Objective: 
Undergraduate programs in dietetics and nutritional sciences need to teach students how to develop strong communication and counseling skills.  Determining how to objectively evaluate students’ skills in these areas remains a challenge.  Standardized patients provide a valid, reliable, and cost-effective tool to teach and evaluate clinical skills.  Dietetics and nutritional sciences faculty members are not typically familiar with this approach to teach communication and interviewing skills.  The purpose of this study was to examine the use of standardized patients to teach and evaluate communication and interviewing skills of 21 undergraduate students enrolled in dietetics and nutritional sciences at the University of Cincinnati Medical Center.  

Methods: 
A standardized patient interview was used as a final evaluation for students enrolled in a nutrition counseling and communication course.  Students were required to complete an interview, including a health history and 24 hour diet recall, with a standardized patient.  The case was a 45-year-old man/woman with diabetes and cardiovascular disease.  The SP completed a 26-item checklist.  This evaluation comprised a portion of the student’s final grade.   

Each student had 90 minutes to complete the interview.  The interviews were video-recorded for later evaluation by faculty, as need, and for future feedback to the student. 

In addition to the SP checklist, each student was required to complete a written case summary and a written discussion of concepts applied from the course to the SP interview.  Each student was also required to meet with the course instructor to review the video of the student's performance.

Students were asked to participate an optional focus group discussion to assess the value of the SP encounter.

Results: 
The average score on the SP checklist was 62.71 out of 70 points (SD = 4.94). On the written patient summary,  the average was 26.57 out of 30 points (SD = 3.74). N= 21 students.

A thematic analysis of the constructs that students applied from the text and lectures suggest that they learned how to: 1.  ask open-ended and probing questions to elicit detailed information from standardized patients; 2.  assess non-verbal communication such as gestures, eye contact, voice tone, and space between self and patient; and 3.  remain emotionally objective and not allow personal feelings and preferences to be revealed to the patient during the interview.

Fifteen students participated in the focus groups.  Student feedback was very positive.  Typical statements from students included “This experience taught me what to expect from future clients and helped me to know where I need to work on my communication skills.”  Because students knew they were being scored on their performance by the standardized patients, some stated that they were nervous and felt that affected their overall performance.  Despite this feeling, students thought the comments from the standardized patients were instructive and encouraging.  One student shared, “I thought I knew how to talk with patients because of my volunteer experiences at the VA Hospital and because my stepfather is a cardiologist.  I have been around these situations all my life.  However, the standardized patient indicated that my communication skills were abrupt and abrasive.  I learned that physicians and dietitians have to speak with patients differently to obtain information.  Stu!

dents stated that activity was their first live exposure to talking with a patient.  Several students shared, “For the first time, I felt a like a professional.  I was in an exam room wearing a lab coat and directing the experience.” 

Conclusion: 
Using a standardized patient experience to teach and evaluate communication and interviewing skills to dietetics and nutritional science students is innovative approach to advance the pedagogy that is offered by most allied health science programs.  Dietetic and nutritional sciences educators can be the leaders by providing undergraduate students with this type of valuable communication experience.  Ultimately, students gain exposure to and confidence in working with clients requiring nutritional assessment and counseling.