A Novel Longitudinal Geriatric Medical Student Experience: Using Teaching Objective Structured Clinical Examinations

Abstract

It has previously been shown that medical students perform poorly when assessing older adults with recurrent falls. To address this and teach students about other geriatric syndromes, a standardized patient, played by one of nine actresses, aging during the course of an afternoon, was developed. The patient is first aged 75 with falls, then 80 with memory problems, then 82 with an acute confusional state. The third-year students interact with the patient on a one-to-one basis. After seeing and examining her, the students write up the case and then meet with the supervising physician after each section to discuss the case. This intervention was well accepted, scoring 5.95 on a 7-point Likert-type scale. At the end of the clinical year, the students participated in an eight-case clinical skills examination that included a 79-year-old man with falls. Using the actor's checklists, the performances of the 42 medical students who had participated in the standardized patient experience were compared with those of the 128 who had not. Over the eight cases, there was no difference in the three domains of communication, information gathering, and physical examination, but in the geriatric case, the students who had participated in the experience performed significantly better in all three domains. The intervention students were also three times as likely to examine the subject's gait (60% vs 20%). A 3-hour interactive session substantially improved specific geriatric competencies. One can only wonder what more dedicated time could accomplish.

A abordagem do envelhecimento na formação universitária dos profissionais de saúde: uma revisão integrativa

“…31,32 Shapiro Cho 33 e Sutin et al 34 abordaram o papel do teatro no ensino de disciplinas relacionadas a questões do envelhecimento. O primeiro destaca que o teatro é uma forma inovadora e simples de ajudar os estudantes de Medicina na reflexão e discussão de temas difíceis, como os estereótipos de envelhecimento, invalidez e perda de independência, sexualidade, vida assistida, os relacionamentos com adultos e crianças e as questões de fim de vida.…”

Perceptions of a longitudinal standardized patient experience by standardized patients, medical students, and faculty

“…Longitudinal standardized patient (LSP) experiences involve a medical student interacting with the same ‘patient’ over time in various scenarios. LSP experiences have been described as a means to provide structured opportunities for practice, assessment, and feedback in clinical skills and foster an appreciation for the continuum of care [4–6]. These interactions are designed to provide students with clinical experiences as well as individualized, developmentally sequenced assessment of clinical skills [7].…”

“…Based on prior literature [4–6,9], the domains of continuity, relationship-building, and feedback were used as the initial model around which to build our understanding of the program.…”

Teaching Medical Student Geriatrics Competencies in 1 Week: An Efficient Model to Teach and Document Selected Competencies Using Clinical and Community Resources

“…Another model is a month‐long multisite fourth‐year geriatrics clerkship using an ambulatory and home care geriatrics program . Two other models used Observed Structured Clinical Examinations to supplement the teaching and assessment of geriatrics skills . These models successfully introduced students to several geriatrics competencies, but these curricula require longer periods of time and can be personnel intensive, so they may prove difficult to implement in many institutions with limited geriatrics resources and different curricular structures.…”

“…4 Two other models used Observed Structured Clinical Examinations to supplement the teaching and assessment of geriatrics skills. 5,6 These models successfully introduced students to several geriatrics competencies, but these curricula require longer periods of time and can be personnel intensive, so they may prove difficult to implement in many institutions with limited geriatrics resources and different curricular structures. Thus, it is likely that sharing curricular experiences devel-oped in a variety of medical school settings will be beneficial for educators leading efforts to teach geriatrics competencies.…”