Document Detail


Use of a computer-based simulated consultation tool to assess whether doctors explore sociocultural factors during patient evaluation.
MedLine Citation:
PMID:  20367726     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
RATIONALE, AIMS AND OBJECTIVES: The delivery of patient-centred care to diverse populations requires that doctors identify sociocultural factors that may affect care. We adapted a computer-based simulated consultation tool and tested its utility for assessing whether doctors explore sociocultural factors during a patient evaluation, and whether they include such information in their case conclusions and follow-up recommendations. METHODS: We developed two detailed patient 'stories' that involved sociocultural issues that doctors needed to identify and consider for adequate clinical management. They were incorporated into an existing 'Virtual Internet Patient Simulation' (VIPS) program designed to test clinical reasoning skills. Doctors and medical students (n = 618) were invited to access the program via Internet. For each consultation, participants were assigned a sociocultural score, corresponding to the number of sociocultural domains explored. Scores were then compared with subjective ratings of participants' performance by expert doctors. RESULTS: 118 respondents completed at least one virtual consultation (19%), 92 conducted both. The mean number of sociocultural dimensions explored by doctors (i.e. sociocultural score) was 3.9 (standard deviation 2.6) for case 1, and 5.2 (standard deviation 2.3) for case 2. The two sociocultural scores were moderately correlated (Spearman r = 0.65, P < 0.001). Sociocultural scores correlated positively with experts' subjective ratings of participants' performance (Spearman r = 0.84 for case 1 and 0.78 for case 2, both P < 0.001). CONCLUSIONS: The adapted computer-based simulated consultation tool provided a feasible means to assess doctors' exploration of sociocultural issues during a clinical evaluation. Further validation of this method should be conducted by comparing VIPS results with other skills assessment methods such as objective structured clinical examination or direct observation of clinical performance.
Authors:
Noëlle Junod Perron; Thomas Perneger; Véronique Kolly; Melissa Dominicé Dao; Johanna Sommer; Patricia Hudelson
Related Documents :
9429336 - Training surgically competent doctors for south african rural settings.
19886096 - Teaching professionalism to junior doctors: experience of a multidisciplinary approach ...
1617356 - Suicide prevention: spreading the gospel to general practitioners.
17269946 - Much variety and little evidence: a description of guidelines for doctor-patient commun...
762866 - Trainees' retention of cardiopulmonary resuscitation. how quickly they forget.
21647356 - Worksite health promotion in six varied us sites: beta testing as a needed translationa...
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of evaluation in clinical practice     Volume:  15     ISSN:  1365-2753     ISO Abbreviation:  J Eval Clin Pract     Publication Date:  2009 Dec 
Date Detail:
Created Date:  2010-04-06     Completed Date:  2010-07-16     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9609066     Medline TA:  J Eval Clin Pract     Country:  England    
Other Details:
Languages:  eng     Pagination:  1190-5     Citation Subset:  IM    
Affiliation:
Academic Primary Care Physicians, Geneva University Hospitals, Genève, Switzerland. noelle.junod@hcuge.ch
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Analysis of Variance
Clinical Competence / standards*
Computer-Assisted Instruction / methods*
Cultural Characteristics*
Humans
Logistic Models
Patient Simulation*
Patient-Centered Care*
Physicians / standards*
Referral and Consultation*
Socioeconomic Factors
User-Computer Interface*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Are therapeutic decisions made on the medical admissions unit any more evidence-based than they used...
Next Document:  How far did we get? How far to go? A European survey on postgraduate courses in evidence-based medic...