Abstract：
BACKGROUND AND OBJECTIVES:This study was intended to assess the usefulness of standardized patients (SPs) in the evaluation of family medicine residents' clinical decision-making skills in ambulatory settings. METHODS:A pool of SPs was trained about the symptoms of one of three clinical conditions (depression, headache, or irritable bowel syndrome). These patients were then surreptitiously incorporated into the office hours of 11 residents on one occasion during their second year and once during their third year of training. A different SP was used at each encounter, but the same clinical case was presented each year for that particular resident. The SPs were given a questionnaire after each office visit to evaluate whether the resident completed elements of history, physical exam, clinical decision making specific to their case, and to report their satisfaction with the encounter. In addition, the assessment component of the resident's progress notes for each SP visit was reviewed by a single examiner to determine if the correct diagnosis was made by the resident. RESULTS:The residents showed a statistically significant decrease in the percentage of checklist items completed for all clinical cases from the second year (82.70%) to the third year (75.55%). However, the average patient satisfaction was unchanged, as was the number of correct diagnoses, even though fewer questions were asked. CONCLUSIONS:The use of SPs is a feasible and potentially useful method for evaluating family medicine resident decision making. Several factors may account for the differences in resident performance with SP scenarios.
journal_name
Fam Medjournal_title
Family medicineauthors
Terry R,Hiester E,James GDsubject
Has Abstractpub_date
2007-04-01 00:00:00pages
261-5issue
4eissn
0742-3225issn
1938-3800journal_volume
39pub_type
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