Research Article

Training Family Medicine Residents in Effective Communication Skills While Utilizing Promotoras as Standardized Patients in OSCEs: A Health Literacy Curriculum

Table 1

OSCE components.

OSCE stationMeasuresScoring
Did not perform (0 pts)Adequately performed
(1 pt)
Expertly performed
(2 pts)

(1) Obtaining the Newest Vital Sign (NVS)
Score range: 0 to 8
Explained the purpose of the NVS to the patient.Examiner clearly did not perform this function.Examiner explained the purpose of the Newest Vital Sign (NVS) and read questions to patient.
Examiner did not accurately score the NVS and/or did not determine patient’s health literacy.
Examiner explained the purpose of the NVS in a nonjudgmental way, read questions, and gave the patient time to provide an answer.
Examiner accurately scored and determined the patient’s level of health literacy.
Read the questions on the NVS to the patient.
Scored the NVS according to instructions.
Used NVS score to determine patient health literacy.

(2) Teach-back method for asthma
Score range: 0 to 22
Sat while speaking with patient.
Spoke slowly.
Used words the patient could understand.
Treated the patient with respect.
Gave the patient the right amount of information for the time allowed.
Provided clear instructions about how to use 2 inhalers.
Asked the patient to repeat back, in a sensitive manner, what was taught about their 2 asthma inhalers.
Was patient when the patient did not get some of the instructions correct the 1st time.  
Used additional methods to instruct the patient about the inhalers (drawings, demonstrations, etc.).
Reviewed what the patient did not understand.
Patient felt they could use these inhalers correctly after this education session.
Examiner clearly did not perform this function.Examiner was relaxed and confident and seemed to care about the patient. The examiner gave information that was usually clear and easily understandable. Most of the words used by the examiner were easily understood. The patient felt comfortable repeating back what the examiner taught.Examiner was relaxed and confident and cared about the patient. He/she sat down and gave the patient information about how to use the 2 inhalers in a way that was easy to understand. The patient did not feel overwhelmed. Examiner used more than just words to teach how to use the inhalers. The patient was able to “teach back” all information given correctly. The patient felt respected through the entire visit. The examiner never used words that the patient did not understand. The patient felt confident to go home and use these 2 inhalers without further instruction.

(3) Explain the DASH diet to hypertensive patient using Ask Me 3
Score range: 0 to 16
Explained that the main problem is high blood pressure.Examiner clearly did not perform this function.Examiner explained the DASH diet using words and terms the patient could understand.
Examiner used at least one of the Ask Me 3 questions while explaining the DASH diet.
Examiner explained the DASH diet using nonmedical words and terms that the patient could understand. The examiner reviewed all Ask Me 3 questions with the patient.
Used the word high blood pressure to describe main problem.
Described the DASH diet to help reduce blood pressure.
Gave the patient examples of what to eat in the DASH diet.
Explained why it is important to lower blood pressure.
Used nonmedical terms.
Used words/abbreviations and lay terms.
Defined Ask Me 3.

(4) Working with an interpreter
Score range: 0 to 16
Positioned interpreter behind or to the side.Examiner clearly did not perform this functionThrough most of the encounter, examiner faced the patient, spoke to the patient and not the translator, used the first person, employed plain language (not jargon or medical terms), and refrained from conversing with the interpreter.Through the entire encounter, the examiner faced the patient, always made eye contact with the patient, always used the first person, did not have extra conversations with the interpreter, and used plain language.
Introduced themselves to the patient through an interpreter.
Maintained eye contact with the patient.
Spoke to the patient and not to the interpreter.
Used the first person when talking to patient.
Refrained from carrying on side conversations with interpreter.
Used plain language.
Used brief statements and provided interpreter with time to relay information.