Standardized Patient Checklist

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Checklist

John Harrison 88 y.o.
 


 
Your Name ______________________ Resident Name _____________________

 

GLOBAL RATING

  1. John Harrison was satisfied with this resident physician encounter. YES NO

COMMENTS:

 

Your response to this item should be as “John Harrison” would respond – NOT as you, the standardized patient, would respond knowing what the resident is being tested on in the checklist.

YES

  • You feel you would come back to this resident physician for the rest of your care.
  • You feel this resident was helpful OR will be able to help you (in your total care).
  • You feel that the resident tried to understand your beliefs and expectations about driving and living independently.

NO

  • You feel anything in the encounter with the resident would negatively impact Mr. Harrison significantly enough to cause him to consider seeing someone else for his care.
  • You feel that the resident made recommendations, but did not try to listen to your thoughts and ideas about driving and living independently

Your response on this item might not add up to the responses you will make on all of the other items on the checklist. That is fine. This item is included so that you can make a global assessment based on your own feelings about the encounter.

In addition, please keep in mind that these are resident physicians who are still in training, NOT seasoned physicians. You should not be comparing their performance to your previous experiences with practicing physicians.

HISTORY

***General principle in dealing with MULTIPLE QUESTIONS buried in a single student question:

Example: Do you drink alcohol or do you do any drugs?

  • Answer only the LAST question asked.
  • Give credit on the checklist for ONLY the questions you answer.

Please record how the resident elicited the following information:

  1. The resident asked about general well being and recent health. (“I suppose fine for my age. My hearing is going, and it is hard to read. I need a nap every afternoon – and I have to be really careful not to fall.”)

DONE CORRECTLY        DONE INCORRECTLY        NOT DONE

DONE CORRECTLY: The resident asked something like: “How have you been feeling lately?”

DONE INCORRECTLY: The resident used a closed ended question such as “So, you are doing fine, are you?” or s/he asked how you were but did not give you time to answer.

  1. The resident asked about visual changes (“I see the eye doctor regularly – and those 2 cataracts taken off. I’m sure I don’t see as well as I used to.”)

DONE CORRECTLY        DONE INCORRECTLY        NOT DONE

DONE CORRECTLY: The resident asked if you have had any changes in your vision, or “How your vision is now?”

DONE INCORRECTLY: The resident asked only if you were seeing an eye doctor.

  1. The resident asked about my beliefs, ideas, feelings or expectations about my independence. (“It is important for me to remain independent. If I stop driving, I can’t live on my own. I will stop driving when I think I am not safe anymore. I think my son should not have contacted you.”)

DONE CORRECTLY        DONE INCORRECTLY        NOT DONE

DONE CORRECTLY: The resident asked you how you felt about driving or if you had any concerns about your driving or shared your son’s concerns about your driving and asked you what your thoughts were about that.

DONE INCORRECTLY: The resident confronted you about your driving, e.g. “It is not safe for you to drive, and you should stop.” This could also be a matter of tone – were the questions asked in a spirit of exploration or judgment?

  1. The resident asked about the amount of support I have available in my home. (“Marion was really the person who kept us connected to folks, you know? My son comes every week, and he calls about every day. I know my neighbors, but I don’t see ‘em much – I don’t get out much. It’s hard for me to talk on the phone, so I don’t do that much anymore. My dog Champ keeps me company though – he’s a good dog.”)

DONE CORRECTLY        DONE INCORRECTLY        NOT DONE

DONE CORRECTLY: The resident asked about help or support you had available in your neighborhood or home.

DONE INCORRECTLY: The resident only asked about whether your son’s visits.

  1. The learner asked me how not driving would affect my ability to live alone. (“I need to drive to get my groceries, pay some bills, and go to church. I can’t be relying on people all the time to take care of me.”)

DONE CORRECTLY        DONE INCORRECTLY        NOT DONE

DONE CORRECTLY: The resident asked you about the relationship between driving and living alone, or how not driving would affect you.

DONE INCORRECTLY: The resident only asked about the places you went when you drove.

  1. The resident asked about your goals related to driving – is it more important that you drive so you can get out and do things or more important that you drive so that it helps you live independently in your home. (“I guess I never thought about it. It’s not like I enjoy driving anymore – I really have to be very careful, and I worry about getting in an accident. I don’t think I can stay in my house if I can’t drive, so I think it’s more important to me as a way for me to stay in my house.”)

DONE CORRECTLY        DONE INCORRECTLY        NOT DONE

DONE CORRECTLY: The resident asked you to examine, in some way, what was important to you about driving.

DONE INCORRECTLY: The resident did not seek to understand what was important to you about driving.

MANAGEMENT

  1. The resident gave me a clear recommendation about my driving.

DONE CORRECTLY        DONE INCORRECTLY        NOT DONE

DONE CORRECTLY: The resident stated clearly their opinion about whether or not you should continue to drive or have a driving test.

DONE INCORRECTLY: Recommendation was not clear.

  1. The resident asked me my reaction to his/her recommendation.

DONE CORRECTLY        DONE INCORRECTLY        NOT DONE

DONE CORRECTLY: The resident asked in an empathetic manner what you thought about the recommendation.

DONE INCORRECTLY: The resident asked you if you were going to follow the recommendation.

  1. The resident acknowledged the importance that you remained in your home.

DONE CORRECTLY        DONE INCORRECTLY        NOT DONE

DONE CORRECTLY: The resident makes an empathetic statement, e.g. “I know it is important for you to stay in your home.” or “I want you to stay in your home as long as it is safe for you to do so.”

DONE INCORRECTLY: The resident stressed importance of safety over your desire to live independently.

  1. The resident explored other options for obtaining transportation/needed services, or offered a referral to a social worker, or recommended that you take a driving test.

DONE CORRECTLY        DONE INCORRECTLY        NOT DONE

DONE CORRECTLY: The resident discussed other options for obtaining necessary transportation, asked you to think about them out loud, or offered a referral to someone who could help you think about options for transportation that would allow you to live in your home.

DONE INCORRECTLY: The resident only offered you one option, or did not seem willing to explore other options with you.

PATIENT-PHYSICIAN INTERACTION

  1. The resident introduced him/herself to me.

DONE CORRECTLY        DONE INCORRECTLY        NOT DONE

DONE CORRECTLY: The resident told you their LAST name AND that they were a resident physician.

DONE INCORRECTLY: The resident ONLY told you that she/he was a resident OR that he/she was asked to come and see you.

  1. The resident behaved warmly, but professionally throughout the entire encounter.

DONE CORRECTLY        DONE INCORRECTLY        NOT DONE

DONE CORRECTLY: The resident respectfully demonstrated genuine care and concern.

DONE INCORRECTLY: The resident demonstrated genuine care and concern, but was overly familiar or personal with you.

NOT DONE: The resident was cold and distant OR condescending OR overly informal and chummy.

  1. The resident used words I could understand.

DONE CORRECTLY        DONE INCORRECTLY        NOT DONE

DONE CORRECTLY: You (as the patient) understood all the terms.

DONE INCORRECTLY: More than two terms were unfamiliar to you.

NOT DONE: Pretty much everything the resident said to you was in “medspeak.”

  1. The resident encouraged me to ask questions and never avoided giving me an answer.

DONE CORRECTLY        DONE INCORRECTLY        NOT DONE

DONE CORRECTLY: The resident specifically asked if you had questions – and answered them directly or promised to get the answer for you.

DONE INCORRECTLY: The resident did not specifically ask you if you had questions but gave you the impression that you could ask questions and that you would get a direct answer.

NOT DONE: The resident never asked if you have any questions, gave you the impression of not being open to questions OR avoided answers to anything you ask.

  1. The resident took into account my concerns when discussing their recommendation about my driving.

DONE CORRECTLY        NOT DONE