except for the rapport and satisfaction rating by the standardised patients. 104 (96%) participants found the programme appropriate and relevant. At the 13 month follow up most improvements were sustained, the confidentiality rating by the standardised patients decreased slightly, and the objective assessment of competence further improved. 106 (98%) participants reported a change in practice attributable to the intervention. General practitioners were willing to complete continuing medical education in adolescent health care and its evaluation. The design of the intervention using evidence based educational strategies proved an effective and quick way to achieve sustainable and large improvements in knowledge, skill, and self perceived competency.

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Author and article information

Contributors

Helen Cahill: h.cahill@unimelb.edu.au

Julia Coffey: jecoffey@unimelb.edu.au

Lena Sanci: l.sanci@unimelb.edu.au

Journal

Journal ID (nlm-ta): BMC Med Educ

Journal ID (iso-abbrev): BMC Med Educ

Title: BMC Medical Education

Publisher: BioMed Central (London )

ISSN (Electronic): 1472-6920

Publication date (Electronic): 7 March 2015

Publication date PMC-release: 7 March 2015

Publication date Collection: 2015

Volume: 15

Electronic Location Identifier: 35

Affiliations

[ ]Youth Research Centre, University of Melbourne, Level 5, 100 Leicester St., 3010 Victoria, Australia

[ ]Department of General Practice, The University of Melbourne, 200 Berkeley Street, Carlton, 3053 Victoria Australia

Article

Publisher ID: 315

DOI: 10.1186/s12909-015-0315-4

PMC ID: 4355139

PubMed ID: 25884413

SO-VID: eeaff1d0-15f7-41ba-a973-225c554f0283

License:

This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

History

Date received : 7 May 2014

Date accepted : 18 February 2015

Custom metadata

ScienceOpen disciplines: Education

Keywords: medical education,heaadsss,young people’s perspectives,medical students,clinical skills,education,youth friendly

Data availability:

ScienceOpen disciplines: Education

Keywords: medical education, heaadsss, young people’s perspectives, medical students, clinical skills, education, youth friendly