Incorporating simulators in a standardized patient exam.

Area of Science:

• Medical Education
• Clinical Skills Assessment
• Simulation Technology

Background:

• Standardizing historical data delivery in simulated patient exams is achievable.
• Standardizing physical exam findings in simulated patient exams remains a challenge.
• This study addresses the need for standardized physical exam components in clinical skills assessments.

Purpose of the Study:

• To design and implement a simulated patient exam incorporating simulated abnormal physical exam findings.
• To evaluate the ability of medical students to gather historical data and identify key physical exam findings.
• To integrate physical exam findings into clinical decision-making within a standardized exam setting.

Main Methods:

• A three-station exam was developed: patient history, physical exam, and presentation.
• Simulated abnormal cardiopulmonary sounds and pulse findings were introduced using digital transducers.
• 171 students completed the 45-minute exam, assessed on data gathering, physical exam identification, and differential diagnosis.

Main Results:

• Students were evaluated on historical data gathering and identification of simulated abnormal cardiopulmonary sounds and pulse findings.
• The exam integrated key physical exam findings into the clinical decision-making process presented to faculty.
• Simulated abnormal findings allowed for consistent assessment without the need for unstable patients.

Conclusions:

• Simulated patients with abnormal cardiopulmonary findings can be effectively used for testing purposes.
• Simulators offer a method to introduce diverse abnormal physical exam findings, overcoming limitations of real patient variability.
• The use of simulated physical exam findings enables complete standardization of clinical simulated patient exams.