Korean Medical Education Review (의학교육논단)

Yonsei university college of medicine (연세대학교 의과대학)
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The Relationship between Medical Students' Assessment of Standardized Patients and Patient‐Physician Interaction Score

표준화 환자에 대한 학생 평가와 환자의사관계 점수와의 관계

  • Han, Eui-Ryoung (Department of Medical Education, Chonnam National University Medical School) ;
  • Kim, Sun (Department of Medical Education, Chonnam National University Medical School) ;
  • Chung, Eun-Kyung (Department of Medical Education, Chonnam National University Medical School)
  • 한의령 (전남대학교 의과대학 의학교육학교실) ;
  • 김선 (전남대학교 의과대학 의학교육학교실) ;
  • 정은경 (전남대학교 의과대학 의학교육학교실)
  • Received : 2019.08.06
  • Accepted : 2019.09.23
  • Published : 2019.10.31
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Abstract

When standardized patients (SPs) are used for educational purposes, the authenticity of role play and the quality of feedback are essential requirements of SPs. This study was conducted to investigate medical students' assessment of SPs and to identify the components of SPs' performance that were most strongly correlated with patient-physician interaction score. One hundred and forty-two fourth-year medical students were asked to complete the Maastricht Assessment of Simulated Patients (MaSP) at the end of a clinical performance examination. SPs evaluated the patient-physician interactions using a 4-point Likert scale (1=poor to 4=excellent). Medical students' assessment of SPs using the MaSP was positively correlated with patient-physician interactions (r=0.325, p<0.01). Items addressing the authenticity of role play (e.g., "SPs appear authentic," "SPs might be real patients," and "SPs answer questions in a natural manner") were closely correlated with patient-physician interactions (p<0.001, p=0.027, and p=0.017, respectively). These results showed that the MaSP appears to be a useful instrument for evaluating SPs' performance and that the authenticity of SPs' performance was positively correlated with medical students' interactions. In order to improve patient-physician interactions, medical students should be given opportunities to practice their skills with SPs who have been trained to portray patients with a specific condition in a realistic way.

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References

  1. Shapiro J. Perspective: Does medical education promote professional alexithymia?: a call for attending to the emotions of patients and self in medical training. Acad Med. 2011;86(3):326-32. https://doi.org/10.1097/ACM.0b013e3182088833
  2. Johnston SC. Anticipating and training the physician of the future: the importance of caring in an age of artificial intelligence. Acad Med. 2018;93(8):1105-6. https://doi.org/10.1097/ACM.0000000000002175
  3. Densen P. Challenges and opportunities facing medical education. Trans Am Clin Climatol Assoc. 2011;122:48-58.
  4. Oh SH, Kim JS, Lee PS. A survey on training and working conditions of residents in 2015. J Korean Med Assoc. 2015;58(12):1179-89. https://doi.org/10.5124/jkma.2015.58.12.1179
  5. Fletcher KE, Underwood W 3rd, Davis SQ, Mangrulkar RS, McMahon LF Jr, Saint S. Effects of work hour reduction on residents' lives: a systematic review. JAMA. 2005;294(9):1088-100. https://doi.org/10.1001/jama.294.9.1088
  6. Jamal MH, Rousseau MC, Hanna WC, Doi SA, Meterissian S, Snell L. Effect of the ACGME duty hours restrictions on surgical residents and faculty: a systematic review. Acad Med. 2011;86(1):34-42. https://doi.org/10.1097/ACM.0b013e3181ffb264
  7. Cherry MG, Fletcher I, O'Sullivan H, Dornan T. Emotional intelligence in medical education: a critical review. Med Educ. 2014;48(5):468-78. https://doi.org/10.1111/medu.12406
  8. May W, Park JH, Lee JP. A ten-year review of the literature on the use of standardized patients in teaching and learning: 1996-2005. Med Teach. 2009;31(6):487-92. https://doi.org/10.1080/01421590802530898
  9. Eagles JM, Calder SA, Nicoll KS, Walker LG. A comparison of real patients, simulated patients and videotaped interview in teaching medical students about alcohol misuse. Med Teach. 2001;23(5):490-3. https://doi.org/10.1080/01421590120075733
  10. Kaplonyi J, Bowles KA, Nestel D, Kiegaldie D, Maloney S, Haines T, et al. Understanding the impact of simulated patients on health care learners' communication skills: a systematic review. Med Educ. 2017;51(12):1209-19. https://doi.org/10.1111/medu.13387
  11. Barrows HS. An overview of the uses of standardized patients for teaching and evaluating clinical skills. AAMC. Acad Med. 1993;68(6):443-53. https://doi.org/10.1097/00001888-199306000-00002
  12. Brown A, Anderson D, Szerlip HM. Using standardized patients to teach disease management skills to preclinical students: a pilot project. Teach Learn Med. 2003;15(2):84-7. https://doi.org/10.1207/S15328015TLM1502_02
  13. Haist SA, Wilson JF, Pursley HG, Jessup ML, Gibson JS, Kwolek DG, et al. Domestic violence: increasing knowledge and improving skills with a four-hour workshop using standardized patients. Acad Med. 2003;78(10 Suppl):S24-6. https://doi.org/10.1097/00001888-200310001-00008
  14. Eddey GE, Robey KL, McConnell JA. Increasing medical student's self-perceived skill and comfort in examining persons with severe developmental disabilities: the use of standardized patients who are nonverbal due to cerebral palsy. Acad Med. 1998;73(10 Suppl):S106-8. https://doi.org/10.1097/00001888-199810000-00061
  15. Vannatta JB, Smith KR, Crandall S, Fischer PC, Williams K. Comparison of standardized patients and faculty in teaching medical interviewing. Acad Med. 1996;71(12):1360-2. https://doi.org/10.1097/00001888-199612000-00022
  16. Rosenbaum ME, Kreiter C. Teaching delivery of bad news using experiential sessions with standardized patients. Teach Learn Med. 2002;14(3):144-9. https://doi.org/10.1207/S15328015TLM1403_2
  17. Boyle D, Dwinnell B, Platt F. Invite, listen, and summarize: a patient-centered communication technique. Acad Med. 2005;80(1):29-32. https://doi.org/10.1097/00001888-200501000-00008
  18. Wilk AI, Jensen NM. Investigation of a brief teaching encounter using standardized patients: teaching residents alcohol screening and intervention. J Gen Intern Med. 2002;17(5):356-60. https://doi.org/10.1046/j.1525-1497.2002.10629.x
  19. Kim J, Lee K, Yoo D, Yang E. Effects of case type and standardized patient gender on student performance in a clinical performance examination. Korean J Med Educ. 2007;19(1):23-30. https://doi.org/10.3946/kjme.2007.19.1.23
  20. Colliver JA, Vu NV, Marcy ML, Travis TA, Robbs RS. Effects of examinee gender, standardized-patient gender, and their interaction on standardized patients' ratings of examinees' interpersonal and communication skills. Acad Med. 1993;68(2):153-7. https://doi.org/10.1097/00001888-199302000-00013
  21. Rutala PJ, Witzke DB, Leko EO, Fulginiti JV. The influences of student and standardized patient genders on scoring in an objective structured clinical examination. Acad Med. 1991;66(9 Suppl):S28-30. https://doi.org/10.1097/00001888-199109001-00011
  22. Wind LA, van Dalen J, Muijtjens AM, Rethans JJ. Assessing simulated patients in an educational setting: the MaSP (Maastricht Assessment of Simulated Patients). Med Educ. 2004;38(1):39-44. https://doi.org/10.1111/j.1365-2923.2004.01686.x
  23. Loffler-Stastka H, Datz F, Parth K, Preusche I, Bukowski X, Seidman C. Empathy in Psychoanalysis and Medical Education: what can we learn from each other? BMC Med Educ. 2017;17(1):74. https://doi.org/10.1186/s12909-017-0907-2
  24. Himmelbauer M, Seitz T, Seidman C, Loffler-Stastka H. Standardized patients in psychiatry: the best way to learn clinical skills? BMC Med Educ. 2018;18(1):72. https://doi.org/10.1186/s12909-018-1184-4
  25. Koponen J, Pyorala E, Isotalus P. A comparison of medical students' perceptions of three experiential methods. Health Educ. 2011;111(4):296-318. https://doi.org/10.1108/09654281111144265
  26. Kim JH. Does practicing communication skills with standardized patients or completion of elective course of communication skills affect the scores of clinical performance examination? Korean Med Educ Rev. 2011;13(1):35-43. https://doi.org/10.17496/KMER.2011.13.1.035
  27. Lee HM, Park HK, Hwang HS, Chun MY. Patient-centeredness of medical students during a real patient encounter and a standardized patient encounter on the clinical performance examination. Korean J Med Educ. 2013;25(2):139-47. https://doi.org/10.3946/kjme.2013.25.2.139
  28. Gormley G, Sterling M, Menary A, McKeown G. Keeping it real!: enhancing realism in standardised patient OSCE stations. Clin Teach. 2012;9(6):382-6. https://doi.org/10.1111/j.1743-498X.2012.00626.x
  29. Rystedt H, Sjoblom B. Realism, authenticity, and learning in healthcare simulations: rules of relevance and irrelevance as interactive achievements. Instr Sci. 2012;40(5):785-98. https://doi.org/10.1007/s11251-012-9213-x
  30. Meltzer EC, Shi Z, Suppes A, Hersh JE, Orlander JD, Calhoun AW, et al. Improving communication with surrogate decision-makers: a pilot initiative. J Grad Med Educ. 2017;9(4):461-6. https://doi.org/10.4300/JGME-D-17-00035.1
  31. Stokes-Parish JB, Duvivier R, Jolly B. Does appearance matter?: current issues and formulation of a research agenda for moulage in simulation. Simul Healthc. 2017;12(1):47-50. https://doi.org/10.1097/SIH.0000000000000211
  32. Pololi LH. Standardised patients: as we evaluate, so shall we reap. Lancet. 1995;345(8955):966-8. https://doi.org/10.1016/S0140-6736(95)90706-8