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Background <p>While effective adolescent health care requires clinicians to initiate and navigate conversations about sensitive topics including substance use, sexuality, mood, and safety, trainees frequently report low confidence in addressing these topics. We designed and evaluated a workshop using adolescent standardized patients (ASPs) to improve medical students’ self‑efficacy in adolescent communication.</p> Methods <p>Graduate medical students on a core pediatrics rotation at a tertiary pediatric hospital in Singapore completed a three‑hour ASP workshop using coached role‑plays with structured feedback. Self‑efficacy (primary outcome) was assessed using a single-group pretest-posttest design. Surveys were conducted immediately pre‑workshop and four weeks later using an adapted, previously published instrument (4‑point Likert scale; higher scores reflect greater confidence). Perceived usefulness of workshop components was collected post‑workshop (10‑point scale). Internal consistency was estimated using Cronbach’s alpha. Pre–post changes were analyzed with paired t‑tests.</p> Results <p>A total of 147 students participated (50% female), with a mean age 27.1 ± 2.6 years. The self‑efficacy scale showed excellent reliability (α = 0.957). Both composite self-efficacy (26.60 ± 6.21 vs. 38.86 ± 3.83, <i>p</i> &lt; 0.001) and self-efficacy across all individual domains increased significantly from baseline to four-week follow-up. Confidence in interviewing adolescent patients rose from 1.88 ± 0.66 to 2.81 ± 0.39 (<i>p</i> &lt; 0.001), and confidence in discussing confidentiality increased from 1.90 ± 0.72 to 2.82 ± 0.39 (<i>p</i> &lt; 0.001). Content-area gains included sexual history (1.60 ± 0.58 to 2.55 ± 0.53, <i>p</i> &lt; 0.001) and sexual orientation (1.66 ± 0.60 to 2.51 ± 0.53, <i>p</i> &lt; 0.001). Students rated ASP feedback (8.47 ± 1.47) and role‑play (8.23 ± 1.51) as highly useful.</p> Conclusions <p>An ASP‑based workshop embedded within a pediatrics rotation was acceptable and associated with significant improvements in self‑reported self‑efficacy for adolescent communication. Findings support the feasibility of ASP‑based teaching in an Asian context and highlight the need for future studies incorporating objective performance measures and clinical behavior outcomes.</p>

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The use of adolescent standardized patients to teach psychosocial risk assessment and its impact on medical student self‑efficacy

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年6月15日

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  • Courtney Davis,
  • Kumudhini Rajasegaran

摘要

Background

While effective adolescent health care requires clinicians to initiate and navigate conversations about sensitive topics including substance use, sexuality, mood, and safety, trainees frequently report low confidence in addressing these topics. We designed and evaluated a workshop using adolescent standardized patients (ASPs) to improve medical students’ self‑efficacy in adolescent communication.

Methods

Graduate medical students on a core pediatrics rotation at a tertiary pediatric hospital in Singapore completed a three‑hour ASP workshop using coached role‑plays with structured feedback. Self‑efficacy (primary outcome) was assessed using a single-group pretest-posttest design. Surveys were conducted immediately pre‑workshop and four weeks later using an adapted, previously published instrument (4‑point Likert scale; higher scores reflect greater confidence). Perceived usefulness of workshop components was collected post‑workshop (10‑point scale). Internal consistency was estimated using Cronbach’s alpha. Pre–post changes were analyzed with paired t‑tests.

Results

A total of 147 students participated (50% female), with a mean age 27.1 ± 2.6 years. The self‑efficacy scale showed excellent reliability (α = 0.957). Both composite self-efficacy (26.60 ± 6.21 vs. 38.86 ± 3.83, p < 0.001) and self-efficacy across all individual domains increased significantly from baseline to four-week follow-up. Confidence in interviewing adolescent patients rose from 1.88 ± 0.66 to 2.81 ± 0.39 (p < 0.001), and confidence in discussing confidentiality increased from 1.90 ± 0.72 to 2.82 ± 0.39 (p < 0.001). Content-area gains included sexual history (1.60 ± 0.58 to 2.55 ± 0.53, p < 0.001) and sexual orientation (1.66 ± 0.60 to 2.51 ± 0.53, p < 0.001). Students rated ASP feedback (8.47 ± 1.47) and role‑play (8.23 ± 1.51) as highly useful.

Conclusions

An ASP‑based workshop embedded within a pediatrics rotation was acceptable and associated with significant improvements in self‑reported self‑efficacy for adolescent communication. Findings support the feasibility of ASP‑based teaching in an Asian context and highlight the need for future studies incorporating objective performance measures and clinical behavior outcomes.