Does hearing the patient perspective improve consultation skills in examinations? An exploratory randomized controlled trial in medical undergraduate education.

Context Medical students may benefit from hearing patients’ experiences, but it is not clear whether offering patients’ viewpoints on medical procedures has any measurable effect on students’ skills or abilities. There are also ethical and practical issues in inviting lay people to repeatedly relive their experiences for students’ benefit. This study explored the effect on students’ exam performance of watching video clips of women describing their experiences of colposcopy. We explored whether students who had viewed such videos performed differently from those who had not heard the patient perspective. Methods Medical students in their penultimate year were randomised to receive one of two online learning modules. The experimental group saw a video of patients describing their experiences of colposcopy, while the control group viewed a clinician describing the procedure. All other elements of the module were the same. Students then completed a multiple choice questionnaire (MCQ) and were assessed by a blinded clinical examiner in an Objective Structured Clinical Examination (OSCE) with a simulated patient (SP). The SP, also blinded, scored students using the Doctors’ Interpersonal Skills Questionnaire (DISQ). Students then rated the module’s effect on their skills and confidence. Regression analyses were used to compare the effect of the two modules on these outcomes, adjusting for gender and graduate entry. Results 88 students were randomised. The experimental group performed better in the OSCE than the control group (odds ratio 2.7 [95% C.I. 1.2 to 6.1]; p=0.016). They also reported significantly more confidence in several key areas, including comfort with patients’ emotional reactions (odds ratio 6.4 [95% C.I. 2.7 to 14.9]; p Conclusions Teaching that includes recorded elements of real patient experience can significantly improve students’ examination performance and confidence.