10.   SIMULATED PATIENTS


Imagination is more important than knowledge. For while knowledge defines all we currently know and understand, imagination points to all we might yet discover and create.

Albert Einstein

Contents:

Homepage - OSCE and OSPE

Compiled Responses

 The Beginning

 01.   Introduction and Basics of OSPE/OSCE

 02.   Is OSPE glorified spotting.. 

  03.   How to set up OSCE and OSPE stations..

 04.   How to collect the answer-sheets in OSCE/OSPE from students.

 05.   OSCE reliability

 06.   Levels of competencies in evaluation

 07.   Practical experiences of OSPE/OSCE

 08.   OSCE in testing Communication and attitudes

  09   Should knowledge be accessed in OSCE/OSPE

 10.   Simulated patients

 11. Examiner training...a must to do...

12.   Standard setting in OSCE

 13.   Disadvantages of OSCE

SIMULATED PATIENTS

Praveen: As we are discussing OSCE can we discuss a very important point faced while conducting it, i.e. SIMULATED PATIENTS.
SIMULATED PATIENTS
It is said that it is best to use well-trained Simulated Patients for consistent performances in communication skills stations. Depending on one’s location, it may be possible to make a pool of expert subjects who assist in both teaching as well as assessment of communication skills.
But training the SIMULATED PATIENTS contributes to a large extent to the reliability of the examination, as consistent  performances makes it sure that all the students are presented with the same challenge.
The SIMULATED PATIENTS should be given their scenarios in advance and then asked to go through their roles with a proper  supervision by a communication skills teacher and/or a clinician/examiner, to develop a suitable standard for the objective that we are testing.

Sita: In addition to simulated patients, they also use Patient substitutes in certain situations
Please find two interesting articles related to both simulated patients and patient substitutes
Suman Singh: If we want to implement OSPE/OSCE at our places in long term we may have to look at simulate patient as an option atleast partially.
Here is a link to a simulated Patient training programme in London.

http://www1.imperial.ac.uk/
medicine/

Praveen: Can we have the full article/link to the article so that we may have a broader view of the concept.
Bhatti: Both the articles carry very useful information. It is interesting to read the below given paragraph from,  STANDARDIZED/SIMULATED PATIENTS IN MEDICAL EDUCATION by  Reed G. Williams, PhD Professor and Vice Chair for Educational Affairs Department of Surgery, SIU School of Medicine.
 ”In 1976, standardized patients first were sent into physician offices in unannounced visits.  A study using this approach by Kopelow and colleagues in Manitoba asked physician faculty members to determine how many items on a checklist a competent physician should perform.  Then, standardized patients were sent into these same faculty members’ practices.  The physicians who set the standards, on average, performed 60% of the items that they said were essential for competent performance.  This study highlighted the problems with developing reasonable standards of performance.” This is from second page of this article.
 It indicates that rigorous training using check lists will minimize the gaps in training and eventually in practice. If experts who lay standards missed 40% items then those who are not involved in similar work are likely to miss even more. The FAIMER fellowship shall surely help us to learn these points.

Discussion Summary

Introduction

Origin and evolution of OSCE

What is OSCE OSPE..

Important terminologies OSCE and OSPE

Process - OSCE and OSPE

Competencies

Advantages OSCE and OSPE

Limitation OSCE and OSPE

The final words