Faculty Development for Medical Educators

When preparing the simulation you should do the following:

• Develop the case/scenario
• Determine the demographics that the simulated patients need to fit into
• Figure out the number of learners you have and how you will schedule them
• Determine the length of the scenario (how long you want students to spend with patient)
• Determine if there is any preparation that students need to do ahead of time.
• Make sure all case materials are kept confidential.

When developing a Hi Fidelity Manikin case the Clinical Simulation Center will provide you with a template that asks for the following:

• Objectives
• Case Overview
• Room Set up
  • Supplies/Monitors/Equipment
• Patient Data Background and Baseline
• Scenario Background – “Door Note” - What patient information should leaners know as they are walking into the sim lab?
• Scenario Development
• Evaluation/Debriefing
   

If are developing a Simulated Patient Case there are a few things to consider.

First consider the parts of an SP experience:

• Door Note - Brief information about the patient, why they are here and student's “tasks” when they are in the room
• Patient Encounter - Time spent in the room with the patient
• Post Encounter  - Exercise completed after students have left the room

Then utilize the template provided by the Clinical Simulation Center.  This template asks for the following:

• Objectives
• Case Overview
• Sections/Parts of the Case - Details
• Evaluation/Checklists/Debriefing

​​​​​​​When filling out the sections and details of the case include the following:

• Door Note
• Opening Statement - The opening statement is for the simulated patient.  It should be spoken verbaitum. 
• Appearance/Behavior/Props - How do we want the SP to look?
• Current Medical History - SP should know what their current medical history is.
• Response to Open-Ended Questions - SP should be told how to answer certain questions.
• Past Medical History - All SPs should have the same past medical history.
• Family History - All SPs should have the same family history.
• Social History - All SPs should have the same social history.
• SP Challenges - What challenging questions should the SP ask the student at the end of the encounter.

Whether you are creating a Manikin Simulation case or an SP Simulation case you need to develop a way to assess students' performance.  

Here are the considerations for checklists and evaluations:

• Sections of Assessment 
  • Sections can include: History, PE, Communication/patient education, Professional Interaction and/or Professional Behavior, Team Communication, Assessment of Skills
• Items should be specific with criteria so we know how to clearly evaluate students.
• Limit the number of items on a checklist especially when working with a simulated patient because there are only so many items they can remember during the encounter. Between 20-25 items is usually standard.
•  Make sure the checklist items are valid.
• Check the case for SP challenge inconsistencies.  Make sure that whatever the challenge question is, is not something students would have already mentioned to the SP earlier in the encounter.
• Decide how the checklist will be scored.
• Decide if there will be a learner post encounter exercise and if so how will that be scored.

For a Simulated Patient checklist there is a lot we can assess.  

For example:

• History
  • Items gathered during the history and can include HPI, PMH, Medications, Family Hx, Social Hx – dependent on details of case
  • Examples:  location of pain, medications, smoking history
• Physical Exam
  • Items that should have been performed during the physical exam
  • Examples: Listened to heart in 4 places, palpated abdomen in 4 quadrants
• Information Sharing/Education
  • Includes any information/education that should be discussed with the patient.   
  • Examples: Counseling a patient on smoking cessation, discussion of safe sex practices, education of a diabetic patient on importance of daily finger sticks or discharge instructions.
• Communication
  • Greeted patient appropriately- introduced themselves name & title/addressed patient by
    name 
  • Expressed interest in patient as a person not just the condition/ explored patient’s reaction to illness/problem/impact on patient’s life
  • Listened and paid attention to patient – note taking balanced with eye contact, did not talk down to patient, summarized information for patient/ non-verbal expression like nodding, eye contact
  • Encouraged patient to tell their story – collected information in an organized fashion, used combination of open and closed ended questions,  avoided technical jargon, did not unnecessarily interrupt
  • The examinee provided me with information regarding the differential diagnosis and next steps.
  • Included patient in decision making/encouraged questions/explored concerns
  • Was emotionally supportive/offered statements of empathy, validated concerns, or showed nonverbal expressions  of concern/empathy
• Professional Behaviors
  • Washed hands upon entering the room/prior to patient contact. 
  • Appropriately draped patient during the physical exam.  
  • Described the physical exam to the patient (what they were doing).
  • Explained the physical exam findings to you (what they found)
  • Considered patient’s comfort during the physical exam.
  • Conducted the exam on the skin

Generally we can use a yes/no style checklist.