An overview of and approach to selecting appropriate patient representations in teaching and summative assessment in medical education
Medical education has a long tradition of using various patient representations in teaching and assessment. With this literature review we aim, first, to provide an overview of the most important patient representations used to teach and assess clinical skills, considering in particular “summative...
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| Format: | Article |
| Language: | English |
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SMW supporting association (Trägerverein Swiss Medical Weekly SMW)
2020-12-01
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| Series: | Swiss Medical Weekly |
| Subjects: | |
| Online Access: | https://www.smw.ch/index.php/smw/article/view/2910 |
| _version_ | 1797974943176065024 |
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| author | Daniel Bauer Felicitas-Maria Lahner Sören Huwendiek Felix M. Schmitz Sissel Guttormsen |
| author_facet | Daniel Bauer Felicitas-Maria Lahner Sören Huwendiek Felix M. Schmitz Sissel Guttormsen |
| author_sort | Daniel Bauer |
| collection | DOAJ |
| description |
Medical education has a long tradition of using various patient representations in teaching and assessment. With this literature review we aim, first, to provide an overview of the most important patient representations used to teach and assess clinical skills, considering in particular “summative exams” that have a pass or fail outcome; second, to provide arguments for choosing certain patient representations; and third, to show the advantages and limitations of different patient representations, especially simulated patients (SPs) and real patients (RPs).
Typical patient representations include case narratives, anatomical models, simulators and mannequins, as well as SPs and RPs. The literature indicates that there are multiple ways of using various patient representations in teaching and that the intended didactical purpose informs the choice of representation. Early in the educational programme, even low-fidelity patient representations can be a good fit for assessment purposes if chosen to match the educational level. The use of RPs in summative, high-stakes assessments (exams with particularly important consequences for the examinee) is limited for methodological and ethical reasons. The methodological implementation of summative exams also entails specific challenges, such as ensuring measurement reliability and fairness towards the examinees. Carefully prepared, SPs can perform their roles with a sufficient degree of authenticity, making summative exams more manageable, and imposing no strain or risk on RPs. The ongoing debate concerning the use of SPs and RPs in summative assessment highlights perceived limitations of SPs in relation to RPs that are often not supported by research. Evidence shows that SPs, in combination with additional simulation modalities as needed, represent the first choice for summative clinical assessment. We also consider the strengths and limitations of this review and reflect on the applicability of our findings.
We conclude that in order to select the right patient representations in clinical teaching and/or assessment, a number of perspectives must be considered: (i) the learning goals, aligned with the stage of study, (ii) the corresponding requirements of the clinical task itself (e.g., performing a phlebotomy or a communication task), (iii) the level of authenticity required and (iv) the resources needed, taking patient safety and feasibility into consideration.
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| first_indexed | 2024-04-11T04:27:44Z |
| format | Article |
| id | doaj.art-fde7795515684938a53bf8b262b0d6f6 |
| institution | Directory Open Access Journal |
| issn | 1424-3997 |
| language | English |
| last_indexed | 2024-04-11T04:27:44Z |
| publishDate | 2020-12-01 |
| publisher | SMW supporting association (Trägerverein Swiss Medical Weekly SMW) |
| record_format | Article |
| series | Swiss Medical Weekly |
| spelling | doaj.art-fde7795515684938a53bf8b262b0d6f62022-12-29T16:02:12ZengSMW supporting association (Trägerverein Swiss Medical Weekly SMW)Swiss Medical Weekly1424-39972020-12-01150495010.4414/smw.2020.20382An overview of and approach to selecting appropriate patient representations in teaching and summative assessment in medical educationDaniel Bauer0Felicitas-Maria Lahner1Sören Huwendiek2Felix M. Schmitz3Sissel Guttormsen4Institute for Medical Education, University of Bern, SwitzerlandDepartment of Health Professions, Bern University of Applied Sciences, SwitzerlandInstitute for Medical Education, University of Bern, SwitzerlandInstitute for Medical Education, University of Bern, SwitzerlandInstitute for Medical Education, University of Bern, Switzerland Medical education has a long tradition of using various patient representations in teaching and assessment. With this literature review we aim, first, to provide an overview of the most important patient representations used to teach and assess clinical skills, considering in particular “summative exams” that have a pass or fail outcome; second, to provide arguments for choosing certain patient representations; and third, to show the advantages and limitations of different patient representations, especially simulated patients (SPs) and real patients (RPs). Typical patient representations include case narratives, anatomical models, simulators and mannequins, as well as SPs and RPs. The literature indicates that there are multiple ways of using various patient representations in teaching and that the intended didactical purpose informs the choice of representation. Early in the educational programme, even low-fidelity patient representations can be a good fit for assessment purposes if chosen to match the educational level. The use of RPs in summative, high-stakes assessments (exams with particularly important consequences for the examinee) is limited for methodological and ethical reasons. The methodological implementation of summative exams also entails specific challenges, such as ensuring measurement reliability and fairness towards the examinees. Carefully prepared, SPs can perform their roles with a sufficient degree of authenticity, making summative exams more manageable, and imposing no strain or risk on RPs. The ongoing debate concerning the use of SPs and RPs in summative assessment highlights perceived limitations of SPs in relation to RPs that are often not supported by research. Evidence shows that SPs, in combination with additional simulation modalities as needed, represent the first choice for summative clinical assessment. We also consider the strengths and limitations of this review and reflect on the applicability of our findings. We conclude that in order to select the right patient representations in clinical teaching and/or assessment, a number of perspectives must be considered: (i) the learning goals, aligned with the stage of study, (ii) the corresponding requirements of the clinical task itself (e.g., performing a phlebotomy or a communication task), (iii) the level of authenticity required and (iv) the resources needed, taking patient safety and feasibility into consideration. https://www.smw.ch/index.php/smw/article/view/2910patient representationsteachingsummative assessmentmedical education |
| spellingShingle | Daniel Bauer Felicitas-Maria Lahner Sören Huwendiek Felix M. Schmitz Sissel Guttormsen An overview of and approach to selecting appropriate patient representations in teaching and summative assessment in medical education Swiss Medical Weekly patient representations teaching summative assessment medical education |
| title | An overview of and approach to selecting appropriate patient representations in teaching and summative assessment in medical education |
| title_full | An overview of and approach to selecting appropriate patient representations in teaching and summative assessment in medical education |
| title_fullStr | An overview of and approach to selecting appropriate patient representations in teaching and summative assessment in medical education |
| title_full_unstemmed | An overview of and approach to selecting appropriate patient representations in teaching and summative assessment in medical education |
| title_short | An overview of and approach to selecting appropriate patient representations in teaching and summative assessment in medical education |
| title_sort | overview of and approach to selecting appropriate patient representations in teaching and summative assessment in medical education |
| topic | patient representations teaching summative assessment medical education |
| url | https://www.smw.ch/index.php/smw/article/view/2910 |
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