The simulated surgical office: an innovation in ambulatory care teaching

Abstract

As hospital-based medicine becomes increasingly focused on the care of severely ill patients, new models of teaching in the outpatient setting must be sought. This paper describes such a new approach: the simulated surgical office (SSO). The SSO has three essential features: first, the use of standardized patients (SPs); second, the use of a problem-based learning (PBL) approach; third, the process of longitudinal follow-up. The SSO curriculum is delivered over a four-week period. Week one comprises five SP-based encounters in an office environment. Week two is a PBL session using those five problems. In week three the SPs return with individualized presentations dependent on the management planned by the student in session one. Session four is a second PBL session focusing on the results of treatment and patient outcomes. A pilot project involving six clinical clerks was conducted. Students, as assessed by SPs, showed growth in clinical competence throughout the course. The students judged the SSO to be realistic, important and challenging.