Using Standardized Patients for Faculty Development in Clinical Skills

Gordon Page, Head, Educational Support and Development, Faculty of Medicine / Office of the Coordinator of Health Sciences
Judith Vestrup, Director, Clinical Skills Program, Surgery, Faculty of Medicine
Joan Fraser, Director, Standardized Patient Examination Programs, Paediatrics, Faculty of Medicine
Sara Brown, Medical Student
Naomi Glick, Medical Student

Standardized Patients (SPs) are healthy people trained to simulate an illness or a clinical problem. SPs are currently used in UBC’s new medical/dental integrated curriculum for clinical skills examinations, for teaching an advanced communication skills workshop to third year students, and for a small portion of the teaching physical examination skills in the sensitive areas of genital and breast examinations. The goal of this proposal is to expand the current instructional use of SPs to give greater and more effective emphasis to the learning of psychosocial skills – communication, interviewing, counselling and history-taking skills. This project will incorporate SPs into their interdisciplinary, introductory clinical skills courses (INDE 410 and INDE 420) in years 1 and 2 of this new program. The rationale for this proposal is based upon problems in recruiting suitable real patients for these courses, and upon the advantages of SPs. The new medical/dental curriculum is designed to reflect a biopsychosocial model of health care. This model emphasizes the essential role of psychosocial skills to students’ and practitioners’ clinical competence. In British Columbia, problems in theses aspects of clinical practice currently account for over 80% of concerns and complaints that patient’s express about health care providers.

Judith A. Vestrup, Surgery, Faculty of Medicine
Gordon Page, Head, Educational Support and Development, Faculty of Medicine
Joan Fraser, Director, Standardized Patient Examination Program, Pediatrics, Faculty of Medicine
Joanne Hoffman, Director, Communication Skills Program, Family Medicine, Faculty of Medicine
Sharon Salloum, Director, Clinical Skills Program (Year 1), Family Medicine, Faculty of Medicine
Nicole Hallgren, Medical Student

Standardized patients (SPs) are individuals trained to simulate an array of medical and psychosocial problems. In year one of our TLEF grant, we introduced SP experiences in communications skills (interviewing and history taking). The SP case studies were written to include both a patient's clinical problem and his/her fears, expectations and understanding of his/her illness. Our evaluation data show that students and their tutors found this valuable. Both groups have recommended additional exposure to SPs, this time with more challenging communications issues (eg the talkative patient, the patient hesitant to share sensitive problems). Accordingly, we plan to add such SP experience and to incorporate video tape self evaluation and group feedback. We will also add new exposure to SPs when physical examination is introduced in second term. This will be specifically aimed at helping students hone communications skills as an integral part of a sensitively performed physical examination. Based on suggestions from our students, we will train these SPs to give constructive feedback on students' ability to establish rapport, put the patient at ease and communicate effectively during the examination process.

Sharon Salloum, Director, Clinical Skills Program (Year 1), Family Medicine, Faculty of Medicine / Vancouver Hospital and Health Sciences Centre
Judith Vestrup, Surgery, Faculty of Medicine
Gordon Page, Educational Support and Development, Faculty of Medicine
Joan Fraser, Director, Standardized Patient Program, Paediatrics, Faculty of Medicine
Nicole Hallgren, Medical Student

Physicians must be able to communicate well with their patients, in order to provide excellent care. We are employing new evidence-based communication strategies to teach Communication Skills to medical students. Increasingly, we are using standardized patients (SPs), trained to simulate a variety of medical and psychosocial problems, to help us teach interviewing, history taking, and feedback skills to first year medical students, in a Communications Skills course. Concurrently, these students are introduced to Family Medicine one afternoon a week, in the offices of community Family Physicians.

The purpose of this project is to reinforce and nurture students’ newly acquired Communication Skills by integrating these skills into the “real world” of clinical medicine. To achieve this, we want to familiarize Family Practice tutors with innovations in the UBC program, and to help create language, processes and expectations which will be common to the Communication Skills course, and the Family Practice office experience. Providing faculty development for this group of busy community physicians is a challenge. We propose the use of SPs to provide Communication Skills workshops, which will create a bridge between the UBC Communication Skills curriculum at the University, and what is taught in the clinical settings in the community.