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Updated: Jun 9, 2026

Problem-Solving Before Instruction (PS-I): A Protocol for Assessment and Intervention in Students with Different Abilities
Published on: September 11, 2021
Standardized Patient Instructor (SPI) interactions are a viable way to teach medical students about health behavior
Heather Wagenschutz1, Paula Ross, Joel Purkiss
1University of Michigan Medical School, Office ofMedical Education, Standardized Patient Program, 3908-B Taubman MedicalLibrary, Ann Arbor, MI 48109, USA. hmwags@umich.edu
Objectives:
We explored comfort levels of third-year medical (M3) students through two health behavior counseling (HBC) interactions with Standardized Patient Instructors (SPIs) in tobacco cessation (TCC) and nutrition and physical activity (NPA).
Methods:
Nearly 200 M3s participated in two SPI HBC interactions; including a role-play interview and subsequent feedback session on performance. Students completed a 5-point Likert scale evaluation measuring pre- and post-comfort level on two HBC sessions.
Results:
Both interactions resulted in statistically significant increases in student's pre- and post-interaction comfort levels. A paired-sample t-test revealed a mean increase of 0.91 for TCC (t = 14.01, df = 197, p<0.001), and a mean increase of 0.69 for NPA (t = 12.65, df = 198, p<0.001).
Conclusion:
The use of SPIs is a viable approach to exposing medical students and future doctors to health behavior counseling, and increasing comfort level with such skills. The SPI experience ensures that HBC opportunities are available and contain meaningful feedback on performance.
Practice Implications:
Encouraging patient behavior modification is a skill that can be developed during undergraduate medical training. Combining HBC with SPI sessions and traditional learning approaches could prove effective in a curriculum intended to teach students strategies that improve patient health behavior.
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