A Standardized Patient Experience: Elevating Interns to Expected Level of Clinical Competency

Area of Science:

• Medical Education
• Emergency Medicine
• Clinical Skills Training

Background:

• Medical students exhibit varied clinical experience entering internship.
• This variability impacts interns' ability to conduct histories, physical exams, develop differentials, and create care plans.
• Standardized foundational training is crucial for consistent intern preparedness.

Purpose of the Study:

• To establish standardized expectations for intern clinical skills.
• To provide a foundational experience for evaluating emergency department patients.
• To mitigate the impact of variable prior medical school experiences.

Main Methods:

• Interns participated in a standardized patient experience during orientation.
• Encounters focused on common chief complaints: abdominal pain, chest pain, and headache.
• Faculty provided immediate feedback using a standardized grading rubric.

Main Results:

• All participating residents found the experience meaningful.
• 90% of interns reported the experience would change their clinical practice.
• 75% of residents reported a practice change one year post-experience; faculty identified early knowledge gaps.

Conclusions:

• The emergency medicine residency program created a foundational experience for intern patient evaluation.
• The program aimed to "level the playing field" and instill "good habits" early in intern year.
• This initiative addresses significant variability in intern preparedness at the start of residency.