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Medical Education  |   December 2007
Standardized Patients and Mechanical Simulators in Teaching and Assessment at Colleges of Osteopathic Medicine
Author Notes
  • From the National Board of Osteopathic Medical Examiners National Center for Clinical Skills Testing (Dr Gimpel, Ms Weidner, and Ms Wilson) in Coshohocken, Pa; from the Foundation for Advancement of International Medical Education and Research (Dr Boulet) in Philadelphia, Pa; and from the New York College of Osteopathic Medicine of New York Institute of Technology (Dr Errichetti) in Old Westbury. 
  • Address correspondence to John R. Gimpel, DO, MEd, National Board of Osteopathic Medical Examiners, 1010 W Elm St, Suite 150, Conshohocken, PA, 19428-2075. E-mail: jgimpel@nbome.org 
Article Information
Medical Education
Medical Education   |   December 2007
Standardized Patients and Mechanical Simulators in Teaching and Assessment at Colleges of Osteopathic Medicine
The Journal of the American Osteopathic Association, December 2007, Vol. 107, 557-561. doi:10.7556/jaoa.2007.107.12.557
The Journal of the American Osteopathic Association, December 2007, Vol. 107, 557-561. doi:10.7556/jaoa.2007.107.12.557
Abstract

Context: A 2001 survey of 19 colleges of osteopathic medicine (COMs) revealed that standardized patient programs (SPPs) are increasingly used in osteopathic medical education. However, no new data have been published since.

Objectives: To evaluate current SPP and mechanical simulator use at COMs compared with previous survey results.

Methods: In 2005, an electronic survey regarding the use of SPPs (eg, staffing, facilities) and mechanical simulators in the teaching and assessment of students' clinical skills was sent to the deans of the 23 fully accredited COMs and branch campuses.

Results: Responses were received from all 23 COMs for a 100% response rate. According to survey results, 19 COMs (87%) had active SPPs, 2 COMs (9%) reported that SPPs were in development, and the remaining 2 COMs (9%) used students as patients. In comparison, only 12 COMs (63%) in 2001 had active SPPs. Results indicated an increased use of standardized patients for assessment, particularly in physician-patient communication, osteopathic manipulative medicine, and osteopathic manipulative treatment. In addition, 12 COMs (52%) reported using mechanical simulators in the teaching or assessment of clinical skills.

Conclusion: From 2001 to 2005, the use of SPPs and mechanical simulators at COMs increased substantially.

Increasingly, standardized patients—actors trained in the skill of portraying patients with various diseases and conditions—are being used to teach and evaluate medical students' clinical skills. First used in student training in the 1960s, standardized patients are trained to simulate not only patient history but also a patient's body language, personality, and emotional characteristics.1 In recent years, standardized patient programs (SPPs) have played a considerable role in developing medical students' clinical skills, particularly physician-patient communication.2-4 
In 2001, the National Board of Osteopathic Medical Examiners (NBOME) surveyed all 19 colleges of osteopathic medicine (COMs) regarding SPPs.5 The NBOME used the results of the survey to proceed with the research and development of the Comprehensive Osteopathic Medical Licensing Examination-USA Level 2-Performance Evaluation (COMLEX-USA Level 2-PE). As a result, standardized patients are now used in required examinations for osteopathic medical students.6,7 
The implementation of the COMLEX-USA Level 2-PE in 2004 ignited interest in re-examining how osteopathic medical students are being trained. The current survey, in addition to providing an update on SPPs, also sought to investigate the use of new technologies used in students' training and assessment. These technologies included various types of simulators, from endoscopic and part-task trainers to whole body robotic simulators. 
Methods
In November 2005, all 23 fully-accredited COMs and branch campuses received a 34-question electronic survey on the use of standardized patients in teaching and clinical assessment. The survey contained 23 questions drawn directly from the 2001 NBOME paper-based survey.5 However, though the 2001 survey questions requested information regarding osteopathic graduate medical education (OGME), the 2005 survey restricted SPP-related questions to undergraduate osteopathic medical education. New questions pertained to the use of mechanical simulators in both undergraduate and graduate medical education. 
The survey was e-mailed directly to the dean of each school. As with NBOME's 2001 survey,5 the deans were asked to provide the following information: 
  • what the status of the school's SPP was
  • details about program administration, staffing, and facilities
  • how the SPP was being used in student education and assessment
As described in the 2002 study,5 an SPP was defined as a program having a paid staff consisting of a program administrator, at least one standardized patient trainer, and a core of part-time, paid standardized patients. 
Respondents were also asked to describe the use of mechanical simulators in osteopathic medical education. Those COMs who did use mechanical simulators were asked to indicate which types of simulators were used for the training and assessment of clinical procedures and psychomotor skills by selecting from the following list: 
  • robotic (eg, METI HPS, ECS, PediaSIM, Laerdal SimMan)
  • part-task (eg, intubation heads, intravenous [IV] arms)
  • surgical (eg, endoscopic trainers)
  • virtual reality (eg, web-based surgical simulators, Immersion)
  • other (eg, ventilators, defibrillators)
Respondents were asked to indicate in which years of under-graduate and graduate school these technologies were used and if they were used for outside contracts. The survey also included questions regarding the number of simulators available, the mechanical simulator facilities available, and the integration of simulators with SPPs. 
Results
The authors received a response from all 23 COMs and branch campuses surveyed for this follow-up study, resulting in a response rate of 100%. Fourteen respondents (61%) identified themselves as deans or associate deans, 5 (22%) were SP program administrators, 2 (9%) were “PhD faculty/directors,” 1 (4%) was a “DO faculty/director,” and 1 survey respondent (4%) selected “other.” In 2005, 19 (83%) of the 23 COMs had active SPPs (Table 1), compared with 12 (63%) of the 19 COMs surveyed in 2001. The remaining 4 COMs (17%) from the 2005 survey indicated that they were either in the process of implementing an SPP or they used students as standardized patients, compared with 4 COMs (21%) in 2001 that neither had an SPP in place nor were in the process of implementing one. 
Table 1
Standardized Patient Programs at Colleges of Osteopathic Medicine in 2005 (N=23)

Program Status

No. (%)
Active19 (83)
In development 2 (9)
Students used as standardized patients
2 (9)
Table 1
Standardized Patient Programs at Colleges of Osteopathic Medicine in 2005 (N=23)

Program Status

No. (%)
Active19 (83)
In development 2 (9)
Students used as standardized patients
2 (9)
×
The departments responsible for administrating the SPP shifted from the dean's office to other areas (Table 2). Whereas the majority of SPPs were administered through the dean's office in 2001, only 1 program was in 2005. 
Table 2
Administration of Standardized Patient Programs at Colleges of Osteopathic Medicine in 2005* (n=21)

Program Administrator

No. (%)
Dean's office1 (5)
Department of Family Medicine 5 (24)
Department of Academic Affairs4 (19)
Curriculum and education 4 (19)
Other
7 (33)
 *Data includes colleges of osteopathic medicine (COMs) that had active SPPs as well as those that used students a patients. Data from a similar 2001 study5 reported administration only of those COMs with active standardized patient programs.
 Other program administrators included learning centers and various departments such as clinical affairs, clinical education, primary care, and primary care education.
Table 2
Administration of Standardized Patient Programs at Colleges of Osteopathic Medicine in 2005* (n=21)

Program Administrator

No. (%)
Dean's office1 (5)
Department of Family Medicine 5 (24)
Department of Academic Affairs4 (19)
Curriculum and education 4 (19)
Other
7 (33)
 *Data includes colleges of osteopathic medicine (COMs) that had active SPPs as well as those that used students a patients. Data from a similar 2001 study5 reported administration only of those COMs with active standardized patient programs.
 Other program administrators included learning centers and various departments such as clinical affairs, clinical education, primary care, and primary care education.
×
Use of Standardized Patients
Similar to the 2001 survey results, standardized patients in 2005 were used primarily during the first 2 years at COMs (Table 3). However, unlike the 2001 data, SPPs now are being used by COMs slightly more for the assessment of clinical skills than for teaching. The only instances in which standardized patients were used more for teaching than assessment were in genital and rectal examinations in men and women. Use of standardized patients to provide assessment of student skills varied by teaching component assessed and year of medical training (Table 3). 
Table 3
Standardized Patient Programs as Used in the Teaching and Assessment of Clinical Skills and Topics at Colleges of Osteopathic Medicine in 2005 (n=19)


OMS*

Total
Clinical Skill or Topic
Year 1
Year 2
Year 3
Year 4
Teaching
Assessment
Complete history1211231215
Focused history 10 14 9 7 15 18
Complete physical examination129411418
Focused physical examination 11 16 12 7 16 19
Male genital and rectal examination81110138
Female genital and rectal examination 8 12 2 0 15 9
Abnormal physical findings715811114
Physician-patient communication 18 18 12 7 16 19
Patient education129741015
Behavioral medicine 7 13 7 2 12 14
OMM or OMT8131061114
Medical ethics 5 10 5 2 10 14
 Abbreviations: OMM, osteopathic manipulative medicine; OMT, osteopathic manipulative treatment.
 *Years 1 through 4 indicate year of osteopathic medical school (OMS) in which colleges of osteopathic medicine (COMs) used standardized patient programs to either teach or assess students.
 Total indicates the number of COMs that use SPPs to teach or assess each respective clinical skill or topic at any point during undergraduate osteopathic medical education.
Table 3
Standardized Patient Programs as Used in the Teaching and Assessment of Clinical Skills and Topics at Colleges of Osteopathic Medicine in 2005 (n=19)


OMS*

Total
Clinical Skill or Topic
Year 1
Year 2
Year 3
Year 4
Teaching
Assessment
Complete history1211231215
Focused history 10 14 9 7 15 18
Complete physical examination129411418
Focused physical examination 11 16 12 7 16 19
Male genital and rectal examination81110138
Female genital and rectal examination 8 12 2 0 15 9
Abnormal physical findings715811114
Physician-patient communication 18 18 12 7 16 19
Patient education129741015
Behavioral medicine 7 13 7 2 12 14
OMM or OMT8131061114
Medical ethics 5 10 5 2 10 14
 Abbreviations: OMM, osteopathic manipulative medicine; OMT, osteopathic manipulative treatment.
 *Years 1 through 4 indicate year of osteopathic medical school (OMS) in which colleges of osteopathic medicine (COMs) used standardized patient programs to either teach or assess students.
 Total indicates the number of COMs that use SPPs to teach or assess each respective clinical skill or topic at any point during undergraduate osteopathic medical education.
×
Staffing of Standardized Patient Programs
The number of standardized patients in the schools' SPPs ranged from 21 to 235. Seventeen (89%) of the 19 COMs with active SPPs reported having access to culturally diverse standardized patients, both male and female, between the ages of 18 and 80 years. Although it is unknown whether survey respondents reported standardized patients' self-identified race or their own general impressions, nearly half of these schools (47%) reported having access to Asian, black/African American, and Hispanic/Latino standardized patients. In addition, though US Census Bureau documents ask survey respondents about race and Hispanic ethnicity in two separate questions because a person of Hispanic ethnicity can be of any race, the current survey did not make such a distinction. 
Of the 23 schools surveyed, 21 schools—both the schools with active SPPs and the 2 schools that used students as patients—employed standardized patient trainers. Thirteen COMs (62%) employed full-time trainers, and 12 COMs (57%) employed part-time trainers. Each COM had no more than 5 full-time and 7 part-time trainers. Six COMs (29%) employed both full-time and part-time trainers. In addition, 16 respondents (76%) indicated that faculty physicians were assigned as supervisors for SPPs. 
Facilities and Equipment for Standardized Patient Programs
All SPP facilities had simulated examination rooms and separate video control rooms, and all SPPs had sphygmomanometers available (Table 4). Since 2001, more COMs with SPPs reported having observation rooms (67% in 2001 vs 89% in 2005), and separate video control rooms (58% vs 100%) available. Standardized patients and students are also now more likely to have separate orientation and rest areas (33% in 2001 vs 95% in 2005). The average number of SPP examination rooms was 10 (range, 4 to 24). In addition, of the survey respondents, 11 COMs had built a new facility since 2001, and 6 COMs reported having plans for a new or updated facility within the next 3 years. 
Table 4
Facilities and Equipment for Standardized Patient Programs at Colleges of Osteopathic Medicine (COMs) in 2005 (n=19)

Standardized Patient Programs

No. (%)
▪ Facilities
□ Examination rooms 19 (100)
□ Observation rooms17 (89)
□ One-way viewing glass 9 (47)
□ Separate video control room19 (100)
□ Separate entrances for standardized patients and students 4 (21)
□ Orientation and rest area for standardized patients18 (95)
□ Orientation and rest area for students 18 (95)
▪ Equipment
□ Video capabilities 18 (95)
□ Audio capabilities18 (95)
□ Osteopathic treatment tables 17 (89)
□ Nonosteopathic examination tables16 (84)
□ Sphygmomanometers 19 (100)
□ Ophthalmoscopes18 (95)
□ Otoscopes 18 (95)
□ In-room sinks
18 (95)
Table 4
Facilities and Equipment for Standardized Patient Programs at Colleges of Osteopathic Medicine (COMs) in 2005 (n=19)

Standardized Patient Programs

No. (%)
▪ Facilities
□ Examination rooms 19 (100)
□ Observation rooms17 (89)
□ One-way viewing glass 9 (47)
□ Separate video control room19 (100)
□ Separate entrances for standardized patients and students 4 (21)
□ Orientation and rest area for standardized patients18 (95)
□ Orientation and rest area for students 18 (95)
▪ Equipment
□ Video capabilities 18 (95)
□ Audio capabilities18 (95)
□ Osteopathic treatment tables 17 (89)
□ Nonosteopathic examination tables16 (84)
□ Sphygmomanometers 19 (100)
□ Ophthalmoscopes18 (95)
□ Otoscopes 18 (95)
□ In-room sinks
18 (95)
×
Mechanical Simulators
Twelve (52%) of the 23 COMs reported using mechanical simulators or equipment (Table 5). At the time the survey was conducted, 11 of 12 COMs had three mechanical simulation rooms; 1 COM was building four rooms to open in 2006. Nine COMs integrated both standardized patients and mechanical simulators into their training and assessment programs. Of these COMs, 7 administered both programs under the same department. All of the COMs that used mechanical simulators had digital audiovisual technology, 8 COMs had a data capturing system, and 7 had ambient sounds for SPPs, medical simulators, or both. Some schools allowed mechanical simulator use for OGME programs and others in the healthcare professions (eg, emergency medical technicians) on a contract basis. 
Table 5
Use of Mechanical Simulators at Colleges of Osteopathic Medicine in 2005 (n=12)


Simulators*
Use
Robotic
Part-Task
Surgical
Virtual Reality
Other
Skills
□ Training of procedures1010227
□ Training of psychomotor skills 8 10 3 1 6
□ Assessment of procedures89226
□ Assessment of psychomotor skills 7 9 3 1 6
□ Science teaching94221
Undergraduate
□ Year 167032
□ Year 2 10 10 2 2 8
□ Year 377115
□ Year 4 2 3 1 2 3
Graduate
□ Year 1 3 2 1 2 3
□ Years 2 through 543124
Outside Contracts
3
3
0
1
1
 *Survey respondents were asked to indicate mechanical simulator use by choosing from the following list: robotic (eg, METI HPS, ECS, PediaSIM, Laerdal SimMan), part-task (eg, intubation heads, intravenous [IV] arms), surgical (eg, endoscopic trainers), virtual reality (eg, web-based surgical simulators, Immersion), and other (eg, ventilators and defibrillators).
 Examples of procedures include emergency department protocols, anesthesia, and advanced cardiac life support, and psychomotor skills include intubation and IV insertion. Science teaching through simulators is used to reinforce preclinical and basic science concepts (eg, cardiology, physiology).
 Outside contracts are awarded to other health care professionals (eg, emergency medical technicians).
Table 5
Use of Mechanical Simulators at Colleges of Osteopathic Medicine in 2005 (n=12)


Simulators*
Use
Robotic
Part-Task
Surgical
Virtual Reality
Other
Skills
□ Training of procedures1010227
□ Training of psychomotor skills 8 10 3 1 6
□ Assessment of procedures89226
□ Assessment of psychomotor skills 7 9 3 1 6
□ Science teaching94221
Undergraduate
□ Year 167032
□ Year 2 10 10 2 2 8
□ Year 377115
□ Year 4 2 3 1 2 3
Graduate
□ Year 1 3 2 1 2 3
□ Years 2 through 543124
Outside Contracts
3
3
0
1
1
 *Survey respondents were asked to indicate mechanical simulator use by choosing from the following list: robotic (eg, METI HPS, ECS, PediaSIM, Laerdal SimMan), part-task (eg, intubation heads, intravenous [IV] arms), surgical (eg, endoscopic trainers), virtual reality (eg, web-based surgical simulators, Immersion), and other (eg, ventilators and defibrillators).
 Examples of procedures include emergency department protocols, anesthesia, and advanced cardiac life support, and psychomotor skills include intubation and IV insertion. Science teaching through simulators is used to reinforce preclinical and basic science concepts (eg, cardiology, physiology).
 Outside contracts are awarded to other health care professionals (eg, emergency medical technicians).
×
Comments
Similar to the data gleaned from the 2003-2004 school survey Osteopathic Medical Education in the United States: Improving the Future of Medicine,8 which showed that 15 (79%) of 19 COMs in 2003 reported the use of standardized patients, a comparison of 2005 data with the previous survey5 revealed a nearly 20% increase in SPP use at COMs. Many factors have likely contributed to this increase. For example, the use of SPPs in international medical education and the emerging supporting evidence in medical education literature and at academic meetings over the past decade have grown.2-4,9-12 As reported in the current study, most COMs have moved SPPs out of the dean's offices to other departments, which can increase program visibility and therefore increase program support and widespread usage. Meanwhile, the public has mandated for a reduction in medical errors, error management, and patient safety, as well as improved patient autonomy and enhanced physician-patient communication skills.13 Likewise, many curricular objectives emphasize clinical skills such as physician-patient communication, professionalism, and osteopathic manipulative medicine (OMM) and osteopathic manipulative treatment (OMT), which OGME programs and the American Osteopathic Association have adopted with the integration of core competencies.14,15 And, of course, the COMLEX-USA Level 2-PE, a multistation performance evaluation of clinical skills using standardized patients, has been incorporated into the licensure examination pathway for osteopathic physicians.16 With the 2008 requirement that all graduates pass this examination, SPP use at COMs can only be expected to continue to rise.6 However, as the data provided in the current study are self-reported, caution must be exercised in interpreting the results. 
The 2001 NBOME survey was a paper document that allowed schools to reply separately whether or not they used SPPs for teaching or assessment of each clinical skill area by academic year. For example, in students' second year of osteopathic medical school, 6 COMs reported using SPPs in the teaching of OMM or OMT, while 2 COMs reported using SPPs in the assessment of OMM or OMT.5 Although these data allowed for an exact comparison of the use of SPPs by teaching or assessment by academic year, they also inflated the total use of SPPs for teaching and assessment (ie, they were counted more than once). By contrast, data from the 2005 survey revealed how many COMs used SPPs by clinical skill and by year (eg, OMM or OMT in year 2), and then teaching and assessment by clinical skill across all 4 years. For example, COMs reported using SPPs to teach or assess OMM or OMT at any point during undergraduate medical education. 
Nonetheless, 2001 data revealed that only 5 COMs (42%) used standardized patients in the assessment of OMM or OMT,5 compared with 14 COMs (67%) in 2005. Likewise, the use of SPPs in the assessment of physician-patient communication skills has more than doubled, from 5 COMs (42%) in 2001 to 19 COMs (100%) in 2005. Similar increases are seen in the use of SPPs for the teaching and assessment of patient education, behavioral medicine, and medical ethics. In addition, other than in the areas of genital and rectal examinations, standardized patients are used more for student assessment than teaching. Because of the sensitive nature of these examinations, schools often use trained clinical professionals (eg, nurses, genitourinary teaching associates) for the teaching or assessment of these portions of physical examination.17 
Although the difference in the use of standardized patients in teaching versus assessment is not statistically significant (P=.75), the greater use of SPPs in assessment may be a result of schools' desire to further improve the reliability of standardized patient–based clinical skills examinations, including the COMLEX-USA Level 2-PE before graduation. Further study of whether schools use SPPs for formative or summative assessment and how schools remediate students who fail school-based or national high-stakes clinical skills examinations would be of interest. 
Survey results also indicated that nearly half of the COMs (47%) employed white, Asian, black/African American, and Hispanic/Latino standardized patients. However, because the survey did not request specific racial data, it is unknown whether the percentage of these patients matches the racial distribution within the United States or the school's geographic location. This distribution should be further studied. 
The current study revealed that 12 COMs (52%) use mechanical simulators at their schools. Until recently, simulation-based medical education for most medical schools—both osteopathic and allopathic—had predominantly used “low-tech” simulations (eg, standardized patients).8,9 Now, various simulators are being incorporated into teaching, learning, and assessment programs at almost half of the COMs. As the fidelity, durability, reliability, and affordability of mechanical simulators continue to improve, COMs and OGME programs are expected to expand the use of these simulators in teaching and assessment. It is also expected that mechanical simulators, alone or in combination with standardized patients, will eventually be incorporated into high-stakes assessments of hands-on skills used for licensure and certification. 
Conclusion
The use of standardized patients and medical simulators for teaching and assessment of clinical skills at COMs has increased considerably since 2001. While the SPPs' and medical simulators' contribution to improving clinical skills and patient outcomes awaits further empirical study, the public can be assured that COMs are committing significant resources and educational efforts to enhance facilities and training programs that teach and assess the clinical skills of their graduates. 
Barrows HS. Simulated (Standardized) Patients and Other Human Simulations. Chapel Hill, NC: Health Sciences Consortium;1987 .
Yudkowsky R, Alseidi A, Cintron J. Curr Surg. 2004;61:499-503. Beyond fulfilling the core competencies: an objective structured clinical examination to assess communication and interpersonal skills in a surgical residency.
Yudkowsky R, Downing SM, Sandlow LJ. Developing an institution-based assessment of resident communication and interpersonal skills. Acad Med. 2006;81:1115-1122.
Hauer KE, Hodgson CS, Kerr KM, Teherani A, Irby DM. A national study of medical student clinical skills assessment. Acad Med. 2005;80(suppl 10): S25-S29.
Errichetti AM, Gimpel JR, Boulet JR. State of the art in standardized patient programs: a survey of osteopathic medical schools. J Am Osteopath Assoc. 2002;102:627-631. Available at: http://www.jaoa.org/cgi/reprint/102/11/627. Accessed November 20, 2007.
Commission on Osteopathic College Accreditation. Accreditation of Colleges of Osteopathic Medicine: COM Accreditation Standards and Procedures. Chicago, Ill: American Osteopathic Association; 2007. Available at: https://www.do-online.org/pdf/acc_predocomstds.pdf. Accessed November 20, 2007.
Rausa MM, Campea M. Osteopathic medical students begin clinical skills test at new testing center to help improve patient care [press release]. September 8, 2004. Available at: https://www.do-online.org/index.cfm?PageID=mc_clinskillstestbeg. Accessed November 30, 2007.
Teitelbaum HS. Osteopathic Medical Education in the United States: Improving the Future of Medicine. Washington, DC: American Association of Colleges of Osteopathic Medicine/American Osteopathic Association; 2005. Available at: https://www.do-online.org/pdf/acc_mededstudy05.pdf. Accessed December 6, 2007.
Ziv A, Wolpe PR, Small SD, Glick S. Simulation-based medical education: an ethical imperative. Acad Med. 2003;78:783-788.
Sensi S, Ben-David MF, Guagnano MT, Merlitti D, Pace-Palitti V, Danieli G, et al. Assessment of clinical competence of medical school graduates in Italy with standardized patients. The opinion of the examinees [in Italian]. Recenti Prog Med. 1998;89:575-577.
Liu M, Huang YS, Liu KM. Assessing core clinical competencies required of medical graduates in Taiwan [in Taiwanese]. Kaohsiung J Med Sci. 2006;22:475-483.
Stevens A, Hernandez J, Johnsen K, Dickerson R, Raij A, Harrison C, et al. The use of virtual patients to teach medical students history taking and communication skills. Am J Surg. 2006;191:806-811.
Institute of Medicine. To Err Is Human: Building a Safer Health system. Washington, DC: National Academies Press;2000 .
ACGME Outcomes Project: An Introduction. Accreditation Council for Graduate Medical Education Web site. 2005. Available at: http://www.acgme.org/outcome/project/OPintrorev1_7-05.ppt. Accessed November 20, 2007.
Gallagher H, Cummings M, Gilman D, McNerney J, Mogil C, Piccinini R, et al, for the AOA Core Competency Task Force. 2007. Report of the Core Competency Task Force: A Report to the AOA Board of Trustees. Chicago, Ill: American Osteopathic Association; 2003. Available at: http://www.com.msu.edu/scs/cc/docs/AOATaskForceReport.pdf. Accessed December 18, 2007.
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Table 1
Standardized Patient Programs at Colleges of Osteopathic Medicine in 2005 (N=23)

Program Status

No. (%)
Active19 (83)
In development 2 (9)
Students used as standardized patients
2 (9)
Table 1
Standardized Patient Programs at Colleges of Osteopathic Medicine in 2005 (N=23)

Program Status

No. (%)
Active19 (83)
In development 2 (9)
Students used as standardized patients
2 (9)
×
Table 2
Administration of Standardized Patient Programs at Colleges of Osteopathic Medicine in 2005* (n=21)

Program Administrator

No. (%)
Dean's office1 (5)
Department of Family Medicine 5 (24)
Department of Academic Affairs4 (19)
Curriculum and education 4 (19)
Other
7 (33)
 *Data includes colleges of osteopathic medicine (COMs) that had active SPPs as well as those that used students a patients. Data from a similar 2001 study5 reported administration only of those COMs with active standardized patient programs.
 Other program administrators included learning centers and various departments such as clinical affairs, clinical education, primary care, and primary care education.
Table 2
Administration of Standardized Patient Programs at Colleges of Osteopathic Medicine in 2005* (n=21)

Program Administrator

No. (%)
Dean's office1 (5)
Department of Family Medicine 5 (24)
Department of Academic Affairs4 (19)
Curriculum and education 4 (19)
Other
7 (33)
 *Data includes colleges of osteopathic medicine (COMs) that had active SPPs as well as those that used students a patients. Data from a similar 2001 study5 reported administration only of those COMs with active standardized patient programs.
 Other program administrators included learning centers and various departments such as clinical affairs, clinical education, primary care, and primary care education.
×
Table 3
Standardized Patient Programs as Used in the Teaching and Assessment of Clinical Skills and Topics at Colleges of Osteopathic Medicine in 2005 (n=19)


OMS*

Total
Clinical Skill or Topic
Year 1
Year 2
Year 3
Year 4
Teaching
Assessment
Complete history1211231215
Focused history 10 14 9 7 15 18
Complete physical examination129411418
Focused physical examination 11 16 12 7 16 19
Male genital and rectal examination81110138
Female genital and rectal examination 8 12 2 0 15 9
Abnormal physical findings715811114
Physician-patient communication 18 18 12 7 16 19
Patient education129741015
Behavioral medicine 7 13 7 2 12 14
OMM or OMT8131061114
Medical ethics 5 10 5 2 10 14
 Abbreviations: OMM, osteopathic manipulative medicine; OMT, osteopathic manipulative treatment.
 *Years 1 through 4 indicate year of osteopathic medical school (OMS) in which colleges of osteopathic medicine (COMs) used standardized patient programs to either teach or assess students.
 Total indicates the number of COMs that use SPPs to teach or assess each respective clinical skill or topic at any point during undergraduate osteopathic medical education.
Table 3
Standardized Patient Programs as Used in the Teaching and Assessment of Clinical Skills and Topics at Colleges of Osteopathic Medicine in 2005 (n=19)


OMS*

Total
Clinical Skill or Topic
Year 1
Year 2
Year 3
Year 4
Teaching
Assessment
Complete history1211231215
Focused history 10 14 9 7 15 18
Complete physical examination129411418
Focused physical examination 11 16 12 7 16 19
Male genital and rectal examination81110138
Female genital and rectal examination 8 12 2 0 15 9
Abnormal physical findings715811114
Physician-patient communication 18 18 12 7 16 19
Patient education129741015
Behavioral medicine 7 13 7 2 12 14
OMM or OMT8131061114
Medical ethics 5 10 5 2 10 14
 Abbreviations: OMM, osteopathic manipulative medicine; OMT, osteopathic manipulative treatment.
 *Years 1 through 4 indicate year of osteopathic medical school (OMS) in which colleges of osteopathic medicine (COMs) used standardized patient programs to either teach or assess students.
 Total indicates the number of COMs that use SPPs to teach or assess each respective clinical skill or topic at any point during undergraduate osteopathic medical education.
×
Table 4
Facilities and Equipment for Standardized Patient Programs at Colleges of Osteopathic Medicine (COMs) in 2005 (n=19)

Standardized Patient Programs

No. (%)
▪ Facilities
□ Examination rooms 19 (100)
□ Observation rooms17 (89)
□ One-way viewing glass 9 (47)
□ Separate video control room19 (100)
□ Separate entrances for standardized patients and students 4 (21)
□ Orientation and rest area for standardized patients18 (95)
□ Orientation and rest area for students 18 (95)
▪ Equipment
□ Video capabilities 18 (95)
□ Audio capabilities18 (95)
□ Osteopathic treatment tables 17 (89)
□ Nonosteopathic examination tables16 (84)
□ Sphygmomanometers 19 (100)
□ Ophthalmoscopes18 (95)
□ Otoscopes 18 (95)
□ In-room sinks
18 (95)
Table 4
Facilities and Equipment for Standardized Patient Programs at Colleges of Osteopathic Medicine (COMs) in 2005 (n=19)

Standardized Patient Programs

No. (%)
▪ Facilities
□ Examination rooms 19 (100)
□ Observation rooms17 (89)
□ One-way viewing glass 9 (47)
□ Separate video control room19 (100)
□ Separate entrances for standardized patients and students 4 (21)
□ Orientation and rest area for standardized patients18 (95)
□ Orientation and rest area for students 18 (95)
▪ Equipment
□ Video capabilities 18 (95)
□ Audio capabilities18 (95)
□ Osteopathic treatment tables 17 (89)
□ Nonosteopathic examination tables16 (84)
□ Sphygmomanometers 19 (100)
□ Ophthalmoscopes18 (95)
□ Otoscopes 18 (95)
□ In-room sinks
18 (95)
×
Table 5
Use of Mechanical Simulators at Colleges of Osteopathic Medicine in 2005 (n=12)


Simulators*
Use
Robotic
Part-Task
Surgical
Virtual Reality
Other
Skills
□ Training of procedures1010227
□ Training of psychomotor skills 8 10 3 1 6
□ Assessment of procedures89226
□ Assessment of psychomotor skills 7 9 3 1 6
□ Science teaching94221
Undergraduate
□ Year 167032
□ Year 2 10 10 2 2 8
□ Year 377115
□ Year 4 2 3 1 2 3
Graduate
□ Year 1 3 2 1 2 3
□ Years 2 through 543124
Outside Contracts
3
3
0
1
1
 *Survey respondents were asked to indicate mechanical simulator use by choosing from the following list: robotic (eg, METI HPS, ECS, PediaSIM, Laerdal SimMan), part-task (eg, intubation heads, intravenous [IV] arms), surgical (eg, endoscopic trainers), virtual reality (eg, web-based surgical simulators, Immersion), and other (eg, ventilators and defibrillators).
 Examples of procedures include emergency department protocols, anesthesia, and advanced cardiac life support, and psychomotor skills include intubation and IV insertion. Science teaching through simulators is used to reinforce preclinical and basic science concepts (eg, cardiology, physiology).
 Outside contracts are awarded to other health care professionals (eg, emergency medical technicians).
Table 5
Use of Mechanical Simulators at Colleges of Osteopathic Medicine in 2005 (n=12)


Simulators*
Use
Robotic
Part-Task
Surgical
Virtual Reality
Other
Skills
□ Training of procedures1010227
□ Training of psychomotor skills 8 10 3 1 6
□ Assessment of procedures89226
□ Assessment of psychomotor skills 7 9 3 1 6
□ Science teaching94221
Undergraduate
□ Year 167032
□ Year 2 10 10 2 2 8
□ Year 377115
□ Year 4 2 3 1 2 3
Graduate
□ Year 1 3 2 1 2 3
□ Years 2 through 543124
Outside Contracts
3
3
0
1
1
 *Survey respondents were asked to indicate mechanical simulator use by choosing from the following list: robotic (eg, METI HPS, ECS, PediaSIM, Laerdal SimMan), part-task (eg, intubation heads, intravenous [IV] arms), surgical (eg, endoscopic trainers), virtual reality (eg, web-based surgical simulators, Immersion), and other (eg, ventilators and defibrillators).
 Examples of procedures include emergency department protocols, anesthesia, and advanced cardiac life support, and psychomotor skills include intubation and IV insertion. Science teaching through simulators is used to reinforce preclinical and basic science concepts (eg, cardiology, physiology).
 Outside contracts are awarded to other health care professionals (eg, emergency medical technicians).
×