Assessment of communication and physical exam skills: A comparison of students, faculty and standardized patients.

PURPOSE/OBJECTIVES: The objective of this retrospective study was twofold: it aimed to investigate dental students' communication and physical exam self-assessment skills by comparing students' self-evaluations with those completed by faculty and standardized patients (SPs). Second, it aimed to compare faculty and SPs assessment of students' communication skills. METHODS: At the end of their first year of training, students (n = 127), participated in one SP encounter about an initial dental consultation. Students completed self-assessment before receiving feedback from faculty (n = 19) and SPs (n = 19). The data source included evaluation forms submitted by students, faculty and SPs. The Wilcoxon signed rank test was used to compare the overall scores between groups. Agreement between evaluations items were analyzed with McNemar's test (p < 0.05). RESULTS: Overall, there were no statistically significant differences in how students and faculty graded for either communication (p = 0.6724) or physical exam (p = 0.1921) skills. However, both students and faculty provided less favorable marks than SPs for communication skills with a statistically significant difference in the overall grading between both students and SPs (p = 0.0146) and between faculty and SPs (p = 0.0045). CONCLUSIONS: While there was disagreement between students and faculty versus SPs, they weren't meaningful differences in scores and the dissimilarities mainly consisted of ratings of explanation skills. We suggest that, when applicable, dental student's self-evaluations may represent an alternative to faculty assessments of communication and physical exam skills. Nonetheless, we recommend that SPs be included in the assessment of communication skills to provide students with comprehensive feedback that more realistically represents the natural patient-provider relationship.

Analysis of pharmacy student communication self-evaluation skills during standardized patient encounters.

INTRODUCTION: The objective of this study was to evaluate pharmacy students' communication self-evaluation skills by comparing student self-evaluations with those completed by course graders and standardized patients (SP). METHODS: As part of a required communications course, third-year pharmacy students completed a medication counseling encounter with a SP during a midpoint encounter and final assessment. Students' communication skills were evaluated by course graders and SPs. Students used the same assessment rubric to also complete self-evaluations immediately after each event and after reviewing a recording of their midpoint encounter. Agreement among student, SP, and course grader ratings on individual items were examined using the kappa statistic. RESULTS: A total of 206 students completed the midpoint encounter, and 208 completed the final assessment. Agreement between students' and SPs' evaluations was high during both the midpoint and final encounters, with >90% agreement on 14 out of 17 items at the midpoint encounter and 16 out of 17 during the final assessment. There were diffiences in scoring for the use of verbal distractors/fillers, with SPs' evaluations showing more favorable scores when differences existed [at midpoint 69 (33.7%) SP vs. 7 (3.4%) student; at final 31 (15%) SP vs. 3 (1.5%) student]. Agreement improved from the midpoint to final assessment (62.9% vs. 83.7%, respectively). CONCLUSIONS: Self-evaluation of communication skills may be an acceptable alternative to faculty or SP evaluations, when appropriate for the purpose of the activity, based on the high agreement observed among communication skills evaluations completed by students, course graders, and SPs.

Focus group describing simulation-based learning for cardiovascular topics in US colleges and schools of pharmacy.

INTRODUCTION: This qualitative focus group study sought to describe how colleges of pharmacy use simulation-based learning (SBL) to teach cardiovascular topics and to identify challenges and benefits. MATERIAL AND METHODS: Participants were recruited from a screening survey disseminated via e-mail to select American College of Clinical Pharmacy Practice and Research networks. Subjects were selected based on diversity in institution and simulation types. Two 1-hour focus group sessions were conducted by the primary investigator following a script designed by the research team. Each recorded session was independently reviewed by all investigators and coded into final themes. Results are reported in a qualitative fashion. RESULTS: Five individuals provided consent and participated. Themes identified include topics, formats, interprofessional education, challenges, strategies for success, and benefits. Frequent topics included advanced cardiac life support, heart failure, hypertension, and transitions of care. Multiple formats were used including standardized patients or providers, task trainers, and high-fidelity mannequins. Multiple institutions reported simulating interprofessional teams by involving students from other health professions. Scheduling, pharmacy program size, faculty availability, and logistics around planning and/or conducting an event were identified challenges. Institutions reported success when clear expectations were provided to students and skill development progressed from low-stakes to high-stakes events. Benefits reported included real world applicability with participants noting that students do not realize the importance of SBL until they have reached rotations. CONCLUSIONS: Various topics and simulation methods were employed to teach cardiovascular topics. While challenges exist, institutions have identified strategies for success and report students recognized the benefits to their learning.

Effectiveness of a Medication Reconciliation Simulation in an Introductory Pharmacy Practice Experience Course.

Objective. To evaluate the effectiveness of a simulated learning exercise on pharmacy students' ability and perception of their ability to perform medication reconciliation. Methods. Third-year pharmacy students were divided into three groups. Group A attended a 30-minute lecture; group B attended the lecture and participated in a 90-minute workshop; and group C received no training. After groups A and B completed their assigned learning activities, all students participated in a simulated medication reconciliation activity with a standardized patient (SP). Students also completed a pre- and post-intervention survey. Results. One hundred eighty-three students participated. Students in group B scored the highest (74.5%) on the SP activity compared to those in group A (68.9%) and group C (66.1%). Students in group B reported high levels of agreement with all statements describing the lecture, workshop, and SP activity, including that more of these activities should be integrated into the curriculum. Conclusion. A simulated learning exercise significantly improved students' ability to perform medication reconciliation, including obtaining an accurate medication list, correctly identifying medication discrepancies, and proposing appropriate resolutions. Simulated learning exercises should continue to be incorporated in pharmacy education, especially exercises for learning pharmacy practice skills such as medication reconciliation.

Web-based versus face-to-face interprofessional team encounters with standardized patients.

BACKGROUND: Challenges exist in developing interprofessional education (IPE) activities including coordinating schedules and obtaining appropriate space for teams to work. Virtual worlds have been explored as a means to overcome some of these challenges. We sought to develop a web-based interprofessional team interaction with a standardized patient (SP), as compared to a face-to-face SP interaction, focusing on the competency area of interprofessional communication. INTERPROFESSIONAL EDUCATION ACTIVITY: Interprofessional teams of students were randomized to complete a web-based or face-to-face SP encounter. The web-based encounter was conducted via video conference that students accessed using their own electronic device. Interprofessional communication was evaluated by faculty observers and the SPs. Participants of the web-based encounter also completed a perceptions questionnaire. DISCUSSION: Interprofessional communication was rated as average/above average by the authors and SPs. Perceptions of the web-based encounter were mixed with not all students willing to complete such an encounter again despite finding it enjoyable and a positive learning experience. The need for adequate preparation was identified, including the opportunity to review the patient case before the encounter. IMPLICATIONS: The web-based SP encounter afforded students the opportunity to utilize communication technology to provide patient-centered care while collaborating as an interprofessional team. Video conferencing presents an opportunity to bypass some logistical challenges in scheduling IPE experiences and can be implemented as a co-curricular activity, avoiding course revisions. Additional studies are needed to further explore student and patient perspectives and clarify when, and with what level of trainees, the experiences are most valuable.

Transformation of an Online Multidisciplinary Course into a Live Interprofessional Experience.

Objective. To design, implement, and assess an interprofessional education (IPE) course in the first professional year of students enrolled in eight different health professions programs. Design. An interprofessional faculty committee created a 1-credit hour required IPE course to not only teach students about the roles and responsibilities of each discipline and how they may contribute to an interprofessional team, but to also improve collaboration and team-based communication skills among health care professions students. Students were placed in interprofessional groups and met weekly to participate in didactic lectures, discussion sessions, and a standardized patient encounter. Assessment. Seven hundred and eighty-three health professions students were enrolled in the course, of which 130 students completed questionnaires at all three time points. Students were neutral about the course and found it moderately valuable (Mean 6.23 [on a scale from 1 to 10], interesting (Mean 5.61), and enjoyable (Mean 5.57). Written feedback from the course indicated that the majority of students enjoyed the standardized patient encounter and thought the course provided a valuable opportunity to interact with other students in other health professions programs. Conclusion. This required course served as an introductory interprofessional approach in preparing health professions students to learn from each other about their various roles and responsibilities and how each can contribute to the health care team.