DEVELOPMENT OF A STANDARDIZED PATIENT PROGRAM IN A DOCTORAL PHYSICAL THERAPY CURRICULUM. Susan Paparella-Pitzel* Developmental and Rehabilitative Science , UMDNJ , Newark, NJ UNIQUE: A standardized patient is either an actor who simulates a patient case or an actual patient who has been carefully trained to represent a patient case in a standardized, unvaried way. Standardized patients (SP) have been widely used in medical and nursing programs, but their use in physical therapy education has not been well documented. The University of Medicine and Dentistry of NJ (UMDNJ) Doctoral program in P.T. threads standardized patients across clinical courses to augment traditional teaching and testing methods. The unique format used in the encounters pairs the student physical therapist (SPT) with a standard patient, and a faculty member who portrays the role of a clinical instructor (CI) rather than the traditional role of faculty examiner. The primary goals of the standard patient encounters were to challenge and refine clinical skills and professional behaviors. Outcomes of these goals were evaluated through direct feedback from the standard patients, grading from faculty portraying the role of the clinical instructor, and student self-assessment. PURPOSE: The purpose of this presentation is to provide educators and clinicians with information regarding the development of a standardized patient (SP) program and its significance and value in a DPT curriculum. FOUNDATION: In response to the transition from an MSPT to a DPT degree and to the changes in the clinical environment's expectation of student performance, curriculum development in this program focused on expansion of clinical skills and professional behaviors as well as the addition of new DPT level courses. Although the use of SP's in physical therapy curriculums is in its very early stages of development, the effectiveness of SP's as a method for teaching clinical skills is well supported in the medical literature. SP's provide structured opportunities for demonstration of clinical cases, formative learning and summative evaluation of learning. The ultimate goal in implementing the SP program was to facilitate the student's transition from the classroom to the clinic. DESCRIPTION: The development of the standardized patient program was conducted in four phases. The first phase included case writing, implementation of a "mock clinic" during first year of course work, and coordination with faculty members for case links to course work. The second phase consisted of modifying the practical testing format, implementing new cases in the second year, and developing and refining feedback methods and student self assessment. In phase three, prior course work was integrated into a standard patient case for a final encounter in the semester prior to clinical experiences. In the fourth phase, student self assessment was refined, and the SP encounters were video taped and reviewed with the students. Presently, there are a total of four standard patient encounters. Newly proposed encounters are being developed for use in classroom demonstration and practical testing. OBSERVATIONS: Observations and responses are summarized from the standard patients, the students and the faculty. The standardized patients that participated in these encounters were experienced in the process as they had also participated in various medical and dental school OSCEs. Standardized patients reported on the training required for the DPT encounters. It is noted by the SP that the DPT encounter training required more focused portrayal and enactment of physical signs and symptoms versus verbal reporting that is prevalent in the OSCE. A new skill for the SP's was that their feedback to the students required comments pertaining to manual skills and handling techniques. The SP's noted that the length of the DPT encounters was longer; approximately 30 minutes per session as compared to 10-15 minutes of testing in the traditional OSCE. Finally the standard patients collectively noted the progressive development of the students' skills over the course of the three year program and related encounters. Student comments, collected from post-encounter evaluations and interviews, included that they studied from prior course material and multiple sources in order to prepare for the mock clinic encounters. The use of faculty members in the role of the CI necessitated the utilization of additional communication skills and was often commented on in the feedback sessions as being a challenge. The majority of the students perceived the portrayal of the cases as realistic and that the encounters were beneficial for the practice and opportunity to apply interventions in a continuous sequence, while managing the other variables inherent to patient care. By using a SP instead of a faculty member portraying the scenario, the student perception upon entering the encounter was directly reflective of the experience of meeting a "real" patient for the first time. Faculty report on the use of standardized patients as a useful method to assess the level of integration of both communication and manual skills. A standard patient encounter, combining linked course material within a semester, provided all the instructors involved in that semester with the opportunity to assess trends in learning as well as areas of deficiency. Finally, the SP encounters provided the opportunity for the course instructor to give direct feedback on a clinical performance representing curriculum content and compare this feedback with the student's self-assessment. CONCLUSIONS: The initial development and execution of a standard patient program in a DPT curriculum appears to provide a systematic method to help the student transition from the classroom to the clinic. Further investigation is needed to explore in depth the benefits and effects of using SP's in educational programs. FUNDING SOURCE: N/A KEYWORDS: professional behavior, standardized patient, clinical skill Copyright 2009 by the American Physical Therapy Association. Requests for reprints should be directed to the corresponding author of the article. 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