Using Standardized Patients to Augment Communication Skills and Self-Efficacy in Caring for Transgender Youth.

Stanley R Vance, Brian Dentoni-Lasofsky, Elizabeth Ozer, Madeline B Deutsch, Matthew J Meyers, Sara M Buckelew
Author Information
  1. Stanley R Vance: Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of California, San Francisco (SR Vance, Jr, MJ Meyers, and SM Buckelew). Electronic address: stanley.vance@ucsf.edu.
  2. Brian Dentoni-Lasofsky: Department of Psychiatry, University of California, San Francisco (B Dentoni-Lasofsky).
  3. Elizabeth Ozer: Division of Adolescent and Young Adult Medicine and Office of Diversity and Outreach, University of California, San Francisco (E Ozer).
  4. Madeline B Deutsch: Department of Family Community Medicine, University of California, San Francisco (MB Deutsch).
  5. Matthew J Meyers: Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of California, San Francisco (SR Vance, Jr, MJ Meyers, and SM Buckelew).
  6. Sara M Buckelew: Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of California, San Francisco (SR Vance, Jr, MJ Meyers, and SM Buckelew).

Abstract

OBJECTIVE: To examine the impact of standardized patient encounters (SPEs) on gender-affirming communication skills and self-efficacy of pediatrics learners.
METHODS: Fourth-year medical students, pediatrics interns, psychiatry interns, and nurse practitioner trainees on 1-month adolescent medicine blocks completed a curriculum with e-learning activities that was expanded to include SPEs. Following e-learning, learners completed 2 SPEs featuring transgender adolescent cases. Faculty observers and standardized patients completed checklists focused on history-taking, counseling, and interpersonal communication, and provided learner feedback after each case. The curriculum was evaluated by comparing skills checklists scores from case 1 to case 2 via Wilcoxon signed-rank tests. Self-efficacy was assessed precurriculum (Assessment 1), post-e-learning (Assessment 2), and post-SPE (Assessment 3) using a previously developed instrument. Changes in self-efficacy scores were assessed via linear regression models with generalized estimating equations.
RESULTS: Forty-three eligible learners participated in the study. The majority were pediatrics interns, and 5 learners had worked in a transgender clinic prior to the curriculum participation. Learners increased median total checklist scores between cases from 22 to 28 (P < .001) (maximum score of 34). Learners' overall self-efficacy scores improved by 3.4 (confidence interval [CI]: 2.9-3.9; P < .001) between Assessments 1 and 2 and by 1.5 (CI: 1.2-1.7; P < .001) from Assessment 2 to 3. Similar improvements in checklist scores and self-efficacy occurred within stratified learner types.
CONCLUSIONS: The combination of SPEs with e-learning is effective at improving self-efficacy and gender-affirming communication skills for a multidisciplinary pediatrics learners. The comprehensive curriculum allowed learners inexperienced with transgender youth to apply knowledge and practice skills.

Keywords

MeSH Term

Adolescent
Child
Clinical Competence
Communication
Curriculum
Humans
Self Efficacy
Students, Medical
Transgender Persons
Male
Female

Word Cloud

Created with Highcharts 10.0.0learners2self-efficacyscores1SPEsskillspediatricscurriculume-learningtransgenderAssessmentstandardizedcommunicationinternscompletedcase3P<001gender-affirmingmedicaladolescentcasespatientschecklistslearnerviaassessed5checklistOBJECTIVE:examineimpactpatientencountersMETHODS:Fourth-yearstudentspsychiatrynursepractitionertrainees1-monthmedicineblocksactivitiesexpandedincludeFollowingfeaturingFacultyobserversfocusedhistory-takingcounselinginterpersonalprovidedfeedbackevaluatedcomparingWilcoxonsigned-ranktestsSelf-efficacyprecurriculumpost-e-learningpost-SPEusingpreviouslydevelopedinstrumentChangeslinearregressionmodelsgeneralizedestimatingequationsRESULTS:Forty-threeeligibleparticipatedstudymajorityworkedclinicpriorparticipationLearnersincreasedmediantotal2228maximumscore34Learners'overallimproved4confidenceinterval[CI]:9-39AssessmentsCI:2-17SimilarimprovementsoccurredwithinstratifiedtypesCONCLUSIONS:combinationeffectiveimprovingmultidisciplinarycomprehensiveallowedinexperiencedyouthapplyknowledgepracticeUsingStandardizedPatientsAugmentCommunicationSkillsSelf-EfficacyCaringTransgenderYoutheducation

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