Sexual Transmitted Infections Training: Peer Role Playing Exceeds Standardized Patient Simulation for Learning Communication Skills

BACKGROUND: Clinical simulation education is becoming increasingly popular in health education, especially the use of expensive standardized patients to teach and practice communication skills. Good communication about stigmatized STI screening, testing, and results is critical in public health practice. This study compared expensive standardized patient (SP) verses inexpensive peer role playing (PRP) for training students who will be counseling those seeking STI screening, using asymptomatic herpes for the case.

METHODS: This experimental design randomized Nurse practitioner students into two groups. Students communication was assessed, as was student perception of the simulation overall and the effectiveness of the training.

RESULTS: Participants (n=22) were randomized into two groups. When comparing the groups, all results were statistically similar, in that all results were well within each other’s standard deviation. The null hypothesis, that both groups would perform identically, was rejected only for the following statement: “I developed a better understanding of the pathophysiology of the conditions in the scenario”. For this statement, the peer role playing group scored a full two standard deviations higher than did the standardized patient group (P = 0.00 for the t-test). Though the sample size was small, Monte Carlo and bootstrap simulations suggested the results would be equivalent given a more robust sample size.

PUBLIC HEALTH CONCLUSIONS: There is no evidence from this work that performing with standardized patients is superior to peer role playing for the scenario provided. Adaptable and affordable, PRP can be widely used for training our diverse community workers as they serve transcultural neighborhoods.