Using a standardized patient walk-through to improve implementation of clinical trials

Fussell, Holly E.; Kunkel, Lynn E.; Lewy, Colleen S.; McFarland, Bentson H.; McCarty, Dennis

doi:10.1016/j.jsat.2008.03.001

Cited by 10 publications

(14 citation statements)

References 16 publications

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“…The literature supports the use of SPs to train and assess clinicians [1,5]. Our study supervisors found the use of SPs to be effective in assessing counselor readiness to work with real patients, and the counselors reported that they found the SP exercises to be realistic and helpful for their training.…”

Section: Discussionsupporting

confidence: 67%

Using standardized patients to train telephone counselors for a clinical trial

et al. 2014

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BackgroundStandardized Patients (SPs) are actors trained to portray health care patients during the training and assessment of health care providers. This paper describes the methods and costs associated with using SPs to evaluate the skills of telephone counselors working on a clinical trial that evaluated a telephone smoking cessation program tailored for smokers using Department of Veterans Affairs mental health clinics.FindingsConducting the SP exercises required five main steps: (1) Write a SP case description detailing patient demographics, demeanor, clinical symptoms and history, and instructions on how to respond to counseling, (2) Identify, select and train actors to portray the SP cases; (3) Conduct audio-taped counseling encounters between the SPs and counselors, (4) Rate the counselors on their core counseling competencies, (5) Provide feedback to counselors. The SPs and study supervisors reported that the checklist was easy to use when rating the counselors. Counselors reported that the SP encounters were realistic and helpful for practicing their clinical work and for building self-efficacy for working with real patients. The labor costs of developing two SP cases and training two SP actors was approximately $1,475. The per-session labor cost of conducting a 1-hour counseling session between one SP and one counselor was approximately $314.ConclusionsUsing SPs to train telephone counselors working on a clinical trial was feasible and offered training benefits beyond those provided by didactic instruction and role plays. Our research group is now routinely using SPs for the training of incoming telephone counselors.

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Section: Discussionsupporting

confidence: 67%

Using standardized patients to train telephone counselors for a clinical trial

et al. 2014

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“…Our work extends a prior analysis based on a single standardized patient at one site for one clinical trial (20). The analysis highlights the use of standardized patient walkthroughs to capture issues with study procedures previously unidentified with didactic training alone.…”

Section: Discussionmentioning

confidence: 89%

“…Even more novel are applications of the methodology to enhance training and identify potential for improvement in protocol procedures in clinical trials of interventions for substance use disorders (20). This report identifies cross-study and cross-site common concerns in protocol implementation and recommendations for resolutions to those concerns.…”

Section: Discussionmentioning

confidence: 99%

“…Limited, yet expanding literature demonstrates possibilities for standardized patients portraying individuals with substance use disorders (9-18), including establishing authenticity of performances with substance abuse treatment practitioners conducting mock assessment interviews (19). Finally, standardized patient walkthroughs illustrate the utility of the methodology for enhanced training capable of identifying and ameliorating challenges to implementing protocol procedures (20). …”

Section: Introductionmentioning

confidence: 99%

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Standardized Patient Walkthroughs in the National Drug Abuse Treatment Clinical Trials Network: Common Challenges to Protocol Implementation

Fussell

Kunkel

McCarty

et al. 2011

The American Journal of Drug and Alcohol Abuse

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Background Training research staff to implement clinical trials occurring in community-based addiction treatment programs presents unique challenges. Standardized patient walkthroughs of study procedures may enhance training and protocol implementation. Objectives Examine and discuss cross-site and cross-study challenges of participant screening and data collection procedures identified during standardized patient walkthroughs of multi-site clinical trials. Method Actors portrayed clients and “walked through” study procedures with protocol research staff. The study completed 57 walkthroughs during implementation of 4 clinical trials. Results Observers and walkthrough participants identified three areas of concern (consent procedures, screening and assessment processes, and protocol implementation) and made suggestions for resolving the concerns. Conclusions and Scientific Significance Standardized patient walkthroughs capture issues with study procedures previously unidentified with didactic training or unscripted rehearsals. Clinical trials within the National Drug Abuse Treatment Clinical Trials Network are conducted in addiction treatment centers that vary on multiple dimensions. Based on walkthrough observations, the national protocol team and local site leadership modify standardized operating procedures and resolve cross-site problems prior to recruiting study participants. The standardized patient walkthrough improves consistency across study sites and reduces potential site variation in study outcomes.

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“…Adapted from computerized clinical guideline development (Horsky et al 2003), business and management (Gustafson 2004), and medical training (Carney et al 1999), walk-throughs have been used in behavioral health to identify areas for improvement in admission procedures (Ford et al 2007) and to pilot screening processes for a clinical study (Fussell et al 2008). Fussell et al (2008) incorporated the use of a standardized patient, often used in diagnostic studies to assess provider sensitivity to specific presented symptoms (Carney et al 1999), to standardize the walk-through procedure.…”

Section: Introductionmentioning

confidence: 99%

Family Peer Advocates: A Pilot Study of the Content and Process of Service Provision

et al. 2011

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Professional family peer advocates are increasingly employed by public mental health systems to deliver family-to-family support that reduces barriers families face in accessing children's mental health care. These services, however, are neither uniformly available nor standardized. This pilot study describes the process, content and context of family-to-family support services. Simulating a parent seeking services, a trained standardized parent participated as a client in meetings with advocates in four programs and collected data through structured observations, a structured survey, and session audiotapes. The "walk-through" process was determined to be feasible and acceptable to family peer advocates as a way of evaluating services. Four family peer advocates provided an average of 25 services during each 2-session simulation with the standardized parent, including the following: information and educational support, instruction and skills development, emotional and affirmational support, instrumental support, and advocacy. Findings also revealed variability in the range of services provided and identified challenges in aspects of service provision, such as boundaries of advocate roles, availability of confidential service environments, and addressing crises and parent concerns about child safety. This paper provides the first in-depth look at services provided by this emerging workforce.

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Using a standardized patient walk-through to improve implementation of clinical trials

Cited by 10 publications

References 16 publications

Using standardized patients to train telephone counselors for a clinical trial

Using standardized patients to train telephone counselors for a clinical trial

Standardized Patient Walkthroughs in the National Drug Abuse Treatment Clinical Trials Network: Common Challenges to Protocol Implementation

Family Peer Advocates: A Pilot Study of the Content and Process of Service Provision

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