Objective: 
A curricular change in 2000 resulted in the inclusion of standardized patient (SP) cases in the assessment program in Years 1 and 2 of the curriculum at Southern Illinois University School of Medicine (SIUSOM).  One of the aims of this change was to help students develop their clinical skills and clinical reasoning earlier in medical school through early patient contact and performance assessment.  The purpose of this poster is to describe how standardized patient exam cases are developed in Years 1 and 2 and their quality enhanced through the use of multidisciplinary teams.

SIUSOM clinical practice exam SP cases are developed utilizing real patient cases.  Originally cases were chosen and developed by one clinical faculty member and one nurse educator.  Once a suitable patient case was identified, data gleaned from the medical record was used by the nurse educator to compose a complete history and physical (H&P).  The clinical faculty member developed the student performance standards.  The nurse educator developed SP training notes, trained the case and performed a “dry run” of the case.

The exam cases were often identified as having key pieces missing from the performance standards.  As a result, a team approach to case development was adopted.  Once the case H&P and draft performance standards are developed, an interdisciplinary team is gathered to review and make recommendations for the case.  The team consists of the course directors (one clinical and one basic science faculty), a unit nurse educator, several general practitioners (Internal Medicine, Family Practice and Pediatrics), the SP program coordinator and the assessment coordinator.  The team reviews the student performance standards in advance of the meeting.  At the meeting each competency is discussed and the performance standards are agreed upon through consensus.

The team approach has provided SIUSOM with a higher quality comprehensive clinical practice exam for our Year 2 medical students.