Simulation design, findings, and call to action for managing difficult patient encounters

Abstract

Objective. To implement and evaluate a laboratory simulation for teaching difficult patient encounter skills to pharmacy students to improve their self-assessed communication abilities and skills in the affective domain. Methods. Twelve simulation scenarios that represented difficult patient encounters in a variety of practice settings were developed. All students completed a self-assessment of their ability to communicate during difficult patient encounters before and after the simulations, and wrote a guided reflection afterward. The impact of the simulation was evaluated using quantitative and qualitative methodology. Three student cohorts were analyzed to determine whether significant change occurred in students’ selfperceived communication abilities. Thematic analysis of the qualitative reflection responses was performed. Results. Over three years, three student cohorts of third-year professional students participated in the simulations (n5236). Students self-rated their ability to communicate on a 0-100 scale. Mean self-rating of ability prior to the simulation was 57.7 (SD515.9) and after was 79.2 (SD515.2). This mean difference of 21.5 points equates to an approximate 20% increase in self-rated ability. Variability in selfratings between the cohorts was not significant. Qualitative analysis revealed that the simulation identified for student areas needing further development which in turn promoted self-awareness. Students expressed that learning in the safe, formative environment provided by the simulation contributed to their professional growth and was relevant to their future practice of pharmacy. Conclusion. This simulation fills a gap in skills-based education, addresses the affective domain of the Accreditation Council for Pharmacy Education (ACPE) Standards, transfers easily to schools and colleges of pharmacy. This supports a call to action for pharmacy educators to provide purposeful opportunities for students to practice communicating with patients during difficult encounters.