Advances in Medical Education and Practice (Jul 2019)

Usefulness of a short training seminar on how to handle difficult patients in simulated education

  • Shikino K,
  • Ito S,
  • Ohira Y,
  • Noda K,
  • Asahina M,
  • Ikusaka M

Journal volume & issue
Vol. Volume 10
pp. 483 – 491


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Kiyoshi Shikino1,2, Shoichi Ito2,3, Yoshiyuki Ohira,1 Kazutaka Noda,1 Mayumi Asahina2,3, Masatomi Ikusaka1,21Department of General Medicine, Chiba University Hospital, Chiba, Japan; 2Health Professional Development Center, Chiba University Hospital, Chiba, Japan; 3Office of Medical Education, Chiba University Graduate School of Medicine, Chiba, JapanObjective: To evaluate a short-time simulation training seminar on how to handle difficult patients using professional simulated patients (SPs) such as actors.Participants: Sixty-three second-year residents at Chiba University Hospital between 2015 and 2017 who only attended the seminar once.Intervention: The participants were divided into small groups, each of which was assigned a supervisory doctor as facilitator. Those who were playing the doctor’s role enacted a medical interview with an SP. After the interview, the facilitator, the SP, and the observing residents participated in a debriefing while watching a recorded video of the interview.Outcome measures: Pre- and post-seminar questionnaires using a 7-point Likert scale (from 1: strongly disagree to 7: strongly agree) were used to examine the differences in “confidence in ability to handle difficult patients” and “learning motivation to handle difficult patients”. The two items examined by both pre- and post-seminar questionnaires, were analyzed by a paired t-test. The residents were also surveyed on their satisfaction with the seminar, acquisition of new knowledge, and impressions and comments (free-text answers).Results: The findings of the questionnaire showed a significant post-seminar increase in confidence (3.1±1.6 to 4.0±1.5 [p<0.01]) and learning motivation (5.3±1.8 to 5.8±1.5 [p<0.01]) as well as high levels of satisfaction (5.8±1.1) with the seminar and acquisition of knowledge (5.7±1.3). Some residents further reported that the seminar led to self-review and was valuable for their future clinical practice.Conclusion: Our seminar on how to handle difficult patients was perceived as effective, as evaluated by the questionnaire, despite the short duration of the session. Factors potentially contributing to this effectiveness include the use of actors as SPs and the post-interview debriefing with feedback from the SP, colleagues, and facilitator.Keywords: difficult patient encounter, simulation scenario, simulated patient, medical education, short training seminar