title: Standardized patients for HIV/AIDS training in resource-poor settings: the expert patient-trainer.
abstract: This article presents a unique approach to HIV/AIDS training in resource-poor settings that incorporates the use of standardized patients (SPs). Integrated Management of Adolescent and Adult Illness (IMAI) is a World Health Organization health systems strengthening initiative with a strong emphasis on training health workers in the management of common diseases and conditions. In IMAI, SPs are called Expert Patient-Trainers (EPTs) to emphasize their role in the training of health workers. EPTs were first used in IMAI training in Uganda in 2004. Since then, the method has been adopted by a number of other countries in Africa, Latin America, and Asia. EPTs are usually recruited from groups of people living with HIV/AIDS. In the classroom, EPTs discuss living with HIV and help participants understand HIV as it affects patients. Course participants spend approximately two hours per day in "skill stations," multiple-station assessments consisting of one-on-one encounters with EPTs. In each encounter, the health worker interacts with an EPT portraying a standardized case. Instructions on how to portray each case provide only broad outlines of the major clinical and counseling points; the EPT is expected to use his or her own life experiences to fill in emotional details. Course facilitators noted that health workers were often initially skeptical about EPTs, but this generally turned to enthusiasm after participating in the skill stations. EPTs benefited from the sense of being part of the training team, the satisfaction of improving the skills of health workers, and learning more about their illness.
authors.affiliation: Harvard Medical School, and Division of Global Health Equity, Brigham and Women's Hospital, Boston, Massachusetts 02115, USA. kj@seung.com
authors.forename: Kwonjune J
authors.initials: KJ
authors.lastname: Seung
authors.forename: Akiiki
authors.initials: A
authors.lastname: Bitalabeho
authors.forename: Lydia E
authors.initials: LE
authors.lastname: Buzaalirwa
authors.forename: Emma
authors.initials: E
authors.lastname: Diggle
authors.forename: Moher
authors.initials: M
authors.lastname: Downing
authors.forename: Mona
authors.initials: M
authors.lastname: Bhatt Shah
authors.forename: Benon
authors.initials: B
authors.lastname: Tumwebaze
authors.forename: Sandy
authors.initials: S
authors.lastname: Gove
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000175:diagnosis / Q000188:drug therapy; D044966:Anti-Retroviral Agents / Q000191:economics / Q000627:therapeutic use; D003479:Curriculum; D015658:HIV Infections / Q000175:diagnosis / Q000188:drug therapy; D006282:Health Personnel / Q000193:education*; D006295:Health Resources / Q000600:supply & distribution*; D006801:Humans; D010353:Patient Education as Topic; D016544:Patient Simulation
chemical_list: D044966:Anti-Retroviral Agents