Med students hone patient skills in exam simulation

by Melanie Evans

Sitting side by side at 11 a.m., Mike Nelson and Mike Connelly appear drunk.
The third-year University Medical School students have been somewhat tipsy — on-again, off-again — since 8:15 in the morning.
Nelson and Connelly posed as intoxicated patients Saturday, volunteering for the medical school’s annual clinical examination for second-year students. Every five minutes the two replayed their routine for a new student who must determine the duo’s health risks.
The exam, conducted each spring, gauges medical school sophomores’ ability to diagnose a range of medical problems while dealing with the human element of medicine: patients.
Describing a case is a far cry from demonstrating one, said Ilene Harris, a professor and senior research associate in the medical school’s curriculum office.
“Clinical knowledge can be assessed using a paper and pencil exam,” said Harris. “What can’t be assessed well are skills in communicating with patients.”
Although not graded, results of the test have clued students and professors to the strengths and weaknesses of the school’s education program.
Medical school administrators are debating whether to add another test for the end of the students’ third year on a pass-fail basis, Harris said. Students would be held back if they did not demonstrate adequate communication skills.
“With all the information you get in the first and second years, you feel overwhelmed,” said Nelson, who took the exam in 1997. “Its nice to know you’ve learned something.”
The exam is a rite of passage for medical students, who start to spend time in clinics with patients during the second quarter of medical school.
Running two hours and 30 minutes, the exam is a marathon of stations. Entering one room after another, students spend five and a half minutes in each with mock patients.
Second-year student Sandy Turbes said a desire to perform well and the time constraint made her nervous, though she knows it is not possible to fail.
“I feel my face getting red each time I go in a room,” she said.
White lab coats line the halls between the five minute sessions. Papers rustle as students rummage through the brief synopsis of what they will encounter at the next station.
The clinical exam included 19 stations, plus three rest areas stocked with water and candy.
Sarah Wilson sat at station 11. Her eyes lowered, she explained to second-year student Topher Obetz why her diabetes has gotten out of control. Conflicting cultural values and economic difficulties have kept Wilson’s character, a Native American patient, from visiting the clinic.
Few students Saturday were prepared to deal with diverse backgrounds, said third-year student Patrick Ridgely, Wilson’s partner at station 11.
Although ethical and personal issues might not be raised in class, they definitely prevail in practice, said Obetz’s classmate Brandi Witt
“I fear that I’m not going to know what I’m doing,” she said. “That I’ll get to rotations in June and I won’t know what to do.”
The opportunity to test her skills in Saturday’s exam was gratifying, she said.