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Sanchez G, Hashmi SS, Bednar E, Horvath S, Kumar B, Sagaser K, Singletary CN, Ramdaney A. Status of abortion curriculum in genetic counseling: Survey of graduate programs and recent graduates in the United States. J Genet Couns 2024. [PMID: 38410885 DOI: 10.1002/jgc4.1875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 12/28/2023] [Accepted: 01/23/2024] [Indexed: 02/28/2024]
Abstract
Genetic counselors (GCs) are trained to help individuals navigate the medical and psychological implications of genetic test results, familial conditions, and ultrasound anomalies. Therefore, familiarity with reproductive options, including abortion, is vital. However, previous studies have found gaps in GCs' knowledge regarding abortion care and there are currently no recommendations regarding abortion curriculum. This study aimed to assess the state of abortion curriculum in genetic counseling graduate programs in the United States and to examine and compare the satisfaction levels of program representatives and recent graduates. Program representatives and recent graduates were invited to complete an anonymous survey evaluating the abortion curriculum, satisfaction with said curriculum, and perceived preparedness to counsel on abortion. Quantitative data from 46 program representatives and 123 recent graduates were analyzed using descriptive statistics and appropriate statistical analyses, including the Mann-Whitney U-test and the Kruskal-Wallis test. Large variability existed in the amount and types of abortion training. Results showed greater satisfaction and feelings of preparation to counsel on abortion in graduates whose program provided a dedicated abortion curriculum (p < 0.001, p = 0.005). In addition, graduates with abortion counseling experience felt less prepared to counsel on abortion than their programs believed them to be (p = 0.04). Graduates perceived procedural timing, facilitation of genetic testing, and resources/support desired by patients before, during, or after an abortion, to be the most important topics, although these were not included in all programs' curriculum. Program representatives and recent graduates alike noted that variability in clinical training is a barrier to abortion education. Our results demonstrate a need for curricular reform to reduce variability in training and ensure that all graduates receive the same foundational abortion education. Further research is needed to determine the scope of GCs in abortion care, as well as which topics and education formats are most helpful in graduate education.
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Affiliation(s)
- Gina Sanchez
- The University of Texas MD Anderson Cancer Center UTHealth Houston Graduate School of Biomedical Sciences, Houston, Texas, USA
- Department of Obstetrics, Gynecology, and Reproductive Sciences at the University of Texas McGovern Medical School, Houston, Texas, USA
| | - S Shahrukh Hashmi
- The University of Texas MD Anderson Cancer Center UTHealth Houston Graduate School of Biomedical Sciences, Houston, Texas, USA
- Department of Pediatrics, McGovern Medical School at UTHealth Houston, Houston, Texas, USA
| | - Erica Bednar
- The University of Texas MD Anderson Cancer Center UTHealth Houston Graduate School of Biomedical Sciences, Houston, Texas, USA
- Gynecologic Oncology Center, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Sarah Horvath
- Department of Obstetrics and Gynecology Division of Women's Health at Penn State, Hershey, Pennsylvania, USA
| | - Bhavik Kumar
- Planned Parenthood Gulf Coast, Houston, Texas, USA
| | | | - Claire N Singletary
- The University of Texas MD Anderson Cancer Center UTHealth Houston Graduate School of Biomedical Sciences, Houston, Texas, USA
- Department of Obstetrics, Gynecology, and Reproductive Sciences at the University of Texas McGovern Medical School, Houston, Texas, USA
- Department of Pediatrics, McGovern Medical School at UTHealth Houston, Houston, Texas, USA
| | - Aarti Ramdaney
- The University of Texas MD Anderson Cancer Center UTHealth Houston Graduate School of Biomedical Sciences, Houston, Texas, USA
- Department of Obstetrics, Gynecology, and Reproductive Sciences at the University of Texas McGovern Medical School, Houston, Texas, USA
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Hamad NB, Folorunsho EF. Simulated Participants' Experiences and Challenges With Online and Face-to-Face Interactions During COVID-19: A Case Study in UAEU. Simul Healthc 2023:01266021-990000000-00089. [PMID: 37823744 DOI: 10.1097/sih.0000000000000752] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/13/2023]
Abstract
INTRODUCTION Direct patient contact is essential when training health professionals for future patient-centered interactions. Simulated participants (SPs) play a critical role during training; however, limited information is available about their personal perspectives. This study explored SPs at the College of Medicine and Health Sciences experiences, adaptations, and preferences regarding online and face-to-face encounters. METHODS After ethical approval, a qualitative research study using structured in-depth interviews was conducted online with 16 SPs, applying critical incident narratives and storytelling. Interview data were transcribed and encoded using thematic framework analysis, after which member checking was conducted to increase credibility. RESULTS All SPs acknowledged the benefits of online delivery models during the pandemic, including the convenience of working from home, continued clinical skills training, and personal protection from COVID infection. Participants preferred face-to-face delivery over online encounters, except for one SP, who saw no difference. Challenges included technical issues, communication problems, and lack of realism. CONCLUSIONS Although these results cannot be generalized, all participants acknowledged the relevance of online portrayals during the pandemic. Most preferred face-to-face delivery models for improving role-playing and enhancing personal communication to achieve better patient outcomes, while one SP had no preference. The use of concurrent online and face-to-face methods may more effectively engage SPs in simulation-based education. Before restructuring programs, further research is needed, including a deeper exploration of students' and educators' perspectives.
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Affiliation(s)
- Nabtta Bashir Hamad
- From the Medical Education Department, CMHS-UAEU (N.B.H., E.F.F), United Arab Emirates
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Alsahafi A, Ling DLX, Newell M, Kropmans T. A systematic review of effective quality feedback measurement tools used in clinical skills assessment. MEDEDPUBLISH 2023; 12:11. [PMID: 37435429 PMCID: PMC10331851 DOI: 10.12688/mep.18940.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/14/2023] [Indexed: 07/13/2023] Open
Abstract
BACKGROUND Objective Structured Clinical Examination (OSCE) is a valid tool to assess the clinical skills of medical students. Feedback after OSCE is essential for student improvement and safe clinical practice. Many examiners do not provide helpful or insightful feedback in the text space provided after OSCE stations, which may adversely affect learning outcomes. The aim of this systematic review was to identify the best determinants for quality written feedback in the field of medicine. Methods: PubMed, Medline, Embase, CINHAL, Scopus, and Web of Science were searched for relevant literature up to February 2021. We included studies that described the quality of good/effective feedback in clinical skills assessment in the field of medicine. Four independent reviewers extracted determinants used to assess the quality of written feedback. The percentage agreement and kappa coefficients were calculated for each determinant. The ROBINS-I (Risk Of Bias In Non-randomized Studies of Interventions) tool was used to assess the risk of bias. RESULTS 14 studies were included in this systematic review. 10 determinants were identified for assessing feedback. The determinants with the highest agreement among reviewers were specific, described gap, balanced, constructive and behavioural; with kappa values of 0.79, 0.45, 0.33, 0.33 and 0.26 respectively. All other determinants had low agreement (kappa values below 0.22) indicating that even though they have been used in the literature, they might not be applicable for good quality feedback. The risk of bias was low or moderate overall. CONCLUSIONS This work suggests that good quality written feedback should be specific, balanced, and constructive in nature, and should describe the gap in student learning as well as observed behavioural actions in the exams. Integrating these determinants in OSCE assessment will help guide and support educators for providing effective feedback for the learner.
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Affiliation(s)
- Akram Alsahafi
- College of Medicine, Nursing and Health Sciences – School of Medicine, National University of Ireland, Galway, Galway, Galway. Co, H91 V4AY, Ireland
- Department of Medical Education, College of Medicine, Taif University, Saudi Arabia, P.O Box 11099, Taif 21944, Saudi Arabia
| | - Davina Li Xin Ling
- College of Medicine, Nursing and Health Sciences – School of Medicine, National University of Ireland, Galway, Galway, Galway. Co, H91 V4AY, Ireland
| | - Micheál Newell
- College of Medicine, Nursing and Health Sciences – School of Medicine, National University of Ireland, Galway, Galway, Galway. Co, H91 V4AY, Ireland
| | - Thomas Kropmans
- College of Medicine, Nursing and Health Sciences – School of Medicine, National University of Ireland, Galway, Galway, Galway. Co, H91 V4AY, Ireland
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Donn J, Scott JA, Binnie V, Mather C, Beacher N, Bell A. Virtual objective structured clinical examination during the COVID-19 pandemic: An essential addition to dental assessment. EUROPEAN JOURNAL OF DENTAL EDUCATION : OFFICIAL JOURNAL OF THE ASSOCIATION FOR DENTAL EDUCATION IN EUROPE 2023; 27:46-55. [PMID: 35051306 DOI: 10.1111/eje.12775] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 10/07/2021] [Accepted: 12/14/2021] [Indexed: 06/14/2023]
Abstract
INTRODUCTION COVID-19 has profoundly affected dental undergraduate teaching and assessment. The pandemic resulted in cessation of face-to face teaching and assessment in many countries, with an associated move online. Objective structured Clinical Examination (OSCE), an important modality for clinical assessment in dentistry and medicine, is not possible with pandemic restrictions in place. As a result, interest in virtual objective structured clinical examination (VOSCE) has been revived. Student and staff evaluation of any assessment process is important, where the views of all involved are required in establishment of authenticity. This papers aims to explore and describe the views of undergraduate dental students and staff in relation to VOSCE MATERIALS AND METHOD: Qualitative methods utilising online focus groups and video recording were used in this study. Five focus groups, involving 24 participants were undertaken. RESULTS Thematic analysis following a deductive semantic approach was carried out resulting in the identification of six themes relating to the VOSCE: VOSCE preconceptions, examination preparation, examination process, fairness, comparison with OSCE and possible improvements. Consideration of these themes, and their interaction, is likely to prove important for optimisation of this assessment modality. CONCLUSIONS Overall, both staff and students considered the VOSCE a useful and fair examination and a suitable alternative to OSCE. The potential for a number of improvements in the assessment process was identified.
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Affiliation(s)
- James Donn
- Department of Restorative Dentistry, Glasgow Dental Hospital and School, The University of Glasgow, Glasgow, UK
| | - James Alun Scott
- Department of Restorative Dentistry, Glasgow Dental Hospital and School, The University of Glasgow, Glasgow, UK
| | - Vivian Binnie
- Department of Public Health, Glasgow Dental Hospital and School, The University of Glasgow, Glasgow, UK
| | - Craig Mather
- Department of Oral Surgery, Glasgow Dental Hospital and School, The University of Glasgow, Glasgow, UK
| | - Nicholas Beacher
- Biological and Medical Sciences, Glasgow Dental Hospital and School, The University of Glasgow, Glasgow, UK
| | - Aileen Bell
- Department of Oral Surgery, Glasgow Dental Hospital and School, The University of Glasgow, Glasgow, UK
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Brown CA, Badger K, Reid MD, Westacott R, Gurnell M, Reed MWR, Chamberlain G, Hatfield E, Sharif A, Sam AH. The influence of candidates' physical attributes on patient ratings in simulated assessments of clinical practice. MEDICAL TEACHER 2022; 44:1277-1282. [PMID: 35820076 PMCID: PMC9612930 DOI: 10.1080/0142159x.2022.2093177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
BACKGROUND We have previously shown that clinical examiners' scoring is not negatively impacted when a candidate has a tattoo, unnatural hair colour, or a regional accent. We investigated whether these physical attributes in exam candidates impact patient scoring. METHODS Simulated/real patients were randomly assigned to watch five videos of simulated candidate performances of a cranial nerve examination: clear fail, borderline, good, 'clear pass' without an attribute, and 'clear pass' with one of the attributes (tattoo, purple hair, accent). Participants scored domains of communication and professionalism. We compared scores for the clear pass candidates with and without attributes. RESULTS One hundred and eighty three patients participated. The total scores for the candidates with tattoos and purple hair were higher than the candidate with no physical attribute (p < 0.001). For the candidate with a Liverpool English accent no difference was identified (p = 0.120). CONCLUSIONS The presence of certain physical attributes (tattoos or purple hair) was associated with higher scores given by patients to candidates in a simulated physical examination station.
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Affiliation(s)
- C. A. Brown
- Division of Health Sciences, Warwick Medical School, Coventry, UK
| | - K. Badger
- Imperial College School of Medicine, Imperial College London, London, UK
| | - M. D. Reid
- Imperial College School of Medicine, Imperial College London, London, UK
| | - R. Westacott
- Birmingham Medical School, University of Birmingham, Birmingham, UK
| | - M. Gurnell
- Wellcome–MRC Institute of Metabolic Science, University of Cambridge and NIHR Cambridge Biomedical Research Centre, Cambridge University Hospitals, Cambridge, UK
| | - M. W. R. Reed
- Brighton and Sussex Medical School, University of Sussex, Brighton, UK
| | - G. Chamberlain
- Imperial College School of Medicine, Imperial College London, London, UK
| | - E. Hatfield
- Imperial College School of Medicine, Imperial College London, London, UK
| | - A. Sharif
- Imperial College School of Medicine, Imperial College London, London, UK
| | - A. H. Sam
- Imperial College School of Medicine, Imperial College London, London, UK
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Alsahafi A, Ling DLX, Newell M, Kropmans T. A systematic review of effective quality feedback measurement tools used in clinical skills assessment. MEDEDPUBLISH 2022. [DOI: 10.12688/mep.18940.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background: Objective Structured Clinical Examination (OSCE) is a valid tool to assess the clinical skills of medical students. Feedback after OSCE is essential for student improvement and safe clinical practice. Many examiners do not provide helpful or insightful feedback in the text space provided after OSCE stations, which may adversely affect learning outcomes. The aim of this systematic review was to identify the best determinants for quality written feedback in the field of medicine. Methods: PubMed, Medline, Embase, CINHAL, Scopus, and Web of Science were searched for relevant literature up to February 2021. We included studies that described the quality of good/effective feedback in clinical skills assessment in the field of medicine. Four independent reviewers extracted determinants used to assess the quality of written feedback. The percentage agreement and kappa coefficients were calculated for each determinant. The ROBINS-I (Risk Of Bias In Non-randomized Studies of Interventions) tool was used to assess the risk of bias. Results: 14 studies were included in this systematic review. 10 determinants were identified for assessing feedback. The determinants with the highest agreement among reviewers were specific, described gap, balanced, constructive and behavioural; with kappa values of 0.79, 0.45, 0.33, 0.33 and 0.26 respectively. All other determinants had low agreement (kappa values below 0.22) indicating that even though they have been used in the literature, they might not be applicable for good quality feedback. The risk of bias was low or moderate overall. Conclusions: This work suggests that good quality written feedback should be specific, balanced, and constructive in nature, and should describe the gap in student learning as well as observed behavioural actions in the exams. Integrating these determinants in OSCE assessment will help guide and support educators for providing effective feedback for the learner.
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Gilani S, Pankhania K, Aruketty M, Naeem F, Alkhayyat A, Akhtar U, Chaudhary M, Sinha S. Twelve tips to organise a mock OSCE. MEDICAL TEACHER 2022; 44:26-31. [PMID: 33656952 DOI: 10.1080/0142159x.2021.1887465] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
The objective structured clinical examination (OSCE) is central to assessing clinical competence in undergraduate and postgraduate exams for medical and allied healthcare professions. A mock OSCE on the other hand is a simulation of the OSCE and a unique learning experience for the examinee. They benefit in a variety of ways; from enhancing their time management skills to receiving feedback that can improve their clinical skills. Unfortunately, opportunities to participate in simulated OSCEs remain limited. Reasons include difficulty in fulfilling organisational requirements and equipment-related costs. Mock OSCEs can be set up by undergraduate students or junior trainees for peers, without senior supervision or direct guidance. This article will discuss 12 tips regarding the arrangement of mock OSCEs to guide organisers, including accessing resources and establishing the content of the exam.
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Affiliation(s)
- Syed Gilani
- Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
- Lancashire Teaching Hospitals NHS Trust, Lancashire, UK
| | - Kishan Pankhania
- Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Maneesha Aruketty
- Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Farah Naeem
- Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Abdulaziz Alkhayyat
- Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Usmaan Akhtar
- Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
- Royal Bolton Hospital, Bolton, UK
| | - Muhammad Chaudhary
- Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
- Macclesfield District General Hospital, Manchester, UK
| | - Siddharth Sinha
- Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
- King's College Hospital, London, UK
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Moult A, McKinley RK, Yeates P. Understanding patient involvement in judging students' communication skills in OSCEs. MEDICAL TEACHER 2021; 43:1070-1078. [PMID: 34496725 DOI: 10.1080/0142159x.2021.1915467] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
INTRODUCTION Communication skills are assessed by medically-enculturated examiners using consensus frameworks which were developed with limited patient involvement. Assessments consequently risk rewarding performance which incompletely serves patients' authentic communication needs. Whilst regulators require patient involvement in assessment, little is known about how this can be achieved. We aimed to explore patients' perceptions of students' communication skills, examiner feedback and potential roles for patients in assessment. METHODS Using constructivist grounded theory we performed cognitive stimulated, semi-structured interviews with patients who watched videos of student performances in communication-focused OSCE stations and read corresponding examiner feedback. Data were analysed using grounded theory methods. RESULTS A disconnect occurred between participants' and examiners' views of students' communication skills. Whilst patients frequently commented on students' use of medical terminology, examiners omitted to mention this in feedback. Patients' judgements of students' performances varied widely, reflecting different preferences and beliefs. Participants viewed variability as an opportunity for students to learn from diverse lived experiences. Participants perceived a variety of roles to enhance assessment authenticity. DISCUSSION Integrating patients into communications skills assessments could help to highlight deficiencies in students' communication which medically-enculturated examiners may miss. Overcoming the challenges inherent to this is likely to enhance graduates' preparedness for practice.
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Affiliation(s)
- Alice Moult
- School of Medicine, Keele University, Keele, UK
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Reger GM, Norr AM, Gramlich MA, Buchman JM. Virtual Standardized Patients for Mental Health Education. Curr Psychiatry Rep 2021; 23:57. [PMID: 34268633 DOI: 10.1007/s11920-021-01273-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/10/2021] [Indexed: 11/28/2022]
Abstract
PURPOSE OF REVIEW The training of psychiatrists and other mental health professionals requires education on a range of interpersonal, communication, and psychotherapy techniques. Classroom and workshop training must be augmented by experiential learning with feedback for skill implementation with fidelity. Virtual standardized patients (VSPs) are computerized conversational agents that can support experiential learning through standardized, consequence-free training environments at reduced costs. RECENT FINDINGS Research on mental health VSPs is rife with feasibility and acceptability pilot studies across various training populations and settings. Users have generally reported positive reactions to training with VSPs, though frustrations with some VSP speech recognition or VSP response relevance has been reported. Several studies have demonstrated a promising transfer of clinical skills from VSP training to human standardized patients and randomized trials supporting improved skill relative to reading or academic study are encouraging. As technology improves and natural language processing and accurate computer response generation for broad ranging conversational topics emerges, the field would benefit from research on the characteristics of effective VSPs for a range of purposes and trainee populations. Well-designed randomized evaluations of VSPs relative to best practices in education are needed, particularly regarding the impact of VSPs on clinical practice among actual patients.
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Affiliation(s)
- Greg M Reger
- VA Puget Sound Health Care System, 9600 Veterans Drive, A-116, Tacoma, WA, 98493, USA. .,University of Washington School of Medicine, Seattle, WA, USA.
| | - Aaron M Norr
- University of Washington School of Medicine, Seattle, WA, USA.,VISN 20 Mental Illness Research, Education and Clinical Center, Seattle, WA, USA
| | - Michael A Gramlich
- VA Puget Sound Health Care System, 9600 Veterans Drive, A-116, Tacoma, WA, 98493, USA
| | - Jennifer M Buchman
- VA Puget Sound Health Care System, 9600 Veterans Drive, A-116, Tacoma, WA, 98493, USA
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10
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Amsalem D, Martin A, Mosheva M, Soul O, Korotkin L, Ziv A, Gothelf D, Gross R. Delivering Difficult News: Simulation-Enhanced Training Improves Psychiatry Residents' Clinical Communication Skills. Front Psychiatry 2021; 12:649090. [PMID: 33746804 PMCID: PMC7973022 DOI: 10.3389/fpsyt.2021.649090] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2021] [Accepted: 02/10/2021] [Indexed: 12/03/2022] Open
Abstract
Background: Delivering difficult news to individuals diagnosed with mental health disorders and their family members can be challenging. The use of simulated patients (SP) is an effective teaching method to enhance clinical skills, particularly those around communication. We developed, implemented, and evaluated the effectiveness of an SP-based training module to improve psychiatric residents' clinical communication skills in delivering difficult news. Methods: We conducted 5-h workshops consisting of 3 components: (1) a high-fidelity simulation session with a professional actor; (2) a 30-min lecture; and (3) role-playing of 3 short scenarios, during which residents rotated taking on different roles (as psychiatrist, patient, or family member). We observed through a 1-way mirror and videotaped each resident's simulation session and followed it with personalized debriefing. Following the workshop, each resident received the full-length video of their simulated interview, together with a list of questions as a take-home assignment. Two months after the workshop, the residents were invited to a second SP-based session, during which 2 independent evaluators, each a board-certified psychiatrist with expertise in medical simulation, evaluated the participants' communication skills using a previously validated instrument. To avoid observation bias, the 2 evaluators rated the videotapes blind to the timing of the simulation (pre- vs. post-training). Participants completed self-report questionnaires on satisfaction and self-confidence, before, after, and 2 months following the workshop. Findings: Of the 28 psychiatric residents who participated in the training day, 24 (86%) completed the post-workshop evaluation. Mean communication score increased from 24.9 to 27.8 (paired t-test: 5.6, p < 0.001). The mean score for the self-confidence questionnaire, calculated on a 1 to 5 Likert scale, increased from 3.4 to 4.0 after the training day, and remained unchanged (4.2) 2 months later (p < 0.001). Conclusions: An SP-based training module proved useful in improving the objectively measured communication skills of psychiatric residents delivering difficult news. The training further enhanced participants' subjective sense of confidence in those clinical skills.
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Affiliation(s)
- Doron Amsalem
- New York State Psychiatric Institute and Department of Psychiatry, Columbia University Vagelos College of Physicians & Surgeons, New York, NY, United States
- MSR–Israel Center for Medical Simulation, Sheba Medical Center, Ramat Gan, Israel
| | - Andrés Martin
- Child Study Center, Yale School of Medicine, New Haven, CT, United States
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Mariela Mosheva
- MSR–Israel Center for Medical Simulation, Sheba Medical Center, Ramat Gan, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Division of Child & Adolescent Psychiatry, Sheba Medical Center, Edmond and Lily Safra Children's Hospital, Ramat Gan, Israel
| | - Omer Soul
- MSR–Israel Center for Medical Simulation, Sheba Medical Center, Ramat Gan, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Division of Child & Adolescent Psychiatry, Sheba Medical Center, Edmond and Lily Safra Children's Hospital, Ramat Gan, Israel
| | - Liran Korotkin
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Amitai Ziv
- MSR–Israel Center for Medical Simulation, Sheba Medical Center, Ramat Gan, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Sheba Medical Center, Integrated Rehabilitation Hospital, Ramat Gan, Israel
| | - Doron Gothelf
- Division of Child & Adolescent Psychiatry, Sheba Medical Center, Edmond and Lily Safra Children's Hospital, Ramat Gan, Israel
- Faculty of Medicine, Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
| | - Raz Gross
- MSR–Israel Center for Medical Simulation, Sheba Medical Center, Ramat Gan, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Division of Psychiatry, Sheba Medical Center, Ramat Gan, Israel
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11
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Kessler LJ, LaMarra D, MacFarlane IM, Heller M, Valverde KD. Characterizing standardized patients and genetic counseling graduate education. J Genet Couns 2020; 30:493-502. [PMID: 33025686 DOI: 10.1002/jgc4.1335] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Revised: 08/28/2020] [Accepted: 08/30/2020] [Indexed: 11/11/2022]
Abstract
Standardized patients (SPs) are laypersons trained to portray patients, family members, and others in a consistent, measurable manner to teach and assess healthcare students, and to provide practice for emotionally and medically challenging cases. SP methodology has been studied with practicing genetic counselors; however, there is minimal empirical evidence characterizing its use in genetic counseling (GC) education. The Accreditation Council for Genetic Counseling (ACGC) Standards of Accreditation for Graduate Programs in Genetic Counseling include SP sessions as one way to achieve up to 20% of the 50 participatory cases required for graduation. The purpose of the current project was to determine the scope, frequency, and timing of SP methodology in ACGC-accredited programs to establish baseline usage, which happened prior to the SARS-CoV-2 pandemic. A 40-item investigator-created survey was developed to document the scope and frequency of SP use among programs. The survey was distributed through the Association of Genetic Counseling Program Directors' (AGCPD) listserv to 43 accredited and 6 programs under development. Surveys were analyzed from 25 accredited programs (response rate = 58%). Seventeen of these programs report inclusion of SP methodology in the curricula (68%), of which 13 report working with an established SP program. SPs are used predominantly for role-plays (70.6%), individualized instruction and remediation (29.4%), and for other reasons such as lecture demonstration, final examinations, practicing skills, and assessing students' goals. Sixteen of the participating programs use SPs to give GC students experience disclosing positive test results. Other details vary among the GC programs including the use of trained SPs, volunteer or paid SPs, actors with and without SP training, or GC students acting as patients. This study demonstrates that GC program SP experiences differ, but are largely viewed as valuable by the programs. Many GC programs report using SP encounters to create multiple opportunities for students to practice and refine clinical skills similar to SPs in medical school.
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Affiliation(s)
- Lisa Jay Kessler
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Denise LaMarra
- Perelman School of Medicine, Standardized Patient Program, University of Pennsylvania, PA, USA
| | - Ian M MacFarlane
- Department of Psychology, Elizabethtown College, Elizabethtown, PA, USA
| | - Melissa Heller
- Department of Genetic Counseling, Arcadia University Genetic Counseling Graduate Program, Glenside, PA, USA
| | - Kathleen D Valverde
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
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Hewat S, Penman A, Davidson B, Baldac S, Howells S, Walters J, Purcell A, Cardell E, McCabe P, Caird E, Ward E, Hill AE. A framework to support the development of quality simulation-based learning programmes in speech-language pathology. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2020; 55:287-300. [PMID: 32020763 DOI: 10.1111/1460-6984.12515] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2019] [Revised: 10/24/2019] [Accepted: 10/27/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Simulation-based learning provides students with a safe learning environment, guaranteed exposure to specific clinical scenarios and patients, time for reflection and repetition of tasks, and an opportunity to receive feedback from multiple sources. Research including studies specific to allied health training programmes have demonstrated that simulation-based learning also helps increase learners' confidence and reduces anxiety related to clinical environments, activities and skills. Such evidence, together with increasing challenges in provision of workplace clinical education, has supported an expansion of integrating simulation-based learning into university curricula. AIMS To provide detailed information about the processes and considerations involved in the development of a simulation-based learning programme for speech-language pathology. METHODS & PROCEDURES Through reflection on the development process of a 5-day simulation-based learning programme, and in light of existing research in simulation, this paper outlines the important steps and considerations required for the development of a simulation-based learning programme to support student competency development in adult speech pathology range of practice areas. MAIN CONTRIBUTION A proposed framework for the development of future simulation-based learning programmes in speech-language pathology. CONCLUSIONS & IMPLICATIONS The framework can be applied to simulation-based learning for university programmes and/or workplace training in speech-language pathology and across several other health disciplines.
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Affiliation(s)
- Sally Hewat
- Speech Pathology Department, Faculty of Education and Arts, The University of Newcastle, Callaghan, NSW, Australia
| | - Adriana Penman
- School of Health and Rehabilitation Sciences, The University of Queensland, QLD, Australia
| | - Bronwyn Davidson
- Melbourne School of Health Sciences, The University of Melbourne, VIC, Australia
| | | | - Simone Howells
- School of Allied Health Sciences, Griffith University, QLD, Australia
| | - Joanne Walters
- Speech Pathology Department, Faculty of Education and Arts, The University of Newcastle, Callaghan, NSW, Australia
| | - Alison Purcell
- Sydney School of Health Sciences, The University of Sydney, NSW, Australia
| | - Elizabeth Cardell
- School of Allied Health Sciences, Griffith University, QLD, Australia
| | - Patricia McCabe
- Sydney School of Health Sciences, The University of Sydney, NSW, Australia
| | - Emma Caird
- School of Health and Rehabilitation Sciences, The University of Queensland, QLD, Australia
| | - Elizabeth Ward
- School of Health and Rehabilitation Sciences, The University of Queensland, QLD, Australia
- Centre for Functioning and Health Research, QLD, Australia
| | - Anne E Hill
- School of Health and Rehabilitation Sciences, The University of Queensland, QLD, Australia
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Wakefield CJ, Smith D, Hogard E, Ellis R, Parry C. Using PETTLEP imagery as a simulation technique in nursing: Research and guidelines. Nurse Educ Pract 2020; 43:102700. [PMID: 32028081 DOI: 10.1016/j.nepr.2020.102700] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Revised: 01/07/2020] [Accepted: 01/15/2020] [Indexed: 11/25/2022]
Abstract
One of the most valuable skill sets developed in nurse education is the ability to develop the clinical and practical skills learned. This can take various forms such as university-based practice, simulation and direct experience with patients. To this end imagery, a process where all of the senses are used to create or recreate an experience in the mind, could represent simulated practice of clinical skills. Research on imagery has indicated that the technique, when used to assist in the performance of skill based procedures carried out by nurses can be beneficial. However, guidelines are lacking in this area of simulated practice. In this article, we review current research on the topic of imagery in enhancing skilled performance and outline a model that can assist in conducting interventions. Furthermore, we consider how this could be implemented within a nursing environment to produce beneficial performance effects in both pre-registration and registered nurses.
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Affiliation(s)
- Caroline J Wakefield
- School of Health Sciences, Liverpool Hope University, Hope Park, Taggart Avenue, Liverpool, L16 9JD, UK.
| | - Dave Smith
- Department of Sport and Exercise Sciences, Manchester Metropolitan University, Crewe Road, Crewe, CW1 5DU, UK
| | - Elaine Hogard
- Human Sciences Division, Northern Ontario School of Medicine at Lakehead University, 955 Oliver Road, Thunder Bay, ON, P7B 5E1, Canada
| | - Roger Ellis
- School of Psychology, Ulster University, Cromore Road, Coleraine, Co. Londonderry, BT52 1SA, UK
| | - Clare Parry
- Department of Sport and Exercise Sciences, University of Chester, Parkgate Road, Chester, CH1 4BJ, UK
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14
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Use of Simulated Patients in Disaster Medicine Training: A Systematic Review. Disaster Med Public Health Prep 2020; 15:99-104. [PMID: 31928571 DOI: 10.1017/dmp.2019.111] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Simulation is an effective teaching tool in disaster medicine education, and the use of simulated patients (SPs) is a frequently adopted technique. Throughout this article, we critically analyzed the use and the preparation of SPs in the context of simulation in disaster medicine. A systematic review of English, French, and Italian language articles was performed on PubMed and Google Scholar. Studies were included if reporting the use of SPs in disaster medicine training. Exclusion criteria included abstracts, citations, theses, articles not dealing with disaster medicine, and articles not using human actors in simulation. Eighteen papers were examined. All the studies were conducted in Western countries. Case reports represent 50% of references. Only in 44.4% of articles, the beneficiaries of simulations were students, while in most of cases were professionals. In 61.1% of studies SPs were moulaged, and in 72.2%, a method to simulate victim symptoms was adopted. Ten papers included a previous training for SPs and their involvement in the participants' assessment at the end of the simulation. Finally, this systematic review revealed that there is still a lack of uniformity about the use of SPs in the disaster medicine simulations.
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Amsalem D, Gothelf D, Soul O, Dorman A, Ziv A, Gross R. Single-Day Simulation-Based Training Improves Communication and Psychiatric Skills of Medical Students. Front Psychiatry 2020; 11:221. [PMID: 32265762 PMCID: PMC7099001 DOI: 10.3389/fpsyt.2020.00221] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Accepted: 03/06/2020] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND Use of standardized (or simulated) patients (SP) is considered an effective teaching method for improving clinical and communication skills. This study assesses the effect of a single-day simulated patients (SP)-based training course on medical students' communication and basic skills in clinical psychiatry during their psychiatry rotation in a university-affiliated tertiary medical center. METHODS Forty-two third-year medical students participated. Communication and basic skills in clinical psychiatry were evaluated by a modified Four Habits Coding Scale (4HCS) and the psychiatric interview coding scale before and after SP training. An actual patient interview by the students 1 week after the training was evaluated by an attending psychiatrist blinded to the student's score during the SP-based training. Self-report questionnaires on satisfaction from the training and its impact on their self-confidence were administered at the end of training. FINDINGS The mean pre-training 4HCS score of 33.9 increased to 52.3 post-training (p < 0.001). The mean psychiatric interview coding scale score increased from 4.33 to 5.36 (p = 0.002). The self-report questionnaire yielded a mean score of 4.21 on a 1-5 Likert scale, implying high levels of satisfaction and self-confidence. CONCLUSIONS A single SP-based training course of medical students sufficed to improve clinical and communication skills in psychiatric settings and enhance their subjective perception of those skills.
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Affiliation(s)
- Doron Amsalem
- The Child Psychiatry Division, The Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel Hashomer, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,MSR-Israel Center for Medical Simulation, Sheba Medical Center, Tel Hashomer, Israel
| | - Doron Gothelf
- The Child Psychiatry Division, The Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel Hashomer, Israel.,MSR-Israel Center for Medical Simulation, Sheba Medical Center, Tel Hashomer, Israel.,Sackler Faculty of Medicine and Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
| | - Omer Soul
- The Child Psychiatry Division, The Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel Hashomer, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Alexandra Dorman
- Sackler Faculty of Medicine and Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
| | - Amitai Ziv
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,MSR-Israel Center for Medical Simulation, Sheba Medical Center, Tel Hashomer, Israel.,Sheba Medical Center, Tel Hashomer, Israel
| | - Raz Gross
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Division of Psychiatry, Sheba Medical Center, Tel Hashomer, Israel
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Wilson WJ, Schmulian D, Sher A, Morris S, Hill AE. Student perceptions of two simulated learning environments in paediatric audiology. Int J Audiol 2019; 59:16-23. [PMID: 31486696 DOI: 10.1080/14992027.2019.1660004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Objective: To determine audiology student perceptions of two simulated learning environments (SLE) in paediatric audiology.Design: A one-shot case study design.Study sample: Fifteen audiology students who completed questionnaires after participating in two SLEs, one simulating auditory brainstem response (ABR) assessments of neonates in a hospital ward and one simulating visually reinforced orientation audiometry (VROA) assessments of young children in an audiology clinic.Results: The students responded positively to 11/11 areas of audiometric testing and client interaction in both SLEs, to 7/7 aspects of their interactions with the mannequins in both SLEs, and to 8/8 aspects of their interactions with fellow students playing the role of parent in the ABR SLE and 7/8 of these aspects in the VROA SLE. The students reported low levels of anxiety towards both SLEs but rated the ABR SLE more highly than the VROA SLE in areas of preparedness, effectiveness, realism, pre-SLE training, reinforcement of lecture content, and overall usefulness.Conclusions: The participating students responded positively to almost all aspects of both SLEs. Further research is warranted using research designs capable of determining if these SLEs directly improve student abilities as they transition from academic settings to clinical placements in paediatric audiology.
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Affiliation(s)
- W J Wilson
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - D Schmulian
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - A Sher
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - S Morris
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - A E Hill
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
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Yang W, Hebert D, Kim S, Kang B. MCRDR Knowledge-Based 3D Dialogue Simulation in Clinical Training and Assessment. J Med Syst 2019; 43:200. [PMID: 31123826 DOI: 10.1007/s10916-019-1262-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Accepted: 03/27/2019] [Indexed: 10/26/2022]
Abstract
Dialogue-based simulation is a real-world practice technique for medical and clinical education that provides students with an opportunity to train using hands-on experiences without putting actual patients being put at risk. In this paper, a 3D interactive dialogue-based training and assessment system that supports the detailed development of clinical trial competency for medical students in a distributed virtual environment was proposed. For clinical training, MCRDR-based natural language understanding to realize the semantic representation of written dialog from the most relevant inference results was applied, and on the basis of this, a convolutional neural network model was also used to make the generated inference more exact and reliable. For clinical assessment, the dialogue-driven competency method was used to encompass medical knowledge, communication skill as well as professionalism skill based on the collected dialogue information. Finally, the potential of the created system was demonstrated with several clinical cases. The preliminary results indicate that the system demonstrates the potential of providing efficient training and flexible assessment, while saving time, improving practical skills and making students more confident.
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Affiliation(s)
- Wenli Yang
- Discipline of Information & Communication Technology, School of Technology, Environments & Design, University of Tasmania Sandy Bay Campus, Launceston, Australia.
| | - David Hebert
- Discipline of Information & Communication Technology, School of Technology, Environments & Design, University of Tasmania Sandy Bay Campus, Launceston, Australia
| | - Sunwoo Kim
- Discipline of Information & Communication Technology, School of Technology, Environments & Design, University of Tasmania Sandy Bay Campus, Launceston, Australia
| | - Byeong Kang
- Discipline of Information & Communication Technology, School of Technology, Environments & Design, University of Tasmania Sandy Bay Campus, Launceston, Australia
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18
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Abstract
This article explores ways in which simulated patients (SPs) can help with preparation for the Clinical Skills Assessment (CSA) of the MRCGP exam by sharpening up communication skills, keeping patients safe and making the most of the 10 minutes allotted. However, for this to work, candidates need to take the process seriously and appreciate the care and attention given by SPs to enhance learning and understanding in exam preparation. The article concludes with some useful hints and tips to improve performance in the CSA.
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Affiliation(s)
- Bernard R Moss
- Emeritus Professor, Staffordshire University, Principal Fellow and National Teaching Fellow, Higher Education Academy UK. Experienced freelance simulated patient, working with Keele and Birmingham Universities and with the RCGP
| | - Sheila Moss
- Experienced free-lance simulated patient, working with Keele and Birmingham Universities and with the RCGP
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20
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Kearney GP, Gormley GJ, Wilson D, Johnston JL. Blurred boundaries: sexuality and power in standardised patients' negotiations of the physical examination. Adv Simul (Lond) 2018; 3:11. [PMID: 29983995 PMCID: PMC6019710 DOI: 10.1186/s41077-018-0069-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Accepted: 06/08/2018] [Indexed: 11/10/2022] Open
Abstract
Background Working with standardised or simulated patients (SPs) is now commonplace in Simulated Learning Environments. Embracing the fact that they are not a homogenous group, some literature suggests expansion of learning with SPs in health professional education by foregrounding their personal experiences. Intimate examination teaching, whether with or without the help of SPs, is protected by a particular degree of ceremony given the degree of potential vulnerability. However, other examinations may be equally intrusive for example the close proximity of an eye examination or a chest examination in a female patient. In this study, we looked at SPs' experiences of boundary crossing in any examinations, sensitised by Foucault's concept of the clinical gaze. We wished to problematise power relations that construct and subject SPs as clinical tools within simulation-based education. Methods We collected data from 22 SPs, through five focus groups. Analysis was an iterative process, using thematic analysis. Data collection and reflexive analysis continued iteratively until concepts were fully developed and all theoretical directions explored. Results Students and SPs construct simulated teaching consultations by negotiating the unequal distribution of power between them. The SPs themselves discussed how they, perhaps unknowingly, acted in accordance with the discourse of the clinical gaze. However, SPs became disempowered when students deviated from the negotiated terms of consent and they used their agency to resist this. The SPs used strong sexual metaphors to express the subjugation they experienced, as discourses of sexuality and gender played out in the Simulated Learning Environment. Conclusion We demonstrate that power dynamics and the clinical gaze can have important consequences within the Simulated Learning Environment. Every physical examination can be potentially 'intimate' and can therefore be underpinned by discourses of sexuality and gendered undertones. In partnership with SPs, simulation-based education should create a teaching space that no longer fosters the discourse of the clinical gaze but facilitates students to learn to reflectively navigate, in the moment, the fine line between touching patients versus touching loved ones, and the blurred boundaries that exist in the gulf between sexual contact and benevolent touch.
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Affiliation(s)
- Grainne P Kearney
- 1Centre for Medical Education, Queen's University, Belfast, Whitla Medical Building, 97 Lisburn Road, Belfast, BT9 7BL UK
| | - Gerard J Gormley
- 2Clinical Skills Education Centre, Queen's University, Belfast, 2nd Floor Medical Biology Centre, Lisburn Road, Belfast, BT9 7BL UK
| | - Diane Wilson
- 2Clinical Skills Education Centre, Queen's University, Belfast, 2nd Floor Medical Biology Centre, Lisburn Road, Belfast, BT9 7BL UK
| | - Jennifer L Johnston
- 1Centre for Medical Education, Queen's University, Belfast, Whitla Medical Building, 97 Lisburn Road, Belfast, BT9 7BL UK
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Abstract
SummaryThe use of simulated patients in medicine offers students a standardised learning experience and a reproducible way of exploring attitudes and teaching communication skills. This would seem to be particularly relevant to psychiatry with its focus on attitudes and interpersonal skills, but doubts have been raised about the utility of simulated patients in teaching skills such as empathy and the generalisability of this learning to the real world. This, tempered with cost implications, may have limited the use of simulated patients to assessment through objective structured clinical examinations rather than to teaching and to learning. This article examines the educational advantages and disadvantages of the use of simulated patients in psychiatric teaching and argues that their judicious use complements undergraduate and postgraduate training in psychiatry. The article offers practical tips on writing simulated patient scenarios to deliver specific learning objectives and discusses the potential use of novel simulation techniques in psychiatric education.
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Pryde I, Sachar A, Young S, Hukin A, Davies T, Rao R. Organising a mock OSCE for the MRCPsych Part I examination. PSYCHIATRIC BULLETIN 2018. [DOI: 10.1192/pb.29.2.67] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Aims and MethodWith the changes introduced recently to the Part I clinical examination, trainers will be expected to modify MRCPsych course teaching accordingly. The aim of this paper is to describe the procedure for organising a mock objective structured clinical examination (OSCE) for MRCPsych trainees.ResultsPrior to the introduction of the new OSCE, we organised an authentic mock OSCE for our trainees. We have now run three consecutive mock examinations which have been successfully evaluated.Clinical ImplicationsA well-organised mock OSCE requires significant investment in terms of planning, resources and enthusiasm, but can have a potentially beneficial impact on and preparation for the real OSCE and training in general.
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Naeem A, Rutherford J, Kenn C. The MRCPsych OSCE workshop: a new game to play? PSYCHIATRIC BULLETIN 2018. [DOI: 10.1192/pb.28.2.62] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
In line with the Royal College of Psychiatrists' commitment to improve its professional examinations based on the best current evidence, Spring 2003 has seen the introduction of the objective structured clinical examination (OSCE). This has replaced the individual patient assessment (IPA) in the MRCPsych Part I clinical examination. An OSCE consists of a series of time-limited clinical tasks that candidates have to perform in a consecutive series of ‘stations' or booths. They have the advantage of being able to test clinical competence using a number of different scenarios via a standardised format (Katona et al, 2000). Their use has become widespread over recent years, particularly in undergraduate psychiatry exams (Brewin & Cantwell, 1997), as they have good reliability and validity (Hodges et al, 1998). This was confirmed by the College's initial pilot OSCE, which had a κ score of around 0.8 for the examination as a whole (Oyebode, 2002).
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Standardized Patients' Perspectives on Workplace Satisfaction and Work-Related Relationships: A Multicenter Study. Simul Healthc 2017; 11:278-85. [PMID: 27093510 DOI: 10.1097/sih.0000000000000160] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
INTRODUCTION The use of standardized patients (SPs) in health care education has grown in the last 50 years. In addition, the requirements for SPs have increased steadily, and thus, the work of SPs has become more difficult and demanding. It has been claimed that SP programs are highly contextualized, having emerged from local, institutional, professional, and national conditions, but their effects on SPs have not been investigated. We have studied the effects of this job development on SPs and their programs. METHODS The study was conducted using a qualitative research design, with semistructured individual in-depth interviews to understand the reactions, values, and perceptions that underlie and influence SP behavior. To cover SP perspectives from more than 1 SP program, a total of 15 SPs from 8 different nursing schools and medical schools in Switzerland were asked to participate. RESULTS Standardized patients feel motivated, engaged, and willing to invest effort in their task and do not mind demands increasing as long as the social environment in SP programs is supportive. The role of the SP trainer and the use of feedback are considered very important. CONCLUSIONS Standardized patient programs require concepts in which the SP perspective has been integrated to better serve SPs' well-being. Standardized patients are valuable partners in the training of health professionals-we need to take care of them.
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Pheister M, Stagno S, Cotes R, Prabhakar D, Mahr F, Crowell A, Schwartz A. Simulated Patients and Scenarios to Assess and Teach Psychiatry Residents. ACADEMIC PSYCHIATRY : THE JOURNAL OF THE AMERICAN ASSOCIATION OF DIRECTORS OF PSYCHIATRIC RESIDENCY TRAINING AND THE ASSOCIATION FOR ACADEMIC PSYCHIATRY 2017; 41:114-117. [PMID: 26763534 DOI: 10.1007/s40596-015-0477-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2015] [Accepted: 12/08/2015] [Indexed: 06/05/2023]
Affiliation(s)
| | - Susan Stagno
- University Hospitals Case Medical Center, Cleveland, OH, USA
| | - Robert Cotes
- Emory University School of Medicine, Atlanta, GA, USA
| | | | - Fauzia Mahr
- Penn State Milton S Hershey Medical Center, Hershey, PA, USA
| | | | - Ann Schwartz
- Emory University School of Medicine, Atlanta, GA, USA
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Amini H, Shakiba A, Sharifi V, Shirazi M, Sadeghi M, Abolhasani F, Hajebi A. Evaluation of the performance of general practitioners in a collaborative care program by employing simulated patients. Soc Psychiatry Psychiatr Epidemiol 2016; 51:1311-9. [PMID: 27155972 DOI: 10.1007/s00127-016-1226-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/25/2015] [Accepted: 04/16/2016] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To compare the performance of the general practitioners (GPs) in a collaborative care (CC) program in Iran with a control group of GPs in the usual care by employing simulated patients. METHODS Six trained simulated patients (SPs) made unannounced visits to 26 GP offices participating in the CC program and to 26 age and sex matched controls. The SPs role played five clinical scenarios of mental disorders and filled out checklists to evaluate the GPs' performance regarding interviewing, taking history, establishing rapport, showing empathy, and giving advice to patients. Additionally, the GPs' plan of care and prescriptions were evaluated later by a psychiatrist based on the documents provided by the SPs. RESULTS There was a significant difference between collaborative care and control group physicians in their global performance; CC physicians built up better patient-physician relationship. They performed better in evaluating a psychotic patient, although not better in their management. CC physicians were marginally better in approach to patients with generalized anxiety disorder (GAD) and mild major depressive disorder. CONCLUSION The overall performance of physicians in CC was better than the GPs in the control group in making an effective patient-physician relationship, and evaluating a psychotic patient. The main weakness of the GPs was in proper treatment of the minor and more common psychiatric disorders and in evaluation of patients with suicidal ideations who were in need for emergent referral. Evaluating performance of the practitioners is feasible employing SPs and the findings can be translated into improvements in the available services.
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Affiliation(s)
- Homayoun Amini
- Department of Psychiatry, Roozbeh Hospital, Tehran University of Medical Sciences, South Kargar Avenue, 13337 95914, Tehran, Iran. .,Psychosomatic Research Center, Tehran University of Medical Sciences, Tehran, Iran.
| | - Alia Shakiba
- Psychiatry and Psychology Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Vandad Sharifi
- Department of Psychiatry, Roozbeh Hospital, Tehran University of Medical Sciences, South Kargar Avenue, 13337 95914, Tehran, Iran
| | - Mandana Shirazi
- Educational Development Center, Tehran University of Medical Sciences, Tehran, Iran.,Departments of LIME and Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
| | - Majid Sadeghi
- Department of Psychiatry, Roozbeh Hospital, Tehran University of Medical Sciences, South Kargar Avenue, 13337 95914, Tehran, Iran.,Psychiatry and Psychology Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Farid Abolhasani
- Department of Health Services, National Institute of Health Research, Tehran University of Medical Sciences, Tehran, Iran
| | - Ahmad Hajebi
- Faculty of Behavioral Sciences and Mental Health, Mental Health Research Center, Tehran Institute of Psychiatry, Iran University of Medical Sciences, Tehran, Iran
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Scallan S, Ball K, Lyon-Maris J, Burrows P, Gorrod E. Using actors to simulate doctors in the continuing professional development of GP trainers and appraisers. EDUCATION FOR PRIMARY CARE 2015; 22:171-7. [DOI: 10.1080/14739879.2011.11493993] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Samantha Scallan
- Educational Research Lead, Wessex School of General Practice and Honorary Fellow, University of Winchester, UK
| | | | - Johnny Lyon-Maris
- Associate GP Dean for Southampton, Wessex School of General Practice, UK
| | - Peter Burrows
- Retired GP, Romsey, Hampshire and Retired Appraiser, Wessex School of General Practice, UK
| | - Eileen Gorrod
- Locum GP, Appraisal Locality Lead, NHS Hampshire, GP Appraiser NESC
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Can 360-Degree Reviews Help Surgeons? Evaluation of Multisource Feedback for Surgeons in a Multi-Institutional Quality Improvement Project. J Am Coll Surg 2015; 221:837-44. [DOI: 10.1016/j.jamcollsurg.2015.06.017] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2015] [Revised: 06/24/2015] [Accepted: 06/25/2015] [Indexed: 11/21/2022]
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29
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Selim AA, Dawood E. Objective Structured Video Examination in Psychiatric and Mental Health Nursing: A Learning and Assessment Method. J Nurs Educ 2015; 54:87-95. [DOI: 10.3928/01484834-20150120-04] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2013] [Accepted: 11/19/2014] [Indexed: 11/20/2022]
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30
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Wright B, McKendree J, Morgan L, Allgar VL, Brown A. Examiner and simulated patient ratings of empathy in medical student final year clinical examination: are they useful? BMC MEDICAL EDUCATION 2014; 14:199. [PMID: 25245476 PMCID: PMC4261253 DOI: 10.1186/1472-6920-14-199] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/19/2014] [Accepted: 08/06/2014] [Indexed: 05/20/2023]
Abstract
BACKGROUND Many medical schools state that empathy is important and have curricular learning outcomes covering its teaching. It is thought to be useful in team-working, good bedside manner, patient perspective taking, and improved patient care. Given this, one might expect it to be measured in assessment processes. Despite this, there is relatively little literature exploring how measures of empathy in final clinical examinations in medical school map onto other examination scores. Little is known about simulated patient (actors) rating of empathy in examinations in terms of inter-rater reliability compared with clinical assessors or correlation with overall examination results. METHODS Examiners in final year clinical assessments in one UK medical school rated 133 students on five constructs in Objective Structured Long Examination Record (OSLER) with real patients: gathering information, physical examination, problem solving, managing the diagnosis, and relationship with the patient. Scores were based on a standardized well-established penalty point system. In separate Objective Structured Clinical Examination (OSCE) stations, different examiners used the same penalty point system to score performance in both interactional and procedural stations. In the four interaction-based OSCE stations, examiners and simulated patient actors also independently rated empathy of the students. RESULTS The OSLER score, based on penalty points, had a correlation of -0.38 with independent ratings of empathy from the interactional OSCE stations. The intra-class correlation (a measure of inter-rater reliability) between the observing clinical tutor and ratings from simulated patients was 0.645 with very similar means. There was a significant difference between the empathy scores of the 94 students passing the first part of the sequential examination, based on combined OSCE and OSLER scores (which did not include the empathy scores), and 39 students with sufficient penalty points to trigger attendance for the second part (Cohen's d = 0.81). CONCLUSIONS These findings suggest that empathy ratings are related to clinical performance as measured by independent examiners. Simulated patient actors are able to give clinically meaningful assessment scores. This gives preliminary evidence that such empathy ratings could be useful for formative learning, and bolsters the call for more research to test whether they are robust enough to be used summatively.
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Affiliation(s)
- Barry Wright
- />Hull York Medical School, John Hughlings Jackson Building, Heslington, York, YO10 5DD UK
- />Child Adolescent Mental Health Service, 31 Shipton Lane, York, YO30 5RE UK
| | - Jean McKendree
- />Hull York Medical School, John Hughlings Jackson Building, Heslington, York, YO10 5DD UK
| | - Lewys Morgan
- />Hull York Medical School, John Hughlings Jackson Building, Heslington, York, YO10 5DD UK
| | - Victoria L Allgar
- />Hull York Medical School, John Hughlings Jackson Building, Heslington, York, YO10 5DD UK
| | - Andrew Brown
- />Hull York Medical School, John Hughlings Jackson Building, Heslington, York, YO10 5DD UK
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O'Connor K, King R, Malone KM, Guerandel A. Clinical examiners, simulated patients, and student self-assessed empathy in medical students during a psychiatry objective structured clinical examination. ACADEMIC PSYCHIATRY : THE JOURNAL OF THE AMERICAN ASSOCIATION OF DIRECTORS OF PSYCHIATRIC RESIDENCY TRAINING AND THE ASSOCIATION FOR ACADEMIC PSYCHIATRY 2014; 38:451-457. [PMID: 24756942 DOI: 10.1007/s40596-014-0133-8] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2013] [Accepted: 04/03/2014] [Indexed: 06/03/2023]
Abstract
OBJECTIVES This study aims to assess and compare objective and subjective scores of empathy in final-year medical students by using firstly a validated student self-assessment just prior to the psychiatry objective structured clinical examination (OSCE), and then comparing this to clinical examiner's and simulated patient's (SP's) assessments of empathy of students using a Global Rating of Empathy scale (GRE) during a psychiatry OSCE. METHODS In 2011, all final-year medical students in the University College Dublin were invited to complete a subjective, self-assessed empathy questionnaire (The Jefferson scale of physician empathy-student version (JSPE-S)). They were also assessed for empathy in four OSCEs by the clinical examiner and the SP acting in that OSCE scenario. RESULTS Included in the analysis were 163 of 184 final-year students JSPE-S (88.6%) questionnaires. The female students scores on the JSPE-S were significantly higher than those of their male peers (t=3.34, p=0.001). Concurrent validity was greater between the SPs' assessments of empathy in the OSCE and the JSPE-S score than between the clinical examiners assessments of empathy and the JSPE-S score (r=0.23, p<0.005; r=0.14, p<0.08). Inter-rater reliability of SP's and clinical examiner's using the GRE was found to be high (F=0.868 (df=171, 171), p value<0.001). CONCLUSIONS SPs may be valid assessors of empathy in medical students during an OSCE.
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Slort W, Blankenstein AH, Schweitzer BPM, Deliens L, van der Horst HE. Effectiveness of the 'availability, current issues and anticipation' (ACA) training programme for general practice trainees on communication with palliative care patients: a controlled trial. PATIENT EDUCATION AND COUNSELING 2014; 95:83-90. [PMID: 24412094 DOI: 10.1016/j.pec.2013.12.012] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2013] [Revised: 11/27/2013] [Accepted: 12/10/2013] [Indexed: 05/17/2023]
Abstract
OBJECTIVE This study aimed to evaluate the effectiveness of a new palliative care 'availability, current issues and anticipation' (ACA) training programme to improve communication skills of general practice trainees (GPTs). METHODS In a controlled trial among third-year GPTs, we videotaped one 20-min consultation between each GPT and a simulated palliative care patient at baseline and at six months follow-up. We measured the number of issues discussed and the quality of communication skills and analysed between-group differences using linear mixed models and logistic regression. RESULTS Fifty-four GPTs were assigned to the intervention and 64 to the control group. We found no effect of the programme on the number of issues discussed or on the quality of GPT communicative behaviour. GPTs infrequently addressed 'spiritual/existential issues' and 'unfinished business'. In a selection of the consultations, simulated patients brought up more issues than the GPTs did. CONCLUSION The ACA training programme was not effective in the way it was carried out and evaluated in this trial. PRACTICE IMPLICATIONS The ACA programme should focus on the issues that scored low in this trial. Future research on GPT-patient communication in palliative care should consider using real patients in a series of consultations to evaluate effectiveness.
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Affiliation(s)
- Willemjan Slort
- Department of General Practice & Elderly Care Medicine, EMGO+ Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands.
| | - Annette H Blankenstein
- Department of General Practice & Elderly Care Medicine, EMGO+ Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - Bart P M Schweitzer
- Department of General Practice & Elderly Care Medicine, EMGO+ Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - Luc Deliens
- Department of Public and Occupational Health, EMGO+ Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands; End-of-Life Care Research Group, Vrije Universiteit Brussel & Ghent University, Brussels, Belgium
| | - Henriëtte E van der Horst
- Department of General Practice & Elderly Care Medicine, EMGO+ Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
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Yazbeck-Karam V, Aoun Bahous S, Faour W, Khairallah M, Asmar N. Influence of standardized patient body habitus on undergraduate student performance in an Objective Structured Clinical Examination. MEDICAL TEACHER 2014; 36:240-244. [PMID: 24289251 DOI: 10.3109/0142159x.2013.856511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
PURPOSE Previous studies have shown that the standardized patient's (SP) gender may affect student performance in an Objective Structured Clinical Examination (OSCE). The aim of this study is to investigate the influence of the SPs' body habitus on students' performance in an OSCE counseling station. METHODS Four equally trained female SPs, with either a normal or an obese BMI participated in an OSCE counseling station for cardiovascular risk factors. Ninety-two, second year medical students were randomly assigned to one of the SPs. Station scores were compared and student behavior and opinion regarding the influence of their SP's body habitus on their performance was assessed. RESULTS There was no difference in mean exam scores for students interacting with SPs with a normal BMI versus increased BMI (14.9 ± 2.2 versus 14.01 ± 2.2/20 respectively, p = 0.06). Additionally, almost all students gave advice about healthy diets (93.5% versus 95.7%) with no specificity regarding the BMI of the SP. CONCLUSIONS The body habitus of the SP did not significantly affect students' performance in an undergraduate OSCE about cardiovascular risk factors, suggesting that students at that level may primarily focus on gaining points the diagnostic checklist without considering SPs as real patients.
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Hodges BD, Hollenberg E, McNaughton N, Hanson MD, Regehr G. The Psychiatry OSCE: a 20-year retrospective. ACADEMIC PSYCHIATRY : THE JOURNAL OF THE AMERICAN ASSOCIATION OF DIRECTORS OF PSYCHIATRIC RESIDENCY TRAINING AND THE ASSOCIATION FOR ACADEMIC PSYCHIATRY 2014; 38:26-34. [PMID: 24449223 DOI: 10.1007/s40596-013-0012-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/23/2013] [Accepted: 11/17/2013] [Indexed: 06/03/2023]
Abstract
OBJECTIVE Twenty years ago researchers at the University of Toronto launched the Psychiatry Skills Assessment Project (PSAP), a research program exploring Objective Structured Clinical Examinations (OSCEs) in psychiatry. Between 1994 and 2005 PSAP produced publications on the feasibility, reliability, validity, ethics, and practical concerns of OSCEs in psychiatry. The current review has two parts: a review of the state of the art of OSCEs in psychiatry 20 years after they were introduced and documentation of the impact of the PSAP research program. METHODS A literature search identified all publications on OSCEs and psychiatry. Articles were coded thematically, and locations of agreement and controversies were identified. Bibliometric analysis identified citations of PSAP research papers, which were analyzed thematically. RESULTS As of May 2013, there were 250 publications related to OSCEs in psychiatry (not including 10 PSAP papers), published in 29 different countries and ten languages. Prominent topics were the validity and acceptability of OSCEs and SPs, systems issues in adopting OSCEs in psychiatry, and the effects on learning. Eighty-eight percent of all publications cited PSAP work (300 citations). Citations were employed for four purposes: as evidence/justification (54 %); to frame replication research (14 %); to support adaptation of OSCEs in other countries and professions (15 %); and for debate (18 %). CONCLUSIONS Over the past 20 years, use of OSCEs has grown steadily in psychiatry, and several national certification organizations have adopted OSCEs. PSAP work, introduced two decades ago, continues to provide a scholarly foundation for psychometric, practical, and ethical issues of interest to this field.
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Osbourne A. Improving the standardized patient experience. J Am Podiatr Med Assoc 2013. [PMID: 23204199 DOI: 10.7547/1020477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND As the facilitator of the standardized patient rotation at the Ohio College of Podiatric Medicine (now Kent State University College of Podiatric Medicine [KSUCPM]) for the past 4 years, I have felt that there is underused time in the program. Therefore, I sought the views of podiatric medical students at KSUCPM who have completed the standardized patient rotation to see how they felt their time in the course was used and whether they felt that the course was useful to them in terms of advancing their podiatric medical education. METHODS A survey was administered to 105 third-year podiatric medical students. These students had already completed the standardized patient rotation, which at KSUCPM is in the second year. RESULTS Seventy-seven students completed the survey. Most of these students felt that there was improperly used time in the course, and many recommended ways of improving the course organization. CONCLUSIONS The students answered positively that the standardized patient rotation was important in terms of improving interviewing skills and worthwhile for future professional development. The students agreed that there likely was underused time in the course and even suggested ways in which they would make the course run more efficiently.
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Affiliation(s)
- Abe Osbourne
- Department of Podiatric Medicine, Kent State University College of Podiatric Medicine, 6000 Rockside Woods Blvd, Independence, OH 44131, USA.
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Barry M, Bradshaw C, Noonan M. Improving the content and face validity of OSCE assessment marking criteria on an undergraduate midwifery programme: A quality initiative. Nurse Educ Pract 2013; 13:477-80. [DOI: 10.1016/j.nepr.2012.11.006] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2012] [Revised: 10/03/2012] [Accepted: 11/30/2012] [Indexed: 10/27/2022]
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Khan KZ, Ramachandran S, Gaunt K, Pushkar P. The Objective Structured Clinical Examination (OSCE): AMEE Guide No. 81. Part I: an historical and theoretical perspective. MEDICAL TEACHER 2013; 35:e1437-46. [PMID: 23968323 DOI: 10.3109/0142159x.2013.818634] [Citation(s) in RCA: 179] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
The Objective Structured Clinical Examination (OSCE) was first described by Harden in 1975 as an alternative to the existing methods of assessing clinical performance (Harden et al. 1975). The OSCE was designed to improve the validity and reliability of assessment of performance, which was previously assessed using the long case and short case examinations. Since then the use of the OSCE has become widespread within both undergraduate and postgraduate clinical education. We recognise that the introduction of the OSCE into an existing assessment programme is a challenging process requiring a considerable amount of theoretical and practical knowledge. The two parts of this Guide are designed to assist all those who intend implementing the OSCE into their assessment systems. Part I addresses the theoretical aspects of the OSCE, exploring its historical development, its place within the range of assessment tools and its core applications. Part II offers more practical information on the process of implementing an OSCE, including guidance on developing OSCE stations, choosing scoring rubrics, training examiners and standardised patients and managing quality assurance processes. Together we hope these two parts will act as a useful resource both for those choosing to implement the OSCE for the first time and also those wishing to quality assure their existing OSCE programme.
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Selim AA, Ramadan FH, El-Gueneidy MM, Gaafer MM. Using Objective Structured Clinical Examination (OSCE) in undergraduate psychiatric nursing education: is it reliable and valid? NURSE EDUCATION TODAY 2012; 32:283-288. [PMID: 21555167 DOI: 10.1016/j.nedt.2011.04.006] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2010] [Revised: 03/28/2011] [Accepted: 04/14/2011] [Indexed: 05/30/2023]
Abstract
UNLABELLED While there is widespread use of OSCE in general nursing specialties, psychiatric nursing has been slow to adopt this evaluation method and it has only recently been introduced to psychiatric nursing education. AIM The main aim of the present study is to test the first application, validity and reliability of the OSCE in undergraduate psychiatric nursing education. METHOD OSCE was developed to assess undergraduate psychiatric nursing students' clinical skills. The students' evaluation of the OSCE process was obtained after the completion of each OSCE circuit. RESULTS The psychiatric nursing OSCE proved to be a reliable and valid method in assessing psychiatric nursing clinical competencies. In general, the students perceived OSCE as a positive experience and stressful on the other hand. CONCLUSION OSCE is a reliable and valid method of assessing the students' psychiatric nursing competency skills. It has been shown to have many advantages over traditional methods of assessment and has the ability to objectively assess psychiatric nursing skills.
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Affiliation(s)
- Abeer A Selim
- Faculty of Nursing, Mansoura University, Gomhuria St, Mansoura, Egypt.
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Meštrović A, Staničić Z, Hadžiabdić MO, Mucalo I, Bates I, Duggan C, Carter S, Bruno A, Košiček M. Individualized education and competency development of Croatian community pharmacists using the general level framework. AMERICAN JOURNAL OF PHARMACEUTICAL EDUCATION 2012; 76:23. [PMID: 22438595 PMCID: PMC3305932 DOI: 10.5688/ajpe76223] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/11/2011] [Accepted: 09/17/2011] [Indexed: 05/27/2023]
Abstract
OBJECTIVES To measure Croatian community pharmacists' progress in competency development using the General Level Framework (GLF) as an educational tool in a longitudinal study. METHODS Patient care competencies of 100 community pharmacists were evaluated twice, in 2009 and in 2010 in a prospective cohort study. During this 12-month period, tailored educational programs based on the GLF were organized and conducted, new services and standard operating procedures were implemented, and documentation of contributions to patient care in the pharmacist's portfolio became mandatory. RESULTS Pharmacists' development of all GLF patient care competencies was significant with the greatest improvements seen in the following competencies: patient consultation, monitoring drug therapy, medicine information and patient education, and evaluation of outcomes. CONCLUSIONS This study, which retested the effectiveness of an evidence-based competency framework, confirmed that GLF is a valid educational tool for pharmacist development.
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Zraick RI. Review of the use of standardized patients in speech-language pathology clinical education. INTERNATIONAL JOURNAL OF THERAPY AND REHABILITATION 2012. [DOI: 10.12968/ijtr.2012.19.2.112] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Richard I. Zraick
- Department of Audiology and Speech Pathology, University of AR for Medical Sciences/Univ. of AR at Little Rock, Little Rock, AR, USA
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Corso SJF, Delgado MB, Gómez-Restrepo C. [Use of Simulated Pacients in Psychiatry]. ACTA ACUST UNITED AC 2012; 41S:52S-68S. [PMID: 26572575 DOI: 10.1016/s0034-7450(14)60179-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2012] [Accepted: 07/27/2012] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Scientific advances and the complexity of human knowledge generate a constant need for creating new tools intended to facilitate learning in an agreeable and lasting form. Simulated patients are one of such tools in medical education. Standardized or simulated patients are actors or people vigorously trained to represent a medical history or, if possible, specific physical findings with the purpose of using such representations as an educational and evaluating supplement in clinic practice. The use of simulated patients has been very well received, particularly in the psychiatric field; however, its usefulness in areas such as psychotherapy or evaluation of residents remains questionable. METHODS A search was made in PubMed with the MESH words ("Psychiatry/education" and "Patient Simulation"); a search was also made in LILACS and scholar Google using similar words. RESULTS Simulated patients are widely used throughout the world in the psychiatry field and their usefulness as an academic tool for pre-graduate students is confirmed in most of the literature reviewed. One of the main benefits of the use of this kind of patients is the acquisition of specific abilities (e.g.: medical history recording); nevertheless, its efficacy in more complex experiences like psychotherapy or certification of psychiatry residents is questioned. CONCLUSIONS Notwithstanding the controversy, most of the literature reviewed confirms the benefits and acceptance of this methodology in the formation of students and psychiatrists.
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Affiliation(s)
- Silvia J Franco Corso
- Médica interna. Asistente de investigación, Departamento de Epidemiología Clínica y Bioestadística, Facultad de Medicina, Pontificia Universidad Javeriana. Bogotá, Colombia
| | - Marta Beatriz Delgado
- Médica anestesióloga. Epidemióloga clínica, profesora asociada y directora de carrera, Facultad de Medicina, Pontificia Universidad Javeriana. Bogotá, Colombia
| | - Carlos Gómez-Restrepo
- Médico psiquiatra. Psicoanalista, psiquiatra de enlace, epidemiólogo clínico, y profesor titular, Departamento de Psiquiatría y Salud Mental, y director, Departamento de Epidemiología Clínica y Bioestadística, Facultad de Medicina, Pontificia Universidad Javeriana. Bogotá, Colombia.
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van Weel-Baumgarten E, Hettinga A, van Plattel-Os E. Simulatiepatiënten of gestandaardiseerde patiënten? Voortschrijdend inzicht in overeenkomsten en verschillen. ACTA ACUST UNITED AC 2011. [DOI: 10.1007/s12507-011-0054-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
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Valler-Jones T, Meechan R, Jones H. Simulated practice — a panacea for health education? ACTA ACUST UNITED AC 2011; 20:628-31. [DOI: 10.12968/bjon.2011.20.10.628] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
| | | | - Helen Jones
- Helen Jones is Senior Lecturer, Pre-registration Nursing, Institute of Health and Society, Academic Unit of Pre-registration Nursing, University of Worcester
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Meštrović A, Staničić Z, Hadžiabdić MO, Mucalo I, Bates I, Duggan C, Carter S, Bruno A. Evaluation of Croatian community pharmacists' patient care competencies using the general level framework. AMERICAN JOURNAL OF PHARMACEUTICAL EDUCATION 2011; 75:36. [PMID: 21519425 PMCID: PMC3073111 DOI: 10.5688/ajpe75236] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/05/2010] [Accepted: 08/18/2010] [Indexed: 05/26/2023]
Abstract
OBJECTIVES To assess Croatian community pharmacists' patient care competencies using the General Level Framework (GLF). METHODS The competencies of 100 community pharmacists working in 38 community pharmacies were evaluated using an adapted version of the GLF. RESULTS Pharmacists demonstrated the best performance in the competency areas drug specific issues and provision of drug products; the poorest performance was in the competency areas evaluation of outcomes and monitoring drug therapy. Pharmacists' behavior varied the most in the following areas: ensuring that the prescription is legal, prioritization of medication management problems, and identification of drug-drug interactions. CONCLUSIONS Competencies were identified that need to be developed to improve pharmacist interventions in community settings. This study provides the first data on pharmacists' performance in Croatia and serves as a starting point for future studies and actions.
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Detection of depression with different interpreting methods among Chinese and Latino primary care patients: a randomized controlled trial. J Immigr Minor Health 2011; 12:234-41. [PMID: 19408119 DOI: 10.1007/s10903-009-9254-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Language barriers may contribute to the under-detection of depression in Latinos and Asians. A total of 782 English, Spanish, and Chinese-speaking primary care patients were enrolled in a randomized controlled trial. Language discordant patients were randomized to Remote Simultaneous Medical Interpreting (RSMI) or usual and customary (U&C) interpreting. The Beck Depression Inventory-Fast Screen (BDI-FS) was administered. Patients were tracked for 1 year. A total of 462 patients completed the BDI-FS. Thirty-three percent had a positive (> or = 4) screen. Twenty-seven percent of BDI-FS positive patients were diagnosed with depression. Among BDI-FS positive patients, Chinese-speakers were less likely to be diagnosed compared with English speakers (31% vs. 10%, P < 0.05). There was a trend towards greater diagnosis with RSMI (27% detection with RSMI vs. 20% U&C, P = 0.41). The diagnosis of depression among BDI-FS positive patients in our population was low, particularly among Chinese-speakers. RSMI could be an important part of a multi-faceted approach to improving the detection of depression.
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Chaturvedi SK, Chandra PS. Postgraduate trainees as simulated patients in psychiatric training: Role players and interviewers perceptions. Indian J Psychiatry 2010; 52:350-4. [PMID: 21267370 PMCID: PMC3025162 DOI: 10.4103/0019-5545.74311] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Teaching skills to enhance competence in clinical settings need to have a focus on learning how to do. This paper describes the subjective experiences and feedback of trainees who participated in a teaching technique using postgraduate trainees as simulated patients. MATERIALS AND METHODS The Objective Structured Clinical Assessment and Feedback was employed for training using trainees as simulated patients and interviewers. This exercise is performed in front of consultants and peers who subsequently provide feedback about the content and process using a structured format. In order to assess the subjective experience of the interviewer and the role players they were requested to provide structured feedback on several aspects. The trainee role player provided feedback on comfort in playing the role, need for further inputs, satisfaction regarding role play, satisfaction with the interview, and the overall effect of the activity. The trainee interviewer gave feedback on his/her level of comfort performing in front of a peer group, being watched, and evaluated in a group. RESULTS The feedback forms from 15 sessions were analyzed. Only two of the role players indicated that they felt very uncomfortable while the rest reported comfort. Twelve of the 15 trainees who simulated patients felt they needed more inputs to improve the clarity of the role play; however they all reported feeling satisfied with the role play or interview. The feedback from the interviewers indicated that most were comfortable in all aspects, i.e. conducting the interview, performing in front of a group, being evaluated, and given feedback in front of a group. CONCLUSION The trainees report indicates that those simulating patients need more clarity on their roles and majority had no discomfort performing in front of a group. Interviewers were satisfied and comfortable with all aspects. On the whole, simulated interviews and role plays were found to be an acceptable teaching method by postgraduate psychiatry trainees.
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Affiliation(s)
- Santosh K Chaturvedi
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, NIMHANS, Bangalore, Karnataka, India
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Merckelbach H, Jelicic M, Pieters M. The residual effect of feigning: How intentional faking may evolve into a less conscious form of symptom reporting. J Clin Exp Neuropsychol 2010; 33:131-9. [DOI: 10.1080/13803395.2010.495055] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Harald Merckelbach
- a Forensic Psychology Section , Maastricht University , Maastricht, The Netherlands
| | - Marko Jelicic
- a Forensic Psychology Section , Maastricht University , Maastricht, The Netherlands
| | - Maarten Pieters
- a Forensic Psychology Section , Maastricht University , Maastricht, The Netherlands
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Miller JK. Competency-based training: objective structured clinical exercises (OSCE) in marriage and family therapy. JOURNAL OF MARITAL AND FAMILY THERAPY 2010; 36:320-332. [PMID: 20618579 DOI: 10.1111/j.1752-0606.2009.00143.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
The field of marriage and family therapy (MFT) has recently engaged in the process of defining core competencies for the profession. Many MFT training programs are adapting their curriculum to develop more competency-based training strategies. The Objective Structured Clinical Examination (OSCE) is widely used in the medical profession to assess clinical competence. These examinations involve using simulated clinical situations as a tool in conducting summative evaluations of trainee competence. This article describes an adaptation of the OSCE procedures for competency-based training of MFT students. Instead of using the procedures as a summative examination as is typical in medical education, this article proposes how to use them as formative exercises in the development of student competence. The development of the OSCE is discussed, including "blueprinting," focused competencies, procedures, and feedback protocols. The article concludes with suggestions of how to continue the development of the OSCE for evaluation in MFT education.
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Affiliation(s)
- John K Miller
- University of Oregon, Eugene, Oregon 97403-5251, USA.
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Hill AE, Davidson BJ, Theodoros DG. A review of standardized patients in clinical education: Implications for speech-language pathology programs. INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2010; 12:259-70. [PMID: 20433345 DOI: 10.3109/17549500903082445] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
The use of standardized patients has been reported as a viable addition to traditional models of professional practice education in medicine, nursing and allied health programs. Educational programs rely on the inclusion of work-integrated learning components in order to graduate competent practitioners. Allied health programs world-wide have reported increasing difficulty in attaining sufficient traditional placements for students within the workplace. In response to this, allied health professionals are challenged to be innovative and problem-solving in the development and maintenance of clinical education placements and to consider potential alternative learning opportunities for students. Whilst there is a bank of literature describing the use of standardized patients in medicine and nursing, reports of its use in speech-language pathology clinical education are limited. Therefore, this paper aims to (1) provide a review of literature reporting on the use of standardized patients within medical and allied health professions with particular reference to use in speech-language pathology, (2) discuss methodological and practical issues involved in establishing and maintaining a standardized patient program and (3) identify future directions for research and clinical programs using standardized patients to build foundation clinical skills such as communication, interpersonal interaction and interviewing.
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Affiliation(s)
- Anne E Hill
- The University of Queensland, School of Health and Rehabilitation Sciences, Division of Speech Pathology, St Lucia QLD 4072, Australia.
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Dastjerdie EV, Saboury A, Mahdian M, Fard MJK. Assessment of Iranian Dental Lecturers Attitude and Perspectives Toward Objective Structured Clinical Examination (OSCE). ACTA ACUST UNITED AC 2010. [DOI: 10.3923/rjbsci.2010.241.245] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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