抽象的な

Unannounced standardized patients to assess child abuse management.

Rao Chandrika*, Sunil Kumar BM, Venkatesh D, Vijaydas Muradi

Background: Unannounced Standardized Patients (USP) can contribute to skill learning of medical students to manage child abuse cases. Objective: To compare the forensic interviewing and counseling skills of Post Graduates (PG) during and after exposure to USP encounter. Study design: Interventional study with USP encounter. Participants: Pediatric postgraduates. Intervention: USPs was selected from volunteer students, trained in two abuse case scenarios. Checklist and feedback form was validated USP encounter as a real patient was managed by the PGs under supervision. Focused Group Discussion (FGD) was held. PGs had a second planned encounter with same SPs in Objective Structured Clinical Examination (OSCE) format. Outcomes: Scores of SP encounters, PG feedback, reflections, FGD. Results: The SPs were able to portray themselves as a patient. The USP feedback revealed that postgraduates demonstrated poor listening skills, were distracted, used mobile phone, did not display adequate confidence and empathy and demonstrated fair competency. The PGs performed better in second encounter. Wilcoxin analysis was significant with P-value<0.001 (z-value=-4.0145). Postgraduates felt that SP appeared authentic, cooperated in history, asked relevant questions, and was natural in interactions. The PGs and SPs reflected that USP was an effective tool, which improved their confidence and counseling skills. The FGD revealed themes about their lack of confidence and awkwardness in child abuse cases, necessity of training, personal barriers, and sensitivity of topic. Conclusion: Interviewing and counseling skills of a PG during and after exposure to an unannounced SP encounter improved. SPs could be trained, could assess and provided constructive and objective feedback.