The effectiveness of unannounced standardised patients in the clinical setting as a teaching intervention.
OBJECTIVE
Teaching medical students to spontaneously identify biopsychosocial issues (e.g. family violence) remains a challenge. We examined the extent to which using unannounced standardised patients (SPs) presenting in a clerk's clinical setting could assist with this teaching challenge.


METHODS
All clerks attended a family violence seminar in their family medicine rotation. Intervention students additionally saw an unannounced SP portraying 1 of 2 scenarios in their preceptor's office during the rotation, and received immediate feedback about their performance. An end of rotation objective structured clinical examination (OSCE) included an SP presentation similar to that seen by the intervention students.


RESULTS
Clerks who received the intervention demonstrated increased questioning about family violence, from 0% (0 of 29 students) to 19% (5 of 26 students) in 1 OSCE scenario (P = 0.019), and from 40% (12 of 30 students) to 76% (19 of 25 students) in the other (P = 0.007).


CONCLUSIONS
Seeing unannounced SPs had a dramatic effect on later student performance. This potentially powerful intervention could be applied to a range of clinical issues.
Undergraduate Education Programme, Faculty of Medicine, Sunnybrook and Women's Health Sciences Center, University of Toronto, 2075 Bayview Avenue, Toronto, Ontario, Canada M4N 3M5. Debra.Elman@utoronto.ca
Debbie
D
Elman
Rosalie
R
Hooks
Diana
D
Tabak
Glenn
G
Regehr
Risa
R
Freeman
D002983:Clinical Competence / Q000592:standards; D003142:Communication; D017579:Domestic Violence; D004504:Education, Medical, Undergraduate / Q000379:methods*; D006801:Humans; D016544:Patient Simulation; D013337:Students, Medical; D013663:Teaching / Q000379:methods