Setting

The study took place at the medical school of the University of Lausanne, Switzerland, which has a 6-year undergraduate curriculum. Clinical teaching begins in the second year only with simulated patients, and then gradually increases since the third year with the beginning of exposure to real patients. Clinical rotations take place in the second half of the 4th year and electives during the whole 6th year. The undergraduate curriculum in adolescent health and medicine includes 13 hours of formal lectures over 6 years and a three-hour training session with ASP during the fourth year, run by faculty members specialized in adolescent health. At this stage of the curriculum, the large majority of students have not had any contact with adolescent patients in a clinical setting yet.

The main purpose of this simulation-based training session is to practice interviewing and communication skills with adolescents. During this session, groups of approximately ten students encounter two ASP in a row. One student interviews the ASP while the others observe. After 5–10 minutes of role-play, the student gives feedback on their feelings and then gets feedback from the ASP, the observing students and the teacher, focused on interviewing techniques, communication skills and attitudes. The feedback is followed by a brief group debriefing on these aspects. Then, another student carries on with the encounter and so on until all students have participated. A group discussion takes place at the end of the session whose purpose is mainly an evaluation of the training session by the students.

ASP at the time of this study were healthy young people between 14 and 21 years old, carefully selected according to their cognitive skills and affective stability, with parental consent. They were trained to portray a clinical vignette of an adolescent patient (e.g., an adolescent with fatigue, substance use, etc.) and to give structured feedback to students.