Abstract
BACKGROUND
Use of web-based standardized patient (SP) modules is associated with improved medical student history-taking and physical examination skills on clinical performance examinations (CPX), but a benefit for communication skills has not been shown.
AIM
We describe an innovative web-based SP module using detailed SP and faculty commentary to teach communication skills.
SETTING
A public medical school in 2008–2009.
PARTICIPANTS
Fourth-year medical students.
PROGRAM DESCRIPTION
A 90-minute web-based module with three simulated clinical encounters was narrated by an expert clinician and SP to explain expected history-taking, physical examination, and communication skills behaviors. All 147 students were encouraged to review the module one month before the CPX.
PROGRAM EVALUATION
One hundred and six students (72%) viewed the web-based module. Students who watched the module performed significantly higher on the CPX communication score (+2.67%, p < 0.01) and overall score (+2.12%, p = 0.03), even after controlling for USMLE Step 1 and clerkship summary ratings. Use of the module did not significantly affect history/physical examination scores (+1.89%, p = 0.12).
DISCUSSION
Students who watched an optional web-based SP module prior to the CPX performed higher than those who did not on communication skills. The web-based module appears to be an effective CPX preparatory activity to enhance communication performance.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
REFERENCES
Stewart MA. Effective physician–patient communication and health outcomes: a review. CMAJ. 1995;152(9):1423–33.
Zolnierek KB, Dimatteo MR. Physician communication and patient adherence to treatment: a meta-analysis. Med Care. 2009;47(8):826–34.
Bredart A, Bouleuc C, Dolbeault S. Doctor-patient communication and satisfaction with care in oncology. Curr Opin Oncol. 2005;17(4):351–4.
Epstein RM, Hundert EM. Defining and assessing professional competence. JAMA. 2002;287(2):226–35.
Kalet A, Pugnaire MP, Cole-Kelly K, Janicik R, Ferrara E, Schwartz MD, et al. Teaching communication in clinical clerkships: models from the Macy initiative in health communications. Acad Med. 2004;79(6):511–20.
Makoul G. Communication skills education in medical school and beyond. JAMA. 2003;289(1):93.
May W, Park JH, Lee JP. A ten-year review of the literature on the use of standardized patients in teaching and learning: 1996–2005. Med Teach. 2009;31(6):487–92.
Lorin S, Rho L, Wisnivesky JP, Nierman DM. Improving medical student intensive care unit communication skills: a novel educational initiative using standardized family members. Crit Care Med. 2006;34(9):2386–91.
Levenkron JC, Greenland P, Bowley N. Using patient instructors to teach behavioral counseling skills. J Med Educ. 1987;62(8):665–72.
Rosen J, Spatz ES, Gaaserud AM, Abramovitch H, Weinreb B, Wenger NS, et al. A new approach to developing cross-cultural communication skills. Med Teach. 2004;26(2):126–32.
Vannatta JB, Smith KR, Crandall S, Fischer PC, Williams K. Comparison of standardized patients and faculty in teaching medical interviewing. Acad Med. 1996;71(12):1360–2.
Hauer KE, Hodgson CS, Kerr KM, Teherani A, Irby DM. A national study of medical student clinical skills assessment. Acad Med. 2005;80(10 Suppl):S25–9.
Hauer KE, Chou CL, Souza KH, Henry D, Loeser H, Burke C, et al. Impact of an in-person versus web-based practice standardized patient examination on student performance on a subsequent high-stakes standardized patient examination. Teach Learn Med. 2009;21:284–90.
Broekkamp H, Van Hout-Wolters, Bernadette HAM. Students’ adaptation of study strategies when preparing for classroom tests. Educ Psychol Rev. 2007;19(4):401–28.
Yudkowsky R, Downing SM, Ommert D. Prior experiences associated with residents' scores on a communication and interpersonal skill OSCE. Patient Educ Couns. 2006;62(3):368–73.
Shirar LE, Vu NV, Colliver JA, Barrows HS. A survey of study methods, preparation time, test-taking strategies, and perceptions of test validity on a clinical performance-based examination. Acad Med. 1992;67(10 Suppl):S10–2.
McGaghie WC, Downing SM, Kubilius R. What is the impact of commercial test preparation courses on medical examination performance? Teach Learn Med. 2004;16(2):202–11.
Zhang C, Rauchwarger A, Toth C, O'Connell M. Student USMLE step 1 preparation and performance. Adv Health Sci Educ Theory Pract. 2004;9(4):291–7.
Pilotti M, Chodorow M, Petrov R. The usefulness of retrieval practice and review-only practice for answering conceptually related test questions. J Gen Psychol. 2009;136(2):179–203.
Cook DA, Levinson AJ, Garside S, Dupras DM, Erwin PJ, Montori VM. Internet-based learning in the health professions: a meta-analysis. JAMA. 2008;300(10):1181–96.
Cook DA, Levinson AJ, Garside S, Dupras DM, Erwin PJ, Montori VM. Instructional design variations in internet-based learning for health professions education: a systematic review and meta-analysis. Acad Med. 2010;85(5):909–22.
Heine N, Garman K, Wallace P, Bartos R, Richards A. An analysis of standardised patient checklist errors and their effect on student scores. Med Educ. 2003;37(2):99–104.
Guiton G, Hodgson CS, Delandshere G, Wilkerson L. Communication skills in standardized-patient assessment of final-year medical students: a psychometric study. Adv Health Sci Educ Theory Pract. 2004;9(3):179–87.
Tamblyn R, Abrahamowicz M, Dauphinee WD, Hanley JA, Norcini J, Girard N, et al. Association between licensure examination scores and practice in primary care. JAMA. 2002;288(23):3019–26.
Lang F, McCord R, Harvill L, Anderson DS. Communication assessment using the common ground instrument: psychometric properties. Fam Med. 2004;36(3):189–98.
Srinivasan M, Hauer KE, Der-Martirosian C, Wilkes M, Gesundheit N. Does feedback matter? Practice-based learning for medical students after a multi-institutional clinical performance examination. Med Educ. 2007;41(9):857–65.
Martin D, Regehr G, Hodges B, McNaughton. Using videotaped benchmarks to improve the self-assessment ability of family practice residents. Acad Med. 1998;73(11):1201–6.
Werner LS, Bull BS. The effect of three commercial coaching courses on step one USMLE performance. Med Educ. 2003;37(6):527–31.
Yedidia MJ, Gillespie CC, Kachur E, Schwartz MD, Ockene J, Chepaitis AE, et al. Effect of communications training on medical student performance. JAMA. 2003;290(9):1157–65.
Rifkin WD, Rifkin A. Correlation between housestaff performance on the United States Medical Licensing Examination and standardized patient encounters. Mt Sinai J Med. 2005;72(1):47–9.
Simon SR, Volkan K, Hamann C, Duffey C, Fletcher SW. The relationship between second-year medical students' OSCE scores and USMLE step 1 scores. Med Teach. 2002;24(5):535–9.
Mann KV. Motivation in medical education: how theory can inform our practice. Acad Med. 1999;74(3):237–9.
Sobral DT. What kind of motivation drives medical students' learning quests? Med Educ. 2004;38(9):950–7.
Wilkinson TJ, Wells JE, Bushnell JA. Medical student characteristics associated with time in study: is spending more time always a good thing? Med Teach. 2007;29(2–3):106–10.
Acknowledgements
We thank Bernie Miller and Jewel Smally for assistance with module creation and examination administration and Christian Burke for technical assistance. This study was supported by a University of California, San Francisco Academy of Medical Educators Innovations Grant.
Conflict of Interest
None disclosed.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Lee, C.A., Chang, A., Chou, C.L. et al. Standardized Patient-Narrated Web-Based Learning Modules Improve Students’ Communication Skills on a High-stakes Clinical Skills Examination. J GEN INTERN MED 26, 1374–1377 (2011). https://doi.org/10.1007/s11606-011-1809-3
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11606-011-1809-3