How student healthcare providers in a communication skills course respond to standardized patient resistance.

Autor: Paulus TM; East Tennessee State University, Research Division, Department of Family Medicine, Quillen College of Medicine, PO Box 70621, Johnson City, TN, 37614, USA. Electronic address: paulust@etsu.edu., Grubbs H; East Tennessee State University, Research Division, Department of Family Medicine, Quillen College of Medicine, PO Box 70621, Johnson City, TN, 37614, USA. Electronic address: heather-grubbs@ouhsc.edu., Rice-Moran R; Department of Curriculum and Instruction, Clemmer College, East Tennessee State University, 402 Warf-Pickel Hall, Johnson City, TN, 37614, USA. Electronic address: ricemoran@etsu.edu., Lester JN; Department of Counseling and Educational Psychology, School of Education, 201 North Rose Avenue, Indiana University, Bloomington, IN, 47405-1006, USA. Electronic address: jnlester@indiana.edu.
Jazyk: angličtina
Zdroj: Social science & medicine (1982) [Soc Sci Med] 2023 Nov; Vol. 337, pp. 116309. Date of Electronic Publication: 2023 Oct 17.
DOI: 10.1016/j.socscimed.2023.116309
Abstrakt: Encountering and responding to patient resistance can be especially challenging for student healthcare providers. Navigating who ultimately holds the authority to know and understand a health concern, make recommendations for a course of action, and accept or resist these recommendations are all part of how epistemic authority is negotiated in medical settings. The purpose of this paper is to systematically examine how student providers enrolled in a communication skills course at an American university responded to standardized patient resistance. The data for this study were 121 video-recorded and transcribed final objective structured clinical examinations from the fall 2019 course. We used discourse analysis informed by principles of conversation analysis to identify several discursive strategies used by the students, including: 1) asking for clarification; 2) expressing uncertainty and offering to gather additional resources; 3) aligning with and offering an account for the resistance; 4) recommending a new course of action; and 5) confronting the resistance. Our findings point to the value of including instruction for both student healthcare providers and standardized patients on how to respond to resistance they encounter in ways that may help improve healthcare outcomes.
(Copyright © 2023 Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
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