J Educ Eval Health Prof.  2019;16:3. 10.3352/jeehp.2019.16.3.

Comparison of the effects of simulated patient clinical skill training and student roleplay on objective structured clinical examination performance among medical students in Australia

• Taylor S
• Haywood M
• Shulruf B

• KMID: 2447238
• DOI: http://doi.org/10.3352/jeehp.2019.16.3

Abstract

PURPOSE
Optimal methods for communication skills training (CST) are an active research area, but the effects of CST on communication performance in objective structured clinical examinations (OSCEs) has not been closely studied. Student roleplay (RP) for CST is common, although volunteer simulated patient (SP) CST is cost-effective and provides authentic interactions. We assessed whether our volunteer SP CST program improved OSCE performance compared to our previous RP strategy.
METHODS
We performed a retrospective, quasi-experimental study of 2 second-year medical student cohorts' OSCE data in Australia. The 2014 cohort received RP-only CST (N=182) while the 2016 cohort received SP-only CST (N=148). The t-test and analysis of variance were used to compare the total scores in 3 assessment domains: generic communication, clinical communication, and physical examination/procedural skills.
RESULTS
The baseline characteristics of groups (scores on the Australian Tertiary Admission Rank, Undergraduate Medicine and Health Sciences Admission Test, and medicine program interviews) showed no significant differences between groups. For each domain, the SP-only CST group demonstrated superior OSCE outcomes, and the difference between cohorts was significant (P<0.01). The superiority of volunteer SP CST over student RP CST in terms of OSCE performance outcomes was found for generic communication, clinical communication, and physical examination/procedural skills.
CONCLUSION
The better performance of the SP cohort in physical examination/procedural skills might be explained by the requirement for patient compliance and cooperation, facilitated by good generic communication skills. We recommend a volunteer SP program as an effective and efficient way to improve CST among junior medical students.

Keyword

Medical students; Patient simulation; Clinical competence; Communication; Volunteers; Australia

MeSH Terms

Australia*
Clinical Competence*
Cohort Studies
Humans
Non-Randomized Controlled Trials as Topic
Patient Compliance
Patient Simulation
Retrospective Studies
Students, Medical*
Volunteers

Reference

References

1. Gilligan C, James EL, Snow P, Outram S, Ward BM, Powell M, Lonsdale C, Cushing AM, Silverman J, Regan T, Harvey P, Lynagh MC. Interventions for improving medical students' interpersonal communication in medical consultations. Cochrane Database Syst Rev. 2016; (11):CD012418. https://doi.org/10.1002/14651858.CD012418.

2. Hargie O, Boohan M, McCoy M, Murphy P. Current trends in Communication Skills Training in UK schools of medicine. Med Teach. 2010; 32:385–391. https://doi.org/10.3109/01421590903394603.

3. Koponen J, Pyorala E, Isotalus P. Comparing three experiential learning methods and their effect on medical students’ attitudes to learning communication skills. Med Teach. 2012; 34:e198–e207. https://doi.org/10.3109/0142159X.2012.642828.

4. Bosse HM, Schultz JH, Nickel M, Lutz T, Moltner A, Junger J, Huwendiek S, Nikendei C. The effect of using standardized patients or peer role play on ratings of undergraduate communication training: a randomized controlled trial. Patient Educ Couns. 2012; 87:300–306. https://doi.org/10.1016/j.pec.2011.10.007.

5. Bosse HM, Nickel M, Huwendiek S, Junger J, Schultz JH, Nikendei C. Peer role-play and standardised patients in communication training: a comparative study on the student perspective on acceptability, realism, and perceived effect. BMC Med Educ. 2010; 10:27. https://doi.org/10.1186/1472-6920-10-27.

6. Lane C, Hood K, Rollnick S. Teaching motivational interviewing: using role play is as effective as using simulated patients. Med Educ. 2008; 42:637–644. https://doi.org/10.1111/j.1365-2923.2007.02990.x.

7. Bosse HM, Nickel M, Huwendiek S, Schultz JH, Nikendei C. Cost-effectiveness of peer role play and standardized patients in undergraduate communication training. BMC Med Educ. 2015; 15:183. https://doi.org/10.1186/s12909-015-0468-1.

8. Taylor S, Shulruf B. Australian medical students have fewer opportunities to do physical examination of peers of the opposite gender. J Educ Eval Health Prof. 2016; 13:42. https://10.3352/jeehp.2016.13.42.

9. Cleland JA, Abe K, Rethans JJ. The use of simulated patients in medical education: AMEE Guide No 42. Med Teach. 2009; 31:477–486. https://doi.org/10.1080/01421590903002821.

10. Weller JM, Nestel D, Marshall SD, Brooks PM, Conn JJ. Simulation in clinical teaching and learning. Med J Aust. 2012; 196:594. https://doi.org/10.5694/mja10.11474.

11. Taylor S, Bobba S, Roome S, Ahmadzai M, Tran D, Vickers D, Bhatti M, De Silva D, Dunstan L, Falconer R, Kaur H, Kitson J, Patel J, Shulruf B. Simulated patient and role play methodologies for communication skills training in an undergraduate medical program: randomized, crossover trial. Educ Health (Abingdon). 2018; 31:10–16. https://doi.org/10.4103/1357-6283.239040.

12. Chong L, Taylor S, Haywood M, Adelstein BA, Shulruf B. The sights and insights of examiners in objective structured clinical examinations. J Educ Eval Health Prof. 2017; 14:34. https://doi.org/10.3352/jeehp.2017.14.34.

13. Murphy S, Imam B, MacIntyre DL. Standardized patients versus volunteer patients for physical therapy students’ interviewing practice: a pilot study. Physiother Can. 2015; 67:378–384. https://doi.org/10.3138/ptc.2014-50E.

14. Schaufelberger M, Frey P, Woermann U, Schnabel K, Barth J. Benefits of communication skills training after real patient exposure. Clin Teach. 2012; 9:85–88. https://doi.org/10.1111/j.1743-498X.2011.00511.x.