The Impact of a Standardized Patient Program on Student Learning of Communication Skills

Article excerpt

INTRODUCTION

A patient-centered care philosophy is an integral part of providing optimal pharmaceutical care (1) Patient-centered care requires the mastery of many important communication skills between a pharmacist and patient. Improving patient education and monitoring, providing support, and enabling patient feedback has a significant impact on a variety of health outcomes. (2-4) The American Association of Colleges of Pharmacy's Center for the Advancement of Pharmaceutical Care (CAPE) recognizes the clear and significant role of communication on patient care by setting guidelines that pharmacy graduates demonstrate an ability to communicate and collaborate with other healthcare professionals. (5) These guidelines do not stipulate how and what communication skills should be taught. The Accreditation Council for Pharmacy Education (ACPE) does provide recommendations about communication skills that should be emphasized, such as interviewing techniques, active listening and empathy, assertiveness, and problem-solving. (6) It is up to the schools of pharmacy to choose appropriate topics and methods in the delivery of this knowledge and practice in skills. (5,6) As with the CAPE document, ACPE standards do not require that any of these topics be taught according to a particular didactic method. (7)

Pharmacy schools often teach the following communication topics: (1) how to initiate communication, (2) establishing a trusting relationship, (3) using effective non verbal communication, (4) eliciting information from the patient, (5) initiating educational interventions, (6) promoting adherence to appropriate drug therapy, (7) encouraging patient involvement in communication and problem solving, (8) organizing the encounter, (9) identifying cross-cultural communication issues, (10) verifying patient understanding, and (11) ending the encounter. (6,8,9) Current methods in teaching communication also include didactic learning, role playing, and the use of standardized patients. Role playing with other students or faculty members and the use of standardized patients typically involve more active learning than do didactic lectures since students are more likely to be learning by doing rather than passively receiving course content. Active learning has been defined as a "style of teaching that requires the learner to formulate answers to questions based on acquired knowledge while continuing to search for new knowledge that may provide better, more complete answers. (7)

The techniques of role playing with other students or staff members and the use of standardized patients present different types of active-learning experiences for students learning communication skills. (10) Role playing is when someone is given a role to act out such as that of a patient or physician. (10) Role playing that occurs in the classroom often involves students taking turns portraying a pharmacist or a patient in a brief interaction. Sometimes role playing may involve students portraying the pharmacist and course staff members portraying the patient. The disadvantages of this approach include the lack of useful and/ or critical feedback from other students, inconsistent learning experiences resulting from wide variations in acting skills among participants, and difficulty pretending a peer or faculty member is a "patient."

The definition of a standardized patient is someone who has been trained to portray a character in a scripted case scenario and who is able to consistently deliver a similar performance when interacting with different students. (11,12) Standardized patients are valuable for several reasons. (10,11) The consistency of the acting by standardized patients allows faculty members to evaluate students more objectively. Also, standardized patients are trained to portray a broad spectrum of personalities and deliver appropriate corresponding reactions in various situations. (11) This permits students to be exposed to different situations and patient personalities and develop the skills to react accordingly. …