The standardized patient assessment examination (SPA) is an integral part of the new Prescription for Excellence: A Physicians Pathway to Lifelong Learning curriculum at Wake Forest University School of Medicine (WFUSM). It consists of two parts: Part I is an exercise in which the student takes a complete history and performs a physical examination on a standardized patient. In Part II the student gives a 2-hour oral presentation of his/her clinical reasoning process and presents a basic science discussion on a topic related to the case. Although WFUSM had been doing standardized patient assessments since 1987, they involved only 25% of the medical school class. In 1998 the exercise was expanded to include the entire medical school class of 108 students. This created logistical challenges related to facilities, cost, recruitment of standardized patients, and faculty to supervise the exercises. In addition, changes were made in the process to allow more integration of the clinical cases with the basic science curriculum. Although these exercises are extremely time consuming and labor intensive for faculty and staff, they are felt to measure reasoning skills not examined in other parts of the curriculum, and emphasize the importance of relating clinical situations back to the basic sciences.

Fourth Year Medical Students are Effective Case Discussion Leaders
Uldis N. Streips Ph.D. and Ronald M. Atlas Ph.D.*


Student and Faculty Attitudes Towards a Neurosciences PBL Pilot in a Traditional Curriculum
Chris Candler, M.D. and Robert Blair, Ph.D.

ABSTRACT