Open Access Research article

Using a formative simulated patient exercise for curriculum evaluation

David J Solomon1*, Heather S Laird-Fick2, Carole W Keefe3, Margaret E Thompson4 and Mary Margaret Noel4

Author Affiliations

1 Office of Medical Education Research and Development and the Department of Medicine, College of Human Medicine, Michigan State University, East Lansing, Michigan, USA

2 Department of Medicine, College of Human Medicine, Michigan State University, East Lansing, Michigan, USA

3 Office of Medical Education Research and Development, College of Human Medicine, Michigan State University, East Lansing, Michigan, USA

4 Department of Family Practice, College of Human Medicine, Michigan State University, East Lansing, Michigan, USA

For all author emails, please log on.

BMC Medical Education 2004, 4:8  doi:10.1186/1472-6920-4-8

Published: 12 May 2004

Abstract

Background

It is not clear that teaching specific history taking, physical examination and patient teaching techniques to medical students results in durable behavioural changes. We used a quasi-experimental design that approximated a randomized double blinded trial to examine whether a Participatory Decision-Making (PDM) educational module taught in a clerkship improves performance on a Simulated Patient Exercise (SPE) in another clerkship, and how this is influenced by the time between training and assessment.

Methods

Third year medical students in an internal medicine clerkship were assessed on their use of PDM skills in an SPE conducted in the second week of the clerkship. The rotational structure of the third year clerkships formed a pseudo-randomized design where students had 1) completed the family practice clerkship containing a training module on PDM skills approximately four weeks prior to the SPE, 2) completed the family medicine clerkship and the training module approximately 12 weeks prior to the SPE or 3) had not completed the family medicine clerkship and the PDM training module at the time they were assessed via the SPE.

Results

Based on limited pilot data there were statistically significant differences between students who received PDM training approximately four weeks prior to the SPE and students who received training approximately 12 weeks prior to the SPE. Students who received training 12 weeks prior to the SPE performed better than those who received training four weeks prior to the SPE. In a second comparison students who received training four weeks prior to the SPE performed better than those who did not receive training but the differences narrowly missed statistical significance (P < 0.05).

Conclusion

This pilot study demonstrated the feasibility of a methodology for conducting rigorous curricular evaluations using natural experiments based on the structure of clinical rotations. In addition, it provided preliminary data suggesting targeted educational interventions can result in marked improvements in the clinical skills spontaneously exhibited by physician trainees in a setting different from which the skills were taught.