Incorporating patient partner scores into high stakes assessment: an observational study into opinions and attitudes

Abstract

BackgroundVolunteer patients (also known as patient partners (PPs)) play a vital role in undergraduate healthcare curricula. They frequently take part in objective structured clinical examinations (OSCE) and rate aspects of students’ performance. However, the inclusion and weighting of PP marks varies, while attitudes and opinions regarding how (and if) they should contribute towards the pass/fail outcome are uncertain.MethodsA prospective observational study was conducted to explore beliefs of PPs regarding inclusion of their scores in a high stakes undergraduate OSCE in a single UK medical school. All PPs delivering components of the local MBChB curriculum were asked to participate in the questionnaire study. Quantitative and qualitative data were analysed using descriptive statistics and framework analysis respectively.ResultsFifty out of 160 (31% response rate) PPs completed the questionnaire; 70% had participated in a final year OSCE. Thirty (60%) felt their marks should be incorporated into a student’s overall score, while 28% were uncertain. The main reasons for inclusion were recognition of the patient perspective (31%) and their ability to assess attitudes and professionalism (27%), while reasons against inclusion included lack of PP qualification/training (18%) and concerns relating to consistency (14%). The majority of PPs were uncertain what proportion of the total mark they should contribute, although many felt that 5-10% of the total score was reasonable. Most respondents (70%) felt that globally low PP scores should not result in an automatic fail and many (62%) acknowledged that prior to mark inclusion, further training was required.ConclusionThese data show that most respondents considered it reasonable to “formalise their expertise” by contributing marks in the overall assessment of students in a high stakes OSCE, although what proportion they believe this should represent was variable. Some expressed concerns that using marks towards progress decisions may alter PP response patterns. It would therefore seem reasonable to compare outcomes (i.e. pass/fail status) using historical data both incorporating and not incorporating PP marks to evaluate the effects of doing so. Further attention to existing PP training programmes is also required in order to provide clear instruction on how to globally rate students to ensure validity and consistency.Electronic supplementary materialThe online version of this article (10.1186/s12909-017-1063-4) contains supplementary material, which is available to authorized users.

Simulated Patients’ Experience towards Simulated Patient-Based Simulation Session: A Qualitative Study

“…Another interesting study also suggested regarding SP's opinion and attitude towards incorporating SP's score into summative assessment [7]. 60% of the SPs perceived that their marks should incorporated into the examination, however 70% of the SPs stated that candidate should not fail for those achieve low SP score but students can be remedial for the poor interpersonal skills.…”

“…60% of the SPs perceived that their marks should incorporated into the examination, however 70% of the SPs stated that candidate should not fail for those achieve low SP score but students can be remedial for the poor interpersonal skills. SPs expressing that they have the responsible to assess communication skills, attitudes, professionalism, and interpersonal skills [4,5,7]. At the same time, SPs were also concerned of consistency among the SPs.…”

Experience towards Simulated Patient-based Simulation Session: An Integrative Literature Review

“…Meanwhile, poor interpersonal skills could be remedied, whereby SPs expressed that they have the responsibility to assess communication skills, attitudes, professionalism, and interpersonal skills. At the same time, SPs were also concerned with consistency among the SPs (9). A few articles also informed regarding SPs' view between 'good' and 'bad' consultation.…”

“…SP is regarded as an expert to comment upon students' certain aspects such as communication skills (9,16) and empathy (18) due to SPs are directly in the clinical encounter and therefore likely to be in a position to assess such skills (9,18) as well as the institution acknowledge the ability of SPs to effectively assess trainees' communication skills and interpersonal skills (9). Few studies had confirmed the reliability and validity of SP's evaluation.…”

Experiences of local residents who portrayed patients in simulated patient exercises

“…[5] Previous research has clarified the process by which lay residents master the task of role-playing a patient [6] and the opinions and attitudes of Simulated Patients. [7] However, the existing research has not adequately examined the significance that participatory SPEs hold for the local residents who act as Simulated Patients.…”