Real patient involvement in role development: evaluating patient focused resources for clinical procedural skills.

BACKGROUND: Simulated patients (SPs) are widely used in medical education. The literature offers little evidence for scenario or SP role development. Published materials describe guidelines for structuring roles but there is little information on process. Anecdotal evidence suggests that SP roles are usually created by health care professionals and teachers. Although this approach has advantages it places the role at risk of omitting or misrepresenting real patients' experiences. AIM: We wanted to explore a systematic approach to role development that was based on individual patient's experiences. METHODS: Real patients were interviewed about their experiences of procedures they had undergone. This information formed the basis of our procedural skills SP roles. RESULTS: Eight new roles were created. Evaluation by SPs (n = 22) showed more positive comments about realism on roles based on real patients' experiences compared with those crafted by our multidisciplinary team although there were no statistically significant differences in numerical ratings. CONCLUSIONS: The approach to writing roles described here is not suited to all simulations. However, it offers guidance to those involved in writing scenarios and has led us to critically reflect on the ways in which we provide educational materials that are patient focused.

Should we explain lower urinary tract symptoms to patients?

AIM: The aim of our study was to evaluate the understanding of lower urinary tract symptom (LUTS) terminology used by patients. MATERIALS AND METHODS: Women attending urodynamic clinics in United Kingdom, Australia, and Italy were asked to complete a questionnaire testing the women's understanding of stress urinary incontinence, urge urinary incontinence, frequency, urgency, nocturia, and hesitancy. Five possible explanations for the meaning of each symptom were given. RESULTS: A total of 138 consecutive women were prospectively recruited. The terms of daytime frequency, nocturia, urgency, urge urinary incontinence, stress urinary incontinence, and hesitancy were defined correctly, according to the International Continence Society terminology, only by 33% (45/138), 44% (61/138), 46% (64/138), 39% (54/138), 37% (51/138), and 41% (57/138) of women, respectively. Over 20% of women were unsure about the meaning of each symptom. We did not find any statistical difference between the three groups in determining the correct definition (P = 0.5). CONCLUSIONS: Our findings showed that most women do not know the correct meaning of LUTS terminology currently used by physicians.