Using Standardized Patients to Augment Communication Skills and Self-Efficacy in Caring for Transgender Youth

Stanley R Vance Jr; Brian Dentoni-Lasofsky; Elizabeth Ozer; Madeline B Deutsch; Matthew J Meyers; Sara M Buckelew

doi:10.1016/j.acap.2021.05.010

Using Standardized Patients to Augment Communication Skills and Self-Efficacy in Caring for Transgender Youth

Acad Pediatr. 2021 Nov-Dec;21(8):1441-1448. doi: 10.1016/j.acap.2021.05.010. Epub 2021 May 19.

Authors

Stanley R Vance Jr¹, Brian Dentoni-Lasofsky², Elizabeth Ozer³, Madeline B Deutsch⁴, Matthew J Meyers⁵, Sara M Buckelew⁵

Affiliations

¹ Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of California, San Francisco (SR Vance, Jr, MJ Meyers, and SM Buckelew). Electronic address: stanley.vance@ucsf.edu.
² Department of Psychiatry, University of California, San Francisco (B Dentoni-Lasofsky).
³ Division of Adolescent and Young Adult Medicine and Office of Diversity and Outreach, University of California, San Francisco (E Ozer).
⁴ Department of Family Community Medicine, University of California, San Francisco (MB Deutsch).
⁵ Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of California, San Francisco (SR Vance, Jr, MJ Meyers, and SM Buckelew).

PMID: 34022426
DOI: 10.1016/j.acap.2021.05.010

Abstract

Objective: To examine the impact of standardized patient encounters (SPEs) on gender-affirming communication skills and self-efficacy of pediatrics learners.

Methods: Fourth-year medical students, pediatrics interns, psychiatry interns, and nurse practitioner trainees on 1-month adolescent medicine blocks completed a curriculum with e-learning activities that was expanded to include SPEs. Following e-learning, learners completed 2 SPEs featuring transgender adolescent cases. Faculty observers and standardized patients completed checklists focused on history-taking, counseling, and interpersonal communication, and provided learner feedback after each case. The curriculum was evaluated by comparing skills checklists scores from case 1 to case 2 via Wilcoxon signed-rank tests. Self-efficacy was assessed precurriculum (Assessment 1), post-e-learning (Assessment 2), and post-SPE (Assessment 3) using a previously developed instrument. Changes in self-efficacy scores were assessed via linear regression models with generalized estimating equations.

Results: Forty-three eligible learners participated in the study. The majority were pediatrics interns, and 5 learners had worked in a transgender clinic prior to the curriculum participation. Learners increased median total checklist scores between cases from 22 to 28 (P < .001) (maximum score of 34). Learners' overall self-efficacy scores improved by 3.4 (confidence interval [CI]: 2.9-3.9; P < .001) between Assessments 1 and 2 and by 1.5 (CI: 1.2-1.7; P < .001) from Assessment 2 to 3. Similar improvements in checklist scores and self-efficacy occurred within stratified learner types.

Conclusions: The combination of SPEs with e-learning is effective at improving self-efficacy and gender-affirming communication skills for a multidisciplinary pediatrics learners. The comprehensive curriculum allowed learners inexperienced with transgender youth to apply knowledge and practice skills.

Keywords: e-learning; medical education; standardized patients; transgender.

Publication types

Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.

MeSH terms

Adolescent
Child
Clinical Competence
Communication
Curriculum
Humans
Self Efficacy
Students, Medical*
Transgender Persons*