Clinical Skills Center

Within each exam room are two 360-degree, ceiling-mounted cameras, omnidirectional hanging ceiling microphones, one desktop computer, one manual medical examination table, wall-mounted equipment and a bedside ultrasound machine. At each monitor station is one desktop computer, one headset and microphone, and a one-way glass window that allows the monitor to view exam rooms live. Three of the seventeen exam rooms reflect the design of an acute care unit, containing suction devices, oxygen masks, and other gases.
 
The monitor stations and the command center have one-way audio and visual capabilities. Through the use of speaker systems, overhead announcements reach the participants within the exam rooms without substantially interfering with the clinician-patient interaction.
 

The Standardized Patient Program serves as the core of the Clinical Skills Center’s activities, managing over one hundred Standardized Patient (SP) events annually. Students practice taking histories, performing physical exams, communicating with patients, and developing differential diagnoses and plans of care both in person and virtually. The SP Program supports all four years of Medical School.

To facilitate the UC Irvine School of Medicine’s iMedEd iPad Initiative, a method which has pioneered a new approach to centralizing where students can access their educational content, students are encouraged to bring their devices to teaching sessions in the Center. This allows for students to reference supplemental learning materials that enhance their own knowledge as well as the patient’s.

Additionally, Ultrasound Standardized Patients are utilized for Ultrasound Education. Within the seventeen exam rooms, Ultrasound and Clinical Skills are often working side by side to support the students’ medical education. 

A Standardized Patient (SP) is an individual trained to simulate a patient with a clinical condition. Published research has demonstrated the efficacy of utilizing SPs to improve students’ clinical competence. The SP Program exposes students to a variety of illnesses and patient backgrounds in an educational environment, so that students are able to gain valuable experience in the clinician-patient interaction.

SPs must have the ability to memorize a patient’s history, reproduce physical traits, accurately recall facts, and think critically in order to respond appropriately in simulated scenarios. If you are interested in becoming a Standardized Patient, please complete the Standardized Patient Form at the bottom of this page.

Please see the frequently asked questions below for more information. For all other questions, please contact mededcsc@hs.uci.edu.

The UC Irvine School of Medicine's Clinical Skills, Simulation and Ultrasound Center is the heart of our longitudinal MS1 and MS2 clinical skills curriculum that includes both education and assessment, as well as our MS3s clinical skills education and OSCE assessments and MS4 transition to residency course. Students begin their 4-year long journey into clinical medicine in the center the first week of MS1 year with a kickoff “Clinical Skill Boot Camp” designed to be an immersive doctoring experience which includes a multi-station patient course with standardized patients, simulation, procedure training and culminates in a debrief with our clinicians and basic sciences course directors. As MS1s and MS2s, students spend Tuesday and Thursday afternoons in the CSC and SIM Centers working in small groups of 3 to 5 students with Dean’s Scholars (faculty physician mentors with extensive experience in clinical skills education). The curriculum is designed to give MS1 and MS2 students a longitudinal experience in patient care and aligns with their basic science course work. 

As MS1s, students learn the intricacies of taking a patient history, followed by a series of systems-based modules. In each module, the MS1 students begin by learning a system-specific physical exam, followed by a standardized patient case in our Clinical Skills Center. Students will then see the same patient in the Simulation Center, where that patient’s disease process will have progressed, and will also learn that system’s ultrasound exams. For many cases, the student will then follow that patient into a small group, team-based learning session. MS1 systems include: History, Cardiovascular, Gastrointestinal, Pulmonary, HEENT, Neurology and Musculoskeletal. Midway through the MS1 year, students begin to work through the “Top Ten Family Medicine Chief Concerns.” MS1 students see patients with Flank Pain, Dizziness and Headaches. As MS2s, students continue with the “Top Ten Family Medicine Chief Concerns” as students see standardized patients with Back Pain, Fever, Fatigue and Edema, Chest Pain, Dyspnea, Abdominal Pain that progress as simulation cases and chief concern specific ultrasound, ultimately culminating in small group case discussions. This longitudinal patient case style curriculum ensures that students develop their physical exam skills, communication skills and clinical reasoning skills in a progressive, additive manner with close physician mentorship and feedback via our Dean’s Scholars.  

MS3 and MS4 students return to the UC Irvine School of Medicine's Clinical Skills Center and Simulation Center for clerkship simulation sessions, procedural skills and OSCEs. Our clinical curriculum assessment consists of Internal Medicine, Ob/Gyn, Family Medicine, Neurology, Surgery, and Pediatrics OSCEs. After completion of their core clerkships, students participate in the Clinical Performance Examination (CPX) which is a standardized patient examination administered to all M.D. medical students in the state of California. The examination is a standardized patient-based clinical skills assessment; demonstration of at least minimum competency on this exam is a requirement for graduation. It is designed by a consortium of clinicians and medical educators from 10 California medical schools to assess clinical skills that are essential to the practice of medicine, regardless of specialty, and is the culmination of their longitudinal clinical curriculum. 

The mission of the Standardized Patient Program is not only to have a patient actor realistically convey an illness to a student, but rather to convey it in a consistent and measurable way.

Ten SPs can be trained to do the same clinical case. No matter which SP interacts with the student, he or she would receive the same information and responses while still interacting with each student.

This allows us to accurately teach and assess students according to one standard per case.

No. Some SPs are trained and experienced actors, but most are not.

You can be a very good SP without ever having been on stage or in a movie.

You may find it different than working from a script, and you may find it frustrating. This work has nothing to do with finding dramatic moments or playing to an audience. 

It can be very repetitive to play the same "patient" with every student.

In addition to portraying the case, the SP needs to observe the behavior of the learner, sometimes needing to remember questions asked or physical exam maneuvers performed, in order to complete a checklist after the student exits the room.

This work also is confidential and you will not be permitted to share this material or use it in any public or private performance.

Yes. Students are told they will be working with SPs. But they are told to behave as though they are with real patients.

Sometimes. If the students are only required to interview the patient, then you will not.

However, in some situations, you will be undergoing a physical examination. For that you would be dressed in a hospital gown, with underwear on underneath. You would know beforehand when this would be expected.

You would take part in very common examinations. For example, students may:

• Listen to your heart and lungs with a stethoscope
• Press on your abdomen looking for tenderness or swellings
• Examine your eyes, ears and throat
• Take your blood pressure
• Assess your muscle strength
• Check your reflexes, pulses, etc.

We create a complete history for you to learn. It includes:

• The reason the patient comes to see the doctor
• His/her past medical history
• Details about his/her life, such as employment, family and activities 

You are taught to portray the emotional state the patient is in during the encounter. We also show you how to move like the patient and how to react to the physical examination.

For example, you may be portraying someone with a bad back. We would show you where it should hurt and what the patient could or could not do because of the back problem. 

Sometimes an individual has a condition that would be very helpful to the student.

If you have a current medical condition, please indicate that on the patient profile form. We will consider this for the faculty-led teaching sessions.

We are looking for men and women of all ages, physical types, ethnic groups and backgrounds to represent various types of patients.

We need individuals who are strong communicators, who can learn quickly, accept direction and adapt easily to a variety of different situations.

Typically, an SP meets with a trainer for a specified amount of time, depending on the complexity of the case and the SP’s experience.

Certain cases require the SP to record a student's performance on an assessment tool (checklist), which will require additional training.

No. We will teach you what you need to know to accurately portray a case.

That is difficult to predict. You will be contacted and scheduled according to the needs of the School of Medicine curriculum, the case being portrayed and — of course — your availability.

There are no guarantees about the types of cases that are available, and some individuals are not suited for certain roles.

You may be scheduled only a few hours over the course of several months or none at all. Alternatively, you may be perfect for a case or cases that play frequently.

SPs receive compensation, both for training time and performance time. SPs also receive compensation for any teaching sessions they may be involved in.

Characteristics we look for are:

• A positive attitude, given the repeated examinations
• No biases over gender, race, religion, national origin or physical characteristics
• Reliability and punctuality
• A person who understands the need for confidentiality
• Someone who is comfortable dealing with healthcare professionals

Being an SP is not for everyone. If you are performing a case, it requires intense concentration while you are at times being interviewed and examined by as many as eight to 10 students in succession.

Being an SP requires energy, discipline and concentration:

• You must be able to respond exactly as the real patient would, and only as that patient, never as yourself.
• You also must be able to maintain not only the patient’s character, but also simulate his or her physical condition during the interview and examination, and do so repeatedly in a consistent manner.
• You may be required to accurately recall the encounter and assess how that student impacted you as the patient.

Being an SP is unusual and interesting work. Most SPs report great satisfaction. Hopefully, we have answered some of your questions to better help you understand what is involved.

Please complete the application through the SP Profile Form linked below. Don’t be concerned if we don’t contact you right away. We will keep your application on file for future needs.