USE OF A REMOTE, LIVE STANDARDIZED PATIENT TO
ASSESS MASTERY OF CLINICAL SKILLS ON ALCOHOL ABUSE
AND DEPENDENCE
Susan Wilhelm, PhD, T Bradley Tanner, MD, and Mary P Metcalf, PhD, MPH
Clinical Tools Inc, Chapel Hill, NC, USA
Introduction: With funding from a NIH/NIAAA grant (#1R44AA016724–
01A1), we created an online medical student curriculum on alcohol abuse. To
assess mastery of clinical concepts, we developed a novel method of conducting
remote live standardized patient (SP) interviews using Google® chat, with a
trained staff member as the SP. In advance of a summative evaluation in 2010,
we conducted a pilot test to assess the utility of the case and gather student
feedback.
Methods: We developed a standardized patient case, Cynthia Stewart, who
presents with insomnia and is diagnosed with alcohol abuse. Five third-year
students interviewed Cynthia during a 45-minute Google® chat experience.
Students completed eight online courses, then performed a second SP interview.
Clinical skill competency was measured using a 13-item done/not done checklist
completed by both the SP and an independent reviewer. Interpersonal skills were
evaluated by the SP using a 9-item checklist and a 5- point Likert scale. Student
self-assessment, assessment of the SP by the student, and patient notes were also
collected.
Results: Clinical skill competency rose modestly from pre-test (64%) to post-test
(77%). Interpersonal skills rose modestly from pre-test (2.65) to post-test (3.22).
Although sample size (n5) was too small for determination of statistical
significance, the results are encouraging for future studies. Student self-assessment
of interpersonal skills were much higher (4.03 pre and 4.11 post) than
those assessed by the SP. A majority of students (80%) rated the SP performance
as very good or excellent. All students correctly identified alcohol abuse as a
possible differential diagnosis on patient notes. We obtained usability feedback
about the standardized patient post-experience. Eighty percent (4/5) agreed or
strongly agreed that the interviewing process was a valuable learning experience,
that the SP interviews were consistent pre/post experience, and that the
patient case was typical of a real patient. All students (n5) agreed or strongly
agreed that the SP interview via Google® chat was an interesting way to
practice clinical skills. Students provided open-ended feedback on ways to
increase the difficulty of the SP case.
Conclusions: Students were able to improve clinical skills through a chat-based
SP interview. Improvements in advance of a more thorough evaluation with a
larger n include refinements to the patient case and assessments and creation of
a second SP case to increase variability pre/post experience.