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0209 Simulated Patients Versus Real Patients As Learning Resources In The Clinical Skill Training Of Medical Students – A Randomised Crossover Trial Of Their Effectiveness
  1. Sean Gardiner1,2,
  2. Frank Coffey1,3,
  3. John O’Byrne1,2,
  4. Fiona Boland1,
  5. Arnold Hill1,4
  1. 1Royal College of Surgeons in Ireland, Dublin, Ireland
  2. 2Cappagh National Orthopaedic Hospital, Dublin, Ireland
  3. 3University of Nottingham, Nottingham, UK
  4. 4Beaumont Hospital, Dublin, Ireland


Background Simulated patients (SPs) and clinical teaching associates (CTAs) are now being used widely in undergraduate medical training programmes, with strong evidence in specialities such as gynaecology underlining their value when compared to using real patients.1 There are no comparable studies in orthopaedics published yet. Increased use of SPs/CTAs in orthopaedics would reduce the need for patients to undergo potentially painful musculoskeletal examinations, and may actually prove to be more beneficial to students as learning aids.

This study aims to conduct a controlled, double-blinded, crossover trial to investigate whether simulated patients are as effective a learning resource in the orthopaedic training of undergraduate medical students as real patients.

Methodology 103 IC3 Royal College of Surgeons in Ireland (RCSI) students attending Cappagh National Orthopaedic Hospital for their IC3 orthopaedic attachment participated.

Subjects were randomly allocated to one of the two study arms. One half of the subjects were assessed and trained using real patients and the other half using simulated patients (Hip osteoarthritis - week 1, Supraspinatus pathology - week 2). Students then crossed over to the other arm after one week, ensuring both groups were exposed to real and simulated patients, followed by an OSCE reassessment of one of the scenarios using real patients.

Minimisation was used to ensure balance between groups in terms of certain factors (computer randomisation based on student’s age, sex, English language status and class ranking). Descriptive statistics will be used to evaluate differences in other baseline characteristics between participating students in the two arms of the trial. Repeated measures analysis of variance (ANOVA), adjusting for baseline covariates will be used to analyse scores.

Results/outcomes Anticipated

Preliminary results suggest that the group taught using SPs achieved higher results.

Potential impact RCSI will integrate SP training as part of their undergraduate syllabus when results are confirmed.


  1. O’Sullivan MEC, Lynn SM, Masiello M, Sinha A, Jones K. A prospective study comparing teaching by clinical teaching associates with traditional methods: BJOG 2013;pp326

  • Category: Course or curriculum evaluation/innovation/integration

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