School of Medicine
Clinical Skills Center
Guidelines and Expectations
for the
Standardized Patient
Table of Contents
1. Clinical Skills Center Staff and Contact information
2. In case of Emergency
3. Glossary of Terms and Abbreviations
4. Services Provided by Standardized Patients (SPs)
¨ Teaching Activities
¨ demonstrations
¨ Small group exercises
¨ Clinical Skills Exams (CSEs)
¨ Objective Structured Clinical Examinations (OSCEs)
¨ Special Services
¨ Gynecologic & Male Genitourinary Teaching
¨ Parent/Child duos for well child visit demonstrations
¨ Minors used for OSCEs
¨ Spanish Speaking SPs
¨ Standardized Nurses
¨ Models
5. Clients
6. Contracting To Provide SPs Services
7. How SPs are Cast
8. Cancellation Expectations
9. Standardized Patient (SP) Preparation for a case
10. Event Day Expectations
¨ Parking
¨ Where to Report
¨ Dress Code
¨ Call Time
¨ Preparatory time
¨ Places
¨ Breaks and Meals
¨ End-of-Day Activities
o Housekeeping
o Checklist submission Confirmation
o Debriefing
11. Key Expectations for SPs
¨ Attendance and Punctuality
¨ Professionalism
¨ Relationships with Students
¨ Modesty
¨ Hygiene
¨ Realism and Staying in Role
¨ Confidentiality
¨ The Camera is Always On
¨ Summoning Assistance During an Encounter
¨ Interacting with Faculty
¨ Altering Performances/Changing Cases
¨ Time out/Time In Teaching Technique
¨ Smoke-Free Campus
¨ Control Room and Room 308 Conduct
¨ External Clients
¨ No Doctor/Patient Relationship
12. Quality Assurance for SPs
13. Compensation
14. Discontinuation of Services
15. Alcohol and Drug Policy
16. Equal Opportunity and Discriminatory Harassment
17. Concerns and Complaints
Appendix A: Specialized SP Groups
I. GTAs and MUTAs
II. Standardized Nurses
III. Parent/Well child visit SPs
IV. English as Second Language SPs
Appendix D: Compensation and Levels of Advancement
Appendix E: Performance Criteria
Appendix F: SP Evaluation Form
Appendix G: confirmation Email
1. Clinical Skills Center Personnel and Contact Information
The Clinical Skills Center (CSC or “the Center”) is part of the Emory Experiential Center for Learning in the Office of Medical Education and Student Affairs (OMESA) in the Emory University School of Medicine (EUSOM) under the direction of Dr. Douglas Ander, Assistant Dean for Medical Education, Dr. J. William Eley, Executive Associate Dean for Medical Education, and Mrs. Margo Kuisis, Director of OMESA.
Connie Coralli, the Associate Director of the Clinical Skills Program, is responsible for the leadership, supervision, daily operations, and long-term planning for the Center.
Center personnel can be reached via the contact information below. Except in emergencies or time-sensitive communications, email is the preferred method of communication since email messages are checked more frequently than phone messages.
For non-urgent matters when phone calls are necessary, please use the office numbers listed below. The Associate Director’s office number listed below automatically rolls over to a cell phone number that also has voice-mail. Please leave a message if Center personnel are unavailable to answer the call at the time. It is unnecessarily disruptive to call both the office and cell phone during normal business hours for non-urgent matters.
Center personnel do not answer their phones during training, while in meetings, or while running events. Please leave voice-mail messages when necessary and Center personnel will respond as soon as possible. Again, emails are responded to faster than phone messages in general.
Standardized Patients (SPs) should always have the 24 hour emergency phone number with them so that, in case of unforeseen emergencies on days they are scheduled to perform, the SP can let the Center know as soon as possible of a delay or cancellation. The Associate Director or a staff member is on call 24/7 for emergencies related to next day events.
Connie Coralli Gina Shannon
Associate Director Program Coordinator
Clinical Skills Program Clinical Skills Program
Room 318 Room 314
Emory University School of Medicine Emory University School of Medicine
1648 Pierce Drive 1648 Pierce Drive
Atlanta, GA 30322 Atlanta, GA 30322
Office: 404 712-9925 Office Cell: 404 295-1776
Cell: 404 308-6026
Adam Bailey Kara Cantrell
Program Coordinator Program Coordinator
Clinical Skills Center Clinical Skills Center
Room 316 Room 316
Emory University School of Medicine Emory University School of Medicine
1648 Pierce Dr. 1648 Pierce Dr.
Atlanta, GA 30322 Atlanta, GA 30322
Office Cell: 404 801-6664 Office Cell: 404 309-6378
If unable to reach any of the Dr. Douglas Ander
above please call: Assistant Dean for Medical Education
Office of Medical Education & Student Director of ExCEL
Affairs (OMESA) Room
Room 357P 1648 Pierce Dr.
Main Phone: 404 712-5655 Atlanta, GA 30322
Office: 404 251-8828
Dr. J. William Eley Margo Kuisis
Executive Associate Dean for Medical Education Director
OMESA OMESA
Room 453A Room 357 P
1648 Pierce Dr. 1648 Pierce Dr.
Atlanta GA 30322 Atlanta GA 30322
Office: 404 712-9979 Office: 404 712-8417
Who to Call for What:
Event Related Matters:
Call the event manager who is in charge of the specific event. The event manager will be the person who engaged and confirmed you for the event, either Connie Coralli, Gina Shannon or Adam Bailey or Kara Cantrell.
Payment Questions:
Kara Cantrell processes and tracks SP payment requests. Questions about payments should be directed to her.
SP Referrals:
Anyone interested in becoming an SP should contact Gina Shannon, via email with an acting resume (if available) and headshot.
Concerns about Students/Faculty:
Connie Coralli
Program Questions and Complaints:
Connie Coralli
2. In Case of Emergency
To cancel participation in an event 24 hours or less prior to that event (only for serious illness or emergency), the SP must talk to a staff member in person or live on the phone. Neither email messages nor voice-mail messages are acceptable for this purpose. An emergency cell phone (usually that of the Associate Director) is answered 24/7 for emergencies related to next day events.
After-Hours Number: 404 308 6026 (Connie’s cell)
Other emergency information:
Emory Police 911
Lock-outs for evenings and weekends: 404 727-6111
3. Glossary of Terms and Abbreviations
The following terms and definitions may be useful:
Adjustment: instructions given to a standardized patient to modify the way he/she is portraying a character in order to improve upon it or make it more standardized & consistent.
Auscultate: One of the four techniques of physical examination accomplished by listening, usually through a stethoscope
Call time: the SP arrival time for a case
Checklist: a list of items for which students are “checked off” to assess their performance with a patient
CC: Chief complaint. A word or short phrase used by the patient to describe the main
reason he/she seeks care. It is usually recorded in the patient’s own words and may or may not be the “real” reason for the visit.
Class of 2012: Learners who will graduate in 2012.
Class of 2013: Learners who will graduate in 2013.
Client: A faculty member, clerkship, course or program using the Clinical Skills Center.
Clinical Skills Exam: an interaction between a learner and a standardized patient in which the learning is interacting (“taking care of”) with the SP and during which the clinical performance of the learner is assessed and graded.
CSC: Clinical Skills Center
EM: Event Manager or Emergency Medicine
Encounter: the time during an event from the beginning of one student to the beginning of another student (exclusive of breaks)
EUSOM: Emory University School of Medicine
Event: The time on one or multiple days in which learners and standardized patients interact for the same purpose, for example the Emergency Medicine CSE is an event.
ExCEL: Emory Center for Experiential Learning. This Center is part of OMESA and contains the Clinical Skills Center and the Simulation Center.
Fellow: An advanced learner; one who has completed medical school, at least three years of post-graduate training, has obtained a “medical doctor” license, and is pursuing specialized training (such as in cardiology, pediatric orthopedics, etc.).
FH: Family history. Information about the health of a patient’s parents, grandparents, sibling, spouse and children.
Formative: Activities primarily designed to be educational for the learner.
GTA: Gynecological teaching associate.
HPI: History of Present Illness. Detailed information about the problem(s) the patient is presenting with for this visit.
Inspection: One of the four techniques of physical examination accomplished by looking & observing.
Internship: The first year of training following medical school.
Jr. Med: Refers to the Junior Medicine Clerkship, a clerkship for students during their required year of clerkships (from year 1 ½ - 2 ½).
LS: Learning Space: the software used in the CSC to schedule, set up, record, and keep records of events.
M1: Students in their first year of medical school.
M2: Students in their second year of medical school.
M3: Students in their third year of medical school.
M4: Students in their fourth year of medical school.
Medical Imaging: a program of study for those professionals who perform x-rays, CT scans, MRIs, etc.
MIRS: Master Interview Rating Scale. A checklist used by SPs to assess communication.
Model: A standardized patient who basically volunteers his/her body for use, there are no
lines to learn or roles to play. An example would be the ultrasound experiences during which you are yourself and students learn to perform ultrasound using your body.
MUTA: Male urogenital teaching associate.
OMESA: Office of Medical Education and Student Affairs. The Clinical Skills Program and Center are a part of this office.
OSCE: Objective structured clinical examination. An examination in which the learner is assessed in the mastery of a discrete clinical skill during a 3-5 minute station. These may or may not involve a standardized patient. Examples would include reading a chest x-ray, taking a sexual history, performing an abdominal exam, interpreting laboratory results.
Otoscope/Ophthalmoscope: the lighted instruments on the walls of the exam rooms used for looking at the ears and eyes.
PA: Physician’s Assistant.
Palpate: A method of physical examination which involves feeling.
PE: Physical examination.
Percuss: A method of physical examination which involves tapping to discern solid vs.
hollow objects
PGY: Post graduate year(s).
Places: An announcement signifying that all standardized patients should go immediately to their rooms and be prepared to start their performance.
PMH: Past Medical History.
Psych: Psychiatry. Refers to the Psychiatry Clerkships OSCE for 3rd year medical
Students.
PT: Physical therapy
Resident: Refers to a physician in training during the first three years after graduation from medical school.
ROS: Review of systems. A rapid review (during the history-taking part of the visit) of screening questions designed to cover key components of each major body systems.
SOAP Note: A common format for a health professional’s written note about a patient. It includes subjective (history) data, objective (physical exam and tests) data, the
assessment, and plan.
SH: Social History: Information about a patient’s occupation, hobbies, living arrangements and habits that may affect your health, such as tobacco, alcohol and recreational drug use, sexual partners, contraception, and sexually transmitted disease prevention.
SOM: School of Medicine.
SP: Standardized Patient.
Start: The beginning of an interaction between a student and a patient, the time the cameras start to record and students begin to be assessed.
Summative: An event primarily for the purpose of grading or evaluating a student.
Table Read: Rehearsing lines sitting around a table.
Time in/Time out: a teaching technique in which the faculty interrupts an interaction between a student and a SP to interject teaching or questioning.
4. Services Provided by SPs
Emory University’s School of Medicine (EUSOM) is dedicated to establishing competencies in clinical, communication, and professional skills of health care providers AND competencies in communication and interpersonal skills in the community and corporate world.
Teaching and Evaluating Students
Some activities involving SPs are primarily for the purpose of educating students by providing them with opportunities to practice clinical skills. Other activities are for the purpose of assessing how well students have learned clinical skills. Many activities at Emory are a mixture of both.
Demonstrations and Small Group Activities
SPs may be involved in class or small group demonstrations in which a faculty member, a learner, or group of learners interview, examine, or interact with an SP in front of the group. Other times, SPs may be involved in a small group exercise, in which they meet with 8-9 students and a faculty facilitator to demonstrate or practice specific skills as a group.
Clinical Skills Exams (CSEs)
Our most frequent activity however, is a one-on-one interaction with the student, usually called a CSE. During a CSE, a learner and SP interact and the learner’s performance is evaluated (either live or afterwards). The SP portrays a patient in a standardized manner (the same way with each student thereby providing each student with the same “exam”). The interactions are assessed usually by completion of checklists by faculty and/or SPs. Clinical Skills Exams are the classical work that SPs do and mimic real clinical interactions.
Objective Structured Clinical Exams (OSCEs)
These are similar to CSEs, however rather than evaluating the comprehensive care of a patient, they deal with assessing performance of a discrete clinical skill in a brief (5-10 minutes) time period. These exams do not mimic anything seen in actual clinical practice for the most part.
While all SP work shares many common elements, each event is individualized to meet the needs of the client utilizing them.
Special Services
In addition, there are specialized services provided by the CSC in which only a subset of SPs participate (Appendix A). One example of this is the use of gynecological and male genitourinary teaching associates (GTAs and MUTAs). These SPs use their bodies to assist students in learning breast, pelvic, male genital and rectal exam skills. Another example of a specialized subset of SPs is parents and young children who allow the faculty to demonstrate well-child visits. A third example would be older children or adolescents who provide experiences in pediatrics. Others involve cases with a “standardized nurse” in the room along with the SP and foreign language encounters with SPs whose first language is something other than English. These are but a few of the unique SPs activities in which our Independent Contractors participate. New uses for SPs occur frequently, so do not be surprised to be contacted for new and exciting opportunities that haven’t been mentioned