Feels Like a ” Real” Patient Interaction The qualities of Standardized Patients for a "real patient interaction” . The skills list for Standardized Patients. A checklist to evaluate the student interaction. Standardized Patients Elizabeth Yznaga, DNP, CNM Clinical OB Simulation Instructor University of San Francisco, School of Nursing

The skills list for standardized patients Portray a Patient Observe student behavior Recall the encounter and complete the checklist Give feedback to the student Adapted from P. Wallace. Coaching Standardized Patients, For use in the assessment of clinical competence. Springer Publishing Company New York, New York, 2007

Standardized patient skills lists are based on the ability to: Portray a patient. Comes prepared with a firm knowledge of case details, checklists, feedback expectations, and copies of required materials. Consistently performs a high quality portrayal by recognizing the details necessary to portray cases and accurately document learner performance.   Observe the students behavior. Adapts quickly and receptively to changes. Maintains the confidentiality of the training process, case materials, and learners' performance Recall the encounter and complete the checklist  Uses language and terminology as specified, and completes forms in detail. Completes assessment forms with consistency and accuracy. Give feedback to the student Able to produce written and verbal feedback that is accurate and consistent in quality. Integrates feedback from staff and SP trainers readily and consistently. .Behaves in a professional manner, recognizing the role of medical educators and their use of SPs to create a fair, objective, and valuable learning experience. Modified from https://simulation.uchicago.edu/content/ucsim-standardized-patient- application

Excellent feedback maintains quality For assessment and evaluation

Do’s and Don'ts of Standardized Patient Feedback Stay in character and on target. Do alter the acuity of your symptoms so that you are clear headed, sober and not in extreme distress or pain while giving feedback. Do make suggestions on how to do things differently. Do allow the learner the opportunity to do something over using your suggestions if there is time. Include both negative & positive behaviors. Do identify the two or three most important things for the learner to change. Do limit your feedback to two or three items with one or two sentences about each. Avoid using but or however because these negate everything that came before those words. Make your points: Point 1, Point 2, and Point 3. G:\ExCEL\OSCE\Feedback\Feedback Guidelines from ASPE 2011.doc

Do’s and Don'ts of Standardized Patient Feedback Don’t offer examples from your own life . Don’t interject personal medical history or experiences. Don’t ever compare this student to another (avoid statements like “you’re the only student today who ________________,” “you did the best job of anyone who’s seem me today, “ etc. Don’t EVER give “golden retriever” feedback such as “that was very good, you’ll make a good doctor, you did a good job, you’re going to be a good doctor, you’re so nice. Do take on the mindset of a coach. We can’t do it for them, but it is our goal to help each learner be the very best they can be. If the students disagrees with your feedback (or becomes defensive or argumentative, do end your feedback and let the staff know. The faculty will discuss the student’s performance with him/her later. You aren’t paid enough to have uncomfortable conversations with students.  G:\ExCEL\OSCE\Feedback\Feedback Guidelines from ASPE 2011.doc

The Checklist for Standardized Patients’ Feedback Feelings Were your feelings respected? Efficiency Were the nursing actions efficient? Touch Were you roughly handled? Communication Were you heard and could you understand the students?

An example of feedback questions for SPs Did the student knock before entering the room?   Did the student identify you by name? Did the student use open-ended questions in gathering your medical history? Did the student allow you to tell your story without interrupting? Was the student easily understood when explaining medical terms? Did the student allow you to have input into the decision making process? Did the student make you feel comfortable? Did the student have a good understanding of the reasons for your visit? Did the student use appropriate facial expressions during the conversation? Was the student empathetic to your needs and concerns? Did the student respect your modesty during the exam? Was the student attentive to your pain? Was your student heavy handed during the exam? Did the student concentrate on your main medical complaint? Were you satisfied with the experience you had with the student?

The checklist adds consistency and reliability Time to make your own checklist. What is on your list? Overall satisfaction History Physical exam Information sharing Clinical courtesy