Simulating the patient experience with a focus on communication

0304-SimulationSimulation is becoming a big part of medical education, and that is on display throughout the Annual Meeting in a series of sessions, “Hands-On: The Standardized Patient.”

The 30-minute sessions, presented in Hall D, focus on four topics: The Difficult Patient, Medication Management, Breaking Bad News, and The Total Body Skin Exam. In each session, a participant has a one-on-one role-playing experience with a trained patient-actor who afterward provides feedback on how the participant performed during the exercise. Attendees need to register before attending sessions.

“The participant goes into a simulated clinic setting that looks like a clinic office and has an encounter with this patient,” said Kanade Shinkai, MD, PhD, director of The Standardized Patient. “There are specific goals for encounters that are given to the participant ahead of time. At the end of the encounter, the participant is provided direct feedback and coaching from that patient-actor and gets a checklist filled out by the actor. It goes through some key aspects of the communication and their impressions of the whole encounter.”

The sessions were introduced as a pilot program during last year’s AAD Summer Meeting, where the response was positive, said Dr. Shinkai, associate professor in the department of dermatology at the University of California, San Francisco (UCSF).

The Standardized Patient sessions focus on topics chosen in a needs assessment conducted by the Association of Professors of Dermatology. The assessment concluded that dermatology professionals need additional practice on:

  • The Difficult Patient, which is a patient who has his or her own agenda
  • Medication Management, which involves counseling a patient with a fear of a medicine (such as isotretinoin) who has a lot of questions
  • Breaking Bad News, in which a patient is given a diagnosis of melanoma
  • The Total Body Skin Exam, in which a patient wants to be admitted to a hospital for a skin condition, which does not require hospitalization.

It is part of the growing trend of using simulations in medical education, especially in school settings, although it also is growing in continuing medical education, said Dr. Shinkai, who is involved with simulation education at UCSF.

“The fact that simulation is well accepted in medical schools and residency training speaks to the value people feel it has for both coaching opportunities and assessment,” she said. “I am excited that the AAD has taken this on. It is a great opportunity for anyone at any stage of their training.”

It is especially difficult for health care professionals to get feedback about their performance from patients in emotional situations, so simulation is a rare opportunity to get that feedback.

“It is clear the direction of the patient experience is valued,” Dr. Shinkai said. “We know that reimbursement is going to be tethered to patient ratings of providers, so this is one way for providers to get feedback on how they are doing, and maybe even develop some skill sets that can help improve their communication skills as well as their reimbursements. It’s a rich opportunity to improve, and that is what it is meant for.”

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