‘THAT’S NOT HOW YOU SHOULD DO IT!’: THE ROLE OF SIMULATED PATIENTS IN FACILITATING MEANINGFUL DISCUSSIONS ABOUT CLINICAL COMMUNICATION
Annelies Lovink (TNW-TG), Karlijn Geelkerken (TNW-TG), Judith ter Vrugte (BMS-IST), Hannie Gijlers (BMS-IST), Marleen Groenier (TNW-TG)
ABSTRACT
Background
Communication skills are essential to high-quality care and simulated patients (SPs) are often engaged to train these skills. SPs are laypeople trained to portray a patient with a specific condition. SPs’ feedback can aid in students understanding the patient’s perspective. Small group discussions with SPs and students are often used in clinical communication skills education, however, the educational quality of the discourse is variable. Our research question was: how do SPs influence discourse quality in students’ discussions after practicing a consultation?
Methods
Twenty group discussions of first-year bachelor’s Technical Medicine students with SPs were recorded and divided into one-minute episodes. In each episode, the discussion quality was coded and SPs’ utterances were categorized. High-quality discussions were characterized by high levels of interaction between students and/or SPs and integrating or modifying perspectives. Low-quality discussions were characterized by externalizing ideas, asking for more information or agreeing without discussion.
Results
Of all episodes, 33% were high-quality discussions. SPs gave feedback from the patient perspective, general feedback (e.g., giving tips) or made other remarks (e.g., giving turns). Utterances related to general feedback were more often associated with high-quality discussions than utterances related to feedback from the patient perspective or the other category (X2=6.872, p = .032, effect size w = 0.180).
Conclusion and Discussion
General feedback from SPs was associated with higher-quality discussions but we do not yet know if SPs might reinforce misconceptions. First-year students might also actively seek performance feedback rather than trying to understand the patient’s perspective.