Programs at The Morchand Center

The Morchand Center is the home of the Standardized Patient (SP) Programs. SPs at The Morchand Center are experienced, professional actors who are specially trained to simulate the signs and symptoms of an illness, believably and consistently, in simulated doctor-patient encounters and to provide feedback to candidates on their performances.

Learning Levels

The Morchand Center offers programs for students and professionals spanning the spectrum of learning levels including:

• Undergraduate Medical School
• Residency
• Secondary Education (Jr. HS and HS)
• Non-Clinical Health Care Professionals (e.g., Front Desk Staff, etc.)
• Learners in Non-Health-Care Fields (e.g., Standardized Client Training for Law Students, Mediation and Dispute Resolution Skills, Language Learning Assessment)

Learning Domains

Some of the most commonly assessed medical learning domains are outlined below. Most simulated encounters incorporate multiple domains for maximum effectiveness.

• History Taking Training and Assessment: this includes basic, complete history; focused history (based on a specific complaint); domestic violence; sexual history, using a medical interpreter; exams in Spanish.
  
  
• Physical Exam Skill Training and Assessment: trainees learn how to conduct a complete PE and focused PE (based on a specific complaint), specific organ systems (ie., Musculoskeletal, HEENT, etc.), how to use a medical interpreter and how to perform exams in Spanish.
  
  
• Interpersonal Communication Skill Training and Assessment: this encompasses: basic communication skills, delivering bad news, communicating with difficult patients, cultural competency, HEADSS Assessment; counseling skills (diet, exercise, smoking cessation, safe sex, et al.); using a medical interpreter and conducting patient interviews in a foreign language.

Major Programs Utilizing Standardized Patients

The following primary programs at The Morchand Center utilize SPs:

• End of Third Year Assessment: This day-long program has run continuously since the Center's inception. A clinical examination administered to all third-year medical students in the New York City Consortium, this program evaluates physical examination, history-taking, communication, diagnostic reasoning, test selection and test interpretation skills. Each student is videotaped in seven patient encounters in which they must meet a variety of challenges from different medical disciplines. The completed tapes and test scores are provided to the candidates and their schools for review and recommendations.
  
  
• Second Year Clinical Skills Assessment: This second-year program evaluates students' history-taking, physical examination and oral and written communication skills, as well as clinical and ethical reasoning, to assure competency. Students take a comprehensive hour-long history and perform a physical examination. They receive immediate verbal and written feedback from their "patients" and/or preceptors regarding their strengths and weaknesses in those particular areas. Those in need of remediation are then teamed with specially-trained faculty members who provide individual retraining.
  
  
• PGY-1 House Staff Assessment: Established in 1995, this program assesses the competency of incoming American and international medical graduates (PGY-1s) in the areas of clinical skills, communication and English proficiency. The cases focus on important communication issues relevant to residency practice, including anticipatory guidance, advance directives, responsible prescribing, medical error apology and informed consent.

Other Program Assessment Topics Include:

• Third-Year Clerkship-Specific SP Programs
• Delivering Bad News
• Ethical Dilemmas in Medicine
• Geriatric Palliative Care
• Team Training in Geriatric Care
• Medical Needs of Culturally Diverse Populations
• Organ Donation Consent Coordinator Approach Training
• Communicating a Medical Error
• Obtaining Consent for Autopsy
• Counseling Patients on Pharmaceutical Advertising
• Employee Customer Service Training
• Emergency Procedure Drills
• End of Life Issues Counseling: Advanced Directives/Health Care Proxy/Organ Donation
• Genetics Counseling
• Gender Issues

Learning and Assessment Formats

The following are the primary methods of assessing trainees' skills:

• Multiple Case Exams (Midterms, Final Exams)
• Time-In-Time-Out
• OSCE Stations
• Practicum Sessions
• Team Training
• Immediate One-on-One Feedback
• Telephone Encounters