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Health Care Attitudes: Does the Experience of Being a Standardized Patient Have an Effect?
Colleen Lewy
ABSTRACT
Attitudes towards health care, such as dissatisfaction, and non-adherence, have been linked to poorer resolution of patient symptoms. Dissatisfaction is based in part on expectations towards health care and health care providers. Thus, understanding the factors that influence expectations and attitudes is crucial to good health.
A recent innovation in medical training and assessment is the standardized patient (SP). SPs are lay-persons hired to simulate patients, in order to train and assess the clinical skills of trainees. When simulating patients, SPs take on new personas with medical, psychological and social problems. Thus, they have unique exposure to medical education training and assessment practices. SP’s experiences might therefore be expected to influence their attitudes towards their actual health care providers.
All SPs on record from a medical school in the Pacific Northwest were asked to complete a questionnaire about their attitudes and expectations towards health care. Of those who chose to participate (N=200, 60.4%), 123 reported having had previous experience as an SP (experienced SPs), the remaining 77 reported having been recruited but not yet started SP training (prospective or “new SPs”). There were no significant differences found between the groups with regard to demographics, such as age, education, race, gender, income, or health status.
New and experienced SPs were compared to determine if they had different health care attitudes and expectations (measures included: patient satisfaction, adherence, control, preferred decisional involvement, and trust). The majority of experienced SPs reported positive impressions of the technical and interpersonal skills they assessed, and they thought that an SP exam should be required as part of the national licensure process for physicians. Experienced SPs were significantly more satisfied with their own providers’ interpersonal skills and felt more in control of their own health compared to new SPs. Curiously, the amount of experience did not seem to matter. Nevertheless, these findings suggest that being an SP does affect certain attitudes about health care. Future studies are needed to further elucidate how training and performing as an SP affects their attitudes towards their own health and their providers.
Wednesday, April 16, 2003
DISSERTATION COMMITTEE
Keith Kaufman, Chairman
George G. Lendaris
Kerth O’Brien
Nancy A. Perrin
Eileen M. Brennan, Graduate Studies Rep.
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