Simulated Patients Research Articles

Knowledge and perception of physiotherapy students and lecturers about the involvement of simulated patients in clinical examinations at physiotherapy training institutions in South-West, Nigeria

Abstract Background Medical educators in Nigeria are beginning to incorporate the use of simulated patients (SPs) in clinical examinations. This study was designed to investigate and compare the knowledge and perception of physiotherapy students and lecturers about the involvement of SPs in clinical examinations at physiotherapy training institutions in South-West, Nigeria. Methods This study used a mixed-method approach, combining cross-sectional analysis and focus group discussions. A validated questionnaire assessed the knowledge and perception of physiotherapy students and lecturers regarding SP involvement in clinical exams. Quantitative data were analyzed with descriptive statistics, chi-square, and Mann–Whitney U tests (p < 0.05). Qualitative data were analyzed using thematic analysis. Results Two hundred and seven clinical students (83 males, 124 females, average age 22.02 ± 1.65 years) and 37 physiotherapy lecturers (25 males, 12 females, average age 48.27 ± 7.49 years) participated in this study. Among the students, 151 were aware of SP involvement in clinical exams: 35.1% had poor knowledge, 53.0% had fair knowledge, and 11.9% had good knowledge. The majority of lecturers (70.3%) demonstrated good knowledge. Most students (147, 71.0%) and lecturers (32, 86.5%) had positive perceptions of SP involvement in exams. Qualitative analysis indicated insufficient training for SPs in clinical examinations at physiotherapy training institutions in South-West Nigeria. Reported drawbacks included a preference for using models, familiarity with SPs, and limitations in the conditions that SPs can simulate. Conclusion Physiotherapy students at physiotherapy training institutions in South-West Nigeria had fair knowledge about the involvement of SPs in clinical examinations while lecturers had good knowledge about the involvement of SPs in clinical examinations. However, both students and lecturers had a positive perception about the involvement of SPs in clinical examinations though the concept of SPs should be differentiated from the use of models.

Simulated Malaria Online Tool: an instrument for evaluating healthcare providers' practices and contributing to the evidence base for certifying malaria elimination and preventing its re-establishment

BackgroundHealthcare providers (HCPs) practice and correct management of suspected malaria (CMSM) are central components of malaria elimination and prevention of re-establishment (POR) in countries in the elimination phase. However, knowledge of malaria surveillance systems and HCPs practices often wanes in countries aiming to eliminate malaria due to the low numbers of cases. The study aimed to implement a valid Simulated Malaria Online Tool (SMOT) for assessment HCP performance in CMSM and POR in a malaria-free area.MethodsHCPs were evaluated using SMOT tool based on four criteria including presenting a suspected malaria case for detection of HCPs’ failures in recognition (a), diagnosis (b), appropriate treatment (c), and urgent reporting (d); and compared with simulated patients (SP). Multiple logistic regression analysis was carried out to estimate adjusted odds ratios (ORs) for the risk of HCPs failures.ResultsThe overall failure proportion was 237 (83%), and the majority of failures were in recognition (a). There was no significant difference between the SMOT and SP based on all failure criteria (P > 0.05). The private clinic (93%) and the public specialized clinic (70%) had the highest and lowest failure proportions. After passing the recognition stage (a), the overall failure proportions decreased to 47.8% and 25.0% for total HCPs and infectious disease specialists, respectively. In the final analysis, private sector (AOR = 4.36: 1.25–15.2), not-specialist providers (AOR = 2.84: 1.29–6.25) and HCPs with ≥ 5 years’ experience (AOR = 2.03: 1.01–6.25) increased the risk of failure.ConclusionFindings confirmed the implementation of SMOT tool in settings where malaria transmission is low or interrupted. The tool is able to identify sub-groups of providers needing strengthening, and contributes to the prevention of malaria re-establishment.

Comparing three methods to assess learning outcomes for a suicide prevention training program for pharmacy staff

ObjectiveTo examine whether pharmacists and pharmacy staff who complete a suicide prevention gatekeeper training program (Pharm-SAVES) react similarly to a written patient case, a live simulated patient (SP), and a prerecorded SP case. MethodsAfter completing the 30-min Pharm-SAVES training, participants completed a written patient case via survey and then, 1 month later, completed a prerecorded SP and live SP interaction via Zoom. For each assessment type, we documented whether the participant asked about suicide and referred the patient to the Suicide and Crisis Lifeline (988). ResultsParticipants (n = 12) asked about suicide in 8 (67 %) written patient cases, 9 (75 %) prerecorded SP cases, and 8 (67 %) live SP cases. Participants referred patients to 988 in 8 (67 %) written patient cases, 5 (42 %) prerecorded SP cases, and 10 (83 %) live SP cases. ConclusionThe number of participants who asked about suicide was similar regardless of assessment type; however, referrals to the Suicide & Crisis Lifeline happened less often with the prerecorded SP cases. InnovationThis is the first study to compare key learning outcomes of pharmacy suicide prevention gatekeeper training across written, live, and prerecorded SP encounters.

Pharmacists’ mental health support behaviours with simulated patients: a mixed-methods pilot study

BackgroundSimulated mental health role-plays provide a safe and relevant learning experience for pharmacy students, improving confidence in and attitudes toward providing mental health support. Little research explores the use of mental health role-plays, enacted by trained actors, with pharmacists. ObjectivesThis study aimed to pilot the adaptation of simulated patient (SP) role-plays, from the university classroom with students, to a workshop with pharmacists, and explore pharmacists’ experiences. MethodsPharmacists attended a two-hour workshop. Trained actors enacted simulated scenarios (previously developed for pharmacy education) with pharmacist volunteers while being observed by peers, a workshop facilitator, and mental health consumer educator (MHCE). Pharmacists engaged in self-assessment immediately post-roleplay, followed by performance feedback and debrief discussions with MHCEs, workshop facilitators, and peers. Pharmacists completed pre- and post-workshop surveys exploring intended mental health support behaviours, then invited to participate in an interview exploring their workshop experiences and opinions about using mental health role-plays in clinical practice (via mystery shopping). Non-parametric tests were conducted to analyse role-play and survey scores, and thematic analyses were undertaken on interview transcripts. ResultsThirty-five pharmacists attended the workshop. Fourteen role-plays were analysed. Pharmacist self-assessment scores were significantly lower than MHCE scores (P = 0.028). Overall, the role-plays significantly increased pharmacists’ intentions in supporting a person experiencing mental health crises such as suicide and psychosis, as well as encouraging other supports (P < 0.05). Four themes emerged from interviews (n = 4): realistic context for skills application and practice, benefits of observing, self-assessment and feedback, and integrating into clinical practice (via mystery shopping). ConclusionSP role-plays of mental health symptoms and crises, enacted by trained actors, may effectively assess and enhance pharmacists’ intended mental health support behaviours. It is recommended that the SP method is adapted into clinical practice, via repeated mystery shopping visits with immediate performance feedback, to shape pharmacists’ mental health support behaviours.

Impact of simulated patient-based communication training vs. real patient-based communication training on empathetic behaviour in undergraduate students – a prospective evaluation study

BackgroundEmpathy is a key competency and is essential for doctor-patient relationships. Studies have proven a continuous reduction of empathy in medical students during their study period. The use of SPs is positively evaluated for competency acquisition and real patient communication training has positive effects on empathy empowerment. Therefore, the present study focusses on the impact of simulated patient (SP) vs real patient (RP) communication training on empathetic behaviour in undergraduate medical students.MethodsThe prospective evaluation took place during a 210-minute skills lab unit on medical communication for 3rd year medical students. Study participants were allocated in advance to one of three groups: one group trained with an SP (SP-group) and was informed about the fact that it was an SP; another group trained with an SP but assumed to encounter an RP (incognito patient group (IP-group)); the last group trained with an RP and was correctly informed about it (real patient group (RP-group). Self-assessed empathy was measured by using Jefferson Scale of Physician Empathy (JSPE) and Interpersonal Reactivity Index (IRI), as these are the most commonly used instruments for assessing empathy. Study participants were evaluated on empathetic behaviour by their group-associated patient using the Consultation and Relational Empathy (CARE) scale.Results146 students participated. There was no significant difference in self-assessed empathy between groups for JSPE and IRI. External assessment via CARE showed a statistically significant difference between SP-group and IP-group , as well as between SP-group and RP-group. There was no significant difference between IP-group and RP-group. This means that students training with real patients (or who believed them to be real) did receive significantly lower performance ratings on their empathy.ConclusionThe results demonstrate a significant lower external empathy rating for students who had trained with a real patient or if they were in the belief of having encountered a real patient; this may be due to inhibitions and a lack of routine. Therefore, we recommend implementing SPs in the early study period with the gradual integration of RPs in the student’s further course of study.

High-Fidelity Simulation in Wound Care Education: A Qualitative Evaluation of Efficacy and Acceptability

BackgroundHigh-fidelity simulation is an effective tool in nursing education, but a research gap exists in its application to wound care training. This study explored the acceptability of working with simulated patients (SPs) with moulaged wounds to improve students' wound care skills. MethodThis descriptive qualitative study used semi-structured interviews with 14 student nurses who competed a high-fidelity wound simulation. Data were analysed using a deductive thematic approach. FindingsFindings are presented with reference to the Australian Standards of Wound Prevention and Management guidelines. Four main themes (and six subthemes) were identified: realism (moulage and SPs), situational awareness (decision making and task focus), reflective practice (learning from others and self-reflection), and consolidation of practice. ConclusionThe standards-based simulation proved effective and acceptable to students.

Pharmaceutical care for patients with headaches: pharmacists' statements and pharmacy practice

Relevance. According to the World Health Organization, headaches are one of the most common symptoms of nervous system diseases. Pharmacists play an important role in communicating with headache patients, as well as in rationally directing self-treatment.Aim. Using the questionnaire and patient’s simulation method, comparing the results of these studies, to evaluate the quality of pharmaceutical care for patients with headaches.Material and methods. An anonymous survey was conducted among 153 pharmacists. Three different trained simulated patients (SP) allegedly suffering from headaches visited 101 pharmacies. The results were recorded visually and on a voice recorder. The commercial segment of the Russian pharmaceutical market for analgesics was analyzed.Results. The leaders in sales in ATC-subgroups were the following INN: Ibuprofen, Paracetamol+Naproxen+Caffeine+Drotaverine+ Pheniramine. Corresponding trade names are most often recommended based on the results of questionnaires and simulated patient methodology (SPM). Prescription drugs (13.1 %/14.9 % in SPM) that shouldn’t be recommended in the pharmacy and combination drugs (87.6 %/91.1 % in SPM) were frequently mentioned. A similar number of INN (20/23) and trade names (52/53) were named. The average number of trade names recommended by one pharmacist was higher in the SPM. In SPM the patient was asked very few questions and almost no information about the drug was specified.Conclusion. The real involvement of pharmacists in the provision of pharmaceutical care to patients with cephalgia appears to be much lower, in contrast to the stated results of the questionnaire. In real pharmacy practice, the approach to interaction with a patient with headache and counselling is formal and requires standardization: the development of protocols, standards and algorithms for interaction with patients with headache based on clinical guidelines.

Investigating the Use of Simulated Patient Ratings in Objective Structured Clinical Examinations to Enhance Undergraduate Medical Assessments in Riyadh, Saudi Arabia.

Objective structured clinical examinations (OSCE) are the gold standard of clinical assessment, and are used to conduct undergraduate family medicine clinical assessment at King Faisal Specialist Hospital and Research Centre (KFSHRC). Some studies have suggested that simulated patient (SP) ratings could provide a better measure of empathy and communication skills than physician scores. The objective of this study is to further explore the effectiveness of simulated patient (SP) ratings inundergraduate OSCE assessments. The research employed a mixed-method approach. Three OSCE assessments for final-year students were selected. Both physicians and SPsevaluated each student, providing global ratings across four domains. The quantitative aspect involved comparing physician and SP scores and assessing correlation. The qualitative aspect involved interviewing SPs to establish what student behaviours led to higher or lower scores. Moderate correlation was found between physician ratings and SP ratings (r=0.53, p<0.01). Internal consistency of the SP ratings was lower than physician scores. SPs considered themselves to be patient advocates and were keen to give formative feedback. The ability of the trainee to truly listen was a major concern. Scoring for SPs was relatively holistic in nature. The results demonstrate that SP scores have slightly weaker reliability but are still relevant and offer a completely different perspective, enriching the assessment data. Assessment should take patientor SP perspectives into account, and not rely solely on the expert physician. Changing the assessment methods will lead to necessary changes in student approach to the OSCE and improve authenticity and validity.

Counselling with a focus on product and price transparency for over-the-counter headache medicines: A simulated patient study in community pharmacies in Munich, Germany.

In Germany, over-the-counter (OTC) medicines may only be dispensed by community pharmacies (CPs). German CPs must ensure 'adequate' counselling, including the cost of medicines. Along with information gathering and advice giving as classic aspects of counselling, the aim was also to investigate counselling indicators of product and price transparency. The cross-sectional study was based on the covert simulated patient (SP) methodology and was conducted in a random sample of CPs stratified by districts in the major German city of Munich. Each of the 178 selected CPs was visited once by one of five trained female students. They simulated a symptom-based sub-scenario 1 with a request for an OTC medicine for a headache and a sub-scenario 2 with standardised information regarding product and price transparency. The assessment, completed immediately postvisit by the SPs, included a total of 23 items. All 178 scheduled visits were completed successfully. The median counselling score with the classic items was 3.0 out of 12 points (interquartile range [IQR] 4.25) and when expanded by items for product and price transparency the score was 4.0 out of 14 points (IQR 4.00). A selection of medicines was offered unsolicited in 38.2% of the visits and in 5.6% of the visits voluntary price information was provided before the transaction. A request for a cheaper medicine led to a significant price reduction (Wilcoxon signed-rank test; p<0.001, r=0.869). Due to the below-average level of counselling, the regional chambers of pharmacists are recommended to initiate measures for improvement. There is also potential for optimisation with regard to product and price transparency as an important extension of the classic counselling aspects. It is therefore recommended that the government raise customers' awareness of the cost of medicines.

Acquisition of key clinical communication skills through simulation-based education: findings from a program for postgraduate psychiatry trainees (ComPsych)

ObjectiveFew studies have investigated the maintenance of skills acquired in classroom-based clinician education. Using an advanced simulation-based clinical communication skill training program for postgraduate psychiatry education (ComPsych), we aimed to investigate skill acquisition through assessing changes in competence (abilities) and performance (practice).MethodsForty trainee psychiatrists (15 males; age range 26–48) participated. Video-recorded Standardized Patient Assessments (SPAs) were delivered twice pre- and post-training to assess learning. Skills were coded by independent psychologists using the Core Communication Skills (CCS) coding system. Simulated patients (SPs) rated trainees' communication performance using the Sim-Patient SPA checklist. Paired t-tests, linear mixed models and logistic mixed models assessed changes in communication skills over time.ResultsFor SPAs, reliability of coder ratings was deemed acceptable (ICC range 0.67 to 0.87). Mean post-training communication performance significantly increased for skills in agenda setting (p < 0.001), information organization (p < 0.001), empathic skills (p = 0.046), and overall skills performance (p = 0.001). Significant decreases for questioning skills were indicative of reduced reliance on these skills post-training. SPs rated all skillsets higher post-training. A modest relationship was detected between frequency (coded) and (SP-rated) quality of communication skills. Improvements in agenda setting and information organisation skills were retained ~ 6 weeks post-training.ConclusionsTraining improved patient-centered communication skills in psychiatry trainees, particularly skills in agenda setting and information organization, with skills retained ~ 6 weeks post-training. There was reduced reliance on questioning skills, which are well utilised generally. The study supports the benefits of this method of communication skills training into postgraduate psychiatry education.

Development of a validated assessment tool for medical students using simulated patients: an 8-year panel survey

BackgroundThe use of simulated patients (SPs) to assess medical students’ clinical performance is gaining prominence, underscored by patient safety perspective. However, few reports have investigated the validity of such assessment. Here, we examined the validity and reliability of an assessment tool that serves as a standardized tool for SPs to assess medical students’ medical interview.MethodsThis longitudinal survey was conducted at Keio University School of Medicine in Japan from 2014 to 2021. To establish content validity, the simulated patient assessment tool (SPAT) was developed by several medical education specialists from 2008 to 2013. A cohort of 36 SPs assessed the performance of 831 medical students in clinical practice medical interview sessions from April 2014 to December 2021. The assessment’s internal structure was analyzed using descriptive statistics (maximum, minimum, median, mean, and standard deviation) for the SPAT’s 13 item total scores. Structural validity was examined with exploratory factor analysis, and internal consistency with Cronbach’s alpha coefficients. The mean SPAT total scores across different SPs and scenarios were compared using one way analysis of variance (ANOVA). Convergent validity was determined by correlating SPAT with the post-clinical clerkship obstructive structured clinical examination (post-CC OSCE) total scores using Pearson’s correlation coefficient.ResultsOf the 831 assessment sheets, 36 with missing values were excluded, leaving 795 for analysis. Thirty-five SPs, excluding one SP who quit in 2014, completed 795 assessments, for a response rate of 95.6%. Exploratory factor analysis revealed two factors, communication and physician performance. The overall Cronbach’s alpha coefficient was 0.929. Significant differences in SPAT total scores were observed across SPs and scenarios via one-way ANOVA. A moderate correlation (r =.212, p <.05) was found between SPAT and post-CC OSCE total scores, indicating convergent validity.ConclusionsEvidence for the validity of SPAT was examined. These findings may be useful in the standardization of SP assessment of the scenario-based clinical performance of medical students.

Actual practices of community pharmacists in the management of diabetes: a comparison of simulated patient-based study with perceived role of involvement.

This study evaluated the level of community pharmacy professionals' (CPPs) actual practices and contrasted it with their self-reported perceived involvement in diabetes management. A self-reported cross-sectional and simulated patient (SP)-based study were employed at community drug retail outlets (CDROs) in Northwest Ethiopia. SP-case scenarios were used to examine the actual practices of CPPs in diabetes management and were compared with self-reported perceived involvement. The data were managed and analysed using SPSS version 26. About 184 participants in the self-reported and 100 CPPs' actual practices using three SP visits were included. The overall actual practice (17.8%) was found to be significantly different compared with the perceived level of involvement (73.5%) (p-value <0.05). About 94.3% of CPPs dispensed requested medications to the SP without a prescription. Despite most participants being perceived to be involved, more than 76% of CPPs did not counsel the SP for lifestyle modifications, avoiding risky behaviours, adherence to treatment, routine blood glucose checkups, diabetic foot care techniques, or consultation with physicians for further management. A significant discrepancy between actual practices and perceived CPPs' involvement in the management of diabetes was observed. The findings may suggest that exploring possible gaps may be crucial.

Managing infectious diarrhea among young children in community pharmacies in Saudi Arabia and the implications for AMR.

Diarrhea remains a major global health issue for children under five, contributing substantially to morbidity and mortality. Community pharmacists play a pivotal role in the management of these children; however, their competence in managing childhood diarrhea in Saudi Arabia is under-researched. This is important to ensure optimal patient care. Simulated patients (SPs) presenting with three pediatric diarrhea scenarios were used to evaluate pharmacists' practice in terms of their counselling, history taking, over-the-counter (OTC) prescribing, medication instructions, diet/fluid advice, and/or information provision. Pharmacists' practice was categorized into adequate, less adequate, and poor. 182 community pharmacists, primarily male and non-Saudi, participated in the study, of which 60% were in chain pharmacies. Only 5% showed adequate practice in currently managing pediatric diarrhea. Of the 182 simulated patient visits, 62% received medication in all three scenarios and 20% were referred to physicians, with 16% of pharmacists failing to provide any form of intervention. The main medications recommended were kaolin (34%), pectin (34%) and metronidazole (11%). While most pharmacists (86%) asked about the patient's identity and age, 15% provided incorrect management information, 16% failed to provide guidance on the prescribed medicines, and 18% dispensed antimicrobials without a valid prescription. A high level of inadequate management of pediatric diarrhea in Saudi Arabia was observed. This highlights the need for extensive training to improve community pharmacists' practice in service delivery including providing counselling and advice on the appropriate management of childhood diarrhea. The latter is particularly important to reduce antimicrobial resistance.

From acting to simulation: Contributions of theatre students to healthcare simulation

IntroductionThe use of student theaters as simulated patients (SP) can improve the learning process, but studies on the SP methodology in Costa Rica are limited. Thus, this study investigated the contribution of theatre students as SP, as perceived by faculty and nursing students. MethodsThis study used the action-research framework and the data collection included observational data and qualitative interviews. The data were analyzed through three phases: pre-analysis, exploration of the material, and treatment/interpretation. Results and discussionParticipants included 20 undergraduate nursing students and eight faculty members. The involvement of actors in the simulation increased the psychological fidelity and realism of the simulation, leading to deeper experiential training. Therefore, the inclusion of theater students as SP with acting training in nursing undergraduate or postgraduate courses can be an effective strategy to promote emancipatory learning and has potential for developing critical-reflective thinking skills when used in a constructivist pedagogical practice.

Experiences of Simulated Patients Involved in Difficult Conversations With Undergraduate and Postgraduate Health Professionals.

Simulated patients (SPs) are trained to simulate real patient scenarios for health professionals' education and training. The value of including SPs in simulated scenarios, particularly in relation to difficult and complex conversations, has been studied in various contexts, with a focus on learner experiences and outcomes. What has not been as extensively explored is the impact of difficult and complex conversations on the SPs. The aim of this study was to explore the perspectives, motivations, and experiences of SPs, particularly regarding difficult or complex conversations. A qualitative approach was taken to gather and interpret SP experiences. Open-ended interviews were the primary means of obtaining data. Thematic analysis guided the interpretation of interview data to generate key themes that encapsulated the SP experience. Twelve participants shared their experiences of working as SPs in scenarios that involved difficult or complex conversations. From these data, 4 major themes were determined: Care for Students, Pedagogical Focus, Emotional Regulation, and Organizational Environment. The importance of empathy and safe design and support for simulations was apparent. This study presents insights into the experiences and perspectives of SPs regarding difficult and complex conversations. Participants highlighted the necessity of uniformity in standards of practice in simulation and the need for advocacy for awareness of simulation-based practices.

Transitioning From Points-Based Grading to a Modified Pass/Fail Grading Approach in a Simulated Patient Program

ObjectiveTo determine the impact of transitioning from points-based grading to a modified pass/fail grading approach in a simulated patient (SP) program on first year pharmacy (P1) student performance in a PharmD curriculum. MethodsCourse-level data from the 2021–2022 and 2022–2023 academic years were collected to assess the impact of transitioning to a modified pass/fail grading approach on P1 student performance. During the 2021–2022 academic year, points-based grading was used. In 2022–2023, a modified pass/fail grading approach was implemented: communication assessment used pass/fail grading and clinical assessment used points-based grading; each assessment was worth 50% of the total SP activity grade. Chi-square tests were used to compare the percentage of students who passed each assessment (≥70%) with those who failed. ResultsAcross both academic years, students completed 9 formative (18 rubrics) and 6 summative (12 rubrics) SP activities. Each activity included separate communication and clinical assessment rubrics. There were no significant differences in performance on 27 of 30 rubrics. There were two formative SP activities where the percentage of students who passed the communication assessment using pass/fail grading (2022–2023 academic year) was different than points-based grading (2021–2022 academic year). In one fall semester activity, the cohort with the modified pass/fail grading approach had lower pass rates, but the opposite trend was observed in the winter semester. ConclusionOur program was able to successfully move to a pass/fail approach for communication assessments of SP activities while maintaining points-based grading for clinical assessments in our P1 curriculum with minimal impact on student performance.

Simulated Patients to Demonstrate Common Stroke Syndromes: Accurate and Convincing

Introduction: Stroke detection in the preclinical setting is challenging, resulting in more than 1/3 of missed strokes by emergency medical services (EMS) personnel. Recently, prehospital identification of anterior large vessel occlusion (LVO) stroke has come into focus. Cortical signs have a high predictive value for the presence of LVO stroke but are often missed. Simulated patients (SPs) could be an excellent tool to train EMS personnel in the evaluation of stroke syndromes with cortical symptoms, but it has not been studied whether they can simulate these important signs convincingly. The main objective of this study was, thus, to examine whether SPs can simulate stroke syndromes and symptoms so that stroke experts can identify them correctly and reliably, applying the NIH stroke scale (NIHSS). Methods: Lay actors were trained to simulate one of 8 stroke syndromes either typical of a lacunary stroke or of an anterior LVO stroke and then videotaped during an examination according to the NIHSS. Stroke experts were asked to rate each item of the NIHSS based on the videos, determine which stroke syndrome was being demonstrated, and rate the quality of simulation. The primary outcome was the correct identification of the target stroke syndrome by the expert raters. Secondary outcomes were the agreement of the rating of the NIHSS score with the target NIHSS score and the expert raters’ assessment of the quality of simulation. Results: Seven of eight syndromes were rated correctly by at least twelve of fifteen raters and the mean rated NIHSS score was within one point of the target score for six of eight syndromes. The mean rating for the quality of simulation was between 3.54 and 3.98 (as rated on a scale from 1 to 4) for each syndrome. Discussion/Conclusion: SPs are capable of simulating acute stroke symptoms and syndromes accurately and convincingly. Thus, they represent a great resource to improve educational interventions that improve stroke recognition.

Remote simulation with simulated patient: Initial clinical learning experience in medical students

To contribute to the development of disciplinary and generic competencies of medical students at Universidad Austral de Chile. through the incorporation of student- centered educational didactics such as remote simulation with a simulated patient (SP). Quantitative, cross-sectional and descriptive research. Non-probabilistic sample included 68 third-year medical students who played two roles: interviewer and evaluator/observer. An instrument adapted from a satisfaction survey was used, applying it at the end of the experience in an anonymous and voluntary digital format (Google Forms). This tool covered 4 areas: Organization, Methodology, Self-assessment, and Evaluation of teaching performance, with closed Likert-type questions of five ordinal categories, two dichotomous questions (yes/no), and 4 open questions. The quantitative analysis was carried out using the SPSS program, and the qualitative one (open questions) with a progressive reduction scheme through three levels. Confidentiality and the fictional contract were protected with signature. The educational experience was very well valued by the students. Similar tendencies were showed in the perception of simulation among the groups that performed the roles of interviewer and evaluator/observer. It is essential to incorporate this type of educational experience into the medical curriculum, since it constitutes a valuable contribution to the development of competencies, through experiential learning, connecting the student with reality, with their emotions, knowledge, and abilities. This approach promotes empathy and communication skills, promoting reflection and self-criticism.

A28Developing and delivering a telephone skills simulation training for non-registered NHS mental health call-handlers

Registered healthcare professionals undertake a wide range of mental health work, sometimes with little preparation and training [1]. Increasingly non-registered staff take on mental health call-handler roles, having conversations with vulnerable individuals over the phone; these staff often lack the training to effectively communicate with callers. The aim of this initiative was to design and deliver a telephone skills training program for non-registered NHS mental health call-handlers, with the hypothesis that such training would improve their communication skills and overall job performance. Studies have shown that receiving training in having supportive mental health conversations over the phone increases staff confidence and changes their attitudes [2] and has the potential to benefit staff retention. A mixed-methods approach was used in the design, incorporating both qualitative and quantitative data collection and based on the needs and feedback of the call-handlers themselves. Evidence shows that involving simulated patients (SPs) can be effective in telephone studies [3]; leading us to train experienced SPs in their roles as members of the community phoning the help line. All was face to face, although conducted over the phone with the SP hidden. Active participants, the SP and the observing participants all became involved in the debrief. The content covered active listening, empathy, signposting and options in handling the challenging situations. Developed over a month, the programme was delivered as part of an overall training for their roles. The evaluation of the session indicated significant self-rated confidence in having calls with members of the public. The scenarios increased in intensity, covering topics ranging from bullying, domestic violence, gambling addiction and intent to take life. Qualitative feedback from the call-handlers showed that they felt more confident and prepared in their roles, and were better equipped to handle challenging situations. The involvement of SPs was also found to be authentic and highly beneficial by the call-handlers. Participants requested frequent practice sessions, face to face or online. Investing in providing targeted training and support for non-registered NHS mental health call-handlers, can have a positive impact on their communication skills, overall job performance and likely staff retention. This can ultimately lead to improved quality of care and patient outcomes in the mental health sector. The involvement of SPs can provide a valuable learning experience, both in role and in the debrief, for call-handlers, and help to prepare them for real-life scenarios. Authors confirm that all relevant ethical standards for research conduct and dissemination have been met. The submitting author confirms that relevant ethical approval was granted, if applicable.

A26Empathic simulation: a novel simulation design to develop empathy in healthcare students

It is well established that simulation is a powerful tool for developing empathy in healthcare students [1]. Previous simulation designs surrounding the ‘patient experience’ have focused on putting the learner into the patient’s position and mimicking health conditions [2]. Empathic Simulation (ES) is a novel simulation design which focuses on healthcare students thinking of ways to improve the patient experience whilst a simulated patient (SP) wears an audio-visual headset recording device. This allows for an immersive video-assisted debrief session where students see how they are perceived through the eyes of the patient, promoting self-reflection and behavioural awareness to a higher degree compared to previous techniques [3]. In March 2023, ES was trialled by 36 3rd year medical students during a ‘Patient Experience Week’ whilst on placement at a District General Hospital. The simulation focused on an SP wanting to self-discharge due to an accumulation of poor experiences during their hospital stay. Students were encouraged to determine and resolve these issues using the resources available to them in a simulation suite. Throughout the simulation, the SP wore a Microsoft HoloLens to record the scenario from their viewpoint. Afterwards, the recording was used to stimulate discussion during an immersive debrief session. Students provided pre and post-simulation feedback using an online polling software. This included rating their confidence with various scenarios, e.g. discussing with patients who wish to self-discharge the reasoning behind their thoughts. Further feedback was also collected via a follow-up survey. 28/36 students provided feedback at the end of their ‘Patient Experience Week’. There was an average of 24% increase in confidence across all scenarios (average rating of 3.1 vs 4.3) and a 16% increase in confidence in the ability to empathize with patients experiencing long-term health conditions (see Average confidence ratings reflecting various scenarios were gathered from students before and after the ‘Patient Experience Week’ in March 2023. This figure demonstrates the average confidence ratings for scenarios related to Empathic Simulation before vs after the session. Empathic Simulation may be an effective simulation design to improve empathy and insight into the patient experience as well as situational and self-awareness in healthcare students. Research into the effectiveness of this novel simulation will be explored in the future. Authors confirm that all relevant ethical standards for research conduct and dissemination have been met. The submitting author confirms that relevant ethical approval was granted, if applicable.