Teaching Clinical Skills
Applying knowledge learned in the classroom to the actual care of patients can be a major and difficult transition for students in medicine and other healthcare professions. At Drexel University College of Medicine, the state-of-the-art Barbara E. Chick, MD '59, Clinical Education Assessment Center (CEAC) provides a custom-designed setting where students can learn, practice and be evaluated on the skills they will need to communicate and work effectively with patients. The CEAC is also an ideal facility for continuing education for physicians and other practicing health professionals.
The CEAC has 10 fully equipped exam rooms surrounding a centrally located control room. In these exam rooms, which replicate a physician's examining room or a hospital room, trainees work with specially trained "standardized patients." Faculty observe their interactions through one-way glass windows, and can communicate with the trainee or patient by intercom.
Each room is equipped with a color video camera. Video can be transmitted to a separate observation room, where a faculty member can view multiple patient-trainee encounters on a bank of monitors. (Professional development programs at the College use this arrangement to teach clinical skills evaluation to faculty members.) The technology also enables faculty at any of our campuses to serve as evaluators through our videoconferencing system.
The medical students' clinical skills videos are maintained in a database over their four years of medical school, enabling them to observe their performance and improvement over time. Faculty members review these videotapes with students to provide feedback on their clinical development.
Recent computerization and installation of advanced audiovisual equipment has made the CEAC one of the most sophisticated facilities of its kind in the world. The patient and trainee activity checklists are computerized, thus providing timely, valuable feedback with printed score reports, often within an hour.
Using Standardized Patients
Standardized patients are volunteers who are specially trained to act as patients. They serve as a resource for teaching and evaluating clinical skills, including physical examination, communications, history-taking, patient counseling and patient education. Each standardized patient is given a specific medical complaint or role, and is taught how to give a medical history and to undergo a physical examination. Some of the symptoms and physical findings of these "patients" are real, while others are simulated.
A professional trainer and faculty members prepare standardized patients for their roles. Standardized patients are able to assist in both teaching and evaluation of students. They are also trained to provide constructive feedback regarding the completeness and style of the "doctor-patient" encounter.
Using standardized patients also provides an opportunity to create simulations of duties that are difficult to handle, such as notifying the family when a patient dies or coping with an angry patient. This practice helps prepare trainees for real-life events, without adverse consequences for themselves or the patient.
Learn more about the Standardized Patient program
A variety of programs at all educational levels use the Clinical Education Assessment Center.
- Medical students begin training in the CEAC in their first year, learning the basics of patient interviewing and physical examination skills. Comprehensive clinical skills training continues throughout the four years, including a fourth-year Clinical Practice Examination to assess clinical skills competency prior to graduation.
- Residency programs use the CEAC to determine the skill levels of incoming residents and to hone skills in specific areas.
- A 10-station OSCE (objective structured clinical exercise) is administered as continuing education for practicing physicians. Determining the learning needs of specialist physicians who plan to retrain as generalists is another use of the CEAC.
- Similar types of programs have been developed or are in development for nursing and other allied health professions students.
- The CEAC has many other academic purposes. For example, a series of videotaped case vignettes is used to stimulate discussion in faculty development programs. Another program utilized CEAC to educate health care providers about the special needs of patients with spinal injury. The design of the CEAC in combination with the Standardized Patient Program provides an extremely useful and adaptable teaching and assessment tool.
- Other medical schools in the region and other programs use our CEAC for training and assessment in collaboration with members of the Clinical Skills Education and Assessment Division. Members of the division also act as consultants to other schools nationwide, advising them on the development of similar programs or facilities.
Contact the Clinical Education Assessment Center
For more information, please contact the director of clinical skills education and assessment at:
Office of Educational Affairs
Drexel University College of Medicine
2900 W. Queen Lane
Philadelphia, PA 19129