Development and assessment of simulated patient based curricular unit in order to improve clinical skills in adolescent medicine of pediatric and family practice residents

Objective: This study describes the development and evaluation of a curricular program aimed at improving the clinical and communication skills required for managing the clinical encounter with adolescents, among pediatric and family practice residents using the technique of standardized patients. Methods: A daylong curricular unit which included: clinical interviews with simulated patients presenting typical clinical problems occurring among adolescents a teaching unit explaining the principles of communication with adolescents and a clinical discussion and feedback session using video clips. Forty-eight residents in pediatrics and family practice undertook the curricular unit. A total of 120 doctor-simulated patient interviews were documented using six patients' case scenarios representing somatization disorder, eating disorder, chronic illness and non-compliance, pregnancy, drug abuse and menstrual disorder. Results: The doctors' self-estimation of clinical skills associated with adolescent medicine that was documented at the beginning of the curricular unit was generally reported as low. In most of the cases the participants did not identify the main problem and diagnoses that were presented. The problems least correctly diagnosed were eating disorder and non-compliant chronic illness. Only in the cases of somatization and pregnancy more than half of the residents identified the problems that were presented. At the end of the curricular unit the doctors expressed a very high level of satisfaction with the program. Conclusion: The present study developed and evaluated a short and structured curricular unit dealing with the principles of communication with adolescent patients using the technique of simulated/standardized patients. It was found that the lack in these skills, which was identified in pediatric and family practice residents, could be bridged using this educational technique.