title: Students' views on the use of real patients and simulated patients in undergraduate medical education.
abstract: OBJECTIVE
  To determine students' views about the strengths and weaknesses of real patient interactions as opposed to simulated patient (SP) interactions in the undergraduate medical curriculum in order to evaluate how their strengths can be optimally used and weaknesses remedied.
  
  
  METHODS
  Five focus-group interviews were conducted among fourth- and fifth-year medical students at Maastricht University in 2007, using a preestablished interview guide. The interviews were recorded, transcribed, and analyzed using qualitative methods.
  
  
  RESULTS
  In general, the 38 participants considered real patient encounters more instructive and more authentic than SP encounters. However, students identified several strengths of SP encounters compared with real patient encounters. For example, SP interactions were helpful in preparing students for real patient interactions (particularly with regard to communication skills and self-confidence), in the teaching of "intimate" physical examination skills, such as gynecological examination skills, and in giving constructive feedback on communication skills. In contrast to what we had anticipated, taking a time-out was considered easier in real patient interactions.
  
  
  CONCLUSIONS
  Both real patient interactions and SP interactions are considered indispensable to undergraduate medical education. Each encounter has unique strengths and weaknesses from the perspectives of students. On the basis of strengths and weaknesses that were identified, suggestions were made for the use of real patients and SPs in undergraduate medical education.
authors: Department of Educational Development and Research, Faculty of Health, Medicine, and Life Sciences, Maastricht University, Maastricht, the Netherlands. L.Bokken@EDUC.unimaas.nl
authors: Lonneke
authors: L
authors: Bokken
authors: Jan-Joost
authors: JJ
authors: Rethans
authors: Lonneke
authors: L
authors: van Heurn
authors: Robbert
authors: R
authors: Duvivier
authors: Albert
authors: A
authors: Scherpbier
authors: Cees
authors: C
authors: van der Vleuten
mesh_terms: D001291:Attitude of Health Personnel; D002982:Clinical Clerkship; D002983:Clinical Competence; D003142:Communication; D003479:Curriculum; D004504:Education, Medical, Undergraduate; D005246:Feedback; D017144:Focus Groups; D006801:Humans; D009426:Netherlands; D016544:Patient Simulation; D010808:Physical Examination; D010817:Physician-Patient Relations; D013337:Students, Medical / Q000523:psychology*