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Using standardised patients in an objective structured clinical examination as a patient safety tool

¹ United States Department of Health and Human Services, Agency for Healthcare Quality and Research, Center for Quality Improvement and Patient Safety, Rockville, MD, USA
² Hoxworth Blood Center, University of Cincinnati Medical Center, Cincinnati, OH, USA
³ The Blood Center of Southeastern Wisconsin, WI, USA

Correspondence to:
Dr J B Battles
Agency for Healthcare Research and Quality, Center for Quality Improvement and Patient Safety, 540 Gaither Road, Rockville, MD 20850, USA; jbattles{at}ahrq.gov Standardised patients (SPs) are a powerful form of simulation that has now become commonplace in training and assessment in medical education throughout the world. Standardised patients are individuals, with or without actual disease, who have been trained to portray a medical case in a consistent manner. They are now the gold standard for measuring the competence of physicians and other health professionals, and the quality of their practice. A common way in which SPs are used in performance assessment has been as part of an objective structured clinical examination (OSCE). The use of an SP based OSCE can be a powerful tool in measuring continued competence in human reliability and skill performance where such skills are a critical attribute to maintaining patient safety. This article will describe how an OSCE could be used as a patient safety tool based on cases derived from actual events related to postdonation information in the blood collection process. The OSCE was developed as a competency examination for health history takers. Postdonation information events in the blood collection process account for the majority of errors reported to the US Food and Drug Administration. SP based assessment is an important patient safety tool that could be applied to a variety of patient safety settings and situations, and should be considered an important weapon in the war on medical error and patient harm.

Abbreviations: BPD, blood product deviation; FDA, Food and Drug Administration; G theory, generalisability theory; HXE, history examination extraction; HXI, history examination interpretation; HIV, human immunodeficiency virus; OSCE, objective structured clinical examination; SD, standardised donor; SP, standardised patient

Keywords: medical error; patient safety; competency assessment; objective structured clinical examination (OSCE); post-donation information