Medical education continues to evolve to meet the demands of our changing health care system. One of these is the development and implementation of competency-based medical education (CBME). The Association of American Medical Colleges (AAMC) defines “CBME as an outcomes-based approach to the design, implementation, and evaluation of education programs and to the assessment of learners across the continuum that uses competencies or observable abilities. The goal of CBME is to ensure that all learners achieve the desired patient-centered outcomes during their training.”
The demand for competent and accountable clinicians in our health care system highlights the need for a forefront clinical skills center in our School of Medicine. As an accredited medical institution, we need to demonstrate that our medical students possess the knowledge, skills, and attitudes essential to the practice of medicine. To achieve the Educational Program Objectives in Clinical Skills instruction and assessment; the CSC is designed to provide immersive training and evaluation for medical students.
The Clinical Skills Center provides a wide array of simulation technologies necessary for students to gain realistic and instructive experiences. The CSC has a simulation room with high-fidelity patient simulators and equipment, that allows learners to practice and develop clinical expertise without any risk of patient harm. It has been shown that the use of simulation shortens the time necessary to learn the skills. On the other hand, simulation-based training allows for errors to be carried to their ultimate consequences without real repercussions or harming the patient. Teaching-based simulation allows the students to receive feedback in real time in an environment that is standardized, reproducible and based on educational objectives.
The Clinical Skills Center core activities revolve around the Standardized Patient Laboratory which are essential to develop skills in physical exams, communication, taking patient histories and the other aspect of clinical practice. Standardized Patients (SP) are specifically recruited and trained with realistic case materials to portray the patient in simulated encounters accurately and consistently. Our program provides the opportunity for learners to exercise their patient care and communication skills through role playing and receiving feedback. These experiences are designed to fill the gap between learning in the classroom and real-life interactions. We believe students learn best through practice and experience. Simulated interactions between the learner and one or more SPs provide the educational opportunity to practice new or difficult situations. These simulated interactions also allow faculty to assess learners’ skills as part of their education.
The design for the space of the Standardized Patient Laboratory is eight exam rooms that are equipped with ceiling and wall-mounted cameras, multi-directional microphones, speakers, telephones, and a computer. The physical exam rooms are also equipped with wall-mounted instruments including hand disinfection area, otoscopes, ophthalmoscopes, materials to perform physical examinations, and an exam table, to replicate typical exam rooms and orient students to a clinical-care environment. Inside each exam room is a writing station with a computer where learners can complete post-encounter exercises electronically such as documenting progress notes to gain valuable experience for when they use electronic medical records (EMRs). The Standardized Patient Laboratory utilizes technologies composed of an infrastructure of more than thirty-two internet protocol video cameras connected to a video capture server, in order to monitor the clinical exams.
The simulation room has Laerdal High-fidelity patient simulators: Sim-Man and Sim-Baby simulators that are wireless, self-contained mannequins controlled remotely. This gives learners a chance to manage all facets of patient care scenarios, pharmacological interventions and responses, and airway management.
On the other hand, to reinforce physical examination skills, the CSC also has the Anatomical Models Laboratory (Low-tech simulators). They are simple mechanical, plastic, or synthetic simulators (models or mannequins) to practice clinical skills or basic clinical procedures such as lancing veins, tracheal intubation, rectal examination, breast examination, sutures, punctures, gynecological examinations, urological, etc.