The two heads of a simulated patient – maximizing their use in communication training

ABSTRACT

Background

Simulated patients (SPs) are an established resource in medical communication training where they portray patients with medical problems to allow medical students to practice communication skills. The range of skills offered by SPs appears to be underappreciated and there is no formal published research exploring their views on how their skills can best be utilized in experiential teaching sessions. This study aims to fill that research gap.

Methods

Eighteen SPs from two medical schools, Hull York Medical School and Durham University, were interviewed using an in-depth, one-to-one, semi-structured approach. Data was transcribed verbatim and thematically analysed.

Results

Three global themes were identified from the data: (i) the benefits of using simulated patients, (ii) prerequisites and (iii) feedback. Benefits of using SPs include their ability to target specific communication skills in role-play. They can facilitate sessions and give feedback to students; and they enable early communication training in a non-clinical setting. Their key asset is the ability to role-play a realistic patient whilst simultaneously appraising the student’s performance and adapting their role to create learning opportunities. We have named this dual approach the two heads of an SP. There are certain essential prerequisites. SPs and tutors need appropriate training. Students should be encouraged to be themselves and engage in consultations. A close SP-tutor relationship is beneficial. For SPs giving feedback to students, a priority is to build student confidence. Views on the use of in-role feedback were polarized.

Conclusion

This study explores SPs’ views on the skills they offer in medical communication training and how these can be best utilized, providing valuable learning points for medical educators.

KEYWORDS:

• Medical communication
• simulated patients
• SPs
• communication training
• empathy
• medical students
• patient centred
• professionalism

Acknowledgements

We would like to acknowledge all the SPs involved in this study and the administration teams in HYMS and Durham who helped facilitate recruitment.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Ethical approval

Ethical approval was granted from the HYMS Ethics Committee on 6 December 2016 (reference number 16 23).

Additional information

Notes on contributors

Nora Sangvik Grandal

Nora Sangvik Grandal graduated from Hull York Medical School in 2019 and now works as a junior doctor in London.

William Laughey

William Laughey is a GP and also works as a GP trainer and appraiser. Within the Hull York Medical School he is the clinical director of PGCME and a PBL facilitator for first year medical students.

Gabrielle M. Finn

Gabrielle M. Finn is Professor of Medical Education and the Director of the Health Professions Education Unit at the Hull York Medical School. She teaches on the MSc, Postgraduate Diploma and Certificate in Health Professions Education and is a supervisor for MSc, MD and PhD students.