SPs and the Curriculum
The Penn Med curriculum is a four-year program. These are some of the courses in which students will encounter SPs:
Year One: August through December
Year Two: August through December
- MD 306: Introduction to Clinical Medicine (ICM)
- History Taking and Physical Exam Skills Practice
- History Taking and Physical Exam Skills Tests
- MD 305: Introduction to the Clinics: Differential Diagnosis
Years Two and Three: January through December - The Clerkship Year
Year Three: January through July
MD 301: Doctor-Patient Relationship - Asthma, Knee Injury, Cancer, Diabetes, HIV Cases
- SPs appear before students in a small group format with a faculty preceptor. Students take turns interviewing the SP and then discuss issues raised by the encounter pertaining to the doctor-patient relationship. Cases include asthma, knee pain, cancer, diabetes and HIV, and touch on many cultural issues, including religion and sexual orientation.
MD 306: Introduction to Clinical Medicine (ICM)
History Taking and Physical Exam Skills Practice
- Second year medical students learn and practice interviewing and physical exam skills with SPs. Students receive feedback from faculty preceptors, SPs, and their fellow students. The course lasts 12 weeks and covers special topics such as taking a sexual history and interviewing and examining challenging patients. Students are tested twice during the course to assess their progress.
History Taking and Physical Exam Skills Tests - Putting It All Together
- These two tests measure second year medical students’ progress in the ICM / MD 306 course, where they learn interviewing and physical exam skills. Students see an SP in a doctor’s office setting and must examine, interview, and advise the SP appropriately. Students receive verbal feedback from the SP and a student partner directly after the encounter.
MD 305: Differential Diagnosis
- The culmination of lessons from ICM, Introduction to the Clinics addresses the gap between medical information and clinical data. The SP component of the course includes an interview and examination by a faculty member in a lecture hall. Students observe the SP faculty-SP encounter, then work in small groups to process and develop the differential diagnosis.
Doctoring II: Breaking Bad News; Discussing Advance Directives; Handling a Difficult Patient; Dealing with a Flirtatious Patient; Disclosing a Medical Error
In small groups, medical students take turns interviewing SPs to practice their skills dealing with a variety of challenging scenarios in the doctor-patient relationship. The course coincides with the clerkship year, so students have the opportunity to apply what they learn in the clinics.
Family and Internal Medicine Clerkship Objective Structured Clinical Examination (FIM OSCE)
This is the second part of the Family and Internal Medicine Shelf Exam. Second and third year medical students take this exam after they have interned in the clinics for several months. Students see four SPs, one-on-one, in a doctor’s office setting. Students must examine, interview, and advise SPs appropriately, as well as write a note and differential for each patient. Students also receive verbal feedback from the SPs directly after each encounter.
Clinical Skills Inventory (CSI)
The Liaison Committee on Medical Education (LCME) requires all U.S. medical schools to conduct a summative clinical skills exam that assesses their students' minimum clinical competencies. Penn Med students are required to pass the Clinical Skills Inventory (CSI) after they complete all required clerkships and before they begin their senior year.
CSI Penn Med lasts a full day, during which students see a series of SPs, one-on-one, in a doctor’s office setting. Students must examine, interview, and advise SPs appropriately, as well as write a patient note after each encounter.
Some other programs that have used SPs include:
- NBME Clinical Skills Assessment Training and Pilot Exams
- Children's Hospital of Philadelphia (CHOP) Anesthesia Fellows
- Anesthesia Residents
- Ethics Committee Retreat
- Family Medicine Conference: Teaching Patient-Centered Communication Skills
- Medicine Clerkship: Geriatric Medicine
- Medicine Clerkship: Ethics and Competency Assessment
- Reproduction: Sexual History Taking
- Sexual History: Adolescent, Colostomy, Menopause, Erectile Dysfunction, Abdominal Pain, Pain on Intercourse, and Vaginal Bleeding
- Surgery Clerkship: Abdominal Pain and Vomiting; Home Infusion Therapy