Effect of a simulated patient-based educational program on the quality of medical encounters at military recruitment centers.

BACKGROUND Simulation-based medical education has become a powerful tool in improving the quality of care provided by health professionals. OBJECTIVES To evaluate the effect of a simulated patient-based educational program for military recruitment center physicians on the quality of medical encounters with adolescent candidates for military service. METHODS Twelve physicians participated in an educational intervention that included a one day SP-based workshop, where simulations of eight typical candidates for military service were conducted. Assessment of the physicians' performance before and after the intervention was based on questionnaires filled by 697 and 508 military candidates respectively upon completion of their medical examination by these physicians. The questionnaire explored health topics raised by the examining physician as well as the atmosphere during the encounter. The candidates were also asked whether they had omitted important medical information during the medical encounter. RESULTS Pre- and post-intervention comparison revealed significant changes in the percentages of candidates who reported that they had been asked questions related to psychosocial topics: school problems--59.7% and 68.9% (P = 0.01), protected sex--29.6% and 36.4% (P = 0.01), mood changes--46.9% and 52.2% (P = 0.05) respectively. Physicians were perceived as being interested in the candidates by 68.2% of the candidates before the intervention and 77.5% after (P < 0.01). The percentage of candidates who reported omitting medical information decreased from 6.6% before the intervention to 2.4% after (P < 0.01). CONCLUSIONS A simulated patient-based educational program for military physicians improved the quality of physician-candidate encounters. Such programs may serve as an effective instrument for training physicians to communicate with adolescents.