Simulated patients for the practical examination of medical students: intentions, procedures and experiences

This paper presents intentions, procedures and experiences related to a simple method for training simulated patients for undergraduate examinations set up as clinical consultations. The examinations took place in the final year of medical school, at the Division for General Practice, University of Bergen, Norway. Thirty-six medical students were assessed by the use of five primary-school teachers serving as simulated patients and 18 authentic patients. Field notes from the process, observations during the examinations, written evaluation from the students and transcript of audiotape from focus group setting with the simulants are presented. Simulants were trained and prepared to simulate common health problems during a brief procedure which seemed to be sufficient as long as standardization was not aimed for. Simulants were not detected from among the ordinary patients by the students. Even the authentic patients did some level of role playing, which must be accounted for in future preparation. Simulants may by means of brief preparatory instructions serve as useful and realistic supplements to authentic patients in the practical examination of undergraduate medical students.