Measuring Outcomes in Competence and Confidence in Clinical Skills Through the Use of Standardized Patients

Limited literature is available concerning the use of standardized patients (SPs) in physical therapy education related to outcomes which are assessed. The purpose of our study was to investigate the effects SP implementation had on first year, doctor of physical therapy (DPT) student’s communication and patient interviewing skills and their confidence in those skills. Our study utilized a comparison group, repeated measures design with the collection of four survey instruments at pre-test and two posttest time points. The instruments for our study measured general self-efficacy (GSE), task-specific self-efficacy (Self-Perceived Communication Competence (SPCC) and Froehlich Communication Competence (FroCom) and confidence (Standardized Patient Learning Outcomes Assessment Tool for Confidence (SPLOAT). Both groups completed the survey instrument packet at all three time points, however, only the experimental group received SP encounters prior to the second and final instrument collections. General linear model repeated measures analysis was utilized and the results indicated baseline differences for the GSE, SPCC and FroCom with the experimental group having higher average scores, thus making comparisons of the groups for these measures less meaningful. Significant improvements in average overall confidence scores (SPLOAT) were evident at each collection time point for the experimental group with significant main effects for time and group. Additionally, there was a significant interaction effect between time and group indicating the experimental group increased in their average overall scores ranging from moderate to substantial for all time points. The experimental group performed significantly higher on the second SP encounter compared to the first. The comparison group received no SP encounters throughout the entire study, however also showed significant increases in average overall scores from the pre-test to posttest1 collections but did not indicate significance at the pre-test to posttest2 or for the posttest1 to posttest2 collections. The increases seen in both groups could be attributed to normal maturation through the curriculum and experience over time. SPLOAT score increases were evident in both groups, however only initially for the comparison group. The SP use of the experimental group supports previous research suggesting that multiple exposures to simulation activities, such as SP, aids in the confidence improvements