SCHOOL OF MEDICINE
CLINICAL SKILLS CENTER
GUIDELINES AND EXPECTATIONS
FOR THE
STANDARDIZED PATIENT
Table of Contents
1.
2.
3.
4.
CLINICAL SKILLS CENTER STAFF AND CONTACT INFORMATION
IN CASE OF EMERGENCY
GLOSSARY OF TERMS AND ABBREVIATIONS
SERVICES PROVIDED BY STANDARDIZED PATIENTS (SPS)
 TEACHING ACTIVITIES
 DEMONSTRATIONS
 SMALL GROUP EXERCISES
 CLINICAL SKILLS EXAMS (CSES)
 OBJECTIVE STRUCTURED CLINICAL EXAMINATIONS (OSCES)
 SPECIAL SERVICES
 GYNECOLOGIC & MALE GENITOURINARY TEACHING
 PARENT/CHILD DUOS FOR WELL CHILD VISIT DEMONSTRATIONS
 MINORS USED FOR OSCES
 SPANISH SPEAKING SPS
 STANDARDIZED NURSES
 MODELS
5. CLIENTS
6. CONTRACTING TO PROVIDE SPS SERVICES
7. HOW SPS ARE CAST
8. CANCELLATION EXPECTATIONS
9. STANDARDIZED PATIENT (SP) PREPARATION FOR A CASE
10. EVENT DAY EXPECTATIONS
 PARKING
 WHERE TO REPORT
 DRESS CODE
 CALL TIME
 PREPARATORY TIME
 PLACES
 BREAKS AND MEALS
 END-OF-DAY ACTIVITIES
o HOUSEKEEPING
o CHECKLIST SUBMISSION CONFIRMATION
o DEBRIEFING
11. KEY EXPECTATIONS FOR SPS
 ATTENDANCE AND PUNCTUALITY
 PROFESSIONALISM
 RELATIONSHIPS WITH STUDENTS
 MODESTY
 HYGIENE
 REALISM AND STAYING IN ROLE
 CONFIDENTIALITY
 THE CAMERA IS ALWAYS ON
 SUMMONING ASSISTANCE DURING AN ENCOUNTER
 INTERACTING WITH FACULTY
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ALTERING PERFORMANCES/CHANGING CASES
TIME OUT/TIME IN TEACHING TECHNIQUE
SMOKE-FREE CAMPUS
CONTROL ROOM AND ROOM 308 CONDUCT
EXTERNAL CLIENTS
NO DOCTOR/PATIENT RELATIONSHIP
12. QUALITY ASSURANCE FOR SPS
13. COMPENSATION
14. DISCONTINUATION OF SERVICES
15. ALCOHOL AND DRUG POLICY
16. EQUAL OPPORTUNITY AND DISCRIMINATORY HARASSMENT
17. CONCERNS AND COMPLAINTS
APPENDIX A: SPECIALIZED SP GROUPS
I.
GTAS AND MUTAS
II.
STANDARDIZED NURSES
III.
PARENT/WELL CHILD VISIT SPS
IV.
ENGLISH AS SECOND LANGUAGE SPS
APPENDIX D: COMPENSATION AND LEVELS OF ADVANCEMENT
APPENDIX E: PERFORMANCE CRITERIA
APPENDIX F: SP EVALUATION FORM
APPENDIX G: CONFIRMATION EMAIL
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1. Clinical Skills Center Personnel and Contact Information
The Clinical Skills Center (CSC or “the Center”) is part of the Emory Experiential Center for
Learning in the Office of Medical Education and Student Affairs (OMESA) in the Emory
University School of Medicine (EUSOM) under the direction of Dr. Douglas Ander, Assistant
Dean for Medical Education, Dr. J. William Eley, Executive Associate Dean for Medical
Education, and Mrs. Margo Kuisis, Director of OMESA.
Connie Coralli, the Associate Director of the Clinical Skills Program, is responsible for the
leadership, supervision, daily operations, and long-term planning for the Center.
Center personnel can be reached via the contact information below. Except in emergencies or
time-sensitive communications, email is the preferred method of communication since email
messages are checked more frequently than phone messages.
For non-urgent matters when phone calls are necessary, please use the office numbers listed
below. The Associate Director’s office number listed below automatically rolls over to a cell
phone number that also has voice-mail. Please leave a message if Center personnel are
unavailable to answer the call at the time. It is unnecessarily disruptive to call both the office
and cell phone during normal business hours for non-urgent matters.
Center personnel do not answer their phones during training, while in meetings, or while
running events. Please leave voice-mail messages when necessary and Center personnel will
respond as soon as possible. Again, emails are responded to faster than phone messages in
general.
Standardized Patients (SPs) should always have the 24 hour emergency phone number with
them so that, in case of unforeseen emergencies on days they are scheduled to perform, the SP
can let the Center know as soon as possible of a delay or cancellation. The Associate Director
or a staff member is on call 24/7 for emergencies related to next day events.
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Connie Coralli
Gina Shannon
Associate Director
Clinical Skills Program
Program Coordinator
Clinical Skills Program
Room 318
Emory University School of Medicine
1648 Pierce Drive
Atlanta, GA 30322
Office: 404 712-9925
Cell: 404 308-6026
connie.coralli@emory.edu
Room 314
Emory University School of Medicine
1648 Pierce Drive
Atlanta, GA 30322
Office Cell: 404 295-1776
gina.m.shannon@emory.edu
Adam Bailey
Kara Cantrell
Program Coordinator
Clinical Skills Center
Program Coordinator
Clinical Skills Center
Room 316
Emory University School of Medicine
1648 Pierce Dr.
Atlanta, GA 30322
Office Cell: 404 801-6664
adam.bailey2@emory.edu
Room 316
Emory University School of Medicine
1648 Pierce Dr.
Atlanta, GA 30322
Office Cell: 404 309-6378
kara.cantrell@emory.edu
If unable to reach any of the
above please call:
Dr. Douglas Ander
Office of Medical Education & Student
Affairs (OMESA)
Room 357P
Main Phone: 404 712-5655
Dr. J. William Eley
Assistant Dean for Medical Education
Director of ExCEL
Room
1648 Pierce Dr.
Atlanta, GA 30322
Office: 404 251-8828
dander@emory.edu
Margo Kuisis
Executive Associate Dean for Medical Education
Director
OMESA
Room 453A
1648 Pierce Dr.
Atlanta GA 30322
Office: 404 712-9979
jeley@emory.edu
OMESA
Room 357 P
1648 Pierce Dr.
Atlanta GA 30322
Office: 404 712-8417
margo.kuisis@emory.edu
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Who to Call for What:
Event Related Matters:
Call the event manager who is in charge of the specific event. The event manager will be the
person who engaged and confirmed you for the event, either Connie Coralli, Gina Shannon or
Adam Bailey or Kara Cantrell.
Payment Questions:
Kara Cantrell processes and tracks SP payment requests. Questions about payments should be
directed to her.
SP Referrals:
Anyone interested in becoming an SP should contact Gina Shannon, via email with an acting
resume (if available) and headshot.
Concerns about Students/Faculty:
Connie Coralli
Program Questions and Complaints:
Connie Coralli
2. In Case of Emergency
To cancel participation in an event 24 hours or less prior to that event (only for serious illness
or emergency), the SP must talk to a staff member in person or live on the phone. Neither
email messages nor voice-mail messages are acceptable for this purpose. An emergency cell
phone (usually that of the Associate Director) is answered 24/7 for emergencies related to next
day events.
After-Hours Number: 404 308 6026 (Connie’s cell)
Other emergency information:
Emory Police
911
Lock-outs for evenings and weekends:
404 727-6111
3. Glossary of Terms and Abbreviations
The following terms and definitions may be useful:
Adjustment: instructions given to a standardized patient to modify the way he/she is
portraying a character in order to improve upon it or make it more standardized & consistent.
Auscultate: One of the four techniques of physical examination accomplished by listening,
usually through a stethoscope
Call time: the SP arrival time for a case
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Checklist: a list of items for which students are “checked off” to assess their performance
with a patient
CC: Chief complaint. A word or short phrase used by the patient to describe the main
reason he/she seeks care. It is usually recorded in the patient’s own words and may or may not
be the “real” reason for the visit.
Class of 2012: Learners who will graduate in 2012.
Class of 2013: Learners who will graduate in 2013.
Client: A faculty member, clerkship, course or program using the Clinical Skills Center.
Clinical Skills Exam: an interaction between a learner and a standardized patient in which the
learning is interacting (“taking care of”) with the SP and during which the clinical performance
of the learner is assessed and graded.
CSC: Clinical Skills Center
EM: Event Manager or Emergency Medicine
Encounter: the time during an event from the beginning of one student to the beginning of
another student (exclusive of breaks)
EUSOM: Emory University School of Medicine
Event: The time on one or multiple days in which learners and standardized patients interact
for the same purpose, for example the Emergency Medicine CSE is an event.
ExCEL: Emory Center for Experiential Learning. This Center is part of OMESA and
contains the Clinical Skills Center and the Simulation Center.
Fellow: An advanced learner; one who has completed medical school, at least three years of
post-graduate training, has obtained a “medical doctor” license, and is pursuing specialized
training (such as in cardiology, pediatric orthopedics, etc.).
FH: Family history. Information about the health of a patient’s parents, grandparents,
sibling, spouse and children.
Formative: Activities primarily designed to be educational for the learner.
GTA: Gynecological teaching associate.
HPI: History of Present Illness. Detailed information about the problem(s) the patient is
presenting with for this visit.
Inspection: One of the four techniques of physical examination accomplished by looking &
observing.
Internship: The first year of training following medical school.
Jr. Med: Refers to the Junior Medicine Clerkship, a clerkship for students during their
required year of clerkships (from year 1 ½ - 2 ½).
LS: Learning Space: the software used in the CSC to schedule, set up, record, and keep
records of events.
M1: Students in their first year of medical school.
M2: Students in their second year of medical school.
M3: Students in their third year of medical school.
M4: Students in their fourth year of medical school.
Medical Imaging: a program of study for those professionals who perform x-rays, CT scans,
MRIs, etc.
MIRS: Master Interview Rating Scale. A checklist used by SPs to assess communication.
Model: A standardized patient who basically volunteers his/her body for use, there are no
lines to learn or roles to play. An example would be the ultrasound experiences during which
you are yourself and students learn to perform ultrasound using your body.
MUTA: Male urogenital teaching associate.
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OMESA: Office of Medical Education and Student Affairs. The Clinical Skills Program
and Center are a part of this office.
OSCE: Objective structured clinical examination. An examination in which the learner is
assessed in the mastery of a discrete clinical skill during a 3-5 minute station. These may or
may not involve a standardized patient. Examples would include reading a chest x-ray, taking
a sexual history, performing an abdominal exam, interpreting laboratory results.
Otoscope/Ophthalmoscope: the lighted instruments on the walls of the exam rooms used for
looking at the ears and eyes.
PA: Physician’s Assistant.
Palpate: A method of physical examination which involves feeling.
PE: Physical examination.
Percuss: A method of physical examination which involves tapping to discern solid vs.
hollow objects
PGY: Post graduate year(s).
Places: An announcement signifying that all standardized patients should go immediately to
their rooms and be prepared to start their performance.
PMH: Past Medical History.
Psych: Psychiatry. Refers to the Psychiatry Clerkships OSCE for 3rd year medical
Students.
PT: Physical therapy
Resident: Refers to a physician in training during the first three years after graduation from
medical school.
ROS: Review of systems. A rapid review (during the history-taking part of the visit) of
screening questions designed to cover key components of each major body systems.
SOAP Note: A common format for a health professional’s written note about a patient. It
includes subjective (history) data, objective (physical exam and tests) data, the
assessment, and plan.
SH: Social History: Information about a patient’s occupation, hobbies, living arrangements and
habits that may affect your health, such as tobacco, alcohol and recreational drug use, sexual
partners, contraception, and sexually transmitted disease prevention.
SOM: School of Medicine.
SP: Standardized Patient.
Start: The beginning of an interaction between a student and a patient, the time the cameras start
to record and students begin to be assessed.
Summative: An event primarily for the purpose of grading or evaluating a student.
Table Read: Rehearsing lines sitting around a table.
Time in/Time out: a teaching technique in which the faculty interrupts an interaction between
a student and a SP to interject teaching or questioning.
4. Services Provided by SPs
Emory University’s School of Medicine (EUSOM) is dedicated to establishing competencies in
clinical, communication, and professional skills of health care providers AND competencies in
communication and interpersonal skills in the community and corporate world.
Teaching and Evaluating Students
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Some activities involving SPs are primarily for the purpose of educating students by providing
them with opportunities to practice clinical skills. Other activities are for the purpose of
assessing how well students have learned clinical skills. Many activities at Emory are a
mixture of both.
Demonstrations and Small Group Activities
SPs may be involved in class or small group demonstrations in which a faculty member, a
learner, or group of learners interview, examine, or interact with an SP in front of the group.
Other times, SPs may be involved in a small group exercise, in which they meet with 8-9
students and a faculty facilitator to demonstrate or practice specific skills as a group.
Clinical Skills Exams (CSEs)
Our most frequent activity however, is a one-on-one interaction with the student, usually called
a CSE. During a CSE, a learner and SP interact and the learner’s performance is evaluated
(either live or afterwards). The SP portrays a patient in a standardized manner (the same way
with each student thereby providing each student with the same “exam”). The interactions are
assessed usually by completion of checklists by faculty and/or SPs. Clinical Skills Exams are
the classical work that SPs do and mimic real clinical interactions.
Objective Structured Clinical Exams (OSCEs)
These are similar to CSEs, however rather than evaluating the comprehensive care of a patient,
they deal with assessing performance of a discrete clinical skill in a brief (5-10 minutes) time
period. These exams do not mimic anything seen in actual clinical practice for the most part.
While all SP work shares many common elements, each event is individualized to meet the
needs of the client utilizing them.
Special Services
In addition, there are specialized services provided by the CSC in which only a subset of SPs
participate (Appendix A). One example of this is the use of gynecological and male
genitourinary teaching associates (GTAs and MUTAs). These SPs use their bodies to assist
students in learning breast, pelvic, male genital and rectal exam skills. Another example of a
specialized subset of SPs is parents and young children who allow the faculty to demonstrate
well-child visits. A third example would be older children or adolescents who provide
experiences in pediatrics. Others involve cases with a “standardized nurse” in the room along
with the SP and foreign language encounters with SPs whose first language is something other
than English. These are but a few of the unique SPs activities in which our Independent
Contractors participate. New uses for SPs occur frequently, so do not be surprised to be
contacted for new and exciting opportunities that haven’t been mentioned
For clarity and brevity, throughout this handbook the term “SP” will be used to mean all SPs,
(GTAs, MUTAs, standardized nurses, etc.), unless otherwise specified.
5. Clients
The Center provides SP activities for various programs and departments at Emory University.
In addition, the Center occasionally contracts with third parties to provide educational and
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experiential sessions using SPs. These may occur on Emory campus or off-site. The Center
considers both internal Emory departments and programs and external third party as clients and
they will be referred to as such in these materials.
Medical Students and Post-Graduate Trainees
In the Medical School, students attend for four years (designated as M1, M2, M3, and M4),
Following medical school, physician education continues throughout three plus years of post
graduate training (PGY1, PGY2, PGY3, etc. or interns, residents, and fellows). All
participants, regardless of their educational or training level are referred to as “learners.”
Academic Health Programs
The Center may also provide educational and experiential sessions for students from the
School of Medicine’s academic health programs, including Physician Assistants (a two-year
Master’s Program), Physical Therapist (a three-year Doctor of Physical Therapy Program), and
Genetic Counseling (a two-year Master’s Program).
Faculty Development
Faculty may also practice their skills or develop new skills utilizing SPs. A current example of
this would be use of SPs as models for teaching emergency room physicians expanded use of
ultrasound technology. When an SP is used as a model, there is no case to portray; the SP is
lending his/her body for learner training.
External Clients
External clients are usually medical groups who are in Atlanta providing training or sponsoring
conferences for which they need SPs. Sometimes they may choose to come to Emory and
utilize both our space and our SPs. Other times they may request that SPs come to the
conference location.
6. CONTRACTING TO PROVIDE SP SERVICES
Potential SPs learn of our work mostly by word of mouth. The Center may also seek referrals
from acting groups or schools, directors, theaters, etc. and on occasion advertise for candidates.
While most of the Center’s SPs have some acting experience or acting interest, all come with
the requisite skills needed to portray patients.
The Center maintains a group of SPs comprised of both genders and a variety of age groups,
racial and ethnic backgrounds in order to be able to fulfill requests that come from faculty for
specific SPs characteristics. Currently the Center utilizes 75 to 100 people over the course of a
year for general SP work. In addition there are SP groups totaling around 50 people who are
used only for specialized experiences GTAs, MUTAs, babies and toddlers; native Spanish
speakers; adolescents; nurses, etc.). See Appendix A for more information on these specialized
SP roles.
Potential SP candidates contact the Center, complete an application and provide an acting
resume and head shot (or photo) and are scheduled for an audition. Auditions are held
periodically throughout the year and consists of the following: a brief introduction to SP work,
discussion about expectations of SPs, viewing of a video showing an Emory SP in a typical
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encounter with a student, portrayal of a monolog or a simple patient case (provided prior to the
audition) and completion of a short checklist related to the clinical case. Portrayal of the case
and completion of the checklist mimics the activities SPs routinely do.
Some of the most important and sought after characteristics are:
 Accuracy in memorization of case details,
 Ability to follow instructions and make adjustments,
 Ability to realistically portray a patient,
 Ability to remember what the learner asked/did and accurately complete a checklist
recording the same,
 Ability to portray various levels of pain, anxiety, etc.
 Ability to provide helpful, professional verbal feedback to learners.
From the auditions, select individuals are invited to a two-day callback in which they learn
more about the program and are further evaluated. Following the callback and upon passing a
criminal background check, successful candidates are invited to join the Center’s program and
asked to sign an Independent Contractor Agreement. Once the contract is signed, SPs are
eligible for assignments.
The Center’s main method of communication with SPs is via email. To participate as an SP, it
will be necessary to have or obtain an email address and regularly read email messages at that
address. Senior SPs (born prior to 1940) can be exempted from this requirement upon request
and may use telephone and regular mail to communicate with the Center. SPs must also have a
working printer and be able to print Emory’s current version of Word documents.
Any SP work in or for the School of Medicine must be arranged through the Clinical
Skills Center. Should you be contacted for SP work though anyone else associated with
Emory, you should contact the Associate Director of the Clinical Skills Center before
accepting such as assignment. Violation of this policy can result in discontinuation of SP
services. Work for other Schools such as the Law School or Nursing School is permitted and
any SP can feel free to accept work from them as long as it does not interfere with
commitments to the School of Medicine.
7. How SPs are Cast
Clients (generally faculty) submit requests for events utilizing SPs. With these requests, the
faculty specifies case details such the age range, gender, ethnicity, physical characteristics, etc.
Based on this information the staff identifies possible SPs.
The following secondary selection criteria are considered to narrow down possible SPs:
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Case requirements (affect to be portrayed, case difficulty, knowledge base needed to portray
case, life experience)
Ability to master the role, personality and requirements of the case.
Ability to interact with the staff & trainees in a professional manner.
Level of experience in portraying case
Level of experience in teaching
Level of experience and quality of feedback (verbal and/or written)
Level of experience for specific level of learner (M1, M2 …physician)
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Past training and experience with requested or similar case
Performance history and ability to integrate feedback
Performance history and ability to maintain changes of case/feedback
Client preferences (client may identify a specific SP or ask NOT to send a specific SP)
Number of events for which the SP is currently confirmed
Development/maintenance of skills*
Number of times SP has interacted with this group of learners (the Center limits the number of
interactions between a specific SP and a student)
*The Center reserves the right to cast in a manner that will best maintain the overall
skills of our SP population.
The Associate Director has the final say in all casting decisions.
Once the best SPs for the part are identified, they are contacted by e-mail to determine
availability and interest. Out of the individuals who are available (for both the training and
event) and interested, final casting decisions are made and confirmations are sent out with the
event details. To be considered, the Center expects a reply to emails within 24 hours. The
Center requests that the SP reply whether or not they are able to participate so that another
candidate can be contacted as soon as possible.
8. Cancellation Expectations
Cancellation by an SP
SPs are free to accept or decline any request without penalty. However, once an assignment is
accepted, the SP is expected to honor that commitment under all circumstances except serious
or infectious illness or serious emergencies. Failure to honor such commitments will result in
discontinuation of services. SPs must follow cancellation policies outlined earlier for those
rare occasions for which cancellation is acceptable. Other auditions or better parts are not
acceptable reasons to back out of an obligation to the program and will lead to discontinuation
of an SP’s services.
Cancellation by the Clinical Skills Center
In the rare event that the Clinical Skills Center cancels a confirmed SP engagement, the
following compensation policies apply:
< 24 hours: SP receives full compensation
> 24 hours but < 1 week: SP receives 50% compensation
> 1 week: no compensation
SPs will be notified of Center-initiated cancellations via email to the address on file.
9. SP Preparation for a Case
Cases are sent out several days prior to an event. SPs are expected to learn the details of their
cases and understand the event specifics (length of case, whether they will give feedback,
complete checklists, etc.). SPs must bring a copy of the case with them to training.
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SPs should arrive at training “off book” having memorized the chief complaint, opening
statement(s), case details and all scripted responses. Training generally starts with a brief
description of how the character is envisioned followed by a table read. SPs should be able to
participate in the table read without having to reference case materials. Lack of adequate
preparation for training may result in replacement, lack of future assignments, or
discontinuation of services.
Instructions in and practice for physical simulations follows the table read, when applicable.
All cases require some level of training and/or rehearsal, the format of which will be
determined by the Center staff in conjunction with the faculty. Considerations that influence
the amount and type of training and/or rehearsal include the complexity of the case, the
experience level of the SP and the purpose of the event. Each case will be assigned a trainer
selected by the Associate Director or her designee.
In addition to the training activities described above other activities may include:
 Video review of the case
 Specialized training to complete a history and/or physical exam checklist
 Master Interview Rating Scale (MIRS) training
 Training on verbal and/or written feedback
 Instruction in feedback techniques
 Practicing feedback skills
 Dress rehearsal of the case
 Other training procedures as required by the nature of the event.
10. Event Day Expectations
Call time
The call-time is usually 30 minutes prior to the start of the session and will be specified in
the e-mail confirmation for the session. SPs are expected to be signed in, seated in Room
308 in the School of Medicine Building (or other assigned meeting room), ready to work at the
call time. This time is compensated and crucial for last minute instructions. Using the
restroom, getting food and beverages, putting on special costumes, make-up, gathering props,
etc should all be accomplished prior to call time.
The 30-minute call time is compensated time and is designed to give the staff time to
communicate any last minute changes, tune up the cases, and answer questions. It also
provides the SP time to prepare his/her exam room and get into character.
Being in Character
You should always be in character (within reason) anywhere you might encounter learners.
This includes hallways, elevators, restrooms, etc.
Parking
Parking at Emory is always a challenge and it sometimes takes 20 minutes from the time you
enter the parking deck until you are parked. Difficulty parking is not an acceptable reason for
lateness. SPs must allow sufficient time to park.
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Parking is available in two Emory visitor lots. The easiest to find but slowest to park in is the
Emory Hospital/Clinic lot on Lowergate off Clifton Rd. across from the hospital. The Michael
St. Deck is quicker to park in and as close as the Lowergate, however finding it the first time
and finding your way across campus is a bit challenging. However, once you find your way
over the bridge (over the railroad track) you end up right at the back of the medical school and
enter just to the right of the elevators.
Where to Report
You will come to Room 308 on the 3rd floor of the medical school unless instructed otherwise.
Dress Code
Please dress in clean clothes that are modest and restrained. For cases in which you are not
changing into a patient gown, your clothing should be consistent with your character. Please
ensure you come to the medical school without any odors or smoke or scented products
accompanying you as these are not appropriate for a medical setting.
Places
Places will be called 15 minutes prior to the start. At this time SPs should go to their rooms,
sign into the computer, change clothes (if necessary) and get into character. Students enter the
suites 5 minutes prior to start and SPs must be in their rooms with the doors closed at that time.
Preparatory Time
The short time prior to an event is a hectic time and much must be accomplished by the staff
during this time. In addition to interacting with the SPs, the staff must prepare rooms, turn on
computers, greet and orient the faculty and students, and get everyone where they need to be
for an on-time start. Please do not ask for special attention, services (copies of the case) or
bring up anything not directly related to and crucial for the successful start of the
upcoming event (i.e. questions about past payments, future assignments, etc.). Each SP is
expected to independently function during this time and prepare for his/her role. Unforeseen
difficulties which threaten the on-time start or the success of the event should be brought to the
staff’s attention immediately.
A clinical skills exam is a carefully choreographed, timed, and directed event in which many
people, activities, and schedules must come together in a coordinated manner. Every effort
must be directed toward an on-time start.
Breaks and Meals
Meals and snacks are provided for SPs when the budget allows. When provided, the food and
beverages are intended to be consumed on site. For daylong events, the client generally
provides a paid lunch break and lunch (when the budget allows). If you have special dietary
needs you should plan to provide for those by bringing food with you.
Compensated Time
All time from the start time until the SP departs is compensated time and the Center expects to
have the SP’s full attention during the entire event. Breaks may be needed for making
adjustments to performances, so using the facilities and checking in with staff should be the
priority of each SP during breaks. SPs are not to use breaks to make phone calls and check eApril 2013
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mail unless the staff has indicated you are not needed. The breaks are synonymous with time
between scenes and lunch as intermission time.
Following breaks and lunch, SPs must be back in their rooms with doors closed 5 minutes
before the start of the next case when students are escorted into the suites.
On occasions when same-day training is done in the morning and there is a break between the
training and the call time for the afternoon event, this may not be compensated time depending
on the situation – consult your event manager in such cases. When it is not compensated, the SP
is free to leave campus or use this time for whatever he/she desires.
End-of-Day Activities
After the last learner of the day, the SP must please complete the following activities prior to
leaving:
 Submit the last checklist and shut down the computer.
 Check to make sure the otoscope/ophthalmoscope is turned off (even if students have
not used it)
 Tidy up the room
 Pull down and tear off used paper from exam table; throw paper away in trash can.
 Place used linens in hamper in central area
 Stow prop boxes if used
 Replace props and special equipment used for the case
 Double-check room to make sure NO training/case materials are left behind
A debriefing of the event usually follows each day’s performance. SPs should plan to stay 515 minutes after the event for this debriefing. The SPs observations and comments, verbal or
written, are always welcome following the event.
11. Key Expectations for SPs
 Attendance and Punctuality
Once an SP has accepted a role he/she is expected to portray that role unless the staff
has released the SP in writing. Cancellations of less than 24 hours due to extreme or
infectious illness or serious family emergency or death require personal, live
notification as described earlier as soon as the circumstances become known.
As noted previously, SP events involve many people in a carefully choreographed
schedule. Lateness or the unexpected absence of an SP creates a situation that can
have serious consequence including, but not limited to, compromise of the integrity of
an exam, students missing a graded event with no option to make it up, wasted
valuable time of faculty, staff and other SPs, and perhaps most disconcerting of all, a
group of students assigned to an exam room with no patient in it.
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The financial cost of scheduling a make-up exam, should the student and faculty
schedule permits, may exceed $1,000 when staff, faculty, student, and SP time is
accounted for. For all these reasons, once a role has been accepted there are few
acceptable reasons not to appear. A first occasion of not showing without timely
notification and an acceptable reason for an absence will result in discontinuation of
an SP’s services without notice.
Punctuality is also of utmost importance so that events can begin on time and stay on
schedule. Traffic and parking around Emory is frequently congested and at times it
takes in excess of 20 minutes to park and get to the School of Medicine building.
Traffic or parking difficulties are not acceptable reasons to be late. SPs will be
allowed one late arrival provided that it does not delay or compromise an event. An
single instance of tardiness which compromises an event or a second instance of
tardiness for any reason will result in the SP’s services being discontinued.
SPs must be available for the full time requested for the session/event and for
related training. SPs should not ask to leave early, leave over lunch or breaks, or
arrive late. SPs are not allowed to ask someone else to “fill in” for them. The Center
expects to have the SP’s full attention during all compensated time in the Center.
Occasionally the Center or the EUSOM may host or participate in a social event
either at Emory or off-site. SPs may be invited to such events and attendance is
optional for the SP. SPs are not required to participate in such social events nor will
their consideration for parts be affected by whether they choose to participate.
 Professionalism
The Center deals with a variety of busy professionals and runs a busy professional
program. An SP assignment is a professional obligation and SPs are expected to act
in a professional manner at all times.
 Relationships with Students
SPs providing services for the Center are not to interact with the medical students on
a personal level since they are in a position of assessing the student’s performance.
Dating any of the students we serve is expressly forbidden and will result in the
discontinuation of SP services. Providing a quality educational experience for the
student is compromised if the student must be concerned with discriminating between
the SP as a patient or as a friend while at the Center.
Should a SP discover, over the course of his/her work, that he/she has an existing
relationship with a learner, the Center staff should be notified. The program can then
schedule the SP with assignments that do not involve that specific learner.
 Modesty
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Female SPs should wear a bra, sports bra, or camisole under their patient gown unless
otherwise directed. Both men and women should wear briefs, boxers, and/or soccer
type shorts under their gowns. No other garments (bathing suits, shorts or pants
without an elastic waist, sweat pants, undershirts, etc are allowed unless specifically
directed otherwise for the case. Undergarments should not be excessively revealing;
for example, thongs are not considered acceptable underwear during case activities
involving physical examination.
Socks are allowed for comfort during the exam. SPs should be prepared to remove
them should the student request (as it is not acceptable for students to examine an SP
through their socks). The SP may put the socks back on after each student exam. If
the socks are on for the first learner, they should be on for every learner.
Anytime an SP is in a gown, an unfolded sheet should be covering the SP’s lap
when the student enters the room. Students should not have to search for a sheet to
cover the SP.
When undressing in the exam rooms, please disrobe accordingly as a camera is on
even when not recording, and most areas of the room are visible to control room staff
and faculty observers. SPs may also use the restrooms for changing as long as a robe
is worn for returning to the exam room.
At no time should the SP be out of an exam room with only a patient gown on,
even if tied in the back. Please remember that the exam rooms are located off a
public corridor. Walking from the exam rooms to the restrooms requires walking
down a public corridor. Therefore, SPs should bring a bathrobe and slippers for
use during breaks or plan to re-dress before leaving the exam room. While the
faculty, staff, SPs and learners may not notice patients in hospital gowns, it is an
unusual sighting for non-clinical staff, faculty, and visitors (which may include
distinguished guests and alumni) to see patients in a partial state of undress.
During exams, learners are expected to drape patients appropriately to avoid exposing
them unnecessarily; however, this is a learned skill and is accomplished successfully
to varying degrees during the learning period.
During the cardiac exam, students must palpate (feel) the chest in the area under the
left breast (and possible other areas). For women the area the learner needs to feel is
frequently located under the elastic or underwire of the bra on the left side. SPs must
be comfortable allowing learners to access this area. Sometimes the learner may ask
the SP to hold the breast out of the way while conducting this part of the exam. This
is totally acceptable and the SP should accommodate the learner’s request.
Learners may need to feel pulses or lymph nodes in the groin. These are generally
located under the elastic of the underwear and the exam does not require exposure of
the genital area. Rather, the student places his/her hand under the underwear or pulls
the elastic up from the bottom to access the pulses and/or nodes.
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Learners have to learn the skills of protecting modesty and it does require a certain
amount of practice. Unfortunately, there will be some misses along the way. The
Center provides a safe atmosphere for students to practice and make mistakes, so if
any of the above-referenced encounters are unacceptable, the SP should withdraw
from the program or accept only assignments involving medical history.
 Hygiene
Our SPs find themselves in poorly ventilated exam rooms for long periods of time.
For the comfort of our learners, faculty, and staff, please come freshly showered.
 Realism and Staying in Character
Realism in portraying patients is an important responsibility of the SP. SPs must
practice and be attentive to using speech patterns, vocabulary, body language,
physical simulations, etc., that mimic real patients. Adjustments are given until SPs
achieve realistic portrayals.
SPs do not speak with the learners “out of role” before or during the simulation
session. SPs should not be seen by any of the students unless the SP is "in role."
Given the configuration of the new building, it is likely that the SP will encounter
students before they enter the exam room, so while on campus, SPs should be aware
of their behavior at all times.
SPs should remain on the 3rd floor in the OSCE area and are not allowed to go into
other areas of the building. Upon arrival for an assignment, SPs should come
immediately to the 3rd floor. Upon completion of an assignment, SPs should leave the
building immediately.
 Confidentiality
o Learner Confidentiality: No learner performances, behaviors, or interactions are
to be discussed outside of the Center. While it is appropriate to discuss
performances during the debriefings, trainings, etc., these should be done without
identifying students. Feedback about specific student should be shared only with
the Associate Director (or designee), the faculty coordinator, and/or the Deans for
Medical Education. The Center must maintain total privacy for the students at all
times. Student confidentiality is protected by a Federal Law (FERPA) and it is a
serious matter to jeopardize student confidentiality.
o SP Confidentiality: Any observations of another SP’s performance during
training or quality assurance/reliability sessions are to be kept in the strictest
confidence. Discussion of SP performance is to be limited to the trainer and
Center staff.
o
April 2013
Confidential Materials: The training manuals, cases, and checklists are the
copyrighted property of the EUSOM. These materials are to be used exclusively
Page 18
for experiences and sessions arranged through the Center and by SPs trained at
the Center. Unauthorized use of these items, discussion of these cases, or sharing
of these documents by an SP will result in termination of the SP’s contract with
the Center. Use of cases by other medical schools or programs is prohibited.
 The Camera Is Always On
Cameras are always on and may be recording – even when the students leave the
room. SP must not make editorial gestures (rolling eyes, thumbs down, etc.) or
comments about the students at any time. The tapes may be sent to faculty or
observed by the student at a later date. Discussions about the student or case with
faculty or other staff should be avoided while the tape is still running. At the end
of the encounter, the SP simply completes checklists or provides feedback without
editorializing.
 Summoning Assistance During An Encounter
To signal staff for assistance (questions, computer difficulties, needing water, etc.,)
the SP takes the brightly colored, green piece of paper from the top drawer in the bed
and places it on the end of the bed or some other highly visible spot. Someone will
talk to the SP via intercom or come to the exam room.
 Interacting with Faculty
For class or small group demonstrations, if the SP has questions about the case or
event, the SP may talk with the faculty facilitator prior to the session. SPs are not to
engage in such conversations in the presence of the student group, but should seek out
the facilitator outside of the learner’s sight and hearing. Frequently, individual
facilitators may have varying understandings about the activities for the day so when
time permits, a discussion prior to beginning in always a good idea to make sure you
are both on the same page.
For CSEs, SPs may be interacting with many different physicians during a CSE and
each will have his/her own individual style. Should an SP have a question, concern,
or comment about a case, it is best to talk with the staff rather than questioning the
faculty preceptor.
 Who Can Alter a Performance or Case?
Many different faculty observers may be involved in precepting cases and each
usually has his/her own idea about how the case should be portrayed. However, the
case author and the trainer had specific goals and objectives when the case was
written and trained. Therefore, only a limited number of people are allowed to
change the way in which a SPs performs a case.
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It is necessary to keep performances true to the original purpose of the case and to
keep SP roles consistent (if one SP changes, all SPs will need to be adjusted). The
physicians watching the cases do not always think about these factors and may wish
to alter the way a SP is performing. It is acceptable for a faculty to “fine-tune” a case
or portrayal, as long as it does not change the way in which the case was originally
envisioned and trained. If a SP is asked to increase or decrease the anxiety level, that
is acceptable. Adding a new symptom not in the original case is not acceptable.
A SP should politely refuse to allow anyone other than the Center staff to change the
case or performance from the way the SP was trained. Should someone request a
change, the SP should explain the need to have the role remain consistent with the
initial training and should refer the faculty to the Center staff to discuss the suggested
change.
 Time Out/Time In Teaching Technique
A time out is a valuable learning process for the students. When the SP is in a time-out
period, the SP is expected to continue the simulation (maintain facial expressions, body
language, etc.). However, the SP is NOT to interact with the student or group until time
in is called. The SP’s subsequent performance in the session must not be modified by
the discussion during the time-out period.
Time outs are only used during teaching sessions and are not used in assessment type
events. Time outs allow the faculty to provide the students with additional information
or redirect them without having to interrupt (theoretically) the scenario. When time in
is called, the scene resumes from where it left off as if the SP had heard none of the
discussion that occurred during the time out.
 Smoke-Free Campus
Emory University is a smoke-free campus inside and outside of buildings, so
please plan and behave accordingly.
 Faculty Room and Hallway Monitoring Area
Should an SP have reason to be in the Faculty Room during an event, the SP must
maintain silence so that others can listen and concentrate. During times of faculty
viewing SPs should maintain silence and enter and exit the room quietly so as not to
disrupt concentration of the faculty. SPs should not be in the hallway during an event.
Privacy is critical at the Center. An SP may be observing (or being observed by)
another SP for training purposes. If the examination is sensitive every effort will be
made by the staff to protect the SP’s privacy. It is also important for an SP to be
sensitive to the activities on the monitors and restrict viewing of the monitor to that
which is necessary for the training.
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 Housekeeping
As mentioned above, SPs are responsible for their examination rooms. Prior to the
event, SPs should check their rooms to ensure there is sufficient stock of all supplies,
including linen, and that needed props or cards are in place.
Following the session, SPs are responsible for returning props to their storage area,
tearing off the used paper on the exam table, and leaving the exam room in pristine
condition. SPs are responsible for putting all trash in the bins, straightening the room,
logging out and turning off the computer, and turning off the lights and wall mounted
equipment at the end of their session. SPs SHOULD MAKE SURE TO TURN OFF
THE OTOSCOPE/OPTHALMASCOPE UNIT AT THE END OF EACH SESSION.
Additionally, if the SP has any problems with the equipment, finds something not
working or utilizes the “last” of something in the room, he or she must notify the staff.
Writing a note on a “sticky” is a good way of passing on this information.
When finished with linen for the day, the SP places it in the hamper in the middle of the
suite.
SPs must not leave any confidential materials (case/checklists/instructions) in the desk
drawer even during brief trips to the bathroom or during a meal break.
SPs should not leave any personal belongings in exam rooms at the end of the session.
Emory is not responsible for any lost of misplaced personal items. Keys are available
for the cabinet in each room for securing personal belongings during breaks and the
Center suggest valuables be locked in the cabinet whenever the SP is out of the room.
 External Clients
When an SP is representing Emory off campus all the guidelines and expectations of an
Emory SP are in effect. In addition, there are some additional considerations when
dealing with external clients and these are covered in Appendix B.
 No Doctor/Patient Relationship
Standardized patients should NOT take any advice or recommendations made during
the course of an OSCE as constituting individualized medical care or advice. Should
something abnormal be found on physical exam, the SP can expect to be informed of
the finding and advised to seek medical evaluation and treatment for the SP’s personal
physician or other healthcare provider. Neither the learners nor faculty provide any
medical advice for SPs and none should be sought or expected.
12. Quality Assurance
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IT IS IMPORTANT TO MAINTAIN A HIGH-QUALITY SIMULATION AT ALL
TIMES.
The quality of the SP performance is a priority at the Center. Quality assurance will be
maintained using several methods:
 Direct observation during training
 Direct, scheduled observation during sessions
 Direct, random observation during sessions
 Videotape review
 Videotape self-review by the SP
Feedback will be provided to the SP as soon as possible.
If, at any time, an SP feels he or she is in need of a review or if the SP has questions or
concerns with the simulation, the SP should arrange some time with the staff through
Gina Shannon, the SP Program Coordinator.
13. Compensation
SP Compensation rates are determined by the Clinical Skills Center administration and
are subject to change. SPs are notified of such changes via the SP email list serve along
with posted copies of the SP Pay Scale. Current rates are shown in Appendix C.
SPs should sign in and out on the event green sheet on the stand outside of Room
#308. Omission of this step may delay processing of payment for the SP services. A
new green sign in sheet must be started for each day and for each event.
The sign-in time should be the call time or the arrival time, whichever is later. DO NOT
sign in earlier than the assigned call time. SPs will not be paid prior to the assigned
call time.
The sign-out time should be the time when all SP assigned activities, including
housekeeping chores, are completed and after dismissal from any debriefing activities.
SPs are given an estimated end time when the event is assigned but payment includes
time spent until the end of the event, including housekeeping and debriefing
activities. This may be earlier or later than the estimated end time given when the event
was assigned.
SPs should submit an invoice for each event worked. In lieu of an invoice, SPs may
complete a gold payment request form, also found on the stand outside Room 308. Sign
in and out times should be consistent with the green sign-in sheet and both must be
completed in full. Incomplete requests or conflicting information between the green
sheets and payment requests will likely result in a delay of payments. Payment requests
may include multiple days as long as they are each for the same client.
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Emory rounds to every quarter hour for payment purposes. For sign in at 8:06 (or any
time until 8:07.5) the SP will be paid beginning at 8 am. For sign in at 8:09 (or anytime
after 8:07.5) the SP will be paid beginning at 8:15. The Center will total the hours
worked and amount owed. Please leave that blank.
Please allow six to eight weeks for payment. A staff member processes payment
requests within seven days of a performance and submits them to Accounts Payable.
After the Associate Director has approved a payment it is process and paid (either by
direct deposit or mailed out to the address of record). If payment is not received in the
expected time period, please contact the Kara Cantrell for assistance. Please do not
contact us within the first 10 days after an event about payment issues.
Payment for training hours is included in the performance payment check. Should
an SP train for a case and not be available to do the case, training time will not be
compensated.
SP compensation is based on a level system which recognizes experience, achievement,
capabilities, responsibility, and professionalism. Level 1 is generally for a short period of
time during which the SP becomes oriented to Emory’s program and SP work in general.
Once the SP has successfully completed several roles or events and been given a
satisfactory performance review he/she advances to Level 2.
Level 2 generally lasts for approximately a year and involves successful performance of
multiple roles for the CSC and advancement in learning and implementing realistic
performances, physical simulations, and student feedback and checklist completion. The
staff periodically reviews SP performance reviews to determine whether a particular SP
meets the criteria for promotion to Level 3.
Level 3 is for experienced SPs with consistently high levels of performance assessment.
Each SP will be notified when a level advancement occurs.
Level 4 is reserved for health professionals with advanced training (nurse practitioners,
midwives, physician assistants, etc.) who may be used to assist faculty with case
evaluation. Additional information on levels can be found in Appendix D. Detailed
information about SP performance criteria and performance assessments is shown in
Appendix E.
Parking
As of the writing of these Guidelines, free parking is provided in Emory visitor lots via a
parking pass presented upon exiting the facility. This is policy is subject to change and
SPs will be notified via the SP email list serve of any changes to this policy. SPs should
not park in Children’s Healthcare of Atlanta lots or other restricted parking lots as they
may be towed. SPs should get a parking card from their Event Manager each time they
visit the Emory campus to allow them to exit the parking lots without charge.
14. DISCONTINUATION OF SERVICES FOR THE CSC
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All cases, checklists, and written materials are the property and copyright of EUSOM or
are on loan from another institution and being used with permission. These cases are to
be used exclusively by SPs booked through the Center. Upon discontinuation of services
for the Center, all written materials are to be returned to the center.
The Center strives to provide a high quality educational experience for its internal and
external clients through its use of SPs. Regular participation is crucial to keep skills
fresh. If, after 6 months of inactivity the Center reserves the right to place the SP on an
inactive list. After 12 months of inactivity, the SP will be removed from the list of the
Center’s SPs. Relisting to an “active status” may be discussed with the Coordinator by
appointment.
If a SP will not be available to provide services for an extended time period, the SP
should contact the Center as soon as possible and let the Center personnel know the
approximate departure and return dates. The Center will note this extended absence in
the SP’s file and if the SP returns, the notation will be removed from the file and the
Center will resume calling the SP for events.
15. Emory University Alcohol and Drug Policy
Emory University adheres to the Provisions for the Drug Free Workplace Act of 1988
and the Drug Free Schools and Communities Act Amendment of 1989. Emory
recognizes that its faculty, staff and students may participate in events where alcoholic
beverages will be served. Such events should provide an atmosphere where the
consumption of alcohol is not the primary focus and where choosing not to drink is as
acceptable as drinking.
For all SPs providing services to the Center, the following activities are expressly
prohibited:
 Drinking alcohol prior to sessions.
 Drinking alcohol during activities sponsored by a client.
 Drinking alcohol at a conference or workshop site where participants or clients may
observe consumption of alcohol.
16. Equal Opportunity and Discrimination Harassment Policy
As outlined in its Equal Opportunity and Discriminatory Harassment Policy (the
“Policy”) (http://policies.emory.edu/1.3), Emory University is dedicated to providing
equal opportunities to all individuals regardless of race, color, religion, ethnic or
national origin, gender, age, disability, sexual orientation, gender identity, gender
expression, veteran’s status, or any factor that is a prohibited consideration under
applicable law. Emory University does not discriminate in admissions, educational
programs, or employment on the basis of any factor outlined above or prohibited under
applicable law. Students, faculty, and staff are assured of participation in University
programs and in the use of facilities without such discrimination.
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In keeping with its commitment to maintaining an environment that is free of unlawful
discrimination and as is detailed in the Policy, Emory prohibits unlawful harassment.
Discriminatory harassment of any kind is not appropriate at Emory, whether it is sexual
harassment or harassment on the basis of race, color, religion, ethnic or national origin,
gender, age, disability, sexual orientation, gender identity, gender expression, veteran’s
status, or any factor that is a prohibited consideration under applicable law.
As independent contractors for the Center, SPs must conduct themselves in a
professional manner that is consistent with the Policy at all times and refrain from any
activity that could be viewed by staff and students as discrimination or harassment.
Discrimination and harassment will not be tolerated, and the Center reserves the right to
immediately terminate the contract with an SP who engages in discriminatory or
harassing behavior.
If an SP feels that he or she is the subject of discrimination or harassment by an Emory
student or employee, the SP should immediately report the behavior to Connie Coralli.
If she is not able to resolve the concerns, Dr. Douglas Ander (Assistant Dean, OMESA)
is available to discuss any concerns.
17. Complaints and Concerns
Please contact Connie Coralli with any complaints or concerns about the Clinical Skills
Center or the particular SP assignments. If she is not able to resolve the concerns, Dr.
Douglas Ander (Assistant Dean, OMESA) is available to discuss any concerns of the
SP.
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Appendix A: Specialized SP Groups
I. GTA and MUTA SPs
SPs who provide GTA and MUTA services are committed to helping students learn how to
provide high quality, comfortable and sensitive breast, pelvic, rectal and male GU exams. As
GTAs and MUTAs become more skilled and knowledgeable, they may serve as both the
instructor and the patient for these learning experiences.
All GTAs and MUTAs must learn and follow Emory’s guidelines while providing services at
Emory.
GTAs and MUTAs are used for teaching students the normal physical exam; therefore the
surgical absence of parts or the appearance of abnormal pathology may exclude a GTA/MUTA
from providing services. Anyone without a normal physical exam for any reason must be
cleared by the Associated Director to be utilized.
Basic GTA and MUTA training procedures*:
1.
Initial meeting to discuss overview and orientation of the job requirements
2.
Observe a session
3.
Physical examination by a clinician
4.
GTA & MUTA curricula and training
5.
Home study
6.
Small group rehearsal
7.
Additional training/observation as required
*Training procedures may be modified for the client/event if necessary. Assessments will require more
training times.
If a GTA/MUTA is not working regularly and does not attend the training session, he or she
will not be able to participate in an event. If there are mitigating circumstances that require rescheduling of the training with the trainer, please contact the Associate Director. The amount
of training required is at the discretion of the Associate Director.
If a GTA/MUTA has been inactive for 3 months, a refresher session(s) will be required with
the appropriate trainer.
If an individual SP develops materials that assist them in the learning of the case or checklist
and feels it would assist others with the case, the SP must submit the materials to Center Staff.
SPs are not to distribute materials without the prior review and approval of the Associate
Director.
Feedback and basic skill training and review are compulsory. Workshops are held on an
annual or semi-annual basis for all GTAs and MUTAs. If an SP cannot attend a workshop, the
SP will not be able to provide services for the Center.
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Orientation to specific event requirements will be provided prior to the event. This may be a
few days prior to the event or the day of the event. The SP will be notified of details in a
confirmation email from Center personnel.
GTA and MUTA selection follows the same parameters as other SPs.
GTAs and MUTAs are paid per student exam. EMSOM does not reimburse for faculty exams
to confirm findings or assist students. GTAs and MUTAs are compensated for scheduled
demonstrations for the class or small groups.
With their sign-in sheet and payment record, each GTA and MUTA must submit a form
bearing the signature of each student they examined. EUSOM will only compensate for one
exam per student so should the SP choose to allow a student not on the assigned list an exam,
be aware this will not be a compensated exam.
II.
Standardized Nurses
For the Emergency Medicine Clerkship OSCE, in addition to having a standardized patient, the
cases utilize a “standardized nurse.” These roles are generally played by actual nurses or
others with some type of health care back ground.
The “Standardized Nurses” have the following functions:
 Since most of the patients are unconscious, altered or distraught, the nurse provides
history gleaned from various family members, friends, witnesses, either personally or
over the phone.
 The nurse “takes orders” from the students for various diagnostic studies needed for the
student to assess and treat these cases and then “passes the results of these tests” back
to the student in a simulated real-time format.
 The nurse checks off items from the checklist that the student completes (or does not
complete) for the faculty to use in grading the student.
 The nurse provides the student with feedback about their particular performance.
 The nurse may provide standard prompts to assist the students during the exams.
III.
Parent/Baby Well-Child Visit Demonstrations
Each year parents of babies and preschool children join small groups of students to observe
an expert pediatrician or family doctor taking a history and performing a physical on these
pediatric patients. For this exercise, patients use the real history of the child, just as they
would if they were going to their own pediatrician. The ages sought for this experience are
children 2-4 months and 2-4 years. It’s always a hectic and fun day.
IV.
Non-English speaking SPs
The EUSOM currently provides a course “Spanish for Medical Providers” for students in
their second year of student. For this course, SPs whose native language is Spanish are
used to discuss common scenarios and culturally relevant content. SPs are used early in the
course for student practice and later in the course as part of the student’s final exam.
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Appendix B: External Clients
External clients may provide events on Emory campus or elsewhere. While on Emory campus,
events run much like internal events. While off campus, arrangements vary widely and SPs
need to be flexible and tolerant of changing conditions. It is important to remember that
whatever the location, a SP is representing EUSOM and the profession of SPs and behave
accordingly
The scheduling procedure is the same as that used for the Center’s internal Emory clients,
however preference is given for Level 3 SPs and those whose attendance, punctuality, and
behavior has been above reproach.
A staff member accompanies SPs to an away site if possible. Alternately a SP participating in
the event is appointed manager for the purposes of organizing and communicating.
SP’s are not to discuss a learner’s performance/behaviors and or faculty behaviors in public
places. Comments about specific learner/faculty behaviors/actions (humorous or otherwise)
are inappropriate in public places.
It is important for the SP to maintain a high quality simulation at all times. Therefore,
quality assurance will be constantly monitored and SPs will be provided feedback on site if
necessary OR upon return to the EUSOM.
External Client Exam rooms: The Center’s goal is to leave a site “cleaner” than upon arrival.
Any modifications for an event that an SP makes to a room (including moving equipment)
must be returned to original condition/set up.
Problems, complaints and comments are to be brought to the attention of the Event Manager or
charge SP on-site. SP’s are not to address concerns with the external client or client’s staff. All
concerns will be addressed by Center staff, either on site or at Emory upon return.
If an SP has an incident or concern with a Center on-site Event Manager, the SP should contact
Connie Coralli directly and immediately.
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Appendix C: Current Compensation Rates
SPs:
Role play scenarios during class
demonstrations, group exercises,
and teaching and/or assessment
activities.
SP Nurses:
SPs with a health care background
who have advanced evaluation and
feedback skills. May portray
nurses in cases.
GTAs:
Gynecological Teaching Associates
trained to teach the breast and
pelvic exam. Teaching rate also
paid for invasive assessment cases.
Payment for training is included in
the per student cost.
MUTAs:
Male Urological Teaching
Associates trained to teach the male
GU and prostate exam. Payment
for training is included in the per
student cost.
Monitor/Office Assistant:
Level I
Training:
$10/hour
Level II
Training:
$12.50/hour
Level III
Training:
$15.00/hour
Level IV
Performance:
$15.00/hour
Performance
$17.50/hour
Performance:
$20.00/hour
Training:
$10/hour
Training:
$15/hour
Training:
$15/hour
Training:
$20/hour
Performance:
$15.00/hour
Performance:
$17.50/hour
Performance:
$20.00/hour
Performance:
$35.00/hour
Teaching
Sessions:
$35.00/student
exam
Teaching
Sessions:
$35.00/student
exam
Teaching
Sessions:
$35.00/student
exam
Teaching
Sessions:
$35.00/student
exam
Teaching
Sessions:
$25.00/student
exam
Teaching
Sessions:
$25.00/student
exam
Teaching
Sessions:
$25.00/student
exam
Teaching
Sessions:
$25.00/student
exam
$10.00/hour
$15/hour
N/A
N/A
$15/hour
$17.50/hour
$20.00/hour
N/A
Training:
Not Required
N/A
N/A
N/A
N/A
Event Manager/Stage Manager
SP Model:
SPs who are not required to learn or
portray a case but a live body is
needed. An example would be to
serve as a body for learners
perfecting ultrasound skills.
April 2013
Performance:
$15.00/hour
Page 29

Level 1 (novice): This is the initial level for SPs during their first 1-6 simulations,
orientation and mandatory MIRS training. Performance evaluations should be satisfactory
for the novice level.

Level 2 (intermediate): Once SPs have completed several initial simulations successfully
they progress to an intermediate level for the first 1+ year. At this level SPs should be able
to perform all types of cases following training, give verbal and written (checklist)
feedback, be competent with MIRS ratings and feedback and be actively involved in the
program. Performance evaluations will indicate a high level of performance, flexibility,
quality, responsibility and reliability. Most will have specialized training in some aspect of
physical exam or evaluation (done/not done, correct/incorrect/not done).

Level 3 (experienced): SPs progress to this level after a year of active involvement in the
program and performance evaluations showing the highest level of performance, flexibility,
quality, responsibility and reliability. Standardization and consistency will be seen
routinely. Student feedback will be at a high level. They will require minimal training to
perfect that case and will have multiple physical simulations perfected.

Level 4 is reserved for health professionals with advanced training and skills who can serve
as faculty proctors for events.
Orientation, MIRS, and required annual training is paid at the Level 1 training rate for all SPs.
April 2013
Page 30
Appendix D: Performance Criteria

The Standardized Patient and Performance Criteria: Standardized Patients are trained
to portray a patient case, assess/document student performance, provide individualized
feedback on clinical, interpersonal skills, professionalism and represent patient satisfaction.
For select events, the SP completes a checklist of physical examination techniques
(correct/incorrect/not done). Feedback may consist of letting the learner know how it felt
to be cared for by him/her and/or reviewing checklist items. As a Standardized Patient
gains experience, knowledge and expertise he/she will be assessed using the following
criteria for advancement to other levels:
1. Ease of training and time training for a high quality performance: As experience
increases for the SP, training time is more efficient and effective.
2. Quality of Feedback: Review of feedback forms from student/faculty/trainer, quality
and detail of verbal and written feedback. Feedback is accurate and consistent in
quality. Upholds training, uses phraseology as specified, and completes
professionalism forms in detail.
3. General Attendance/punctuality: Consistently arrives on time or provides adequate
advance notice when late.
4. Preparation: Prepared with case details, knowledge of checklist and feedback.
5. Working with staff, students, and peers: Works well with Center staff, students and
peers.
6. Flexibility: Ability to adapt to quick changes in the event.
7. Ability to receive feedback and integrate feedback: Integrates feedback readily and
consistently and does not object to changes given.
8. Consistently performs in a high-quality manner: Understanding details necessary to
portray cases and document student performance.
9. Contributes positively to the attitude and morale of peers: Consistently contributes to
Center morale and attitude. Does not contribute or spread malicious gossip or rumors.
10. Checklist accuracy and reliability: Consistent checklist accuracy and reliability
11. Professionalism: Represents Center professionally at all times and is conscious of
impact to internal and external clients.
April 2013
Page 31
Appendix E: Confirmation E-mail
EVENT DATE(S)
EVENT CALL TIME & END TIME:
REPORT TO:
PURPOSE/OBJECTIVES:
LEVEL OF PARTICIPANT
EVENT MANAGER
ROLE:  SP
 Other
 Small Group  Class Demo
 PTA
 GTA
 OSCE
 Other
FORMAT :
SESSION:
CHECKLISTS:
FEEDBACK:
COMPENSATION:
NOTES:
April 2013
Page 32
Approved by:
Connie H. Coralli, MN MPH
Associate Director
Clinical Skills Center
___________________________________
Margo Kuisis
Director
Office of Medical Education
& Student Affairs
___________________________________
Douglas Ander, MD
Assistant Dean for
Medical Education
April 2013
Signature
Signature
Date
Date
___________________________________
Signature
Date
Page 33