Uncertainty Communication Toolkit

Training Materials

Standardized patients (SPs) have a critical role in this program; SPs are responsible for assessing how the trainee performs according to the uncertainty communication checklist (UCC) and providing them with feedback. The following training materials should be used to ensure that SPs are properly trained so that they rate trainees in a consistent manner. Two to four weeks prior to curriculum implementation, a session should be set up to facilitate standardized training of the SPs. Standardized training ensures that SPs will improve the consistency of checklist application. During the training session, we suggest introducing the curriculum and explaining the context of diagnostic uncertainty, reviewing the selected simulation cases, reviewing the Uncertainty Communication Checklist (UCC) in detail, and then launching into the training videos to provide practice and examples. Do not share the numeric minimum passing standard with the SPs, so that they can be objective in their rating of the resident performance.

Training Videos

There are a total of eight training videos, including three simulation videos, three videos that annotate how the simulated encounters should be scored, and two feedback exemplar videos. We suggest showing the simulation videos and the annotated scoring video back-to-back while making sure to pause to answer SP questions throughout the session. The feedback videos show how SPs can approach providing individualized feedback to the residents based on their specific encounter.

Headache Training Video (Approx. 6 mins.):

Back Pain Training Video (Approx. 6 mins.):

Abdominal Pain Training Video (Approx. 7 mins.)

Annotated Headache Training Video (Approx. 7 mins.):

Annotated Back Pain Training Video (Approx. 7 mins.):

Annotated Abdominal Pain Training Video (Approx. 8 mins.):

Headache Feedback Training Video (Approx. 10 mins.):

Back Pain Feedback Training Video (Approx. 7 mins.):

The UCC is a 21-item checklist used by SPs to assess participants’ standardized patient encounters. Explain that the learner must perform all aspects of the item, so if they do not complete the item completely mark it as “no.” When introducing the checklist, provide the context of why each item is important (for example, Item 1 - introducing that I am being discharged in the beginning of the conversation - is important to put the patient in the mindset that they are going home). Make special note of action items that the SPs will need to perform, and which items vary between cases (i.e. Items 2 and 7). Before starting the videos during the training session, provide each SP with multiple blank copies of the UCC and encourage them to score the actor as they follow along with the video, just as they will be scoring trainees in the future.

View Checklist

Explains the variations in SP and clinical scenarios across the simulation cases, should be used to facilitate SP case assignment. Please use the details provided for each case to match the case with an SP. You may need to alter some of the case details (i.e. age, conditions, etc) in order to better fit the assigned SP. Any changes applied to the SP Simulation Instructions will need to be carried over to the corresponding Resident Simulation Instructions. We suggest assigning no more than three cases per SP, to ensure that the SP is able to accurately portray each case and does not confuse the details between cases.

Clinical Scenarious Spreadsheet

SP Simulation Instructions

Case by case SP instructions for performing simulation cases (note – these go along with the Resident Simulation Instructions for the simulation cases). At the end of the training session, let each SP know which cases they will be responsible for learning and portraying during the simulated encounters. We suggest providing copies of each scenario, and reviewing the assigned cases during the training session so that they have the opportunity to ask questions.