Patient Classifications
Participants in the Standardized Patient Program are used in a variety of settings and encounters to help students develop clinical procedural skills, integrate clinical knowledge with human interaction, and improve patient communication skills.
Different patient encounters can be simulated to focus on different aspects of these skills as determined by specific curricular goals. Most of these patient encounters can be grouped into one of the three general categories detailed below, all of which use individuals from the Standardized Patient Program pool.
Depending on the event, the student-patient interaction may consist exclusively of the patient interview or it may integrate the patient interview with a focused, non-invasive physical exam. Invasive and highly-sensitive physical examination is limited to a group of specially-trained patients.
Standardized Patients with Specific Medical Findings
Paid patients with specific medical findings are recruited for certain teaching events based on their medical and social histories. These individuals' life experiences in addition to the physical manifestations of their condition are educationally valuable in helping students translate textbook understanding into human experience. Patients in this group often spend time speaking about living with their condition, promoting a holistic perspective in patient care.
Example:
Physician and Society
Understanding Illness Workshop, August 2003
After learning interviewing strategies in large group lecture, first year medical students assembled in small groups to practice soliciting patients' understanding of their chronic illness and their related experiences.
Standardized Patients with General Histories and Medical Findings
Health sciences students need exposure to individuals with specific medical conditions and chronic illnesses as well as individuals with more routine medical and social histories. All individuals are useful in helping students develop interviewing and physical exam skills. Additionally, individuals with any medical and social history can be trained to provide valuable feedback to students in developing professionalism and patient rapport.
Example:
Physician and Patient II
Interviewing and Physical Exam Tutorials, Fall 2004
All second year medical students had the opportunity to combine the history-taking and physical exam skills they learned in their first year into a full doctor’s visit. Each week for 11 weeks, paid patients worked with a pair of medical students and a physician tutor at medical sites across the Twin Cities. The paid patients provided a safe, supportive environment for students to become experienced in taking patient histories and performing physical exams and provided valuable feedback to students in developing professionalism and patient rapport.
Standardized Patients
with Scripted Cases
Individuals are trained to portray medical cases ranging from simple, with little role play involved, to more complex, with significant emotional features and intricate medical histories. The complexity of the cases generally increases as the students progress through their education. Cases are written with various levels of demographic specificity and are designed to be reflective of individuals and conditions found in actual medical practice. When trained, individuals can portray these cases uniformly, time and time again, for different students and provide a valuable means for student assessment.
Example: Primary Care Clerkship OSCE,
January 2005
At the end of the Primary Care Clerkship, third and fourth year medical students participated in a high-stakes Objective Structured Clinical Exam (OSCE) to assess their learning during the eight week rotation in primary care. During the OSCE, more than a dozen standardized patients were trained to portray different medical cases, enabling students to assess a series of patients much as they would in an actual clinic setting. Students were evaluated using objective checklists and were given performance feedback from standardized patients and from the residents and physicians serving as evaluators.
Example: Professional Skills, Veterinary Medicine OSCE, March 2004
Second year veterinary medicine students participated in a low-stakes OSCE designed to provide them with client interactions in a controlled setting. Each student interacted with three separate standardized clients, each representing a different pet owner. Written for the knowledge level of second year students, the cases emphasized communication skills by creating encounters in which various client emotions were emphasized. The simulated clients provided feedback to students about their communication skills, sharing impressions that actual clients in clinic settings seldom do. Course instructors reviewed student videotapes and provided further feedback and instruction based on students’ performances.
Example: Surgical Intensive Care Fellowship OSCE, October 2004
Standardized patients were assembled into groups of two or three and were trained to simulate the emotions and concerns of the family members of critically ill patients. Using written medical cases depicting critically ill patients, fellows provided family counseling concerning the care of their loved one to these diverse groups of family members. These 30 to 60 minute encounters provided an extended, realistic format for fellowship instructors to evaluate communication skills and gaps in fellows’ training. The outcomes were useful both for feedback to the current fellows and to refine teaching with future fellows.
back to the top
|
Return to: Academic Health Center | U of M Home
