by Matt Newman,
PharmD, PGY1 Pharmacy Practice Resident, The Johns Hopkins Hospital
Recent graduates of Doctor of Pharmacy programs are likely familiar
with the role of simulation in education. Activities like patient counseling
laboratories and clinical skills practicums are common, even if the formats may
vary. While these instructional methods are useful and are aimed at providing a
true-to-life experience, one aspect of pharmacy practice in the “real world” is
not easily taught: social and emotional compassion and competence.
As a pharmacy student, I participated in a somewhat dreaded patient
counseling lab during “angry week.” In
this session, rather than being presented with a calm and cooperative patient
needing advice about smoking cessation or seeking help with the high cost of co-payments,
the patient was irate about a perceived medication error that had occurred with
her prescription. Sitting in the counseling room, I remember a distinct feeling
of uneasiness as I pondered the best way to manage the patient’s emotional
state and formulate an appropriate response to her concerns. I have found that the best way to improve
this skill set is through experience.
You may have had a similar lab in pharmacy school. And you probably already have some idea of
what social emotional competence means and how you might demonstrate it in
practice. Exact definitions vary, but emotional
intelligence is considered “the overlap between emotion and intelligence,” or,
“the intelligent use of emotions.”1 It is a set of skills used to
read, understand, and react effectively to emotional signals sent by others and
oneself.2 While this sounds
obvious, assessing one’s ability to utilize this skill set can be difficult.
There is, however, an increasing body of literature regarding social emotional
intelligence, which demonstrates an expanding awareness of its importance.
While the need for emotional intelligence in healthcare has been
thoroughly described, there has been little research about how to best teach
and measurement it, especially among pharmacy students.1 A group of instructors at one pharmacy school sought
to measure the development of social emotional competence in students before
and after a series of simulated patient counseling activities. To do so, a
group of first-year students were asked to complete the Social Emotional
Development Index (SED-I) before and after participation in mock patient
consultations. Students were also graded on a scale of 0-3 for social emotional
competence.
The SED-I is a self-assessment tool in which participants respond to
questions such as “I take the lead role,” “People know that I care about them,”
and “I act without considering another person’s perspective” with the goal of
assessing the respondents SED in four domains: connection, influence,
consideration, and awareness. In this study, students took the SED-I at baseline
and after performing two mock counseling sessions on topics such as smoking
cessation, nonprescription medications, blood pressure, and blood glucose
monitoring. Statistical analysis demonstrated a significant positive
correlation between students’ patient counseling assessment scores (as judged
by the instructors) and their self-assessment using the SED-I.1 In other words,
students who performed better in the lab also scored higher on the SED-I.
These results indicate the potential utility of the SED-I as a tool to
evaluate the development of social emotional intelligence. While not
surprising, it is useful to note that the students who performed better on the
lab activities were the ones who had more developed social emotional
intelligence. This reinforces the
current understanding that this type of intelligence is important during
patient interactions. The authors noted that pharmacy curricula are effective
at teaching core knowledge and technical skills, but social skills may be more
important in order to influence patient behavior.1 A possible limitation of the study is
the use of second-year pharmacy students as the “patients” in the counseling
sessions; the use of professional actors would have made the counseling
sessions more realistic.
Another group of pharmacy faculty studied students’ perceptions of
emotional intelligence material used in a communications course.3 Objectives
for this course included “Define an emotional concept,” “Relate how
self-confidence would be beneficial to the Director of Pharmacy in a large
hospital,” and “Describe the characteristics of people who are competent in
communication skills and relate how these characteristics would benefit the
pharmacist who manages a staff of 20.” In addition to traditional didactic content, a
patient counseling activity similar to the previous study was used to teach the
core principles. Instructors reviewed a video recording of the counseling
activity with the students, and noted the empathic responses used. They also
role-modeled for the students. Additionally, students were asked to answer two
reflective questions and course content was assessed on a formal examination.
Student responses were mostly positive: they recognized the importance of these
skills and the need to apply them to practice. It is interesting to note that
the authors mention the lack of standardized tools available to assess the
students. Perhaps the SED-I could have been used to assess student performance
in this type of educational activity.
I wonder how my patient counseling lab experience may have been
different if the SED-I, or another measure of social emotional intelligence,
had been used. While most may not think about social emotional intelligence in
day-to-day interactions, awareness of the concept is important. The same skills
needed for effective patient counseling would also be useful in ensuring
productive interactions with many others, including peers, family, and members
of the medical team.
Using simulation to teach social skills is useful but it is not
without caveats. Using students or actors as “patients” during patient
counseling labs is a great way for students to gain experience and confidence
in their interactions. However, it is difficult to emulate real emotions and
personalities as they will be experienced in the clinical setting. Finding the best method of evaluating
student’s social and emotional development is a work in progress. Regardless, including
instruction regarding social emotional intelligence into pharmacy curriculums
is important and simulated patient interactions serve as a reasonable
substitute for real-life experience.
References
1. Galal S, Carr-Lopez S, Seal CR, et al. Development and
assessment of social and emotional competence through simulated patient
consultations. Am J Pharm Educ.
2012;76: Article 132.
2. Romanelli F, Cain J, Smith KM. Emotional intelligence as a predictor of academic and/or professional success. Am J Pharm Educ. 2006;70: Article 69.
3. Lust E, Moore FC. Emotional intelligence instruction in a pharmacy communications course. Am J Pharm Educ. 2006;70: Article 06.
2. Romanelli F, Cain J, Smith KM. Emotional intelligence as a predictor of academic and/or professional success. Am J Pharm Educ. 2006;70: Article 69.
3. Lust E, Moore FC. Emotional intelligence instruction in a pharmacy communications course. Am J Pharm Educ. 2006;70: Article 06.
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