Are you interested in being part of the education of our medical students and other Health Professions students?

The use of standardized patients (SP's) to teach and assess clinical and problem-solving skills, is common in medical education. Historically, a number of terms have been used to describe "patients" used for instructional or assessment purposes. These terms--programmed patient, patient instructor, patient educator, professional patient, surrogate patient, teaching associate, or simulated patient--have been used interchangeably with "standardized patient."

SP's are people who have been trained to accurately portray the role of a patient with a specific medical condition. The descriptor "standardized" comes from the fact that SP's are specifically trained to not only represent the context of situations or problems, but to also consistently recreate that same situation or problem each time they encounter a student. Consequently, each student will see a patient with the same history and physical findings. In teaching clinical skills, SP's may interact one-on-one with a learner or may simulate a patient in a small group discussion or problem-solving session. When SP encounters are used for assessment, clinical skills may be documented by the SP's via a checklist, scored by clinical raters, and/or videotaped for later scoring.

Why use standardized patients?

Advantages of using standardized patients in teaching and evaluating students include the following:

• SP's can be authentic and indistinguishable from real patients.
• SP performances are reliable and reproducible. The symptoms, emotional problems, and degree of difficulty of a patient problem presented are the same for each learner and can be matched to the learner's level of training. Students can interview an SP as many times as necessary and can openly discuss problems and complications in the SP's presence.
• The patient problem needed for teaching or evaluation is available at any time and is not dependent on the availability of a real patient.
• Medical students are able to practice interviewing and examination skills without the embarrassment and anxiety they might feel if they have to learn these skills with real patients. The SP is there to help the student learn and is not bothered by the students' level of expertise or need to repeat any portion of the encounter.
• The risk of harming, tiring, or upsetting the patient is eliminated.
• SP's can provide feedback about students' professional demeanor; interest, concern, or understanding; listening skills; appeal as a future physician; and ability to engender treatment compliance.

At the University of South Carolina School of Medicine-Columbia, SP's have been integrated into the first and second year Introduction to Clinical Medicine small group sessions for the purposes of introducing students to patient interactions and developing good communication and physical examination skills. Thus, the early focus is on teaching; formative assessment is often provided by the SP as part of the sessions. At the end of the second year and during the third and fourth years of the curriculum, SP's are incorporated into assessment exercises known as Objective Structured Clinical Examinations (OSCE's).

We also use SPs in our Ultrasound Institute. The students get a clearer understanding when they have a live person to ultrasound. The SP does nothing but lay on the exam bed while the students perform the scans. The procedure is non-invasive, and perfectly safe. The ideal SP for ultrasound training is someone younger, tall, and slender.

Our Physician Assistant Program utilizes SPs for assessing physical exam skills, medical interviewing skills, and professionalism.

To date, standardized patients have contributed to the skills development of over 2000 USCSM graduates. Most students are extremely grateful for the opportunity to work with SPs and receive feedback on their skills. SP's will continue to be an integral part of the curriculum, as accrediting and licensing organizations, as well as the lay public, are resolute in their demand for competent, caring, and confident physicians.

If you would like information about how you can become involved in this exciting program please contact:

Robin Fiorello
Phone: 803-216-3614
Email: Robin.Fiorello@uscmed.sc.edu