Students watch a video of a brief (~10 minute) standardized psychiatric outpatient interview and write a Post-Encounter Note. Students have 15 minutes to write the note based off notes taken during the interview and review of the facesheet, which includes vitals, current medications, and any relevant information (e.g. the patient's clock drawing). Documented student assessment includes a relevant history, mental status exam findings, differential diagnosis that includes at least three diagnoses accompanied with rationale based on findings, and diagnostic plan. Grading is based entirely on documentation using standardized rubric scoring elements for each section of the note, with written feedback given to the student for improvement.
The purpose of this assessment is to 1) demonstrate information gathering and reporting skills; 2) gauge interpretation of findings and synthesis of information (i.e., case formulation and clinical reasoning); 3) review and encourage appropriate diagnostic plan and next course of action in the developing physician; and 4) simulate the Step 2 CS format of testing to the student early in their training with prompt feedback to familiarize the student with the exam so they may set expectations and prepare appropriate study practices. Different cases exist for major psychiatric diagnoses, with plans to develop more. This assessment could easily be adapted to other specialties (general medicine, neurology, pediatrics, surgical specialty clinic, etc.).
This assessment has been integrated into the University of Texas Medical Branch third year psychiatry clerkship for the past two years, with the assessment given halfway through the clerkship and feedback received usually within one week. A poster presented at two educational conferences details findings from student surveys and correlations with other performance measures (e.g. NBME exam score). A poster presented at two academic conferences about the results and correlations of this assessment is also included.
Michael Miller, MD, University of Texas Medical Branch at Galveston
Dawnelle Schatte, MD, University of Texas Medical Branch at Galveston
Undergraduate Medical Education (UME)
Standardized/Simulated Patient (SP)
Clinical Experience- Ambulatory
Patient Presentation - Learner
KeywordsVideo, Case, Documentation, Interview, Step, Standardized, Formulation
© 2020 Attribution-NonCommercial