Standardized Patient Case Using the HEEADSSS Model for an Adolescent Interview

Abstract

Abstract Introduction This resource is a standardized patient (SP) case for medical student education in pediatrics. Within a 15-20 minute time frame, the students are asked to interview a female adolescent using the HEEADSSS (Home environment, Education and employment, Eating, peer-related Activities, Drugs, Sexuality, Suicide/depression, and Safety) model and then identify risky behaviors of the adolescent and provide brief counseling. Methods A standard history and physical examination are not performed, but are presumed to have occurred already and are normal. A SP postencounter checklist and a student postencounter form are used to determine pass/fail for the student and for faculty to use for formative feedback to the student. The case requires a trained SP female, dressed in typical adolescent fashion. The training summary is provided. When used for formative evaluation, faculty must be available to observe and provide feedback to the learners. Postencounter exercises for students and SP checklists require either paper checklists or a web-based SP encounter system to record data. Results This case was developed, tested, and modified over seven separate testing dates from 2005 and 2006, with an average of six students per test date. The failure rate for the 38 encounters was 10.5%. All failures were due to the student not identifying two of three most urgent risky behaviors. Data presented here are from the encounters completed after modifications by the faculty, which improved the clarity of the educational objectives and the ability of the postencounter form to measure whether the student met the objectives. All encounters occurred in the same facility and all SPs were trained by the same trainers. Discussion We have used this case in a third-year pediatric clerkship that incorporates teaching about the HEEADSSS interview. We have also used it for formative evaluation with faculty feedback. This case could also be used for summative feedback, if appropriate teaching were provided. Our data suggest we used appropriate pass/fail criteria for third-year medical students and that this criteria could also be applied to fourth-year students. If pass/fail criteria were adjusted for expected residency-level performance, the case could be used for formative or summative evaluation in pediatric and family medicine residencies.

Keywords

• HEEADSSS
• Risk-Taking
• Interview
• Risk Behaviors