Background. Health disparities and the role of clinician bias and stereotyping play a part in creating and maintaining these disparities are well documented. The literature suggests that much of this process is subconscious. Perspective-taking, a suggestion that the subject put him or herself in the shoes of another, has been shown to reduce subconscious stereotyping and improve empathy. Improved patient-provider interactions may aid in reducing health disparities. Standardized patients offer a well accepted strategy for facilitating and assessing the patient-provider interaction.
Purpose. To assess the effect of perspective-taking on physician assistant students in clinical interviews with African-American standardized patients (SPs).
Methods. A randomized, controlled, double-blind study was designed to examine the effect of perspective-taking, on interactions between physician assistant (PA) students and African-American standardized patients (SPs). The experimental (E) group was instructed to take the perspective of their patient (i.e., imagine how their patient was feeling) prior to their interaction. The control (C) group received standard instructions. Both groups interacted with three separate standardized patients portraying three different clinical cases. SPs scored students using a validated instrument rating them from a low (1) to high (5) on their interpersonal skills.
Results. One-hundred and five PA students, balanced for race and gender prior to randomization, each participated in three SP cases for 311 interactions. The E group (n=52) achieved higher scores than the C group (n=53) on interpersonal skills overall with a mean of 3.38 (SD 0.35) vs. 3.26 (SD 0.42) (p = .005) and on rapport in particular with a mean of 3.45 (SD 0.43) vs. 3.25 (SD 0.51; p<.000). The effect size was small, at 0.31.
Conclusions. A brief perspective-taking instruction made a small but statistically significant difference in SP ratings of interactions with physician assistant students. Improved interpersonal skills obtained through this simple intervention could help to improve equity and quality of healthcare.
|Commitee:||Blatt, Benjamin, Cora-Bramble, Denise, Shatzer, John, Sparks, Caroline|
|School:||The George Washington University|
|School Location:||United States -- District of Columbia|
|Source:||DAI-B 69/02, Dissertation Abstracts International|
|Keywords:||Patient-provider interaction, Prejudice, Standardized patients, Stereotyping|
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