gms | German Medical Science

Question: Communication training involving standardised patients (SP) and peer role-play (RP) are widely employed throughout undergraduate medical education. Surprisingly, a recent review [1] revealed, that there seems to exist only one study comparing the use of SPs and RPs directly. To evaluate the hypotheses that

1.

communication training with SPs is significantly better accepted than RPs and are considered to allow a better preparation for real parent-physician communication, whereas

2.

both, a training with SPs and RPs leads to a comparable OSCE performance.

Methods: We conducted a randomised controlled trial in the undergraduate course of paediatrics at the Medical Faculty of Heidelberg (Germany) using SP and RP in a paediatric communication training. The communication training was based on nine parents-physician-cases in a paediatric ambulatory setting including a medical and a communicational problem each. We compared two intervention groups

1.

communication training with standardised patients (IG-SP; N=30) and

2.

communication training using peer role-play (IG-RP; N=28) with

3.

a control group (CG; N=32) receiving no communication training.

Participating students rated how worthwhile the training was considered, realism of training situation and how students feel prepared for future parents-physician communication using a questionnaire including 10 items with Likert-scales ranging from 1=very high to 6=very low. Student’s OSCE performance was evaluated accessed using Calgary Checklist ([2], 20 items, VAS 1 – 10).

Results: Communication training using SPs was considered to be significantly more worthwhile (1.50 ±.42 for IG-SP vs. 1.83 ±.36 for IG-RP; p=.003; 1=very high, 6=very low). Both, training with SPs and with RPs was perceived highly realistic (1.47±.36 for IG-SP vs. 1.40±.38 for IG-RP, n.s.; 1=highly realistic; 6=not realistic). However, participants practicing with SPs feel significantly better prepared for future real parents–physician contacts (2.00 ±.89 for IG-SP vs. 2.71 ±1.08; p=0,008; 1=well prepared; 6=not prepared). Using the Calgary Checklist IG-RS performed significantly better in the six-station-OSCE compared to IG-SP (82.20 ±3.32 for IG-RP vs. 78.66 ±6.23 for IG-SP; p=0,017), whereas both IG-SP and IG-RP performed significantly better than CG.

Conclusion: Although both SPs and RPs are highly realistic, student’s acceptance for communication trainings using SPs are significantly higher compared to RPs. Objective performance measures revealed communication training using SPs or RPs increases students osce performance significantly compared to CG. We conclude SPs and RPs are both valuable methods for parent-physician communication training in undergraduate medical education. Concerning the higher cost-effectiveness of RPs educators should think of using both methods, although their students may prefer SPs.