title: Feasibility of "Standardized Clinician" Methodology for Patient Training on Hospital-to-Home Transitions.
abstract: BACKGROUND
  Patient engagement in health care is increasingly recognized as essential for promoting the health of individuals and populations. This study pilot tested the standardized clinician (SC) methodology, a novel adaptation of standardized patient methodology, for teaching patient engagement skills for the complex health care situation of transitioning from a hospital back to home.
  
  
  METHODS
  Sixty-seven participants at heightened risk for hospitalization were randomly assigned to either simulation exposure-only or full-intervention group. Both groups participated in simulation scenarios with "standardized clinicians" around tasks related to hospital discharge and follow-up. The full-intervention group was also debriefed after scenario sets and learned about tools for actively participating in hospital-to-home transitions. Measures included changes in observed behaviors at baseline and follow-up and an overall program evaluation.
  
  
  RESULTS
  The full-intervention group showed increases in observed tool possession (P = 0.014) and expression of their preferences and values (P = 0.043). The simulation exposure-only group showed improvement in worksheet scores (P = 0.002) and fewer engagement skills (P = 0.021). Both groups showed a decrease in telling an SC about their hospital admission (P < 0.05). Open-ended comments from the program evaluation were largely positive.
  
  
  CONCLUSIONS
  Both groups benefited from exposure to the SC intervention. Program evaluation data suggest that simulation training is feasible and may provide a useful methodology for teaching patient skills for active engagement in health care. Future studies are warranted to determine if this methodology can be used to assess overall patient engagement and whether new patient learning transfers to health care encounters.
authors.affiliation: From the Scott & White Healthcare (H.W.-J., A.K.H., T.C., C.J.), and Texas A&M University (H.W.-J.), Health Science Center, College of Medicine, Temple, TX.
authors.forename: Hania
authors.initials: H
authors.lastname: Wehbe-Janek
authors.forename: Angela K
authors.initials: AK
authors.lastname: Hochhalter
authors.forename: Theresa
authors.initials: T
authors.lastname: Castilla
authors.forename: Chanhee
authors.initials: C
authors.lastname: Jo
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D010351:Patient Discharge; D010353:Patient Education as Topic / Q000379:methods*; D010358:Patient Participation / Q000379:methods*; D010865:Pilot Projects; D015397:Program Evaluation