- Why use a Standardized/Simulated Patient?
- Where are Standardized/Simulated Patients used in the curriculum?
- Why do we have to work with Standardized/Simulated Patients?
- What happens during an encounter with a Standardized/Simulated Patient?
- What kind of feedback will I recieve?
- What are "time-out" sessions?
- How are the cases developed?
- Where are Standardized/Simulated Patient encounters held?
SP encounters provide the learner with an opportunity to practice interpersonal skills that will help them later to connect with real patients. They have been carefully trained to portray an actual patient. The use of interviewing, counseling, and information gathering techniques can be tried safely even in the most emotionally charged situations such as breaking bad news, or drug and alcohol counseling. Learners also can practice physical examination techniques and receive immediate feedback regarding skills.
Remember, the SP is not meant as a replacement for experience with real patients but rather as a highly realistic learning resource. This method will allow you to try out a variety of approaches to a patient problem in a safe environment and without causing harm to a real patient.
The goal of these encounters is to achieve the educational goals rather than to cure the patient.
SPs are playing the role of someone else from the time they meet you until the simulation is completed. The roles will be clearly defined before each session begins. You both will stay in role until the feedback session. Sometimes you or the facilitator will want to call a time-out session to discuss any part of the clinical interaction.
Research has found that encounters with SPs have certain advantages that cannot be duplicated by the use of paper problems, role playing, questionnaires, or even real patients.
- The opportunity to learn and work in a controlled, reproducible, clinical situation.
- The clinical problem is present at any time or any place.
- It provides a unique opportunity to practice the various skills.
- The SP can provide you with objective and unbiased feedback.
A typical encounter with an SP may involve interviewing, counseling, or examining the patient in the same manner as a regular clinic encounter. Learners are to interact with each SP as they would with a real patient. SPs have been trained to expect the same treatment as if they were the actual patient, and they will interact with the clinician accordingly. At the end, if the session objectives require it, the learner recieves feedback.
The simulations are authentic and the situations realistic, being rooted in actual patient cases. There is typically given a “presenting scenario” which provides the learners with general background information regarding the setting and the patient they are about to see. Learners should do what they feel is necessary in order to evaluate a patient with a particular issue—it is up to the learner to decide what needs to be examined.
Feedback usually comes in two forms: oral or written. Depending on the objectives of the course or session, learners might receive one or both forms of feedback.
Checklists, written feedback, usually are developed for SPs to score a learner’s performance in various categories. When you are scored by checklist, you will most often receive an online score report summarizing the checklist items missed.
You may also receive more narrative written feedback that summarizes interpersonal skills. Other times, the facilitator will want the learner to specifically ask an SP for information about their performance, informing the learner how the encounter made the patient feel from their perspective.
Occasionally, the SP also is trained in medical illness and is prepared to provide feedback on specifics of examination technique or diagnosis.
During some work with SPs, learners may use a “time-in and time-out” method to distinguish active interaction time with the patient from discussion time with a larger group. During time-out periods, the SP will remain in “time-out mode” (not interacting with a learner during discussion) until the learner calls “time-in” and continues the interaction. Time-outs are called by the learner or facilitator to increase the productivity of the encounter.
Cases are written by faculty members and administrators. Most are based on real patient scenarios.
In Pitt's Medical School, students typically encounter SPs in the 3rd, 4th, or 5th floor classrooms or in our Educational Spaces during their first two years of study. SP encounters during clerkships and the Clinical Competency Assessment often take place at the Peter M. Winter Institute for Simulation Education Research (WISER).
Learners from other disciplines should contact their course administrators to see where the encounters will take place.