Document Detail

The simulation game: an analysis of interactions between students and simulated patients.
MedLine Citation:
PMID:  23278825     Owner:  NLM     Status:  In-Data-Review    
Context  Institutional interactions are often asymmetrical in that the professional has more control over the conversation. It is difficult to say who the professional is in simulated consultations between simulated patients (SPs) and medical students because these feature a real (educational) institutional context and a simulated (medical) institutional context. This study describes this asymmetry and makes educational recommendations based on the description. Methods  One hundred assessed conversations between SPs and Year 3 students were transcribed and analysed using discourse analysis (DA). We aimed to find linguistic patterns in predefined parts of the conversations (questions, topic initiations, openings, closings) that might suggest conversational dominance. Results  The SP is conversationally more dominant, despite performing the role of the patient, in that he or she asks more direct questions, is more likely to initiate topics, is more likely not to follow topic changes by students, and closes the consultation. The student is likely to follow topics initiated by the SP and to seek permission to pre-close the consultation. Conclusions  The apparently greater dominance of the SP indicates that the simulated consultation differs from the doctor-patient consultation in certain key aspects. It is in that sense unrealistic. We argue, however, that 'realism' ought not to be a goal of simulated consultation and that what matters is that such consultations are sufficiently realistic for their educational purpose. We discuss the educational implications that follow from this.
Anne de la Croix; John Skelton
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Medical education     Volume:  47     ISSN:  1365-2923     ISO Abbreviation:  Med Educ     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-01-02     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7605655     Medline TA:  Med Educ     Country:  England    
Other Details:
Languages:  eng     Pagination:  49-58     Citation Subset:  IM    
Copyright Information:
© Blackwell Publishing Ltd 2013.
Department of Medical Psychology and Psychotherapy, Erasmus University Medical Centre, Rotterdam, the Netherlands Institute for Medical Education Research Rotterdam, Erasmus University Medical Centre, Rotterdam, the Netherlands School of Health and Population Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK.
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