This video has been adapted from a presentation by Dr Silas Taylor during an Education Focussed community "Lunch & Learn" session.
The Online Simulated Patient interaction and Assessment (OSPIA) platform is an innovative approach to learning & assessing communication skills. Simulated patients (SPs) are an evidence-based means for teaching these skills. OSPIA capitalises on an existing SP program at UNSW Medicine by making interactions with SP’s available online, using video-telephony and a responsive website to enable assessment of student performance. Features include a booking function, training, and innovative patient-led assessment, making the platform sustainable without significant administrative input. Feedback to students includes a ‘thumbs up’ tool and written comments, time-stamped to the recording of the interaction, whilst ‘read-the-screen’ algorithms provide non-verbal communication behaviour analysis.
The OSPIA platform is used for Medicine students in Years 1 and 2 of the medical program and is highly automated. Over a period of 8 weeks, students are given access to the OSPIA platform by using their regular zID through the Medicine LMS (eMed). They must complete one simulated consultation within that period. Within the platform, students are given a series of comprehensive training materials to teach them how to use OSPIA.
At the start of the assessment period, the pool of existing volunteer Simulated Patients (SPs) are notified via email that the assessment period has begun and they are encouraged to log into the OSPIA platform and create appointment options for when they are able to participate in an interview. They do this via the calendar feature within the OSPIA site and simply enter the dates and times they are available for a 30-minute consultation period, which can include day or evening, 7 days per week.
Once the SPs have begun entering the appointments, students can log into their calendar and see what times are available. Students then choose a time that is convenient for them and request to book that SP. Upon booking, the SP receives an email and (optionally) a text message to inform them of the booking – the SP can then confirm the appointment by SMS, email, or by logging in and confirming on the platform. Prior to a first booking, and available for a refresher at any time, the SP is provided training via the portal in the form of professionally created videos and PDF guides covering everything from the basics of using the platform, to ensuring their device is suitable, use of feedback mechanisms and how to assess the students via the assessment form.
When the consultation arrives, both the student and the SP login into the OSPIA website and enter the virtual meeting room and begin the interview. The SP has their own “script” (provided via the training guides) that they can follow in order to respond to the student’s questions. As the interview progresses, the SP can optionally enter feedback on the student’s performance into the system which will tie that feedback to its corresponding segment of the video, to be reviewed by students afterwards. Once the interview has completed, the SP is then able to complete the SOCA (Student-Patient Observed Communication Assessment) form to grade the student’s performance and enter in any further written feedback. This is automatically sent to the student when completed.
Students are provided feedback on their non-verbal forms of communication which is monitored by sophisticated computer algorithms. For example, students that seem to be dominating the conversation compared to the input from the patient will receive feedback in the form of visual analysis which will suggest they should allow the patient more time to talk.
Pros & Cons
- The OSPIA platform has been built from the ground up to be “set and forget” - little technical maintenance or administration work is required for its on-going use;
- Uses real people (volunteers) as the simulated patients – not “bots” or equivalent non-human alternatives. This provides the necessary authenticity for students to hone work-place relevant communication skills. ;
- Time and space constraints do not exist – students and SPs can manage their own bookings with complete flexibility and autonomy;
- The program also reflects new realities of telemedicine – it prepares students for the particularities of online interactions which will become far more frequent in the future;
- Students love it, providing feedback such as "Going forward: I think this platform can be a really useful way for students to practice history-taking skills, even with each other.”
- The OSPIA platform was custom built for Medicine and can only be redeployed for other domains with further investment, both financial and human resources, and in conjunction with a commercialising organisation;
- OSPIA in Medicine relies heavily on volunteer simulated patients (although there has yet to be a shortage). Different contexts may require other types of arrangements for the ‘other’ participant;
- OSPIA still requires some administrative input to ensure that our volunteers are available over specific periods of time and to answer occasional non-technical questions.
The OSPIA platform has been custom built for Medicine but is now being commercialised and the organisation so doing is interested in seeking out avenues for future development into other domains. If you are in Medicine and would like to know more or are interested in future applications of an OSPIA-like system to other domains, please contact Dr Silas Taylor ([email protected]).
Best practice tips
Having established that an online interaction with assessment and feedback is something your students would benefit from, it’s important to consider the other participants: who will they be, where will you recruit them from, will you need to pay them (if so, how much and can you afford this?!), how will you manage this recruitment and retention task. Ideally, you want this to be as sustainable as possible, such that it does not create a drain on your resources.
Different users of an OSPIA-like system would need to create e.g. a new scenario (or scenarios) and training videos/package. Different workflows will create further tasks and resource implications.