Impact Of Standardized Patients Research Articles

Impact of Standardized Patients on First Semester Nursing Students Self-Confidence, Satisfaction, and Communication in a Simulated Clinical Case.

BackgroundUtilizing standardized patients (SPs) as a strategy to potentially improve beginning level nursing students’ confidence, satisfaction, and communication after simulated clinical cases is an innovative approach in nursing education.AimThe aim of this study was to examine to what extent an SP affected first semester nursing students’ self-confidence, satisfaction, and communication using a simulated clinical case.MethodsFirst semester undergraduate students in a bachelors of nursing program at a large university in the South-Central region of the United States (N = 100), were randomly assigned to one of the two groups. Each group was assigned the same case using either an SP or high-fidelity manikin. Students completed postsurveys immediately following completion of the simulation. Student’s self-confidence, satisfaction, and communication were measured using the National League for Nursing Student Satisfaction and Self-Confidence in Learning for Nursing Education Research and an SP/Faculty Communication Checklist.ResultsAn independent sample t test comparing the two student groups on each of the outcome variables was conducted for each of the research questions. Students who completed the simulation with an SP, reported greater satisfaction, and improved communication. Student reflective comments were significantly more positive in the SP group. There was no statistical difference between the two groups in self-confidence.ConclusionFurther research is needed to determine whether the use of SPs versus high-fidelity manikins in simulated cases results in increased self-confidence in beginning level nursing students. Student satisfaction and communication are key components for nursing student success. The impact of SPs and the effect on student outcomes could have long-term benefits for undergraduate nursing programs.

Promoting Professional Behaviours in Physical Therapy Students Using Standardized Patient Feedback.

Purpose: Physical therapy (PT) students receive feedback on their professional behaviours from academic and clinical faculty. Another avenue for providing feedback to PT students is by using standardized patients (SPs). Very little research is available on the impact of SPs' specific feedback on whether, and how, PT students learn professional behaviour, and what research is available has focused on clinical competencies, communities of practice, and broad assessments of professional behaviours. The purpose of this study was to record PT students' perspectives on how combined verbal and written SP feedback affected their professional behaviours. Method: The sample of convenience consisted of seven students enrolled in a PT professional education programme in the northeastern United States before starting their first full-time clinical experience. The students agreed to participate in an SP experience focused on professional behaviours. This study used a phenomenological approach to understand the students' perspectives on receiving a combination of verbal and written SP feedback. Results: The students' perspectives on receiving SP feedback were categorized into four themes: seeing through the patient's eyes; SPs offer unique contributions to student learning; timely, verbal feedback adds a deeper understanding of professional behaviours in preparation for the clinic; and verbal feedback promotes student self-efficacy of professional behaviours. Conclusions: Using SPs' written and verbal feedback in the curriculum can be a valuable tool for enhancing the development of PT students' professional behaviour.

Utilizing Standardized Patient Feedback to Facilitate Professional Behavior in Physical Therapist Students: A Pilot Study

Purpose: Physical therapist (PT) students receive feedback on professional behavior performance from academic and clinical faculty members. Literature is lacking on the impact that verbal feedback from standardized patients (SPs) may have on physical therapist student learning of professional behaviors. The purpose of this pilot study was to examine the use of standardized patients’ feedback as a strategy for professional behavior development. Methods: A sample of convenience identified 13 doctoral physical therapist students prior to initiation of their first full-time clinical experience. Subjects were excluded if they had prior experiences with standardized patients or had completed a full-time clinical experience. Using a randomized control design, the experimental group (n=7) received standardized patient verbal feedback and written rubric assessment, whereas the comparison group (n=6) received written rubric assessment alone after completing standardized patient case scenarios. Outcome measures included the Modified Standardized Patient Satisfaction Questionnaire (MSPSQ), Professional Behaviors Assessment (PBA), and Professionalism Physical Therapy Core Values Assessment (PPTCVA). Results: Data analysis included pre and post intervention comparisons of Modified Standardized Patient Satisfaction Questionnaire rubric assessment scores, Professional Behaviors Assessment scores, and Professionalism Physical Therapy Core Values Assessment scores. No statistically significant differences were found on these outcome measures, although trends for changes in performance were noted. Conclusions: Limited research exists on the impact of standardized patients’ verbal feedback with the use of a standardized rubric on physical therapist student professional behavior. This pilot study did not provide significant evidence on the value of this educational strategy in development of professional behaviors in doctoral physical therapist students. Future research may be beneficial to examine differences in perceptions of professional behavior between standardized patients, students, and faculty.

Impact of standardized patients on the training of medical students to manage emergencies.

Background:Teaching emergency management should educate medical students not only for facts and treatment algorithms but also for time effective physical examination, technical skills, and team interaction. We tested the hypothesis, that using standardized emergency patients would be more effective in transmitting knowledge and skills compared with a more traditional teaching approach.Methods:Medical students (n = 242) in their fourth (second clinical) year were randomized to receive either training on standardized patients simulating 3 emergency settings (“acute chest pain,” “stroke,” and “acute dyspnea/asthma”) or traditional small group seminars. Before and after the respective training pathways, the students’ knowledge base (multiple-choice examination) and practical performance (objective structured clinical examination using 3 different emergency scenarios) were assessed.Results:Teaching using standardized patients resulted in a significant albeit small improvement in objective structured clinical examination scores (61.2 ± 3 for the standardized patient trained group vs 60.3 ± 3.5 for the traditional seminar group; P = 0.017, maximum achievable score: 66), but no difference in the written examination scores (27.4 ± 2.4 vs 27.0 ± 4.4; P = 0.341; maximum achievable score: 30).Conclusion:Teaching management of emergencies using standardized patients can improve medical students’ performance in clinical tests, and a change from traditional seminars in favor of practice sessions with standardized patients does not compromise the learning of medical facts.

Accuracy of portrayal by standardized patients: results from four OSCE stations conducted for high stakes examinations.

BackgroundThe reliability in Objective Structured Clinical Exams (OSCEs) is based on variance introduced due to examiners, stations, items, standardized patients (SP), and the interaction of one or more of these items with the candidates. The impact of SPs on the reliability has not been well studied. Accordingly, the main purpose of the present study was to assess the accuracy of portrayal by standardized patients.MethodsFour stations from a ten station high-stakes OSCE were selected for video recording. Due to the large number of candidates to be evaluated, the OSCE was administered using four assessment tracks. Four SPs were trained for each case (n = 16). Two physician assessors were trained to assess the accuracy of SP portrayal using a station-specific instrument based on the station guidelines. For the items with disagreement a third physician was asked to review and the mode was used for analysis. Each instrument included case-specific items on verbal and physical portrayal using a 3-point rating scale (“yes”, “yes, but” and “not done”). The physician assessors also scored each SP on their overall performance based on a 5-item anchored global rating scale (“very poor”, “poor”, “ok”, “good”, and “very good”). SPs at location 1 were trained by one trainer and SPs at location 2 had another trainer. All SPs were employed in a high-stakes OSCE for at least the second time.ResultsThe reliability of rating scores ranged from Cronbach’s alpha of .40 to .74. Verbal portrayal by SPs did not significantly differ for most items; however, the facial expressions of the SPs differed significantly (p < .05). An emergency management station that depended heavily on SPs physical presentation and facial expressions differed between all four SPs trained for that station.ConclusionsVariation of trained SP portrayal of the same station across different tracks and at different times in OSCE may contribute substantial error to OSCE assessments. The training of SPs should be strengthened and constantly monitored during the exam to ensure that the examinees’ scores are a true reflection of their competency and devoid of exam errors.

The Impact of Standardized Patients’ Feedback on the Students’ Motivational Levels

In this study, we focused on the impact of standardized patients’ feedback on the motivational levels of learners for learning communication skills. A control group post-test design was used. The students had two standardized patient encounters in addition to training and debriefing sessions. The students in the study group received face-to-face feedback after the first encounters; but not the control group. We used the motivation dimension of Motivated Strategies for Learning Questionnaire. The standardized patients’ feedback effected students’ motivational levels. The students who received feedback had lower levels of test anxiety, and higher levels of self-efficacy.