Evaluation of resident performance in an outpatient internal medicine clinic using standardized patients.
ABSTRACT To observe and evaluate the performance of primary care internal medicine residents within the outpatient clinic milieu.
Longitudinal descriptive study.
48 internal medicine resident encounters with two standardized patients at the University of Wisconsin General Internal Medicine Clinics.
Residents were rated by the standardized patients with a medical skills checklist and an interpersonal skills checklist, and by the staffing physician with a clinical reasoning skills checklist. The investigators reviewed audiotapes of the standardized patient encounters for strategic management skills.
Resident performance on these scales was examined for improvement with years of training; when considered separately, no such effect was seen for either standardized patient case. When the cases were grouped together, however, there was significant improvement on the Clinical Reasoning Instrument. The grouped standardized patient data were compared with data from inpatient faculty evaluations of the residents. Faculty evaluations correlated with standardized patient evaluations of resident performance only on the medical checklist. Finally, comparison of the four assessment scales demonstrated a significant correlation between interpersonal skills, as assessed by the patient, and strategic management skills.
Resident outpatient performance, measured in a blinded setting, does not improve with year of training. Faculty inpatient assessments of residents correlate with medical "thoroughness" as measured by a medical skills checklist, and interpersonal skills as rated by standardized patients correlate with resident use of strategic medical management.
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ABSTRACT: OBJECTIVE: To investigate a brief teaching intervention using standardized patients (SPs) trained to improve residents’ detection and advising of problem drinkers. DESIGN: Pretest-posttest design assessing resident behavior and skills. SUBJECTS: Nineteen internal medicine residents in a University Hospital General Internal Medicine Clinic. INTERVENTION: Announced SPs were interviewed by residents and presented to faculty who provided brief instruction on the National Institute on Alcohol Abuse and Alcoholism guidelines for screening and brief counseling of problem drinkers. MEASURE: Unannounced SPs assessed resident behavior and skills. RESULTS: Following the teaching intervention, 2 times more residents screened for alcohol use and nearly 3 times more residents did brief counseling. Residents reported that the intervention was informative and valuable. CONCLUSION: A single, 1-hour teaching intervention lead to a 2- to 3-fold increase in resident detection and advising of problem drinkers. SPs provide effective teaching encounters and a useful measure of resident behavior.Journal of General Internal Medicine 05/2002; 17(5). DOI:10.1007/s11606-002-0039-0 · 3.42 Impact Factor
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ABSTRACT: Background: Scheduling unidentified standardized patients (SPs) into physician outpatient practices to assess quality of care and physician performance has been used infrequently for housestaff evaluation. The article's purpose is to describe the feasibility and acceptability of using unidentified SPs for evaluation of housestaff performance of the clinical breast examination and other preventive practices in the outpatient setting.Description: SPs, posing as new patients with an uncomplicated medical history, were scheduled under pseudonyms into the clinics of 20 randomly selected consenting residents. Following each encounter, the SPs completed an evaluation checklist on prespecified aspects of the history and physical.Evaluation: Four(20%) of the residents who actually had an SP encounter suspected that they had seen an SP, and 7 (21%) of the 34 consenting housestaff who actually did not see an SP thought that they had. At the end of the study, none of the housestaff had expressed a reluctance to participant in the unidentified SP evaluation and 39 (83%) stated they would participate in a similar evaluation in the future. Seventeen (36%) of all surveyed housestaff felt the SP evaluation had no effect on overall patient care, whereas 30 (64%) felt it had a positive effect on patient care.Conclusions: The use of unidentified SPs in the outpatient setting is a feasible method of evaluation that was acceptable to the majority of internal medicine housestaff at our institution without appearing to negatively impact on patient care.Teaching and Learning in Medicine 01/1997; 9(1):60-65. DOI:10.1080/10401339709539814 · 1.12 Impact Factor
Atención Primaria 01/2001; 28(8):560–564. DOI:10.1016/S0212-6567(01)70448-9 · 0.89 Impact Factor