The Longitudinal Standardized Patient Project: innovation from necessity

Constraints on time and resources prevented first- and second-year medical students from having sufficient time to complete required tasks in standardized patient (SP) communication skills training sessions, and to appreciate the SP character as a "person." Case believability was limited by having each individual SP portray multiple patients in different encounters.

In 2010, a series of nine longitudinal SP cases was developed, in which the same SP would portray the same patient with the same student across 19 SP encounters during the two-year preclinical Introduction to Clinical Medicine course at the University of Louisville School of Medicine. Each SP character had a unique health history and illness trajectory that matched the history-taking and communication skill content in the course.

Students had more time to focus on the communication skill topic for each SP session because they did not need to spend as much time learning about the individual patient and the patient's previous medical history. Students learned more about continuity of care, and documented their progress notes in a longitudinal patient chart. SPs were able to identify performance issues with their continuity students more readily than if they had been seeing students for the first time.

Additional case content has been developed as new SPs participate in the program, including versions of some patient cases to represent both genders. Specific outcomes measures need to be developed and researched to assess the overall impact of this program.