J Educ Eval Health Prof.  2019;16:3. 10.3352/jeehp.2019.16.3.

Comparison of the effects of simulated patient clinical skill training and student roleplay on objective structured clinical examination performance among medical students in Australia

• Taylor S
• Haywood M
• Shulruf B

• KMID: 2447238
• DOI: http://doi.org/10.3352/jeehp.2019.16.3

Abstract

PURPOSE
Optimal methods for communication skills training (CST) are an active research area, but the effects of CST on communication performance in objective structured clinical examinations (OSCEs) has not been closely studied. Student roleplay (RP) for CST is common, although volunteer simulated patient (SP) CST is cost-effective and provides authentic interactions. We assessed whether our volunteer SP CST program improved OSCE performance compared to our previous RP strategy.
METHODS
We performed a retrospective, quasi-experimental study of 2 second-year medical student cohorts' OSCE data in Australia. The 2014 cohort received RP-only CST (N=182) while the 2016 cohort received SP-only CST (N=148). The t-test and analysis of variance were used to compare the total scores in 3 assessment domains: generic communication, clinical communication, and physical examination/procedural skills.
RESULTS
The baseline characteristics of groups (scores on the Australian Tertiary Admission Rank, Undergraduate Medicine and Health Sciences Admission Test, and medicine program interviews) showed no significant differences between groups. For each domain, the SP-only CST group demonstrated superior OSCE outcomes, and the difference between cohorts was significant (P<0.01). The superiority of volunteer SP CST over student RP CST in terms of OSCE performance outcomes was found for generic communication, clinical communication, and physical examination/procedural skills.
CONCLUSION
The better performance of the SP cohort in physical examination/procedural skills might be explained by the requirement for patient compliance and cooperation, facilitated by good generic communication skills. We recommend a volunteer SP program as an effective and efficient way to improve CST among junior medical students.

Keyword

Medical students; Patient simulation; Clinical competence; Communication; Volunteers; Australia

MeSH Terms

Australia*
Clinical Competence*
Cohort Studies
Humans
Non-Randomized Controlled Trials as Topic
Patient Compliance
Patient Simulation
Retrospective Studies
Students, Medical*
Volunteers