1. Kazakhstan Health Technology Transfer and Institutional Reform Project Day 2 Developing standardised patient roles

2. Kazakhstan Health Technology Transfer and Institutional Reform Project “Medical schools cannot rely on clerkship experiences alone to provide adequate basic skills training” (Ledingham and Harden, 1998) This is true worldwide

3. Kazakhstan Health Technology Transfer and Institutional Reform Project A standardised patient is a non physician trained to accurately and consistently portray a patient in a simulated clinical situation for teaching or testing purposes

4. Kazakhstan Health Technology Transfer and Institutional Reform Project Use of SPs Complements and enhances more traditional learning opportunities elsewhere in the curriculum. Provides opportunities for students to become proficient in communication, clinical skills and practical procedures before using them in the wards Provides a safe environment

5. Kazakhstan Health Technology Transfer and Institutional Reform Project Running a Standardized Patient Program – what to consider Recruitment Training Different levels of role

6. Kazakhstan Health Technology Transfer and Institutional Reform Project Roles Information gathering Shared decision making Communicating risk Informed consent Breaking bad news Emotional / challenging roles Intimate roles etc

7. Kazakhstan Health Technology Transfer and Institutional Reform Project Planning a Clinical Skills Encounter with SPs Prior to the session you should: integrate the content of your clinical skills session to material presented in other parts of the course.

8. Kazakhstan Health Technology Transfer and Institutional Reform Project A typical half day session Pre learning materials before the session Plenary session Students meet in groups with tutor Clinical encounter Feedback Discussion

9. Kazakhstan Health Technology Transfer and Institutional Reform Project The room These activities can be observed – in the same room as the student, or – remotely via a video link or – a two-way mirror from another room. With a video link and good camera angles it is possible for the remainder of the group to clearly observe their colleague’s performance with you and discuss this together.

10. Kazakhstan Health Technology Transfer and Institutional Reform Project highlight points of good practice as well as inaccuracies/ deficiencies so that the interest of the whole group is maintained while watching a colleague together. n get the group to give their views on their colleagues performance before you give yours. n avoid embarrassing the students in front of their colleagues or the simulated patients. Don’t do anything which may cause a student to think they are being ridiculed while on-camera.

11. Kazakhstan Health Technology Transfer and Institutional Reform Project Developing Roles Who writes them? Is there a template? Sharing

12. Kazakhstan Health Technology Transfer and Institutional Reform Project Today Each group will develop roles based on their curriculum A simple role eg painful joint Each will be preceded by a clear educational objective which links to the curriculum, and will be part of a half day learning event

13. Kazakhstan Health Technology Transfer and Institutional Reform Project Who are the learners? What is the main learing objective What pre reading will they do? Will there be a plenary And then let us create the encounter

14. Kazakhstan Health Technology Transfer and Institutional Reform Project Writing Objectives

15. Kazakhstan Health Technology Transfer and Institutional Reform Project Ideally, objectives should contain these three elements: Performance Criteria Condition Performance - describes "what a learner will be able to do to demonstrate that they have mastered the topic" Criteria - describes "how well the learner must perform" the objective Condition - describes "the important conditions (if any) under which" the performance occurs

16. Kazakhstan Health Technology Transfer and Institutional Reform Project The following guidelines are provided to assist in the development of appropriate learning objectives for a proposed educational experience. Step 1. Describe the information, skills, behaviors, or perspectives participants in the session will acquire through attendance and participation. Step 2. Clearly identify the outcomes or actions participants can expect to demonstrate as a result of the educational experiences. See the action words below. Step 3. Write the learning objectives that relate to these outcomes and that reflect the content of the session. Objectives describe the behavior of the learner, and are stated clearly define or describe an action are measurable, in terms of time, space, amount, and/or frequency.

17. Kazakhstan Health Technology Transfer and Institutional Reform Project Useful words Recognize Construct Evaluate Prioritize Articulate Identify Analyze Describe Develop Create Apply Define Discuss Assess List

18. Kazakhstan Health Technology Transfer and Institutional Reform Project Now we will practice and see if the roles work Please mix up the groups so that we can have a “student” who is not familiar with the role We will need Someone to be the standardised patient Someone to be the student Someone (or two) to observe and mark

19. Kazakhstan Health Technology Transfer and Institutional Reform Project We will now develop a more difficult role A complicated role eg Patient refusing medication A distressing role eg Breaking bad news A management role

20. Kazakhstan Health Technology Transfer and Institutional Reform Project Afternoon We will create four physical examination clinical skills sessions: Cardiovascular examination Vital signs Examination of the breast Examination of the shoulder

21. Kazakhstan Health Technology Transfer and Institutional Reform Project For each, we will : – define learning objectives – Plan how the afternoon will run – Create a role for an SP – Create a check list for the examiner