Simulated PatientsValuing the patient voice
in medical education
Teaching, research and evaluation
Interactive aspects of the consultations:- communication and interpersonal
skills- diagnostic and management
processes- physical examination
Feedback, formative and summative assessment by MEs +/- SPs
1962 - neurological examination training – Howard Barrows.
Early 1970s –behavourally based rating scale of basic clinical skills – Paula Stillman.
1970s – Patient instructors: real patients as teachers and formative assessors.
History and evolution
1980s – Summative assessment (performance based examinations).
1980s / 1990s – research into SPs establishes reliability and validity.
By 1993 80% of U.S. medical schools use SPs in teaching and assessment.
History and Evolution
Knows = Knowledge
Knows how = Competence: knowing how to use knowledge
Shows how = Performance: demonstrating how knowledge is used
Does = Independent action
Miller’s developmental stages
Simulated patients
Terminology
Simulated patients
Standardized patients
Terminology
Simulated patients
Standardized patients
Surrogate / Substitute patients
Terminology
Simulated patients
Standardized patients
Surrogate / Substitute patients
Actors
Terminology
Simulated patients
Standardized patients
Surrogate / Substitute patients
Actors
Clinical Teaching Associates
Terminology
Commitment to training Healthcare providers
Attributes of Effective SPs
Commitment to training Healthcare providers
Positive regard for Health care providers and students
Attributes of Effective SPs
Commitment to training Healthcare providers
Positive regard for Health care providers and students
Motivation and Enthusiasm
Attributes of Effective SPs
Commitment to training Healthcare providers
Positive regard for Health care providers and students
Motivation and Enthusiasm Availability, reliability and punctuality
Attributes of Effective SPs
Commitment to training Healthcare providers
Positive regard for Health care providers and students
Motivation and Enthusiasm Availability, reliability and punctuality Good communication skills
Attributes of Effective SPs
Commitment to training Healthcare providers
Positive regard for Health care providers and students
Motivation and Enthusiasm Availability, reliability and punctuality Good communication skills Acting skills
Attributes of Effective SPs
Commitment to training Healthcare providers
Positive regard for Health care providers and students
Motivation and Enthusiasm Availability, reliability and punctuality Good communication skills Acting skills Ability to “de-role”
Attributes of Effective SPs
Commitment to training Healthcare providers
Positive regard for Health care providers and students
Motivation and Enthusiasm Availability, reliability and punctuality Good communication skills Acting skills Ability to “de-role” Ability to be trained
Attributes of Effective SPs
Availability
Advantages
Availability Custom-made cases
Advantages
Availability Custom-made cases Realism
Advantages
Availability Custom-made cases Realism Standardization
Advantages
Availability Custom-made cases Realism Standardization Responsive consistency
Advantages
Availability Custom-made cases Realism Standardization Responsive consistency Reducing risk to real patients
Advantages
Availability Custom-made cases Realism Standardization Responsive consistency Reducing risk to real patients Transition
Advantages
Availability Custom-made cases Realism Standardization Responsive consistency Reducing risk to real patients Transition Relative safety for learners
Advantages
Exploration / observation of alternative approaches
Educational Opportunities
Exploration / observation of alternative approaches
Direct feedback- Immediate, descriptive, relevant,
specific and constructive- From the patient’s perspective- As teachers
Educational Opportunities
Exploration / observation of alternative approaches
Direct feedback- Immediate, descriptive, relevant,
specific and constructive- From the patient’s perspective- As teachers
Pause, rewind, fast forward, replay: analysis and rehearsal
Educational Opportunities
Exploration / observation of alternative approaches
Direct feedback- Immediate, descriptive, relevant,
specific and constrictive- From the patient’s perspective- As teachers
Pause, rewind, fast forward, replay: analysis and rehearsal
Focus on process skills
Educational Opportunities
Scepticism re realism and student acceptance
Barriers
Scepticism re realism and student acceptance
Questions re reliability and validity
Barriers
Scepticism re realism and student acceptance
Questions re reliability and validity
Increased complexity, duration and cost of teaching sessions
Barriers
Scepticism re realism and student acceptance
Questions re reliability and validity
Increased complexity, duration and cost of teaching sessions
Power challenges
Barriers
“If we could all just learn to listen, everything else would fall into place. Listening is the key to being patient centered.”
Ian McWhinney (cited in Kelly 1998)
Top Related