Using Standardized Patients to Educate Medical Students about Organ Donation

Abstract

Medical students at Mount Sinai School of Medicine participated in an intervention designed to promote knowledge and improved communication skills related to cadaveric organ donation. The intervention required students to interact with a standardized patient for approximately 10 minutes and respond to questions posed about organ donation in a primary care context. A coding scheme for communication content was developed based upon students' accuracy and missed opportunities for educating patients. Data are presented for 2007 and 2008 first-year medical students (N=170) and results indicate several areas of students' missed opportunities for patient education including: (1) logistics of the state health care proxy, (2) timing of funeral arrangements, and (3) ability to choose organs for transplantation. The value of using standardized patients for communication training and health education/promotion is discussed.

Keywords:

• Organ Donation
• Medical Students
• Standardized Patients

Acknowledgements

This project was supported by grant No. 1 R39OT05404 from Health Resources and Services Administration's Division of Transplantation (HRSA/DoT), U.S. Department of Health and Human Services. The contents of this publication are solely the responsibility of the authors and do not necessarily represent the view of HRSA/DoT.

Notes

1. SPs were instructed on the content of an actual “ER” episode. However, they were encouraged to comment only on the general premise of the episode as medical students may or may not have been exposed to this specific show or episode.

2. Subsequent to participating in the online module, students also took a ten-question quiz assessing their donation knowledge. Information on this measure is available from the first author.

3. Students from the spring 2006 cohort also participated in the intervention. Due to a lack of time and resources, their reactions to the SP case were not analyzed.

4. Only the message content produced by medical students and SPs was transcribed. Specifically, no information was recorded on students' identifying characteristics (e.g., racial background, sex) or the non-verbal communication (e.g., eye contact, proxemics) that may have occurred during the interaction.

5. Significant differences were also identified in the amount of time students were given to discuss donation between semesters. Results of a one-way ANOVA, using semester as a fixed factor, were significant, F (1, 166) = 73.68, p<0.001, η2=0.31 with students in the 2007 semester being given more time for the donation discussion. Additionally, a series of chi-square tests were used to examine differences in students' inclusion of various topics on the basis of semester. Eight topics reached significance and results on these tests are available from the first author and are not presented in the interest of space.

6. At the time of the intervention, New York State still operated under a registry of intent, which requires permission from next-of-kin for the procurement of a registered donor's organs at the time of death. As of July 2008, the registry was changed to a registry of consent, whereby individuals may document their legal consent to donation without familial consent.

7. The authors thank an anonymous reviewer for his/her recommendation on the use of a more comprehensive communication coding scheme.

Additional information

Notes on contributors

Thomas Hugh Feeley

Thomas Hugh Feeley, Ph.D is from the Department of Communication, University at Buffalo, The State University of New York, New York

Ashley E. Anker

Ashley E. Anker Ph.D. is from the Department of Communication, University at Buffalo, The State University of New York, New York

Rainier Soriano

Rainier Soriano, M.D. is from Geriatrics & Adult Development, Medicine, & Medical Education, Mount Sinai School of Medicine

Erica Friedman

Erica Friedman, M.D. is from the Department of Medical Education, Mount Sinai School of Medicine