Teaching patient selection in aesthetic surgery: use of the standardized patient.
ABSTRACT This study evaluates the effectiveness of standardized patients for teaching patient selection in esthetic surgery. Six actors received detailed character descriptions. Each was interviewed by a resident for 30 minutes in a conference setting. Participants completed a questionnaire, and a discussion was held. Written simulations were administered before and after the sessions, from which a faculty standard was developed using hierarchical cluster analysis. Resident responses were compared with the standard using a squared euclidean metric. Residents' pre- and posttest scores were compared with the faculty standard using 2-way analysis of variance. Accuracy scores were found to be significantly lower (more accurate) after the training than before (P < 0.001). Upon a 6-item questionnaire, both faculty and residents agreed that it was a worthwhile exercise (faculty mean, 6.2 out of 7; resident, 6.3) and that the standardized patients were believable. Standardized patients can provide effective instruction in traditionally difficult-to-teach areas such as communication and patient selection.
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ABSTRACT: As of 2006, the Accreditation Council for Graduate Medical Education had defined six "core competencies" of residency education: interpersonal communication skills, medical knowledge, patient care, professionalism, practice-based learning and improvement, and systems-based practice. Objective structured clinical examinations using standardized patients are becoming effective educational tools, and the authors developed a novel use of the examinations in plastic surgery residency education that assesses all six competencies. Six plastic surgery residents, two each from postgraduate years 4, 5, and 6, participated in the plastic surgery-specific objective structured clinical examination that focused on melanoma. The examination included a 30-minute videotaped encounter with a standardized patient actor and a postencounter written exercise. The residents were scored on their performance in all six core competencies by the standardized patients and faculty experts on a three-point scale (1 = novice, 2 = moderately skilled, and 3 = proficient). Resident performance was averaged for each postgraduate year, stratified according to core competency, and scored from a total of 100 percent. Residents overall scored well in interpersonal communications skills (84 percent), patient care (83 percent), professionalism (86 percent), and practice-based learning (84 percent). Scores in medical knowledge showed a positive correlation with level of training (86 percent). All residents scored comparatively lower in systems-based practice (65 percent). The residents reported unanimously that the objective structured clinical examination was realistic and educational. The objective structured clinical examination provided comprehensive and meaningful feedback and identified areas of strengths and weakness for the residents and for the teaching program. The examination is an effective assessment tool for the core competencies and a valuable adjunct to residency training.Plastic and Reconstructive Surgery 07/2011; 128(1):291-8. · 3.33 Impact Factor
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ABSTRACT: Communication and interpersonal skills (CIS) are one of the 6 general competencies required by the Accreditation Council for Graduate Medical Education (ACGME). The clinician-patient communication (CPC) workshop, developed by the Institute for Healthcare Communication, provides an interactive opportunity to practice and develop CIS. The objectives of this study were to (1) determine the impact of a CPC workshop on orthopedic surgery residents' CIS (2) determine the impact of physician alone or incorporation of nursing participation in the workshop, and (3) incorporate standardized patients (SPs) in resident training and assessment of CIS. Stratified by training year, 18 residents of an Orthopaedic Surgery Residency Program were randomized to a CPC workshop with only residents (group A, n = 9) or a CPC workshop with nurse participants (group B, n = 9). Data included residents' (1) CIS scores as evaluated by SPs and (2) self-reports from a 25-question survey on perception of CIS. Data were collected at baseline and 3 weeks following the workshop. Following the workshop, the combined group (group A and B) felt more strongly that the ACGME should require a communication training and evaluation curriculum (post mean = 52.7, post-pre difference = 15.94, p = 0.026). Group A residents felt more strongly that communication is a learned behavior (post mean = 82.7, post-pre difference = 17.67, p = 0.028), and the addition of SPs was a valuable experience (post mean = 59.3, post-pre difference = 16.44, p = 0.038). Group B residents reported less willingness to improve on their communication skills (post-mean = 79.7, post-pre difference = -7.44, p = 0.049) and less improvement in professional satisfaction in effective communication than group A (post mean group A = 81.9, group B = 83.6, post-pre difference group A = 7.11, group B = 1.89, p = 0.047). Few differences between groups regarding CIS scores were detected. While there was no demonstrable difference regarding CIS, our study indicates that participants valued the importance of communication training and found SPs to be a valuable addition. The addition of interprofessional participation appeared to detract from the experience. Further study is warranted to elucidate the variables associated with interprofessional education within the context of CIS training and assessment using SPs in residency.Journal of Surgical Education 01/2013; 70(1):95-103. · 1.07 Impact Factor
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ABSTRACT: The overall objective of this study is to assess the usefulness of a standardized patient (SP) educational activity in the evaluation of surgery residents' communication skills. This is a pre/post observational study on surgery residents' communication skills, attitudes, and self-perceptions after an educational activity with standardized patients. Scott & White Healthcare is a Central Texas-based non-profit integrated healthcare system with more than nine hospitals, 60 clinics, and a health plan. Scott & White Memorial Hospital in Temple is a Level-1 Trauma Center and the clinical site for the Texas A&M Health Science Center-College of Medicine in Temple, Texas. In all, 14 residents of the Texas A&M Health Science Center-College of Medicine/Scott & White General Surgery Residency Program participated in the SP education activity. After the activity, residents agreed more with the statements: "Communication skills are a learned behavior" and "Effective communication with patients is more difficult in high-stress situations." A significant increase in positive attitude toward physician-patient communication was measured in PGY3 and PGY-4 residents after the activity. However, there was no significant difference in residents' self-perceptions of communication skills after the activity. The residents believed the activity was somewhat useful, and feedback from the SPs was informative and helpful. Overall, in a formative setting, the SP methodology was a useful methodology to assess surgery residents' patient communication. The use of this methodology might require specific curriculum integration that is appropriate to the year of postgraduate training. This study demonstrates how SPs can be integrated into a Surgery Residency curriculum for teaching and assessing communication.Journal of Surgical Education 05/2011; 68(3):172-7. · 1.07 Impact Factor