Our project sought to implement a simulated patient final exam via video-conference platform for scholar students registered across three sections of the Advanced Clinical Social Work Practice in Integrated Healthcare course during Spring/Summer 2020. Volunteers were trained as simulated patients using instructor-developed patient profiles in preparation for the sessions with students. Students were given referral documentation for approximately ten simulated patients to prepare for the week prior to the exam and then were assigned one of those patient referrals approximately 30 minutes prior to their exam session. For the exam, each student was given the opportunity to demonstrate their learning in a 15-minute session with a simulated patient during which they completed a mental health or substance use screening, brief intervention, and referral for ongoing treatment. Students were required to complete clinical documentation in Canvas following their session with the simulated patient.
We trained 19 volunteers to be simulated patients. Volunteers lived across three time zones and ranged in age, from about ten years old to their mid-70's. A total of 58 scholar students, across four time zones, completed the exam with a simulated patient using BlueJeans, which is HIPAA-compliant and had the capacity for simultaneous sessions. A series of storms the night before the exam took out the wifi and power for a number of students and volunteers, which necessitated the use of phone for some sessions. All exams were either video- or audio-recorded and reviewed by the course instructors to assess the final grade for each student. Each simulated patient completed a brief rating form for their sessions that provided feedback related to the student clinician's rapport, therapeutic approach, and ability to address the goals of the referral. Students were further assessed by the instructors using a rubric that included the nine competency domains of integrated health (SAMHSA, 2014) and standards of clinical documentation.
The use of the simulated patient final exam has been a core component of this course in years previous but relied on in-person implementation. However, this project "flipped" the exam for remote implementation due to the COVID-19 pandemic. Many students taking the course had limited experience providing tele-therapy and tele-health services to clients; this project provided a concrete method to train students for remote-based social work practice, which has become a standard of care within the pandemic context. Completing this project demonstrated to students that it is totally viable to engage all aspects of their learning and demonstrate the ability to apply and reflect on their clinical skills and knowledge - even if they are not seeing clients in real life. This project demonstrated to the instructor team that a remote-based simulated exam is able to facilitate the same learning objectives as an in-person exam, while also providing additional learning related to the use of technology in the delivery of clinical care.
We will write a brief report to share with colleagues in our department, as well as prepare a brief submission to a peer-reviewed journal to share our learning with colleagues in the broader social work field.
Advice to your Colleagues:
It was really important to set up a time to go through the details of the final exam with our technology team. We had a lot of tools/resources at our disposal to support this project and our technology team was able to provide detailed insight that really clarified which were the best to use. Also, it was very important to engage email, phone, and text for communication throughout the exam experience with all parties. The use of text was particularly clutch when trying to communicate with folx in the midst of 13 simultaneous exam sessions!