Use of standardized patients during a psychiatry clerkship

Standardized patients are used in teaching medical students and evaluating their clinical skills during the psychiatric clerkship. The purpose of this study was to evaluate whether the addition of a Psychiatry Clinical Standardized Patient Examination (PCX) during the third-year clerkship improved students' performances on the psychiatry component of the Clinical Competency Examination (CCX) that is used at our institution to prepare fourth-year students for the National Board of Medical Examiners Step 2 Clinical Skills Exam (Step 2 CSA).

Scores on the CCX were analyzed by two-by-two tables (yes/no response to each clinical competency item versus took/did not take PCX) using Fisher's exact test.

Of the 469 students who took the CCX between 2002 and 2004, 246 students also took the PCX. Compared to students who did not take the exam, students who took the PCX were significantly more likely (p<0.05) to receive positive ratings on the CCX items for professionalism, addressing patients' stressors at work and home and inquiring about thoughts of harm to self or others.

The implementation of the PCX during the psychiatry clerkship significantly improved student performance on several important components of the CCX, which is used to prepare students for the Step 2 CSA. This suggests that the use of standardized patients during the clerkship may help students improve their interviewing and interpersonal skills.