title: Medical student and faculty perceptions of volunteer outpatients versus simulated patients in communication skills training.
abstract: OBJECTIVE
  To determine whether medical students and faculty perceive differences in the effectiveness of interactions with real patients versus simulated patients (SPs) in communication skills training.
  
  
  METHODS
  In 2008, the authors recruited volunteer outpatients (VOs) from the Johns Hopkins University School of Medicine internal medicine practice to participate in communication skills training for all first-year medical students. VOs and SPs were assigned to clinic rooms in the simulation center. Each group of five students and its preceptor rotated through randomly assigned rooms on two of four session days; on both days, each student interviewed one patient for 15 minutes, focusing on past medical and family history or social history. Patients used their own histories, not scripts; students were not blinded to patient type. Students and faculty then rated aspects of the interview experience. Generalized linear latent and mixed-models analysis was used to compare ratings of communication skills training with VOs versus SPs.
  
  
  RESULTS
  All 121 first-year students participated in 242 interviews, resulting in 237 usable questionnaires (98%). They rated their experiences with VOs significantly higher than those with SPs on comfort, friendliness, amount of learning, opportunity to build relationships, and overall meeting of communication skills training needs. The 24 faculty preceptors' ratings of the 242 interactions did not differ significantly between VOs and SPs.
  
  
  CONCLUSIONS
  Use of VOs was well received by students and faculty for teaching communication skills. Expanding and further studying VOs' participation will allow greater understanding of their potential role in communication skills training of preclinical medical students.
authors.affiliation: Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland 21287, USA. sclever@jhmi.edu
authors.forename: Sarah L
authors.initials: SL
authors.lastname: Clever
authors.forename: Robert A
authors.initials: RA
authors.lastname: Dudas
authors.forename: Barry S
authors.initials: BS
authors.lastname: Solomon
authors.forename: Hsin Chieh
authors.initials: HC
authors.lastname: Yeh
authors.forename: David
authors.initials: D
authors.lastname: Levine
authors.forename: Amanda
authors.initials: A
authors.lastname: Bertram
authors.forename: Mitchell
authors.initials: M
authors.lastname: Goldstein
authors.forename: Nicole
authors.initials: N
authors.lastname: Shilkofski
authors.forename: Joseph
authors.initials: J
authors.lastname: Cofrancesco
mesh_terms: D000046:Academic Medical Centers; D000328:Adult; D003142:Communication; D003430:Cross-Sectional Studies; D003479:Curriculum; D004504:Education, Medical, Undergraduate / Q000379:methods*; D004521:Educational Measurement; D005180:Faculty, Medical; D005260:Female; D006801:Humans; D007388:Internal Medicine / Q000193:education; D008297:Male; D010045:Outpatients; D016544:Patient Simulation; D010465:Perception; D012044:Regression Analysis; D013337:Students, Medical; D011795:Surveys and Questionnaires; D014481:United States; D014838:Volunteers; D055815:Young Adult