“Teach 1, do 1 … better”

PURPOSE: To see if senior medical students who had served as standardized patients (SP) demonstrated improvement in their own interpersonal communication skills. METHOD: From George Washington School of Medicine's class of 1996, 154 fourth-year students took a clinical practice examination that used professional SPs. Within the preceding six months, 28 of these students had been SP-examiners in similar examinations for first- and second-year medical students. The professional SPs rated the fourth-year examinees using checklists that measured five dimensions of interpersonal communication skills. Four of these five dimensions were identical to those measured on the examinations for which the fourth-year students had served as SPs. Hypothesizing that the SP-experienced seniors would outscore their inexperienced classmates on those four dimensions, but not on the fifth, the authors analyzed the fourth-year students' scores. P values were computed by the F test from a two-way analysis of variance. RESULTS: As predicted, the group with prior SP experience significantly outscored their inexperienced colleagues in each of the four expected dimensions of interpersonal communication skills, with p values ranging from .000 to .023. The score differential in these dimensions ranged from 3.8 to 11.8 percentage points. As further predicted, there was no significant difference between the scores of the two groups on the fifth dimension. CONCLUSION: Compared with their inexperienced peers, senior medical students with prior SP experience consistently demonstrated superior scores when their own communication skills were tested in a similar manner. The U.S. Medical Licensing Examinations propose to incorporate SP clinical examinations; in response, medical schools will use more SP examinations in their own curricula. Such examinations are expensive when using professional standardized patients; the authors believe that an SP program using senior medical students will prove an attractive alternative. Such programs may have the added advantage of making better communicators of senior medical student teachers as well as the students they teach.