an overview and discussion of the literature 2010 publications involving standardized patients
TRANSCRIPT
An Overview and Discussion of the Literature
2010 Publications Involving Standardized Patients
My apologies to Best Buy…
Educational Scholarship
• Clear Goals
• Adequate Preparation
• Appropriate Methods
• Significant Results
• Effective Presentation
• Reflective Critique
Glassick
Objectives
• Provide a guided discussion of the published literature from 2010 involving SPs
• Discuss the unique applications of SPs in teaching, assessment and research
• Guide participants through discussion on the potential application of findings to their own program
• Stimulate ideas for studies involving standardized patients.
Clear goals
Thinking ‘both this…
• Review Medline capabilities
• Decisions on limitations
• Skills in literature search
Adequate Preparation
Methods
Medline search
• MeSH descriptors:–Standardized patient(s)
–Simulated patient(s)
–OSCE
–Objective structured clinical examination
Limited to English language, 2010
Appropriate Methods
Results
• Initial result: – 427 papers– Titles scanned – Irrelevant papers discarded.
• Left with 423 articles • Reviewed all abstracts
Result was 154 articles
Significant Results
Which Journals? N=91
Medical Education
Medicine Osteopathic Med
Nursing Pharmacy
Allied Health Dentistry
Psychology Pastoral Care
Medical Informatics Nutrition
Location of Author
• Australia• Belgium• Brazil• Canada• Chile• France• Germany• India
• Iran• Israel• Italy• Japan• Korea• Malaysia• Netherlands• Nepal
• Pakistan• South Africa• Sweden• Switzerland• Taiwan• UK• USA
Questions to Ponder
• Unique aspect of the use of standardized patients is presented in the article
• Consider ways that the use of findings from current literature can enhance your program
• Do the papers presented offer ideas for further research?
Effective Presentation
Organizing the Chaos
• What do we do?
• Where do we do it?
• When do we do it?
• With whom do we do it?
• Why do we do it?
• How do we do it?
• What can we learn from the experience?
Categories
• Teaching / Assessment
• Communication skills / Feedback
• Logistics
• Impact of the SP experience
• Really Cool Stuff
Teaching vs Assessment
• Primary skills– Interview – Physical examination (neuro, MSK)– Specialized exams (GTA)– Skills (ultrasound)
• Special Concepts– Populations (geriatrics, pt with disability)– Topics (palliative care)– Situations (transitions of care, student to resident)– Delivery: by SP vs other
Academic Medicine
• Brown R, Graham C, Richerson N et al
• Evaluation of Medical Student Performance on Objective Structured Clinical Exams with Standardized Patients with and without Disabilities
Use of Assessment with SPs
• Outcome measures– Comparison of curricula– Comparison of training sites
• Special topics – Demonstration of knowledge– Critical thinking skills– Patient context– Challenging patient situations (say “no”)– Self assessment
Medical Education
• Yudkowsky R, Otaki J, Lowenstien T et al.
• A hypothesis-driven physical examination learning and assessment procedure for medical students: initial validity evidence
Communication Skills
• Motivational interviewing• Behavior change• Palliative care• Elderly with altered mental status• Persons with mental health issues (suicide)• Organ procurement • Bad news delivery• Adherence to medication
Behavioral and Cognitive Psychotherapy
• Hartzler B, Beadnell B, Rosengren D et al
• Deconstructing Proficiency in Motivational Interviewing: Mechanics of Skilful Practitioner Delivery During Brief Simulated Encounters
Communication Skills
• Nonverbal communication
• Patient centered communication
• Professionalism
• Empathy
Patient Education and Counseling
• Thompson B, Teal C, Scott S et al
• Following the clues: Teaching Medical students to explore patient contexts
Annals of Internal Medicine
• Weiner S, Schwartz A, Weaver F et al
• Contextual Errors and Failures in Individualized Patient Care
JAMA
• Schwartz A, Weiner S, Harris I, Binns-Calvey A.
• An Educational Intervention for Contextualizing Patient Care and Medical students’ Abilities to Probe for Contextual Issues in Simulated Patients
Academic Medicine
• Blatt B, LeLacheur S, Galinsky A
• Does Perspective-Taking Increase Patient Satisfaction in Medical Encounters?
Feedback
• Not much in 2010 on – Who should give it– How to give it – When to give it – Why to give it
Logistics
• Description of OSCE experience
• Build an OSCE
• Prepare for an OSCE
• Prepare a hybrid simulation
Logistics
• Validity studies
• Checklist development
• Comparison of scoring methods
• Repeat use of cases
• Post encounter scoring
• The “who” in scoring
• Gender issues
Medical Teacher
• Pell G, Fuller R, Homer M. Roberts T.
• How to Measure the Quality of the OSCE: A review of metrics – AMEE guide no. 49
Just Read This
Medical Education
• Durning S, Artino A, Boulet J, et al
Making Use of Contrasting Participant Views of the Same Encounter
Medical Education
• Hettinga A, Denessen E, Postma C
Checking the Checklist: a content analysis of expert- and evidence-based case-specific checklist items.
Academic Medicine
• Swygert K, Muller E, Scott C, Swanson D
• The Relationship Between USMLE Step 2 CS Patient Note Ratings and Time Spent on the Note: So Examinees Who Spend More Time Write Better Notes?
Impact of SP experience
• Impact of experience on students
• Still not much on the SPs themselves– Can they?
• SP vs faculty
– Should they?• Role play vs SP• SP vs actual patients
– Guides for SPs
Academic Medicine
• Bokken L, Rethans JJ, Jobsis Q et al
Instructiveness of Real Patients and Simulated Patients in Undergraduate Medical Education: A Randomized Experiment
Simulation in Healthcare
• Nestel D, Clark S, Tabak D, et al
Defining Responsibilities of Simulated Patients in Medical Education
International Journal of Psychophysiology
• Hulsman R, Pranger S, Koot S et al
How stressful it doctor-patient communication? Physiological and psychological stress of medical students in simulated history taking and bad-news consultations
Really Cool Stuff
• Faculty Development– Skills as raters– Development of skills – Reentry to practice
American Journal of Gastroenterology
• Alevi D, Baiocco PJ, Chokhavatia S et al.
• Teaching the competencies: using observed structured clinical examinations for faculty development
Academic Medicine
• Kogan J, Hess B, Conforti L, Holmboe E
• What Drives Faculty Ratings of Residents’ Clinical Skills? The Impact of Faculty’s Own Clinical Skills
It’s a depth of field issue….
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Reflective Critique
BIBLIOGRAPHY
www.utmb.edu/oed
• Once you open the OED home page, go to “standardized patient “ section.
• Go to subheading “bibliography”