Clinical Applications of Standardized Patients (SPs) Kaohsiung Medical University May 8, 2007.
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Transcript of Clinical Applications of Standardized Patients (SPs) Kaohsiung Medical University May 8, 2007.
Clinical Applications of Standardized Patients (SPs)
Kaohsiung Medical University
May 8, 2007
Lynn Seng, MSEd
University of Pennsylvania
School of Medicine (“Penn Med”)
Philadelphia, PA USA
Director, Special Educational Projects, 1984-2006
Director, Standardized Patient Program,
1996-2006
What & Who Are SPs?
What are Standardized Patients (SPs)?
People who are trained to
pretend to be patients
for the purposes of
educating and evaluating students.
“Standardized” because ...
1. SPs are trained to act and react in a specific, predictable way, according to the goals of the program; and
2. Cases are often portrayed by more than one SP for the same program.
Who are SPs?
“Regular” people like your neighbors, shop clerks, dog walkers, etc.
Some are actors; many are not. Are all ages, sizes, colors, genders, etc.
SPs are paid professionals
$12 - $22 USD per hour
$25 - $38 USD for specialized programs (e.g., gynecology physical exams)
SP Characteristics
Are able to act Can memorize roles and lists Have excellent retention skills Are reliable Want to help educate students
SPs in Clinical Education
What schools use SPs?
Allied Health Clinical Psychology Dental Medical Nursing Pharmacy Physical Therapy Veterinary
How SPs are being used in medical education Help teach clinical, communication, and
interpersonal skills Provide practice in a safe environment Introduce professionalism Evaluate skills
7 Reasons for SPs in Medical Education
1. Fewer real patients to use for teaching
Hospitalized patients are sicker Hospitalizations are shorter Patients are more empowered
2. Faculty are too costly
Faculty required to devote more time to research and clinics
Schools unable to compensate departments for faculty time
3. Reliable and consistent educational experiences
Faculty design SP programs to match curriculum
Every student sees same clinical “patients”
4. Provide a safe environment
Physical exam skills Emotional interviews (e.g., Giving Bad
News) Diagnosis, treatment, management Cannot harm SPs
5. Schools need better evaluation tools SPs provide reliable measures of
students’ skills
Schools use SPs to evaluate and improve own curriculum
6. Help students prepare for exams USMLE Step II CS
Students develop test-taking skills and confidence
7. SPs provide feedback
Immediate
Interpersonal skills
Purpose of SP Feedback
To increase students’ awareness of their verbal and non-verbal behaviors ...
Purpose of SP Feedback
... and how their verbal and non-verbal behaviors affect their patient.
Benefits
Patient perspective Immediate Verbal, with discussion & clarification Appropriate
Skills Taught with SPs
Clinical Skills
Interviewing & History Taking Physical Exam Differential Diagnosis Treatment & Management
Communication Skills
Difficult Subject, e.g.,Colon cancer screening (3rd most common
cancer in Taiwan)Teen suicideHIV+/AIDSWorker fatigue & stressSexual assault
Communication Skills
Difficult Patient, e.g.,Teenager: contraception & pregnancyNon-compliant patient: asthma inhalersForeigner: illegal; tourist; cyber-brideBehavior modification: smoking cessationFlirt: suggestive, inappropriatePhysician
Professionalism
Substance Abuse Teaching, Evaluating Ethics, e.g.,
GiftsRelationships
Interpersonal Skills
Professional Appearance & Behavior Eliciting & Giving Information Listening Empathy Respectfulness
University of Pennsylvania School of Medicine
SP Programs
Penn Med SP Programs
Medical Students Residents & Fellows Faculty & Community Physicians
and ...
Penn Med SP Programs
Medical School Administration Hospital Ethics Committee Other U of P schools Other Philadelphia schools
Medical Students
History & physical exam Diagnosis, treatment, and management Communication Interpersonal Feedback Cultural Competence Introduction to professionalism
SP Contact Hours in 2006
MS1: 12 MS2: 33.5 MS3: 10.5 MS4: 8
Total: 64 hours
Residents & Fellows
Improving clinical skills Giving and getting feedback Ethical dilemmas Teaching & evaluating students Teamwork
Faculty & Community Physicians
Updating clinical skills Improving interpersonal skills Addressing ethical dilemmas Practicing giving bad news Improving feedback to students and
residents
Association of Standardized Patient Educators (ASPE)
www.aspeducators.org
Annual Meetings:June 17-20, 2007 Toronto, Canada
June 29-July 2, 2008 San Antonio, Texas
Questions & Answers
