Williams Brent C, Hall Karen E, Supiano Mark A, Fitzgerald James T, Halter Jeffrey B
Department of Internal Medicine, Divisions of Geriatric Medicine and General Medicine, Ann Arbor Veterans Affairs Healthcare System, Ann Arbor, Michigan, USA.
J Am Geriatr Soc. 2006 Sep;54(9):1447-52. doi: 10.1111/j.1532-5415.2006.00857.x.
Professional societies have called for increased geriatrics training for all medical students and physicians. A Geriatrics Standardized Patient Instructor (GSPI) was developed in which learners assess the functional status of a patient preparing for hospital discharge. Standardized patients (SPs) rate learners on functional assessment and communication skills, and provide feedback. Seventeen SPs were trained. Correlations of ratings by SPs with ratings by three geriatricians of videotaped encounters indicated good reliability (correlation coefficient = 0.69 and 0.70 for functional assessment and communication skills, respectively). Results from two learner groups illustrated the utility and feasibility of the GSPI. First, 138 house officers in nine specialties experienced the GSPI as a formative evaluation during implementation of new geriatrics curricula. Mean scores+/-standard deviation (on a 100-point scale) for functional assessment and communication skills were 78+/-16 and 86+/-11, respectively. House officers rated the overall experience positively (mean rating (1 = poor, 5 = excellent) 3.9+/-0.8). Second, 171 first-year medical students (M1 s) encountered the GSPI as part of an intense, multimodal educational intervention. Mean scores on functional assessment and communication skills were 93+/-10 and 93+/-7, respectively. Mean overall rating of the experience by M1 s was 4.1+/-0.8. After demonstrated success as a teaching tool in these two groups of learners, the GSPI has been successfully used with second- and third-year (M3) medical students and house officers from a total of 12 specialties and incorporated into multistation Objective Standardized Clinical Examination exercises for incoming house officers and M3 s. Unlike existing diagnosis-oriented SPs, the GSPI can be used to assess and teach geriatrics skills to physician learners across disciplines and levels of training.
专业协会呼吁为所有医学生和医生增加老年医学培训。为此开发了一种老年医学标准化患者指导教师（GSPI），让学习者评估准备出院患者的功能状况。标准化患者（SP）对学习者的功能评估和沟通技巧进行评分，并提供反馈。培训了17名标准化患者。标准化患者的评分与三位老年病医生对录像会诊的评分之间的相关性表明可靠性良好（功能评估和沟通技巧的相关系数分别为0.69和0.70）。两组学习者的结果说明了GSPI的实用性和可行性。首先，九个专业的138名住院医师在新的老年医学课程实施期间将GSPI作为一种形成性评估。功能评估和沟通技巧的平均得分±标准差（满分100分）分别为78±16和86±11。住院医师对总体体验给予了积极评价（平均评分（1=差，5=优秀）为3.9±0.8）。其次，171名一年级医学生（M1）将GSPI作为强化多模式教育干预的一部分。功能评估和沟通技巧的平均得分分别为93±10和93±7。M1对该体验的平均总体评分为4.1±0.8。在证明作为这两组学习者的教学工具取得成功后，GSPI已成功应用于来自总共12个专业的二、三年级医学生（M3）和住院医师，并纳入了针对新入职住院医师和M3的多站客观标准化临床考试练习中。与现有的以诊断为导向的标准化患者不同，GSPI可用于跨学科和培训水平向医生学习者评估和教授老年医学技能。
