Using Objective Structure Clinical Exams to Enhance Psychotherapy Skills Training and Assessment

Clinical training in psychotherapy is an essential component of PMHNP education (ANCC, NONPF), yet developing psychotherapy skills is one of the most challenging learning requirements that PMHNP students face.  The use of standardized patients (SPs) – actors trained to accurately and consistently portray patients in simulated clinical situations -- is a promising strategy for both formative (low stakes) practice and teaching of basic psychotherapy skills, and summative (high stakes) evaluation of psychotherapy competencies.   

This presentation describes the development and implementation of Objective Structured Clinical Examinations (OSCEs) using standardized patients in simulated case scenarios for both teaching and evaluation of psychotherapy skills in a PMHNP psychotherapy course. The SP program was embedded in the course context which included (a) readings and lectures regarding supportive, psychodynamic and cognitive-behavioral therapy, (b) observation and discussion of exemplar videos of faculty demonstrating psychotherapy skills with an SP in the context of simulated psychotherapy sessions, and (c) practice of psychotherapeutic skills in role-play of simulated psychotherapeutic encounters with peers. 

 For the formative OSCE, three SPs were trained to portray three separate cases.  Each student (N = 18) had the opportunity to individually conduct a 15-minute video recorded interview with an SP in a simulated psychotherapy office.  After the encounter students received immediate verbal and written feedback from the SP. In the following week, each student transcribed and critiqued his/her video according to predetermined criteria and received written faculty feedback. 

At the end of the course, a summative OSCE was conducted and students were video recorded in two separate 10-minute SP encounters – one focused on demonstrating supportive psychotherapy skills and the other on implementing specific cognitive-behavioral therapy techniques in the context of the SP scenario. Students again received immediate feedback from SPs. The video recordings were evaluated by faculty using a rating checklist as part of students’ course grade. Open-ended questions and Likert scale questions were used to collect student evaluative data regarding the SP experience after both SP sessions. Student evaluative feedback, faculty impressions, lessons learned, and next steps will be presented.