The Science Journal of the American Association for Respiratory Care

2012 OPEN FORUM Abstracts


Leo Wittnebel, Ruben D. Restrepo, Richard Wettstein, Donna D. Gardner, Helen Sorenson; Respiratory Care, UTHSCSA, San Antonio, TX

Background: Standardized patients (SPs) are routinely used across the US to prepare 3rd and 4th year medical students (MDS) for their US Medical License Examination (USMLE) Step 2-Clinical Simulation and evaluate their clinical assessment skills. These SPs are given scripted scenarios that are “played” during the patient encounter in a mock examination room. To the best of our knowledge, this is the first study evaluating the use of SP interaction on RT students (RTS) prior to their first clinical rotation. Methods: RT faculty (RTF) revised a previously validated 13-item Likert type scoring instrument used to gauge interviewing skills for the USMLE. After consensus 8 items deemed most relevant to the role of a RT (proper introduction, appearance, organization, types of questions, listening, nonverbal facilitation, comfort during physical, and closure of the interview) were analyzed. A “cough and shortness of breath” scenario was selected and RTS utilized material learned from the Patient Assessment course to obtain a history and physical examination of the chest. The RTS were evaluated by RTF and SPs and were also asked to score themselves on their performance. Pearson correlations, chi square and descriptive analysis were performed using SPSS 11.0. Results: Overall RTS mean scores (1 to 3 scale) were 2.59 by RTF (n=4), 2.78 by SPs (n=4), and 2.35 by RTS (n=24). Perceived competence was significantly different between RTS and SPs (p=0.001) and between SPs and RTF (p=0.005) but not between RTF and RTS (p=.078). Chi square analysis indicated no significant difference in rating between RTF (χ2=6.00, df 4, p=.199). No significant correlation was found between any individual item and the mean overall score. Conclusions: While no individual item had a significant relationship to overall RTS score, the chi square results demonstrate inter-rater reliability for RTF on an assessment used almost exclusively for MDS. While RTS had a significantly lower perception of their competency when compared with scores given by SPs, their scores were not significantly different from those by RTF. Ex post facto qualitative statements provided by the SPs revealed the perception that RTS performed at or above the level of the typical MDS. While further research is needed to determine the validity of this comparison, this study attests to the potential viability of using the simulated patient encounters as a valid means of evaluating clinical assessment skills in RT students. Sponsored Research - None * p < 0.05