Standardized patient simulation is frequently used in undergraduate and graduate medical education for training and assessment. The value of this tool has not been widely demonstrated in infectious diseases (ID) fellowship training.
Four standardized clinical scenarios were developed to assess knowledge and skills pertinent to ID care. These cases included: newly diagnosed HIV infection; latent tuberculosis infection; fever in a returned traveler; and orthopedic infection with retained hardware. Simulations were performed with standardized patients in the Vanderbilt Center for Experiential Learning and Assessment. First and second year ID fellows were evaluated in April of the 2012-2013, 2013-2014, and 2014-2015 academic years as a component of ID fellowship. An ID faculty member observed each fellow simulation and then provided feedback. Faculty evaluated fellow performance on individual tasks using a five-point Likert scale (1 for poor, 3 for adequate, 5 for excellent). Fellow performance was measured quantitatively based on individual task performance. Qualitative feedback was also provided verbally and recorded in comment form.
Between 2012 and 2015, 18 fellows were assessed by standardized patient simulation. Two cases were used each year; as such, multi-year data is only available from the 2012-2013 and 2014-2015 academic years. In the scenario in which fellows counseled a patient with newly diagnosed HIV, fellows performed well (task assessment mean 3.75-4.63) with the exception of screening for depression and suicidal ideation and inquiring about coping mechanisms and support systems (mean 2.85, median 2.5, range 1-5). In the scenario in which fellows evaluated a patient diagnosed with latent tuberculosis infection, fellows performed well (task assessment mean 3.88-4.65) with the exception of screening for HIV and other immunosuppressed conditions (mean 3, median 3, range 1-5). The identification of these educational gaps has led to program interventions. Simulation was accepted as an educational and assessment tool by both ID fellows and faculty.
Standardized patient simulation provides an additional tool for ID fellow assessment as well as fellowship program evaluation.
L. Rawn, None
P. Wright, None
A. Person, None