Two rooms are required, or alternatively the standardized patient
can participate via an online facility using audio but not camera
Telephone or online audio link to a different room
Incoming calls/messages to unmuted personal phones during
class when it would be usual practice to mute phones during lectures.
Script and SP briefing notes for multiple telephone call
scenarios including incoming and outgoing calls
Students will work in small groups of 6-8.
Students take it in turns to use the telephone, ensuring the loud speaker function is selected so that the rest of the group can hear the conversation.
Some students will be asked to make telephone calls whilst others will receive incoming calls.
Students making outgoing calls will be given limited information about the call, including name and role of the recipient and the nature of the enquiry that they need to make. Students receiving an incoming call will not be given any information about it in advance.
The rest of the group listen to the conversation between both participants.
After each call the participant will be asked to evaluate their own performance and the rest of the group will be asked to offer further feedback and suggestions.
The standardised patient will also give feedback at the end of the session on how they found the conversations.
Ground rules are established and include:
For outgoing calls students may request any additional information about procedures and/or the patient’s case that they feel they would usually ask before making such a call in the clinical setting.
Students may not ask for any additional information before incoming calls, in accordance with the fact that they would have no pre-warning about such calls in practice, but during the call they may ask the facilitator any questions that they might reasonably ask a radiographer during such a call in practice.
The standardized patient is given a list of the nature of both incoming and outgoing calls in advance, along with the details of their own role as patient/staff/relative, and whether they are to place or receive the call. A copy of the patient appointment list is also made available.
Standardized patients are encouraged to visit the MacMillan Cancer support web pages to gain a broad understanding of what radiotherapy is before participating in this activity. The following link can be used. However, conversations are designed to limit the specific radiotherapy knowledge required and to focus instead on developing appropriate conversational skills in the clinical setting.
Standardized patients are encouraged to ask questions in advance about how they might respond to anticipated questions. They may also ask any question that they feel a real patient might reasonably ask in response to information given by the other participant, e.g. If a student offers a different appointment time they might ask if that change will apply just to the one day or to every treatment.
Example of an outgoing call scenario
Patient details = Jessica Cats, registration number 098326 T
Information for student participant – Student will phone Jessica Cats to confirm her new appointment time is 2pm. She should have been contacted by a member of staff yesterday to let her know about the machine closure and new timing. The machine will be closed this morning due to routine maintenance so it is a one-off occurrence.
Information for standardized patient – Told yesterday that machine is closed in the morning today so appointment time will be moved to the
afternoon. Had to rearrange her hair appointment but treatment is more important so she does not want to miss it.
Questions for the standardized patient to ask – Why was the machine down this morning? Is it likely to happen again as I have important appointments next week that I would need to work around?
Example of an incoming call scenario
Standardized patient role – Doctor Felicity Hoffman, from clinic
Enquiring about patient – Immanuel Mahtoombe 804536 T
Student given appointment list in advance – Mr Mahtoombe’s appointment is listed as 1pm.
Standardized patient to ask –Hello, this is Doctor Hoffman. I need to confirm an appointment time for a patient of mine.
Desired response from student – Student should ask for clarification on who is calling and where they are calling from.
SP response – I’m calling from the chemotherapy clinic. I’m with Mr Mahtoombe now and need to know when his appointment time is this afternoon.
Desired response from student – Student should recognize that it is okay to release this information under these circumstances and should disclose the relevant appointment time from the list.
Additional questions for the standardized patient to ask – Can I ask how long his appointment will be? He is concerned about being on time to pick his children up from school.
Desired response from student –Student should already be aware that appointments typically take around 20 minutes but that delays can sometimes happen. Ideally the student should ask the doctor to instruct the patient to speak up if he finds that his treatment is delayed and his school pick up time is approaching.
Each conversation will be informally evaluated by the facilitator against key information that should have been transmitted between giver and receiver, and whether each participant’s needs were met. E.g. In the case of a change of appointment change did the patient receive the new appointment time and did the student explain why it had changed? The facilitator will offer feedback on whether these basic elements of the conversation have been achieved before inviting debrief.
The participating student is encouraged to evaluate their own performance, focusing on how they felt about the experience, what went well/not so well in their opinion, and what, if anything, they might do differently next time.
The remaining members of the group are then encouraged to share further ideas about how they might have handled the conversation differently. Discussion is monitored by the facilitator to ensure that all feedback is constructive and that comments are fair. The facilitator may add further tips/advice and clarify areas of good practice.
The SP is encouraged to add any feedback about how the conversation was perceived from the patient’s/staff member’s point of view.
A short debrief will take place after each conversation so that the remainder of the group can draw on the resultant feedback before attempting the next conversation. Although simple scenarios are initially used in this first year simulation exercise, if feedback is well received and student performance appears to be improving as the class progresses, increasing levels of difficulty can be added at the facilitator’s discretion, e.g. asking the standardized patient to be a little more impatient in their responses.
Name: Mrs Andrea Maggs
Job title: Senior Lecturer in Radiotherapy and Oncology
Department: Department of Allied Health, College of Health, Science and Society, University of the West of England
Simulation experience / simulation research:Module lead for year 1 Radiotherapy simulation week, including design and implementation of telephone conversation simulations and Radiotherapy set up simulations. Co-authorship of online branched learning scenarios in years 1 and 2 to simulate communication experiences, including evaluation and publication of year 2 branched learning scenarios. Currently co-designing online escape rooms to simulate treatment set ups for all 3 years of the programme, with plans to evaluate this innovative approach.