(P479-LB) Standardized Patient Simulations Improve Sexual Health-related Interpersonal Communication and Medical History Taking for Students: Results from the Tanzanian Health Professionals Trial

Background: Tanzania faces a substantial sexually transmitted infection (STI) and HIV disease burden complicated by complex cultural, political, and legal issues, yet there is limited health professional training to manage common sexual health (SH) issues in practice. We assess the effectiveness of a novel comprehensive Afrocentric SH curriculum intervention for improving SH-related interpersonal communication (IC) and medical history-taking (MHT) behaviors using standardized patient simulations and student ratings of the experience.

Methods: 412 health professional students in midwifery (13), nursing (122), and medical students (277) at a large academic center in Dar es Salaam, Tanzania participated in the human subjects' approved Tanzanian Health Professionals (THP) randomized controlled sexual health education trial. Students completed four standardized patient simulations focused on 1) adolescent pregnancy, 2) sexual violence, 3) erectile penile discharge, and 4) erectile dysfunction. Two of the four simulations were randomly assigned at baseline and for the 3-month follow-up assessment. All simulations were conducted in Kiswahili and recorded via Zoomâ. Videos were evaluated by trained bilingual clinical research faculty using standardized behavioral checklists. Intervention and control group total baseline and follow-up IC and MHT checklist difference scores were compared using linear regression analyses for students with complete simulation and ratings data. In addition, student satisfaction with simulation experiences was assessed using student ratings of impact on their key learning measures.

Results: The final analytic sample included data from 402 health professional students. Of these, 202 were enrolled in the control arm and 200 in the intervention. On average, the treatment group had difference scores that were 7.82 points higher on the IC measure (B =7.82, SE 0.197, p< 0.0001) and 2.49 points higher on the MHT measure (B=2.49, SE 0.270, p< 0.0001). Students agreed/strongly agreed that the simulation experience increased their ability to communicate in SH interviews (98%), manage SH concerns across gender (96%) and age (96%), use professional language (94%), and recognize moments for empathy (97%) in SH interviews.

Conclusion: Sexual health simulation data demonstrates significant improvement in SH-related interpersonal communication and medical history taking and highly favorable experience ratings among students in the THP trial.