Training Standardized Patients to Provide Effective Feedback: Development, Implementation, and its Effect on the Efficacy of Medical Students' Education

Abstract

Introduction: Standardized patient (SP) encounters are a pivotal part of medical student training and provide essential feedback on student performance. Feedback has been shown to develop interpersonal skills and alter motivation levels, reducing anxiety and increasing students' confidence in skills. Therefore, optimizing the quality of SP feedback will allow educators to provide students with more focused comments on performance, leading to personal development and better patient care. This project hypothesis states SPs receiving feedback training have greater confidence and offer feedback that is more effective during student encounters.

Methods: SPs were taught to give quality feedback through a training workshop. Training consisted of a presentation centered on a structured feedback model, allowing each SP the opportunity to practice both giving and receiving feedback. Evaluations were conducted using surveys administered immediately prior to and after training to determine training efficacy. Data gathered included demographics along with questions broadly relating to comfort/confidence in providing feedback and knowledge of communication skills. Performance of required feedback tasks was evaluated by observing SPs during encounters with students using a standardized checklist.

Results: Attitude assessment between pre- and post-training surveys demonstrated statistical significance for the following items: I have strong knowledge base regarding giving feedback. (p=0.0006), I can easily identify learners' areas that need improvement. (p=0.0007), I am comfortable reading and interpreting learners' nonverbal messages (i.e., body language). (p=0.0152). Knowledge assessment between pre- and post-training surveys showed statistical significance. Evaluation of SP performance demonstrated over 90 percent completion for six out of 10 required feedback tasks. The lowest mean completion was for the following items: gave at least one constructive comment (70.2 percent); tied constructive comment to feeling (57.2 percent); and gave recommendation for next time regarding constructive comment (55.0 percent).

Conclusions: SPs gained knowledge from the training course implemented. Attitudes and self-confidence when providing feedback also improved after training. Some SPs complete specific feedback tasks easier than others do during student encounters and may require additional training for tasks associated with constructive criticism. Feedback performance also improved over subsequent days.