Benefits of Integrating Standardized Patient Encounters into Pre-clerkship Neurology Curriculum

Abstract Introduction Standardized patient encounters (SPEs) are a foundational tool in medical education, yet their pre-clerkship role in undergraduate medical education, particularly in neuroscience, remains less clearly defined. This study evaluates the impact of integrating SPEs into a pre-clerkship Nervous System course on student knowledge, diagnostic confidence, and performance. Our objective was to design reproducible neurology-focused SPEs for pre-clerkship learners and assess its effectiveness in improving knowledge acquisition and diagnostic confidence with common neurological conditions. Methods Second-year medical students at our institution who were enrolled in a 6-week Nervous System course participated in four structured SPEs addressing common neurologic presentations. Students conducted focused neurologic histories, examinations, and diagnostic reasoning. Knowledge was assessed using a 10-item quiz administered before and after the SPEs. Performance on 12 SPE-related NBME final exam questions was compared with national averages. Diagnostic confidence was evaluated using pre- and post-SPE self-assessment surveys. Results Students demonstrated significant improvement in knowledge, with a median quiz score increase of 1.0 point (Hodges-Lehmann estimate, 95% CI: 0.0-3.5; p < 0.0001). On the NBME exam, our students outperformed national averages across nearly all SPE-related items (FIU mean = 0.87 vs. 0.71; p < 0.05). Students also reported significant increases in diagnostic confidence across all neurologic conditions assessed (all p < 0.001). Discussion Integration of SPEs into a pre-clerkship neurology course resulted in immediate gains in knowledge and confidence, and higher standardized exam performance, underscoring SPEs as a valuable early experiential learning modality in clinical neuroscience education.