The Use of Simulated Patients Is more Effective than Student Role Playing in Fostering Patient-Centred Attitudes during Communication Skills Training: A Mixed Method Study.

Objective: While simulated patients (SPs) are considered a standard tool in communication skills training, there is no evidence thus far of their comparative benefit to the more cost-effective option of student role playing. We compared the effectiveness of both approaches in developing patient-centred attitudes in students. Methods: We retrospectively compared students who participated in the clinical communication course (CCC), based on student role playing (CCCsp-, n = 160), to students who participated in the CCC with SPs (CCCsp+, n = 146), and students with no formal CCC (CCC-, n = 122). We used validated questionnaires to assess patient centredness. We also conducted focus group interviews (FGI) to better understand the impact of CCC with sp. Results: Students after the CCC with simulated patients achieved a significantly higher score in the patient-practitioner orientation scale than other groups (p < 0.001). Conclusions: There is a strong positive correlation between the implementation of simulated patients and patient-centred attitudes among students. Data from the FGI revealed that students perceived training with SP as more realistic, safe, and engaging than student role playing. Practice Implications. Our research provides evidence to justify costs and resources invested in simulated patient programs.

Perceptions of clinical teachers acting as examiners regarding the value of Objective Structured Clinical Examinations.

OBJECTIVES: OSCE (Objective Structured Clinical Examination) is a common method of assessing clinical skills used at many universities. An important and at the same time difficult aspect of good examination preparation is obtaining a properly trained and well-motivated group of assessors. To effectively recruit and maintain cooperation with assessors, it is worth to know their opinion. The aim of this study was to investigate the opinions of teacher-examiners about OSCE and to identify the factors that could shape this opinion and influence on motivation. METHODS: A cross-sectional study was conducted using a questionnaire on teachers who participated as OSCE examiners. This questionnaire consisted of 21 questions about their perceptions. Answers were rated in a five-point Likert-type scale. Chi-square or Fisher's exact test was used to analyze the data. RESULTS: A total of 49 (out of 52) teachers participated in this study. Nearly 90% of examiners believed that it is fair, more than 90% that it is transparent. Despite the fact that 67% of examiners believe the examination is difficult to organize and 71% believe it is stressful for students, according to 72% of respondents the OSCE has a positive effect on learning. More than 91% of examiners believed that the OSCE is an appropriate test to assess students' skills. Opinions about examination were independent of specialty, seniority, gender or taking the OSCE as students. CONCLUSION: Teacher-examiners viewed the OSCE as a fair and transparent examination, adequate for assessment of skills and, despite it being difficult to organize, worth doing as it is appropriate to assess practical skills and positively influences students' motivation to learn tested skills.

Clinical communication course and other factors affecting patient-centered attitudes among medical students.

OBJECTIVES: Patient-centered care (PCC) is associated with better relationships, resulting in a decrease in symptoms, hospitalizations and health costs. However, studies analyzing factors influencing patient-centered attitudes show ambiguous results. The purpose was to assess the impact of the Clinical Communication Course (CCC) in Jagiellonian University, Cracow and other factors on Patient-Centered Attitudes (PCA) and Attitude toward Clinical Skills Learning (CSLA). METHODS: We retrospectively compared Polish-speakers (CCC+, n = 160), English-speakers (CCCen+, n = 55) after the CCC and upperclassmen Polish-speakers without it (CCC-, n = 122). Validated questionnaires to measure PCA (Leeds Attitude Toward Concordance II and Patient-Practitioner Orientation Scale (PPOS)) and for CSLA (Communication Skills Attitude Scale with negative subscale (CSAS-N)) were used. The higher the scores, the more PCA, and negative CSLA respectively. Students completed questionnaires and answered questions regarding age, sex, motivation to study (coded as humanitarian - MotHUM, financial - MotFIN, combination - MotMIX) and considered specialization - coded as with more human contact (family medicine, psychiatry, pediatrics - SpecHUM) and others (SpecNHUM). Statistics were prepared in R. RESULTS: CCC+ scored higher in PPOS (2.91 vs. 2.74; p = 0.003) than CCC- and higher in CSAS-N than CCCen+ (31.22 vs. 28.32; p = 0.004). In CCC+ SpecHUM scored lower than SpecNHUM in PPOS (2.65 vs. 2.94, p = 0.012). MotFIN scored higher then MotMIX in PPOS (3.01 vs. 2.7, p = 0.036). Correlations were statistically significant. CONCLUSION: CCC improved PCA in CCC+. They showed more negative CSLA than CCCen+. Among CCC+, surprisingly, SpecNHUM presented more PCA than SpecHUM as well as MotFIN compared to MotMIX.

The efficacy of an education-based secondary outpatient prevention programme after acute coronary syndrome hospitalisations and treatment in Poland. The Patient Club initiative.

BACKGROUND: Guidelines on cardiovascular prevention from the European Society of Cardiology advocate sustained educational measures to be undertaken by both doctors and nurses to ensure lifestyle changes for patients after acute coronary syndromes (ACS). A planned programme of a series of educational meetings for patients after ACS was initiated in form of the Patient Club. AIM: To assess the efficacy of the Patient Club initiative in terms of increased knowledge on cardiovascular risk factors as well as utilisation of healthy lifestyle in patents who attend the programme. METHODS: Patients in nine cardiology centres in Poland, who were treated for ACS between October and December 2014, were included. A dedicated questionnaire on healthy lifestyle and knowledge on cardiovascular risk factors was filled in by patients at hospital discharge. In January 2015 the same questionnaire was filled in by the same group of patients before their local Patient Club meeting. RESULTS: There were 1273 patients hospitalised for ACS who were invited to join the Patient Club initiative. Of them, 372 (29%) filled in the questionnaire both at discharge and at the Patient Club meeting. The percentage of patients who smoked cigarettes decreased from 14% to 5% (p < 0.001), and the number of those who had at least 30 min of physical activity daily increased from 50% to 58% (p = 0.015). CONCLUSIONS: Patients who attended Patient Club meetings usually four weeks after ACS showed significant benefit in terms of healthy lifestyle changes and more guideline-recommended management of cardiovascular risk factors.