What is a “standardized patient”?
“The Simulated/Standardized Patient (SP) is a person who has been carefully coached to simulate an actual patient so accurately that the simulation cannot be detected by a skilled clinician. In performing the simulation, the SP presents the gestalt of the patient being simulated; not just the history, but the body language, the physical findings and the emotional and personality characteristics as well.”
From Howard S. Barrows “Simulated (Standardized) Patients and Other Human Simulations” 1987
Here at the EEC, we hire men and women of all ages, many of them actors, to portray the patients that our students will examine. Our SPs are highly trained and have a great deal of experience. The majority of them work as SPs at all the medical schools in the Chicagoland area. They are true professionals.
What makes the patients “standardized”? We cast multiple SPs per patient case. Each SP is carefully trained to portray the case in the exact same manner as his/her counterpart and must do so many times per day. Therefore, the portrayals are “standardized.”
Why use SP’s for assessing students’ clinical skills?
By using SP clinical encounters, we are able to reliably assess the students’ interviewing, physical examination and communication skills. Once all of the evaluation checklists are scored, we will be able to directly compare each student’s performance to his/her fellow classmates. Also, there is the matter equity in the SP assessment. Therefore, all students taking an examination in our center will see the same exact “patients.” This is not possible in a real clinical setting, where the patients change daily.
Using standardized patient examinations is also an excellent method with which to evaluate curriculum and promote faculty development.
Who designs the cases?
Physicians and Health Professionals from within the university write and develop the patient cases. The case authors also participate in the training of the standardized patients, along with the EEC staff, to assure an accurate and realistic portrayal. We also share and exchange cases with other standardized patient programs throughout the nation.
The Evaluation Suite
All projects take place in the EEC Evaluation Suite which has been designed to simulate a physician’s office. There are fourteen patient examination rooms each fully equipped with the necessary medical equipment as well as two pan/zoom/tilt cameras and microphones. There is a computer in every exam room on which the SP completes the case checklist.
There are laptop stations outside of each exam room on which students complete a post-encounter exercise based on the patient case. Students may also be asked to order lab tests, view the results, read and interpret EKGs, MRIs, X-rays or examine different types of specimens all on computer.
We have a state-of-the-art digital recording system with which we record all SP encounters. The students are then able to observe their recorded patient encounters as a form of self-evaluation.
Members of the faculty are able to observe the students’ performances live from the observation room. This allows the faculty to offer immediate feedback to the students on their performance. This is all done within the controlled and safe environment of our center. As a result, the students feel more comfortable about having had the chance to interview an SP before seeing a real patient. Any mistakes made during the patient encounter are then corrected prior to going out into the field.
The EEC and High Fidelity Biosimulation:
The EEC has recently become home to a new patient, the METI Emergency Care Simulator (ECS). The ECS (or “Frank,” as he has been nicknamed) is a computer driven high fidelity mannequin that accurately mirrors human physiology.
Alone or in groups, students, residents, and faculty can interact with the ECS in a variety of training scenarios, make real time clinical decisions, and witness the impact their decisions have on the outcome of their patient. Participants can perform a physical exam while obtaining appropriate findings, intervene with technical procedures, and even administer medication in a safe environment without real risk to a real patient.
Faculty have found the ECS to be an excellent way to help students gain a better understanding of human physiology in varied disease states, hone student procedural and clinical decision making skills, and hopefully, improve patient safety and care in the real world.
Biosimulation used in conjunction with the Standardized Patient Program at the Education and Evaluation Center provides Rosalind Franklin University of Medicine and Science with a broad spectrum of simulation resources for students, faculty, and the community to improve quality in patient care.
For more information, please contact: Barbara L. Eulenberg, Director of Standardized Patient Education Phone: 847-578-8462 Email: Barbara.Eulenberg@rosalindfranklin.edu The Education and Evaluation Center at Rosalind Franklin University of Medicine and Science 3333 Green Bay Road, North Chicago, Illinois 60064