Development of a standardized patient instructor to teach functional assessment and communication skills to medical students and house officers

Professional societies have called for increased geriatrics training for all medical students and physicians. A Geriatrics Standardized Patient Instructor (GSPI) was developed in which learners assess the functional status of a patient preparing for hospital discharge. Standardized patients (SPs) rate learners on functional assessment and communication skills, and provide feedback. Seventeen SPs were trained. Correlations of ratings by SPs with ratings by three geriatricians of videotaped encounters indicated good reliability (correlation coefficient=0.69 and 0.70 for functional assessment and communication skills, respectively). Results from two learner groups illustrated the utility and feasibility of the GSPI. First, 138 house officers in nine specialties experienced the GSPI as a formative evaluation during implementation of new geriatrics curricula. Mean scores +/- standard deviation (on a 100-point scale) for functional assessment and communication skills were 78 +/- 16 and 86 +/- 11, respectively. House officers rated the overall experience positively (mean rating (1=poor, 5=excellent) 3.9 +/- 0.8). Second, 171 first-year medical students (M1 s) encountered the GSPI as part of an intense, multimodal educational intervention. Mean scores on functional assessment and communication skills were 93 +/- 10 and 93 +/- 7, respectively. Mean overall rating of the experience by M1 s was 4.1 +/- 0.8. After demonstrated success as a teaching tool in these two groups of learners, the GSPI has been successfully used with second- and third-year (M3) medical students and house officers from a total of 12 specialties and incorporated into multistation Objective Standardized Clinical Examination exercises for incoming house officers and M3 s. Unlike existing diagnosis-oriented SPs, the GSPI can be used to assess and teach geriatrics skills to physician learners across disciplines and levels of training.