SP Key Issues
From Clinicaltools.com
This process was started at the 2009 IME Conference in a Modified Delphi Discussion on March 14th 2009 2:15 to 3:15pm
Contents |
Round 1: Identify options for modes of delivery
Question: how can we develop “realistic” portrayals of patients?
Synchronous: like a phone
- telephone
- chat, used every day, blackberry support. More universal
- video - skype vs gmail vs hotmail messenger - volume and sound sometimes not as good, university may have some restrictions due to bandwidth
Asynchronous: like email
Perhaps a future way of communication.
- email - must be secure to highlight eventual need to be secure so we can protect patient confidentiality
- discussion boards - would allow more efficient use of SP resources.
- texting - used by a physician working with patient with glucose control. May be more efficient for both and with a shorter delay. Again need to pay attention to confidentiality issues
Non SP interaction
- documentation as a part of the SP experience. Thus the learner would learn how to summarize the interaction. Need more effort defining this.
Round 2: Feedback
Types of feedback
Students would get in terms of their performance in the SP experience
- final summary of both content and process
When
- along the way.
- Medical or SP could stop
What if they do something extremely wrong
Example: like say swear at a patient
- SP should disclose
- having a record is handy.
- Define professionalism requirements and respond.
- You might miss this with chat since it is harder to get feedback.
- Need a follow-up process to resolve issue.
- Avoid being punitive and ensure this is a learning experience.
- Need to have SP trained in how to answer/respond to certain questions.
Professional Interaction
Look for response to the SP thanking the medical student to show proper dialog.
Round 3: Integration with Other Learning
How to integrate remote SPs into other educational approaches (such as TBL) To Be done!
Round 4: Take advantage of Strengths
How to utilize the value of being able to engage a diverse population of SPs, and the value and potential of anonymity.
Clear benefits
- Support for more languages and cultures
- learn to use simpler language.
Topics to cover
What skills could be practiced with a remote SP experience To Be done!
Round 5: Address Weaknesses
How to address weaknesses (e.g. scalability)
SP Training: Keep validity and reliability
- Review sessions on a regular basis.
- System should have way to review.
- Could the learner rate the SP
- Follow standard SP models - proper training.
Compensation
- Pay like regular SPs
- Actors? - used for their acting coursework
- Altruism.
- Potential support system for SP
SP Limitations
Different language, culture, literacy, vocabulary [could also be a benefit in that the student would need to adapt to a broader range of patients]
Skills Limitations
Cannot do physical examination skills
Round 6: Interface
What should it look like?
How should the user interact with it?
How should the SP interact?
Provide didactic case information
Do you provide before, during or after the SP experience?
How much to provide
What types of SP medical status information should be provided as text and what should the students have to work for?
- as little as possible
- they have to work for it.
- Depends on mission of the education
- Different cases for different levels of experience.
How should students choose tests during the SP experience?
- Need to do a differential before they can order tests.
- Cover access to tests.
- Potentially do test but provide delay
Original Abstract
Title: Building Consensus on Implementing Remote Standardized Patient Encounters
Authors and degrees: T. Bradley Tanner, MD; Mary P. Metcalf, PhD, MPH; Susan Wilhelm, PhD. (Please underline the presenting author)
Institution: Clinical Tools, Inc.
Idea
For medical students in the pre-clinical years, Standardized Patients (SPs) can help the learner integrate medical science knowledge into a clinical framework. A remote SP experience, where the encounter occurs via the Internet in comparison to traditional “face-to-face” encounters, could offer many advantages.
Why the Idea was Necessary: A pool of remote SPs could be potentially less expensive, and more available. Also, the remoteness may offer an opportunity for more variety in patients and the anonymity may offer other benefits. Although there is an abundance of experience with the utilization of SPs in a live context, the concept of utilizing remote SPs is novel. There are few standards to guide educators interested in utilizing SPs remotely.
What Needs to be Done
We seek to determine the parameters that would define a successful remote SP encounter. We seek to reach consensus regarding the implementation of a remote SP experience from leaders in medical education innovation.
Evaluation Plan
A modified Delphi approach will be used to gather feedback. After explaining the theory behind the “remote” SP encounter, we will then use iterative rounds of discussion to create the framework on which to build our “remote” SP experience.
As an example, we will reach consensus on learner-patient interaction technology as follows: Round 1 will present options for modes of delivery (chat, video, discussion boards, or other technology) and elicit further suggestions. Based on responses, we will ask participants to rate the importance of the mode of delivery in Round 2. Discussions will continue until a general consensus is reached on the optimal mode of delivery of the proposed remote SP experience.
Additional consensus will be sought in terms of how to integrate remote SPs into other educational approaches (such as TBL), the value of being able to engage a diverse population of SPs, and the value and potential of anonymity.
Future Development
Once the framework of the remote SP program is developed, we will create, integrate, and evaluate the use of remote SP to impart knowledge and clinical skills training in medical school education via our NIAAA funded project.
