350 OBSTACLES TO EVALUATING RESIDENTS USING UNANNOUNCED STANDARDIZED PATIENTS. (10th December 2015)

• Record Type: Journal Article
• Authors: Lineberry, M. J.; Wilson, J. F.; Gibson, J. S.; Griffith, C. H.; Haist, S. A.
• Is Part Of: Journal of investigative medicine. Volume 53:Number 1(2005)
• Page Start: S315
• Page End: S315
• Publication Date: 2015-12-10
• Subjects: Clinical medicine -- Periodicals; Medicine -- Research -- Periodicals; Medicine; Research -- United States; Clinical medicine; Medicine -- Research; Periodicals; 616.075
• DOI: 10.2310/6650.2005.00006.349
• Languages: English
• ISSNs: 1081-5589

Abstract

Abstract : Purpose: Clinical performance of residents is typically assessed by attending physicians. The patient's perspective may provide important evaluative information, but typical patient satisfaction scores provide only general feedback. This study's aim was to investigate barriers to an alternate approach: using unannounced standardized patients (USPs) to evaluate residents in a clinic setting. Methods: 30 internal medicine residents participated in a 2-hour workshop utilizing USPs. In the 7 months following the workshop, residents saw 2 USPs presenting with domestic violence (DV) in clinic. Residents' clinical performance was evaluated by USPs immediately following the encounter. Project researchers recorded qualitative data regarding barriers to introducing USPs, supplemented by post-study interviews with residents and USPs. Results: Recruitment of novel USPs unknown to residents, creation of realistic clinic charts and information, and scheduling were major logistical problems. Recruitment of residents was more difficult than comparable workshop studies that did not include USPs. Uncertainty and a degree of performance anxiety about the open-ended aspect of evaluation through clinic USPs characterized resident attitudes. Residents were sensitized to USPs, attempted to identify USPs in advance, and talked with each other about USPs, even though the evaluation was research related. Conclusions: Logistics of USPs, integrating USPs realistically into clinic scheduling and medical records systems, resident attitudes, sensitization of residents to USPs, and longitudinal contamination were major barriers to implementation of USPs in a clinic setting. Despite barriers, USPs may provide a unique dimension for evaluation of resident clinical performance.