THE SIMULATED SURGICAL OFFICE - AN INNOVATION IN AMBULATORY CARE TEACHING

As hospital-based medicine becomes increasingly focused on the care of severely ill patients, new models of teaching in the outpatient setti ng must be sought. This paper describes such a new approach: the simul ated surgical office (SSO). The SSO has three essential features: firs t, the use of standardized patients (SPs); second, the use of a proble m-based learning (PBL) approach; third, the process of longitudinal fo llow-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 se ssion focusing on the results of treatment and patient outcomes. A pil ot project involving six clinical clerks was conducted. Students, as a ssessed by SPs, showed growth in clinical competence throughout the co urse. The students judged the SSO to be realistic, important and chall enging.