Impact of a feedback strategy in a series of communication-focused patient care simulations

Introduction

Patient care simulations (PCS) and objective structured clinical examinations (OSCE) allow pharmacy students to practice communication. Feedback can help improve communication, but the impact over time is not well understood.

Objective

This study investigated the impact of a feedback strategy on pharmacy students' communication skills over three PCS. It also evaluated the alignment between students' self-scoring and faculty scoring.

Methods

Pharmacy students participated in three sessions (PCS1, OSCE, and PCS3) that were focused on the affective domain. Individualized numerical and narrative feedback was provided to students on their performance after PCS1. Students' communication was scored by faculty graders out of an 18-point validated rubric. Students self-scored their communication with the same rubric. Faculty and student scores were compared using a linear mixed effects model, and an intraclass correlation coefficient was used to measure agreement.

Results

In PCS1, 82 students scored an average of 15.41 ± 2.14 for faculty scores and 16.06 ± 1.55 for self-graded scores (0.36, p < 0.001). In the OSCE, 81 students had an average of 15.93 ± 1.86 for faculty scores and 16.45 ± 1.35 for self-graded scores (0.1, p = 0.18). In PCS3, 74 students scored an average of 15.22 ± 2.15 for faculty scores and 16.25 ± 1.44 for self-graded scores (0.14, p = 0.08). A correlation between faculty and student scores was seen for PCS1. Over the three sessions, no significant differences were found between student self-graded scores (p = 0.08), but faculty scores did differ, with the OSCE having higher scores than PCS3 (p < 0.01). Many students with faculty-graded scores greater than 1 standard deviation below the mean scored themselves higher than faculty did.

Conclusion

Feedback after PCS1 did not significantly improve scores. Students with low faculty-graded scores frequently scored themselves higher indicating low self-awareness.