INDIGO Home University of Illinois at Urbana-Champaign logo uic building uic pavilion uic student center

An educational intervention for contextualizing patient care and medical students' abilities to probe for contextual issues in simulated patients

Show full item record

Bookmark or cite this item: http://hdl.handle.net/10027/8307

Files in this item

File Description Format
PDF JAMA10-1310R1 Schwartz-edited _1_.pdf (111KB) Main article PDF
Microsoft Word Online only materials (1).doc (77KB) Tables Microsoft Word
Title: An educational intervention for contextualizing patient care and medical students' abilities to probe for contextual issues in simulated patients
Author(s): Schwartz, Alan; Weiner, Saul J.; Harris, Ilene B.; Binns-Calvey, Amy
Abstract: Context: A contextual error occurs when a physician fails to identify elements of a patient’s environment or behavior, such as access to care, that must be addressed in order to appropriately plan care. Research has demonstrated that contextual errors can be identified using standardized patients. Objective: To evaluate an educational intervention designed to increase physicians' skills in incorporating the patient's context in assessment and management of care and to thereby decrease the rate of contextual errors. Design, Setting, and Participants: Quasi-randomized controlled trial, with assessments by blinded observers. Fourth-year medical students (n=124) in internal medicine subinternships at the University of Illinois at Chicago or Jesse Brown VA Medical Center from July 2008 – April 2009 and August 2009 – April 2010 participated and were assessed. Intervention: A 4-hour course on contextualization. Main outcome measures: Probing for contextual issues in an encounter, probing for medical issues in an encounter, and developing an appropriate treatment plan. Outcomes were assessed using 4 previously validated standardized patient encounters performed by each participant, and were adjusted for subinternship site, academic year, time of year, and case scenario. Results: Students who participated in the contextualization workshops were significantly more likely to probe for contextual issues in the standardized patient encounters than students who did not (90% [95% confidence interval {CI}, 87-94% ] vs 62% [95% CI, 54-69%]), and significantly more likely to develop appropriate treatment plans for standardized patients with contextual issues (69% [95% CI, 57-81%] vs 22% [95% CI, 12-32%]. There was no difference between the groups in the rate of probing for medical issues (80% [95% CI, 75-85%] vs 81% [95% CI, 76-86%]) or developing appropriate treatment plans for standardized patient with medical issues (54% [95% CI, 42-67%] vs 66% [95% CI, 53-79%]). Conclusion: Medical students who underwent an education intervention were more likely to contextualize care for individual standardized patients.
Issue Date: 2010-09
Publisher: American Medical Association
Citation Info: Schwartz A, Weiner SJ, Harris IB, Binns-Calvey A. An educational intervention for contextualizing patient care and medical students' abilities to probe for contextual issues in simulated patients. JAMA. 2010 Sep 15;304(11):1191-7.
Type: Article
URI: http://hdl.handle.net/10027/8307
ISSN: 1538-3598
Sponsor: This project was funded in part by a National Board of Medical Examiners (NBME) Edward J. Stemmler, MD, Medical Education Research Fund grant. There were no other external sponsors.
Date Available in INDIGO: 2012-05-09
 

This item appears in the following Collection(s)

Show full item record

Statistics

Country Code Views
United States of America 161
China 25
United Kingdom 17
Netherlands 7
Germany 3

Browse

My Account

Information

Access Key