For more than 50 years, standardized patients have been a staple of medical school instruction. These individuals are trained in symptoms and problems associated with disease and act as patients to give medical students hands-on training in the practice of medicine.

Today, the University of Louisville School of Medicine has taken use of standardized patients (SPs) to a new level, allowing more students to achieve learning objectives in a compressed time period and learn more about managing the continuity of care for patients.

The Longitudinal Standardized Patient Project gives students a single SP to see throughout their two-year Introduction to Clinical Medicine course. In the course, students must successfully master the core patient history-taking, examination and communication skills they will need for their future training and ultimately, as practicing physicians.

“In the program, each student only sees ‘their’ patient, one of nine patient characters we have developed, in 19 different patient encounters,” said Charles Kodner, M.D., director of the Introduction to Clinical Medicine course. “This single SP enables the development of a continuity relationship, eliminating the need for the student to review the patient’s history with each encounter. Students gain time to focus on the purpose of the patient visit and the individual learning outcome they are expected to achieve.

“In short, the Longitudinal Standardized Patient Project more closely mirrors what our students will see when they start caring for actual patients later in their training and once they become practicing physicians.”

The ongoing student-SP relationship has strong benefits for the student, said Carrie Bohnert, director of the UofL Standardized Patient Program. “Students begin to realize much earlier in the medical education that patients are real people with potentially complex personal and medical histories,” she said. “They are able to experience a doctor-patient relationship that has continuity – something not otherwise available during the first two years of medical school.”

An unexpected benefit has been the growing role of the SP as teacher as well. “Our SPs have developed personal teaching relationships with their students and are able to identify subtle changes in student skill development or lack of development and other problems that might otherwise be missed without a strong continuity relationship,” Bohnert said.

The program has been well-received, Kodner said. “As we survey students both before and after the Longitudinal Standardized Patient Project, we have observed substantial increases in our students’ perceptions that the cases were realistic and that they could learn about medical problems and their patient as a person in the time available.”

Said Bohnert, “the outcomes of this program have exceeded expectations, allowing our students to experience both the joys and the challenges of a long-term doctor-patient relationship.”

Kodner and Bohnert discuss the program in an article, “The Longitudinal Standardized Patient Project: Innovation from Necessity,” in  Academic Medicine, published online Nov. 18 and scheduled for publication in an upcoming issue of the print version of the journal.

Academic Medicine is the scholarly journal of the Association of American Medical Colleges, the accrediting body and professional organization of medical schools in the United States and Canada.

Funding for the Longitudinal Standardized Patient Project was provided in part by a Paul Weber Award of $50,000 for Excellence in Teaching, awarded May 2010 by the University of Louisville.