A simulated patient-based program for training gynecologists in communication with adolescent girls presenting with gynecological problems.

摘要

Most gynecologists lack the unique skills required for communication with female adolescent patients and with their parents. Years of clinical experience are required to develop communication skills that would facilitate the confidence of the young patient already during the first visit. Simulation-based medical education at the Israel Center for Medical Simulation (MSR) has become a powerful force in quality-care training for healthcare providers using empirical educational modalities, enabling controlled proactive experiential exposure to both regular and complex scenarios. Among the various MSR programs, for various medical sectors, training programs have been developed to improve the skills of physicians communicating with adolescents, including primary care physicians and school doctors. This paper describes the first reported simulated patient-based MSR training program for gynecologists in communication with adolescents who present with common complaints encountered in gynecology clinics. Twenty gynecologists participated in eight individual simulated scenarios conducted at simulated physicians' offices, equipped with audio-visual recording cameras and one-way mirrors for observation. Three physicians experienced in debriefing and in facilitating group discussions led the debriefing sessions, using the video recording of the simulated scenario following the simulation exercises. These discussions focused on communication techniques when facing adolescent patients with or without their parents, hidden agendas disclosed by using systematic physical and psychosocial reviews, the emotional load often associated with clinical problems, and the non-judgmental and supportive approach to adolescent patients. The clear recommendation that emerged from the high satisfaction of the program participants was to expand simulated patient-based programs for gynecologists and to include it as an integrated part of the training curriculum in pediatric and adolescent gynecology.