Tools of Learning

The tools of patient-context teaching and learning rely heavily, if not exclusively, on highly interactive methods, such as clinical clerkships in which students gain firsthand experience in clinical settings with real patients. Earlier clerkships are planned in the new curriculum to begin this experience sooner in students’ training.

Student Dara Spearman with standardized patient Jin-Chen Cheng Photo: Martin Vloet

Faculty members also identify learning outcomes and educational experiences that provide students with opportunities to learn and get feedback on the knowledge and skills they are developing in the delivery of health care in different sociocultural contexts. Small-group facilitated discussions provide students with opportunities to share ideas and experiences. Interactive, patient-based computer programs reinforce and provide additional sources for student learning.

Another method of learning, the Standardized Patient Program, in which trained individuals portray, often with astounding realism, patients presenting any variety of symptoms, illnesses or complaints, is another way in which Michigan is a leader. “We have one of the most robust Standardized Patient Programs in the country,” says Joe Fantone, “and along with the Comprehensive Clinical Assessment, it is one of the ways U-M has been in the forefront of patient-based learning.”

“Standardized patients are recruited through the clinics,” explains Casey White. Physicians will find a patient who’s interested in participating and recommend them to the Program. The Medical School also advertises, and word-of-mouth is very effective.

“The ‘patients’ are very committed to patient care and medical training,” White says. “We train them not just to simulate, but to actually evaluate and provide feedback to students.”

David Stern Photo: D.C. Goings

The Standardized Patient Program, highly regarded by faculty and students alike, is likewise well regarded as a model nationally. According to Director David Stern, M.D., Ph.D., associate professor of internal medicine and medical education, "While about half of all medical schools have a single or a few standardized patient experiences, Michigan is a national leader with each medical student encountering about 16 different standardized patients over the four-year curriculum. In addition, our patients help students by providing feedback on both content of the student’s evaluation and how it was communicated, so students learn firsthand from patients how to improve their communication skills. The students and faculty see this as one of the unique strengths of our educational program, supported by the dean for over 10 years.

“We have a longstanding interest,” Stern says, “in training a diverse group of patients for all roles throughout the curriculum. Our overriding goal is to provide students with an opportunity to practice difficult communication skills in a controlled setting, so they can become effective communicators with patients in the clinic and hospital settings they’ll one day work in as physicians."

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Medicine for a New Millennium