Questions About SP Assessment

What is an SP?

A simulated patient (SP) is someone who has been carefully trained to portray a simulated case based upon an actual patient’s physical findings, personal and medical history, symptoms and personality characteristics. The simulated patient allows the medical student the opportunity to practice both clinical examination and interviewing skills in a safe and non-threatening environment.

Why are SPs used instead of real patients?

Simulated patients have several advantages over the use of real patients. As mentioned above, SPs can be trained to consistently reproduce the history, emotional tone, communicative style and physical signs of an actual patient without placing stress upon a real patient. Some additional advantages are standardization of patient problems, availability and cost efficiency.

SPs provide faculty with a standard assessment format. In other words, students are assessed interacting with the same patient portraying the same history, physical signs, etc.

Availability – SPs can be available at any time during the day and for extended periods of time.
Cost-Efficiency – SPs can be trained to record student performance accurately and consistently, alleviating the need for direct observation by a clinical faculty member.
SPs can also be trained how to perform certain basic clinical procedures and, in turn, instruct medical students.

How are SPs used to assess clinical performance?

SP assessments generally take one of two formats: 1) OSCE; 2) CPX. The objective structured clinical examination (OSCE) is a limited performance assessment, which consists of several brief (15 minutes) stations where the student performs a very focused task, such as a knee examination, fundoscopic examination. The clinical practice examination (CPX) is an extended performance assessment which consists of several long (20 minutes) stations where students interact with patients in an unstructured environment. Unlike the OSCE format, students are not given specific instructions in the CPX format. The CPX more closely resembles the clinical environment and provides information about a student’s abilities to interact with a patient, initiate a session, and incorporate skills of history-taking, physical examination, and patient education. When considering the use of a performance, or any assessment method, the format of assessment should be driven by the purpose of assessment. For example, if faculty are interested in knowing how students perform specific physical examination or radiology skills, then the OSCE format would be suitable. If, however, the faculty are interested in knowing how students perform more complex clinical skills, then the CPX format is ideal.

Please contact Jim Baker, Director, Clinical Skills Center, for current programs running and their costs.