title: Student self-reported communication skills, knowledge and confidence across standardised patient, virtual and traditional clinical learning environments.
abstract: BACKGROUND
  Advanced communication skills are vital for allied health professionals, yet students often have limited opportunities in which to develop them. The option of increasing clinical placement hours is unsustainable in a climate of constrained budgets, limited placement availability and increasing student numbers. Consequently, many educators are considering the potentials of alternative training methods, such as simulation. Simulations provide safe, repeatable and standardised learning environments in which students can practice a variety of clinical skills. This study investigated students' self-rated communication skill, knowledge, confidence and empathy across simulated and traditional learning environments.
  
  
  METHODS
  Undergraduate speech pathology students were randomly allocated to one of three communication partners with whom they engaged conversationally for up to 30 min: a patient in a nursing home (n = 21); an elderly trained patient actor (n = 22); or a virtual patient (n = 19). One week prior to, and again following the conversational interaction, participants completed measures of self-reported communication skill, knowledge and confidence (developed by the authors based on the Four Habit Coding Scheme), as well as the Jefferson Scale of Empathy - Health Professionals (student version).
  
  
  RESULTS
  All three groups reported significantly higher communication knowledge, skills and confidence post-placement (Median d = .58), while the degree of change did not vary as a function of group membership (Median η (2)  < .01). In addition, only students interacting with a nursing home resident reported higher empathy after the placement. Students reported that conversing with the virtual patient was more challenging than conversing with a nursing home patient or actor, and students appeared to derive the same benefit from the experience.
  
  
  CONCLUSIONS
  Participants self-reported higher communication skill, knowledge and confidence, though not empathy, following a brief placement in a virtual, standardised or traditional learning environment. The self-reported increases were consistent across the three placement types. It is proposed that the findings from this study provide support for the integration of more sustainable, standardised, virtual patient-based placement models into allied health training programs for the training of communication skills.
authors.affiliation: Curtin University, School of Psychology and Speech Pathology, GPO Box U1987, Perth, WA, 6845, Australia. m.quail@curtin.edu.au.
authors.forename: Michelle
authors.initials: M
authors.lastname: Quail
authors.affiliation: George Washington University, Washington, USA. brundage@gwu.edu.
authors.forename: Shelley B
authors.initials: SB
authors.lastname: Brundage
authors.affiliation: Citrine Technologies, Atlanta, USA. josh@citrinetechnologies.com.
authors.forename: Josh
authors.initials: J
authors.lastname: Spitalnick
authors.affiliation: Curtin University, School of Psychology and Speech Pathology, GPO Box U1987, Perth, WA, 6845, Australia. p.allen@curtin.edu.au.
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Allen
authors.affiliation: Curtin University, School of Psychology and Speech Pathology, GPO Box U1987, Perth, WA, 6845, Australia. j.beilby@curtin.edu.au.
authors.forename: Janet
authors.initials: J
authors.lastname: Beilby
mesh_terms: D002983:Clinical Competence / Q000592:standards; D003142:Communication; D004501:Education, Medical / Q000379:methods; D004521:Educational Measurement; D004645:Empathy; D005260:Female; D006801:Humans; D008297:Male; D016544:Patient Simulation; D010817:Physician-Patient Relations; D057566:Self Report; D013337:Students, Medical / Q000523:psychology*; D014584:User-Computer Interface; D055815:Young Adult