Using Standardized Medical Students to Improve Teaching

1. Using Standardized Medical Students to Improve Teaching Mark H. Gelula, PhD Director of Faculty Development Research Assistant Professor Department of Medical Education University of Illinois at Chicago

2. What is a Standardized Medical Student? Standardized medical students are actual medical students or residents. They are trained using scripted material to behave as actors who play proto-typical medical students. Each prototype represents a teaching problem commonly encountered in teaching situations.

3. Literature Background Using a standardized medical student as a teacher training method for attending physicians (clinical teachers) is relatively new. Its use has been documented twice in the medical education literature (Lesky and Wilkerson, 1994; Simpson, Lawrence and Krogull, 1992). However, neither of these papers describe the development of standardized medical students in a way that mirrors the well established design and use of standardized patients in medical education (Swanson and Stillman, 1990). Nor do the documented studies employ standardized medical students in the context of an ongoing institutionalized faculty development program.

4. Standardized Students at UIC • Objective Standardized Medical Students have been developed within an institutionalized faculty development program to provide highly structured teacher training opportunities for junior faculty. • Residents have been trained using this method and it augurs well for their teaching improvement as well

5. How Does It Work? • Students are scripted. There is very little room for improvisation. • Faculty are invited to "teach" a standardized medical student in a 10 minute, realistic teaching encounter. • Teaching encounters are videotaped • Standardized students give immediate feedback to the faculty person

6. Post Taping Leads to Learning • Faculty meet in a review session where the focus is on learning from discussion of the experience • Faculty observe segments of their own and each other’s encounters • The facilitator provides a structure to the discussion, a focus on specific learning issues and offers suggestions for continued improvement

7. Assessment • Because faculty teach different standardized students behaving in an identical script we are able to observe faculty teaching improvement over time

8. Faculty, Resident, and Student Attitudes • The medical students believe this will help to improve teaching • Faculty who have participated find it • enjoyable • interesting • stimulating to their teaching • Residents have found the process useful to their teaching improvement

9. Implications • Standardized medical students provide a useful way of providing 1:1 and group faculty development for the improvement of instruction • Relatively few faculty have participated (16 to date). • Faculty should be used as proselytizers • Resident teaching improvement may benefit as well

10. Project Funding The Standardized Medical Student Project have been funded through a 1997 comprehensive program grant from the Fund for the Improvement of Post Secondary Education (FIPSE), Grant #P116B70318: "Improving Clinical Teaching Skills Through Standardized Medical Students."