Original Publication
Psychotropic Medication Informed Consent: A Cross-Specialty Role-Playing
Skill Builder
Emily Diana*, Derrick Hamaoka, MD, Matthew Goldenberg, MD, MSc, Kelly L. Cozza, MD
*Corresponding author: emily.diana@usuhs.edu
Abstract
Introduction: Obtaining informed consent (IC) is an essential medical practice. Utilization of IC role-playing training with medication study
cards and self-peer-supervisor review should improve student fund of knowledge and strengthen IC skills for clerkship-level medical
students. Methods: Between 2017 and 2020, approximately 555 clerkship medical students used our formative role-playing exercise
tools. Students independently prepared psychotropic medication study cards and role-played IC during group didactics. Peer and
supervisor reviews were not recorded but were discussed as a group. Students completed routine anonymous postclerkship surveys
regarding the IC exercise. An enhanced IC curriculum was deployed in 2020, adding a training video and peer/supervisor feedback form.
Student feedback and specialty shelf exam scores were reviewed to assess the exercise’s efectiveness. Results: Surveys indicated
satisfaction with the exercise and increased confidence in obtaining IC. Interestingly, the student group that received enhanced IC training
had fewer shelf exam failures than those without, perhaps indicating improved fund of psychotropic medication knowledge. Discussion:
Peer role-playing IC training is well accepted by students, allows practice of essential elements of IC and shared decision-making, and
provides an engaging way to improve medication fund of knowledge. Our clerkship has initiated development of an IC objective
structured clinical examination station and is adapting the exercise across specialties for longitudinal learning in response to the positive
feedback and ease of use. Structured review of psychotropics and peer IC role-playing can be tailored for other specialties, medications,
and procedures and further developed for use in pre- and postclerkship education.
Keywords
Informed Consent, Entrustable Professional Activity 11, Role Play/Dramatization, Role-Playing, Shared Decision-Making, Communication
Skills, Competency-Based Medical Education (Competencies, Milestones, EPAs)
Educational Objectives
By the end of this activity, learners will be able to:
1. Memorize and utilize an essential steps rubric for obtaining
informed consent.
2. Develop and demonstrate psychotropic medication fund of
knowledge.
3. Propose and discuss a medication plan in patient-friendly
terms.
4. Practice shared decision-making techniques.
5. Assess and discuss self- and peer performance in
obtaining informed consent.
Citation:
Diana E, Hamaoka D, Goldenberg M, Cozza KL. Psychotropic
medication informed consent: a cross-specialty role-playing skill
builder. MedEdPORTAL. 2021;17:11152.
https://doi.org/10.15766/mep_2374-8265.11152
Introduction
Discussing treatment options and obtaining informed consent
(IC) are cornerstones of medical practice. Physicians have
an ethical and legal duty to participate in IC-covered, shared
decision-making conversations with patients to allow them
to make knowledgeable and more autonomous medical
decisions.
1,2
According to the Association of American
Medical Colleges, obtaining IC for tests and/or procedures is
regarded as one of the core Entrustable Professional Activities
(EPAs), EPA 11, meaning that medical students should be
proficient at this activity before entering residency.
3
The
incorporation of IC practice into medical student learning
has been found to be efective by both medical students
and patients.
4,5
To address EPA 11, the Uniformed Services
University (USU) School of Medicine developed an IC curriculum
for clerkship students using rubric-driven medication study
cards with peer- and faculty-reviewed patient vignette role-
playing to practice this skill. This exercise was developed
Copyright © 2021 Diana et al. This is an open-access publication distributed under the terms of the Creative Commons Attribution license. 1/7