| Use of a computer-based simulated consultation tool to assess whether doctors explore sociocultural factors during patient evaluation. | |
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MedLine Citation:
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PMID: 20367726 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Noëlle Junod Perron; Thomas Perneger; Véronique Kolly; Melissa Dominicé Dao; Johanna Sommer; Patricia Hudelson |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Journal of evaluation in clinical practice Volume: 15 ISSN: 1365-2753 ISO Abbreviation: J Eval Clin Pract Publication Date: 2009 Dec |
Date Detail:
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Created Date: 2010-04-06 Completed Date: 2010-07-16 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9609066 Medline TA: J Eval Clin Pract Country: England |
Other Details:
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Languages: eng Pagination: 1190-5 Citation Subset: IM |
Affiliation:
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Academic Primary Care Physicians, Geneva University Hospitals, Genève, Switzerland. noelle.junod@hcuge.ch |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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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* |
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