Advanced Communication Skills Cases

Overview:

These 3 cases are designed to enhance the communication skills of health care professional students by providing them an opportunity to interact with a standardized patient (SP) on various advanced topics. These cases are intended to build on basic history taking skills that students have already acquired. Topics addressed in the cases include:

1. Patient with medically unexplained physical symptoms

2. Facilitating a triadic interview

3. Patient with non-adherence issues

4. Advance directives

5. Sexual history taking

6. Domestic violence

Setup:

The small group sessions ideally should be comprised of about 6-7 students and a facilitator, depending on the availability of faculty at your institution (max 10 students). At our institution, students receive lectures that provide them with the information/foundation needed to interact with complicated standardized patients prior to the small group sessions. This can also be done through demonstration or readings.

Overview of Cases:

Case / Number of sessions
to complete / Hours needed
for each session / Topics addressed
Lynn Jenkins / 2 / 2 ½ hours (min.) / 1. Medically unexplained physical symptoms
Carlson Cavanaugh / 2 / 2 ½ hours (min.) / 1. Triadic interview
2. Non-adherent patient
3. Advance directives
Marcia Giancomello / 2 / 2 ½ hours (min.) / 1. Sexual history taking
2. Domestic violence

These cases are designed as “problem based learning” (PBL) cases. A comprehensive tutorial on PBL can be found at http://hsc.unm.edu/SOM/UME/TED/ed_dev/teaching_tools.shtml under the link “Faculty and Student Guide to Problem-Based Learning at the UNM SOM.” During each PBL case, students are expected to generate learning issues that must be researched and discussed at the start of the following small group session. This modality encourages students to be more motivated and proactive in their learning, which sets the pattern for them to become successful life-long learners. The role of the facilitator is to serve as a resource, tutor, and evaluator. Facilitators should not lecture or provide answers to clinical questions that arise during small group. They are instead expected to direct the flow of the session by guiding the students in their problem solving efforts and by giving ongoing feedback about their communication skills.

Course Materials:

1. Facilitator handbook that contains facilitator information, student pages, and

standardized patient scripts

2. Student pages

3. Standardized patient scripts

4. Evaluation form of the standardized patients

5. VINDICATE SLEEP mnemonic (for all cases)

6. ETHNIC card (for Carlson Cavanaugh case)

7. Problem Based Learning (PBL) grid

8. Your local institution’s Advance Directives form

Key Points:

1. Standardized patients should be given their scripts at least 3 weeks in advance so they may memorize it. The Course Director should hold a training/informational session about 45 minutes prior to each session to emphasize key points that the SPs are expected to deliver during the session and to clarify any last-minute questions

2. VINDICATE SLEEP mnemonic and Problem Based Learning (PBL) grid should be distributed on the first day of small group – one copy for each student

3. ETHNIC card distributed at the beginning of the Carlson Cavanaugh case – one copy for each student

4. Your local institution’s Advance Directives form distributed near the end of session two in the Carlson Cavanaugh case – one copy for each student

5. Student pages are distributed one at a time at each small group session – one copy for each student

6. At the end of each session, an evaluation form of the standardized patient’s performance is given to the facilitator so he/she can provide feedback – one copy for each facilitator