Implementing standardized patient simulations to promote learning of pathophysiology and building of diagnostic and clinical communication skills

In our organs-based integrated preclerkship curriculum, Organ Systems-1: Immune, Hematopoietic and Cardiovascular System introduces Year-1 medical students (MS1) to normal biology, physiology, infectious diseases, pathophysiology and pharmacology of these three systems. Concurrently promoting development of diagnostic and clinical communication skills is also essential to training future physicians. Studies indicate standardized patient (SP) encounters augment medical students’ learning experiences, build clinical and professional skills, and boost confidence. End-of-course surveys consistently indicate our students find small-group activities that require application of didactic concepts to low-stakes clinical settings highly useful and engaging. Our goal is to horizontally integrate basic science coursework with introductory clinical skill training in the preclerkship curriculum and better equip them to make the most of their clerkships. Thus, we introduced SP case-based simulations for immune, hematopoietic and cardiovascular disorders to enhance MS1 patient interview, physical exam, and diagnostic skills within the restructured organ systems-based course, Organ Systems-1 (OS1). To that end , in the spring 2024 iteration of OS1 we developed and piloted six case-based SP simulated encounters: a set of 3 immunologic and hematologic-oncologic cases and a set of 3 cardiovascular cases. Before each case, the SP received and studied detailed notes on the initial presentation/chief complaints, relevant medical and family history, and physical exam findings. Before each encounter, the MS1 team (3-4 students) received a summary intake sheet and verbal instructions to perform patient interview and focused physical exam. Teams received a modest degree of coaching from faculty. Per their interview and exam findings, teams developed a differential diagnosis, ordered and interpreted relevant lab and imaging studies, reached a final diagnosis, and proposed a basic treatment/management plan, which they discussed directly with the SP. SPs gave immediate formative feedback regarding team performance. Students completed pre- and post-tests with didactic questions related to each case set. Post-tests also evaluated students’ perceptions of learning per a Likert scale (1-strongly disagree, 2-disagree, 3-neutral, 4-agree, 5-strongly agree). SPs offered faculty suggestions for improving the encounters. Post-test scores on didactic questions improved vs. pre-test scores [n=26-34]. The majority of participants agreed or strongly agreed SP encounters helped them apply knowledge (67-71%), identify areas needing improvement (69-77%), and gain confidence in patient interview skills (67-76%). We will use student and SP feedback to improve the encounters for formal implementation in spring 2025. These encounters require no special equipment and are easily adaptable for small-group learning activities. This abstract was presented at the American Physiology Summit 2025 and is only available in HTML format. There is no downloadable file or PDF version. The Physiology editorial board was not involved in the peer review process.