Using Standardized Patients to Teach Clinical Ethics

A literature search shows multiple uses for standardized patients for teaching and evaluating clinical skills. However, there is little written about the use of standardized patients for teaching clinical ethics. When the Standardized Patient Program was organized at the Medical College of Ohio at Toledo in 1991, the Ethics Program realized the potential for innovative and interactive learning opportunities for medical students. Topics including ethical issues in psychiatry, domestic violence, physician assisted suicide, taking a sexual history, giving bad news and discussing DNR status have been incorporated into cases in which standardized patients are trained. These cases are then used to help students learn about these difficult issues. Student interaction with standardized patients in the second year teaches them how to communicate with a manic patient refusing psychotropic medication; and how to take a sexual history without embarrassment. In the third year medicine clerkship, students have to discuss “bad news” with a patient and try to obtain a “code status” decision. By using standardized patients, we make our teaching more clinically relevant for students. We build didactic presentations around case studies to demonstrate what physicians are likely to encounter in the clinical setting. In this paper we will describe how the synergistic relationship between the standardized patient and ethics programs has enhanced the educational process for our medical students.