The HEADSS Assessment: A Virtual Psychosocial Interview for Adolescents and Young Adults

The purpose of this exercise is to provide medical students an opportunity to practice their skills performing a HEADSS assessment with an adolescent standardized patient through video conferencing. All students are required to complete an observed HEADSS assessment over the course of their clerkship. With the COVID-19 pandemic, this activity was adapted to be done virtually, with no direct in-person patient contact. 

The key personnel in this online module include: medical students as the learners, adolescents aged 13-17 as standardized patients, and fellows and/or faculty members as the observers. In preparation, medical students received a handout outlining the objectives for the encounter, recommended reading, an overview of the key aspects of the proposed encounter with suggested areas of focus, an explanation of the formative feedback to be provided, and guidance on submitting a written narrative of the encounter. Standardized patients were provided two scripts - one to mirror a typical encounter with a 14-year-old patient in early adolescence, and one to mirror a typical encounter with a 17-year-old in middle adolescence - and asked to choose between the two characters for each encounter. A one-hour training session was performed to familiarize the standardized patients with the video conference format as well as provide opportunities for practicing their roles. 

The specific learning objectives for the medical students are as follows: 

• Counsel patients on confidentiality related to adolescent assessment and the limitations. 
• Perform an adolescent psychosocial interview rooted in the HEADSS assessment. 
• Develop rapport with the adolescent and practice using a strengths-based approach. 
• Practice therapeutic communication techniques, particularly with respect to counseling on health promotion and harm reduction on sensitive subjects such as comprehensive sexual health and substance use. 
• Practice written documentation skills through submission of a narrative report of the clinical encounter. 

Upon completion of the encounter, medical students received immediate verbal feedback from both the standardized patient and fellow or faculty member. Students later received written formative feedback on their narrative documentation from the fellow or faculty member. The following resources are included to support adaptation to other institutions: PowerPoint for the standardized patient training, standardized patient case scripts, standardized patient encounter handout for medical students.