Planning for Next Year: Part 1

Report
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
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Australia
Belgium
Brazil
Canada
Chile
France
Germany
India
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Iran
Israel
Italy
Japan
Korea
Malaysia
Netherlands
Nepal
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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
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Teaching / Assessment
Communication skills / Feedback
Logistics
Impact of the SP experience
Really Cool Stuff
Teaching vs Assessment
• Primary skills
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Interview
Physical examination (neuro, MSK)
Specialized exams (GTA)
Skills (ultrasound)
• Special Concepts
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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
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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
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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, BinnsCalvey 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
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Description of OSCE experience
Build an OSCE
Prepare for an OSCE
Prepare a hybrid simulation
Logistics
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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 casespecific 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
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It’s a depth of field issue….
Reflective Critique
BIBLIOGRAPHY
www.utmb.edu/oed
• Once you open the OED home page, go to
“standardized patient “ section.
• Go to subheading “bibliography”

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