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Karen E Hauer - One of the best experts on this subject based on the ideXlab platform.
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assessing 3rd year medical students interprofessional collaborative practice behaviors during a Standardized Patient encounter a multi institutional cross sectional study
Medical Teacher, 2015Co-Authors: Christy K Boscardin, Maria Wamsley, Malathi Srinivasan, Aimee Sznewajs, Andrew Nevins, Karen E HauerAbstract:AbstractBackground: To understand how third-year medical student interprofessional collaborative practice (IPCP) is affected by self-efficacy and interprofessional experiences (extracurricular experiences and formal curricula).Methods: The authors measured learner IPCP using an objective structured clinical examination (OSCE) with a Standardized nurse (SN) and Standardized Patient (SP) during a statewide clinical performance examination. At four California medical schools from April to August 2012, SPs and SNs rated learner IPCP (10 items, range 0–100) and Patient-centered communication (10 items, range 0–100). Post-OSCE, students reported their interprofessional self-efficacy (16 items, 2 factors, range 1–10) and prior extracurricular interprofessional experiences (3 items). School representatives shared their interprofessional curricula during guided interviews.Results: Four hundred sixty-four of 530 eligible medical students (88%) participated. Mean IPCP performance was 79.6 ± 14.1 and mean self-effica...
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assessing 3rd year medical students interprofessional collaborative practice behaviors during a Standardized Patient encounter a multi institutional cross sectional study
Medical Teacher, 2015Co-Authors: Sandra K Oza, Maria Wamsley, Malathi Srinivasan, Christy K Boscardin, Aimee Sznewajs, Andrew Nevins, Win May, Karen E HauerAbstract:AbstractBackground: To understand how third-year medical student interprofessional collaborative practice (IPCP) is affected by self-efficacy and interprofessional experiences (extracurricular experiences and formal curricula).Methods: The authors measured learner IPCP using an objective structured clinical examination (OSCE) with a Standardized nurse (SN) and Standardized Patient (SP) during a statewide clinical performance examination. At four California medical schools from April to August 2012, SPs and SNs rated learner IPCP (10 items, range 0–100) and Patient-centered communication (10 items, range 0–100). Post-OSCE, students reported their interprofessional self-efficacy (16 items, 2 factors, range 1–10) and prior extracurricular interprofessional experiences (3 items). School representatives shared their interprofessional curricula during guided interviews.Results: Four hundred sixty-four of 530 eligible medical students (88%) participated. Mean IPCP performance was 79.6 ± 14.1 and mean self-effica...
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assessment of medical students shared decision making in Standardized Patient encounters
Journal of General Internal Medicine, 2011Co-Authors: Karen E Hauer, Arianne Teherani, Alicia Fernandez, Christy Boscardin, George W SabaAbstract:BACKGROUND Shared decision-making, in which physicians and Patients openly explore beliefs, exchange information, and reach explicit closure, may represent optimal physician–Patient communication. There are currently no universally accepted methods to assess medical students’ competence in shared decision-making.
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consequences within medical schools for students with poor performance on a medical school Standardized Patient comprehensive assessment
Academic Medicine, 2009Co-Authors: Karen E Hauer, Arianne Teherani, Kathleen M Kerr, David M Irby, Patricia S OsullivanAbstract:PURPOSE Medical schools increasingly employ comprehensive Standardized Patient assessments to ensure medical students' clinical competence. The consequences of poor performance on the assessment and the institutional factors associated with imposing consequences are unknown. METHOD In 2006, the investigators surveyed 122 U.S. medical school curriculum deans about comprehensive assessments using Standardized Patients after core clerkships, with questions about exam characteristics, institutional commitment to the examination (years of experience, exam infrastructure, clerkship director involvement), academic consequences of failing the assessment, and satisfaction with remediation. RESULTS Ninety-three of 122 (76%) deans responded. Eighty-two (88%) conducted a comprehensive assessment in years three or four of medical school. Of those, required remediation was the only consequence of failing employed by 61 schools (74%), and only 39 (47%) required retesting for graduation. Participants were somewhat satisfied with (mean 3.45 out of maximum 5, SD 1.08) and confident in (3.37, SD 1.17) their remediation process. Satisfaction and confidence were associated with requiring remediation (P = .003) and retesting (P < .001), but experience with the exam, exam infrastructure, and clerkship director involvement were not. No school demographic characteristics or measures of institutional commitment were related to external reporting of students' comprehensive assessment scores. CONCLUSIONS Despite the prevalence of comprehensive assessments, schools attach few academic consequences to poor performance. Educators are only moderately satisfied with their efforts to remediate poor performers. However, schools with greater trust in their remediation process than other schools are more likely to enforce consequences of poor performance.
Malathi Srinivasan - One of the best experts on this subject based on the ideXlab platform.
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assessing 3rd year medical students interprofessional collaborative practice behaviors during a Standardized Patient encounter a multi institutional cross sectional study
Medical Teacher, 2015Co-Authors: Sandra K Oza, Maria Wamsley, Malathi Srinivasan, Christy K Boscardin, Aimee Sznewajs, Andrew Nevins, Win May, Karen E HauerAbstract:AbstractBackground: To understand how third-year medical student interprofessional collaborative practice (IPCP) is affected by self-efficacy and interprofessional experiences (extracurricular experiences and formal curricula).Methods: The authors measured learner IPCP using an objective structured clinical examination (OSCE) with a Standardized nurse (SN) and Standardized Patient (SP) during a statewide clinical performance examination. At four California medical schools from April to August 2012, SPs and SNs rated learner IPCP (10 items, range 0–100) and Patient-centered communication (10 items, range 0–100). Post-OSCE, students reported their interprofessional self-efficacy (16 items, 2 factors, range 1–10) and prior extracurricular interprofessional experiences (3 items). School representatives shared their interprofessional curricula during guided interviews.Results: Four hundred sixty-four of 530 eligible medical students (88%) participated. Mean IPCP performance was 79.6 ± 14.1 and mean self-effica...
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assessing 3rd year medical students interprofessional collaborative practice behaviors during a Standardized Patient encounter a multi institutional cross sectional study
Medical Teacher, 2015Co-Authors: Christy K Boscardin, Maria Wamsley, Malathi Srinivasan, Aimee Sznewajs, Andrew Nevins, Karen E HauerAbstract:AbstractBackground: To understand how third-year medical student interprofessional collaborative practice (IPCP) is affected by self-efficacy and interprofessional experiences (extracurricular experiences and formal curricula).Methods: The authors measured learner IPCP using an objective structured clinical examination (OSCE) with a Standardized nurse (SN) and Standardized Patient (SP) during a statewide clinical performance examination. At four California medical schools from April to August 2012, SPs and SNs rated learner IPCP (10 items, range 0–100) and Patient-centered communication (10 items, range 0–100). Post-OSCE, students reported their interprofessional self-efficacy (16 items, 2 factors, range 1–10) and prior extracurricular interprofessional experiences (3 items). School representatives shared their interprofessional curricula during guided interviews.Results: Four hundred sixty-four of 530 eligible medical students (88%) participated. Mean IPCP performance was 79.6 ± 14.1 and mean self-effica...
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physician communication regarding prostate cancer screening analysis of unannounced Standardized Patient visits
Annals of Family Medicine, 2013Co-Authors: Bo Feng, Malathi Srinivasan, Jerome R Hoffman, Julie A Rainwater, Erin Griffin, Marko Dragojevic, Frank C Day, Michael S WilkesAbstract:PURPOSE Prostate cancer screening with prostate-specific antigen (PSA) is a con - troversial issue. The present study aimed to explore physician behaviors during an unannounced Standardized Patient encounter that was part of a randomized controlled trial to educate physicians using a prostate cancer screening, interac- tive, Web-based module. METHODS Participants included 118 internal medicine and family medicine physicians from 5 health systems in California, in 2007-2008. Control physicians received usual education about prostate cancer screening (brochures from the Center for Disease Control and Prevention). Intervention physicians participated in the prostate cancer screening module. Within 3 months, all physicians saw unannounced Standardized Patients who prompted prostate cancer screening discussions in clinic. The encounter was audio-recorded, and the recordings were transcribed. Authors analyzed physician behaviors around screening: (1) engage- ment after prompting, (2) degree of shared decision making, and (3) final recom - mendations for prostate cancer screening. RESULTS After prompting, 90% of physicians discussed prostate cancer screen- ing. In comparison with control physicians, intervention physicians showed somewhat more shared decision making behaviors (intervention 14 items vs con- trol 11 items, P <.05), were more likely to mention no screening as an option (intervention 63% vs control 26%, P <.05), to encourage Patients to consider different screening options (intervention 62% vs control 39%, P <.05) and seek- ing input from others (intervention 25% vs control 7%, P <.05). CONCLUSIONS A brief Web-based interactive educational intervention can improve shared decision making, neutrality in recommendation, and reduce PSA test ordering. Engaging Patients in discussion of the uses and limitations of tests with uncertain value can decrease utilization of the tests.
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Ratings of Physician Communication by Real and Standardized Patients
Annals of family medicine, 2007Co-Authors: Kevin Fiscella, Malathi Srinivasan, Peter Franks, Richard L. Kravitz, Ronald M. EpsteinAbstract:PURPOSE Patient ratings of physician's Patient-centered communication are used by various specialty credentialing organizations and managed care organizations as a measure of physician communication skills. We wanted to compare ratings by real Patients with ratings by Standardized Patients of physician communication. METHODS We assessed physician communication using a modifi ed version of the Health Care Climate Questionnaire (HCCQ) among a sample of 100 community physicians. The HCCQ measures physician autonomy support, a key dimension in Patient-centered communication. For each physician, the questionnaire was com- pleted by roughly 49 real Patients and 2 unannounced Standardized Patients. Standardized Patients portrayed 2 roles: gastroesophageal disorder refl ux symp- toms and poorly characterized chest pain with multiple unexplained symptoms. We compared the distribution, reliability, and physician rank derived from using real and Standardized Patients after adjusting for Patient, physician, and stan- dardized Patient effects. RESULTS There were real and Standardized Patient ratings for 96 of the 100 physicians. Compared with Standardized Patient scores, real-Patient-derived HCCQ scores were higher (mean 22.0 vs 17.2), standard deviations were lower (3.1 vs 4.9), and ranges were similar (both 5-25). Calculated real Patient reliabil- ity, given 49 ratings per physician, was 0.78 (95% confi dence interval (CI), 0.71-0.84) compared with the Standardized Patient reliability of 0.57 (95% CI, 0.39-0.73), given 2 ratings per physician. Spearman rank correlation between mean real Patient and Standardized Patient scores was positive but small to moderate in magnitude, 0.28. CONCLUSION Real Patient and Standardized Patient ratings of physician com- munication style differ substantially and appear to provide different information about physicians' communication style.
Steven Vernino - One of the best experts on this subject based on the ideXlab platform.
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Standardized Patient handoff improves resident confidence and Patient safety p4 279
Neurology, 2014Co-Authors: Justin T Jordan, Steven VerninoAbstract:OBJECTIVE: To evaluate the effects on neurology resident physician confidence, comfort levels and Patient safety concerns before and after implementation of a Standardized Patient handoff method. BACKGROUND: In the era of increasing duty hour regulations, inPatient care is necessarily more fragmented among practitioners. Accordingly, Patient handoffs are more frequent between providers. Despite their importance in daily hospital care, the technique of Patient care handoffs is little studied, especially in regards to Patient safety. DESIGN/METHODS: Using a five-point Likert scale, neurology residents were anonymously surveyed regarding the quality of Patient handoffs, as well as the frequency of handoff-related Patient safety concerns. Then, we developed our own Standardized EMR tool for Patient handoffs, whose use was required for residents. Additionally, time and location were Standardized for resident handoffs to ensure consistency. After six months of using this new system, a second anonymous survey was performed. Student t-test was used to compare mean responses between surveys. RESULTS: Twelve residents responded to each survey. Overall, there was a positive trend in the perceived quality of Patient handoffs following our intervention. The frequency of face-to-face handoffs (p=0.0073) occurring in a quiet location (p= 0.0059) significantly increased. Residents significantly expressed more confidence in their own handoff techniques (p=0.03423), and reported more consistency between handoffs (p=0.0118). Additionally, residents perceived improved Patient safety after a handoff (p=0.0074), with decreased reports of handoff-associated Patient safety events (p=0.0269). CONCLUSIONS: In this small pilot study, requiring neurology residents to use a Standardized Patient care handoff tool and technique improved confidence in their own handoffs, as well as perceived Patient safety. Further evaluation of Standardized handoff methods is warranted. Study Supported by: None Disclosure: Dr. Jordan has nothing to disclose. Dr. Vernino has received personal compensation in an editorial capacity for JAMA Neurology.
John F. Wilson - One of the best experts on this subject based on the ideXlab platform.
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house staff nonverbal communication skills and Standardized Patient satisfaction
Journal of General Internal Medicine, 2003Co-Authors: Charles H Griffith, John F. Wilson, Shelby Langer, Steven A. HaistAbstract:OBJECTIVE: To examine the association of physician nonverbal communication with Standardized Patient (SP) satisfaction in the context of the “quality” of the interview (i.e., information provided and collected, communication skills).
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A model for setting performance standards for Standardized Patient examinations.
Evaluation & the health professions, 2003Co-Authors: Gregg Talente, Steven A. Haist, John F. WilsonAbstract:Setting standards for complex performance assessments is difficult. This report describes and evaluates a model for setting performance standards for Standardized Patient examinations. A variation of a modified Angoff standard-setting procedure was used to set cutoffs for a Standardized Patient exercise. Analysis of the procedure was based on evaluation of the impact of the iterative process, the ability of the final standards to accurately classify trainees and the judges’confidence in the procedure and final standards. The practicality of the process also was assessed. The iterative steps in this procedure led to a reduction in the variance between the judges’ratings. All seven judges reported confidence in the final standards. The mean time commitment for each judge was 4.7 work hours. This model for setting performance standards successfully set useful standards for this exam, was practical, and can be utilized to set performance standards for other Standardized Patient examinations.
Maria Wamsley - One of the best experts on this subject based on the ideXlab platform.
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assessing 3rd year medical students interprofessional collaborative practice behaviors during a Standardized Patient encounter a multi institutional cross sectional study
Medical Teacher, 2015Co-Authors: Sandra K Oza, Maria Wamsley, Malathi Srinivasan, Christy K Boscardin, Aimee Sznewajs, Andrew Nevins, Win May, Karen E HauerAbstract:AbstractBackground: To understand how third-year medical student interprofessional collaborative practice (IPCP) is affected by self-efficacy and interprofessional experiences (extracurricular experiences and formal curricula).Methods: The authors measured learner IPCP using an objective structured clinical examination (OSCE) with a Standardized nurse (SN) and Standardized Patient (SP) during a statewide clinical performance examination. At four California medical schools from April to August 2012, SPs and SNs rated learner IPCP (10 items, range 0–100) and Patient-centered communication (10 items, range 0–100). Post-OSCE, students reported their interprofessional self-efficacy (16 items, 2 factors, range 1–10) and prior extracurricular interprofessional experiences (3 items). School representatives shared their interprofessional curricula during guided interviews.Results: Four hundred sixty-four of 530 eligible medical students (88%) participated. Mean IPCP performance was 79.6 ± 14.1 and mean self-effica...
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assessing 3rd year medical students interprofessional collaborative practice behaviors during a Standardized Patient encounter a multi institutional cross sectional study
Medical Teacher, 2015Co-Authors: Christy K Boscardin, Maria Wamsley, Malathi Srinivasan, Aimee Sznewajs, Andrew Nevins, Karen E HauerAbstract:AbstractBackground: To understand how third-year medical student interprofessional collaborative practice (IPCP) is affected by self-efficacy and interprofessional experiences (extracurricular experiences and formal curricula).Methods: The authors measured learner IPCP using an objective structured clinical examination (OSCE) with a Standardized nurse (SN) and Standardized Patient (SP) during a statewide clinical performance examination. At four California medical schools from April to August 2012, SPs and SNs rated learner IPCP (10 items, range 0–100) and Patient-centered communication (10 items, range 0–100). Post-OSCE, students reported their interprofessional self-efficacy (16 items, 2 factors, range 1–10) and prior extracurricular interprofessional experiences (3 items). School representatives shared their interprofessional curricula during guided interviews.Results: Four hundred sixty-four of 530 eligible medical students (88%) participated. Mean IPCP performance was 79.6 ± 14.1 and mean self-effica...
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Interprofessional Standardized Patient Exercise (ISPE): The Case of “Elsie Smith”
MedEdPORTAL Publications, 2013Co-Authors: Josette Rivera, Michi Yukawa, Susan Hyde, Amber Fitzsimmons, Janelle Christman, Alice Gahbauer, Alison Scheid, Maria WamsleyAbstract:Abstract Introduction Interprofessional education occurs when students/trainees of two or more healthcare professions engage in learning with, from, and about each other, and is viewed as a primary...
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the impact of an interprofessional Standardized Patient exercise on attitudes toward working in interprofessional teams
Journal of Interprofessional Care, 2012Co-Authors: Maria Wamsley, Jennifer Staves, Lisa Kroon, Kimberly S Topp, Mehran Hossaini, Barbara Newlin, Caroline Lindsay, Bridget C ObrienAbstract:Effective interprofessional education engages participants in authentic tasks, settings and roles. Using these guiding principles, an interprofessional Standardized Patient exercise (ISPE) was developed and implemented for 101 dental, medical, nurse practitioner, pharmacy and physical therapy students. This study describes the ISPE and evaluates its impact on students' attitudes toward working in interprofessional teams. The attitudes toward health care teams (ATHCT) survey was administered pre- and post-ISPE and to a sample of non-participating students. Faculty and students were surveyed post-ISPE about outcomes and satisfaction. Focus groups were conducted with students from each profession. Students' attitudes toward team-based care improved significantly on the team value and team efficiency subscales of the ATHCT. There were significant differences in attitudes toward team-based care by profession. Faculty and student satisfaction with the ISPE was high. These findings contribute to the growing body...
