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Comparison of single versus multiple learners in standardized patient communication skills training in palliative care
Journal article   Peer reviewed

Comparison of single versus multiple learners in standardized patient communication skills training in palliative care

Michael L. Spear, Leland J. Rockstraw and Bruce Bernstein
Journal of interprofessional education & practice, v 15, pp 34-37
Jun 2019
DOI: https://doi.org/10.1016/j.xjep.2019.01.008

Abstract

Simulation training has gained wide usage over many disciplines in medical education. According to Donovan et al., "In the use of simulated patients, the actors are experienced, and the participants could interact with the 'patients' in a controlled learning environment, working realistically with the emotions and feelings generated by the 'patients' and thereby adding a sense of reality to the learning situation."1–9 We hypothesize that in the rich environment of a standardized patient simulation, if learners share the simulation, the learning will be enhanced and the experience will be more valuable than if each learner is alone in this experience. The purpose of this project was to compare use of a single learner versus multiple learners in a standardized patient palliative care simulation. The format of this educational resource was to run 26 simulation sessions using a standardized patient encounter. The standardized patient was a young adult who had relapsed with non-curable osteosarcoma. The simulation was done with either a single learner (a pediatric resident) or 2 learners (a resident and a nurse student), to determine if there was increased learning with multiple learners in a single scenario. The simulation was 20 min for each session, 2 sessions per afternoon, and a 40-min debriefing per session. Each simulation was recorded and the video was used solely for debriefing. The target learners were pediatric residents and nursing students from the Drexel University College of Nursing. The objectives were: 1) To assess degree of pediatric resident and nursing trainee baseline comfort and learning of communication skills when dealing with palliative care using standardized patients, 2) To encourage collaboration between nurses and residents in this scenario, 3) To quantify the level of perceived improvement in comfort and interdisciplinary collaboration, 4) To perform a thematic qualitative analysis of the scenario via a post simulation debriefing, to learn how the educational experience may work, and be enhanced, and 5) To compare a scenario with an individual learner versus a multidisciplinary learning environment. The objectives were assessed with pre- and post-Likert scales, and a qualitative discussion/survey after the intervention. Each learner demonstrated significant learning and increasing comfort based on this assessment, and the results trended toward even more learning in the inter-disciplinary format. The impact of this study was to develop an inter-disciplinary training model in difficult communications with patients, which truly represents the way this communication should occur with our patients and their families. The resources needed included standardized patients, and a robust simulation center.

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