Kado Clinical Skills Center
The Kado Family Clinical Skills Center provides students and professionals with educational resources focused on the development & improvement of clinical performance.
Our specific goals include:
- Developing quality experiential learning programs at the undergraduate, graduate, and continuing education levels.
- Conducting research that contributes evidence to enhance health care education.
- Partnering with health care providers to provide assessments and training initiatives to enhance patient safety.
- Fostering strong community outreach programs that educate and inspire the individuals we serve.
Learners and Clients
Wayne State Medical Students
Small Group Sessions with Standardized Patients (Parachute Club)
During the first year, students are required to attend a series of faculty led small-group sessions. Three of these small group sessions provide students an opportunity to interview a Standardized Patient (SP). The SP will present as a patient to one interviewing student, ending the session by providing the student with patient-centered feedback. This is followed by a faculty-led debrief, wherein students engage in discussion and questions regarding the case presentation, challenges with eliciting an interview and a discussion of interpersonal and communication skills. The SP encounters are designed to be complementary to ongoing discussions in the other small group sessions, designed to ensure the student will:
- Learn to communicate effectively with patients
- Learn the proper way to obtain an organized and concise medical history
- Demonstrate professional behaviors including preparation, participation, punctuality, and for team members.
The Clinical Medicine OSCE is an end-of-year practical exam designed to assess students’ clinical skills. During this exam, students will have one patient encounter wherein they elicit a history (no physical exam). After the encounter, students will write a post encounter note, detailing the as well as a problem list, listing at least two main problems they identified in the patient’s history. The objective of the OSCE is to determine if the student has achieved the following objectives:
- The ability to take a satisfactory medical history including psychosocial, nutritional, occupational, and sexual dimensions.
- The ability to document the clinical encounter.
- Demonstrate taking a focused and organized medical interview.
- Demonstrate professional behaviors
The Physical Diagnosis (PD) unit of Clinical Medicine II (Second year of medical school) builds upon the Interview, History Taking, Physical Examination and Clinical Decision-Making (EBM) skills students started learning in their first year. PD sessions begin in November and commence with a practical exam, scheduled throughout March. A written exam is also given in April. At the Clinical Skills Center, students will work with standardized patient teaching associates and faculty to:
- Refine history taking skills
- Build on their knowledge of pathophysiology
- Perform physical exam maneuvers on all five organ system / regions of the human body. (Head and Neck, Abdomen, Cardiovascular / Respiratory, Musculoskeletal, and Neurological)
- Additional special sessions are facilitated by staff of the clinical skills center; these include:
- Harvey: Small group faculty-led sessions utilizing the Harvey cardiopulmonary simulator. Here students have the opportunity to learn how to identify normal and abnormal heart and lung sounds.
- Ultrasound: Students work with faculty from Henry Ford Hospital, learning how to capture and interpret ultrasound images (cardiac, musculoskeletal, abdominal).
- Male GU / Female GTA: Students work in small groups with plastic models to learn the basic clinical skills associated with performing the male genitourinary exam and the female pelvic exam.
- Eye Exams: Students attend faculty-led didactic and practical sessions where they have the opportunity to discuss anatomy, pathology and practice performing eye examinations on each other.
By the end of the course, students will be able to:
- Elicit a comprehensive patient-centered history
- Perform a comprehensive physical exam on a patient, in the proper sequence.
- Recognize / elicit abnormal findings
- Recognize the elements of presenting in an organized fashion
- Define a problem list and generate differential diagnoses for the main problem
- Recognize symptoms and physical findings of common medical conditions
- Gynecological Teaching Sessions
- Clinical Refresher Course – Offered to rematriculating third year students
- Year III OSCE – Clinical Skills Exam offered to students near the end of their third year to assess their ability to perform a focused clinical encounter and effectively write a post-encounter note.
- OB/GYN Clerkship High-fidelity simulation
Emergency Medicine Clerkship OCSE
(View the Emergency Medicine High-Fidelity Simulation information in the Available Simulation Modalities section below.)
End of Life Scenarios
Wayne State University MS4 Advanced Surgical Skills Elective (ASSE)
This is a clerkship/rotation offered primarily to 4th year medical students who are planning on entering a career in General Surgery or another surgery subspecialty. However, it is not limited to students who are planning on surgery as a career. Students entering into Family Practice, Emergency Medicine, Obstetrics and Gynecology and Radiology have been accepted into the clerskship/rotation. The clerkship/rotation is a month long. The time commitment is eight hours per day, fiv days a week, 40 hours per week, or 160 hours per month, depending on how you want to look at it. The elective is designed to prepare the student for their upcoming PGY-1 residency job which starts July 1. The elective includes cognitive teaching and surgical skills training.
There are five parts to the elective and these are listed below:
- Pre-training Assessment and Testing The students undergo initial testing on the first day of the clerkship/rotation. They undergo three surgical skills tests and seven cognitive exams.
- Surgical Skills Modules There are 14 different surgical skills we teach. They include basic and intermediate open and laparosocpic skills. Each surgical skills module is taught by a clinical surgery faculty member from Wayne State/DMC or Henry Ford Hospital. Each module has a syllabus with stated goals and objectives for the surgical skill being taught.
- Patient Management Problems (PMPs) There are 16 PMPs which are the most common problems a PGY-1 resident is most likely to encounter to during their first year of residency. Students are responsible for the teaching of these modules and lead the discussion within the group along with a faculty moderator/proctor.
- Anatomy Module There are 14 anatomy modules. Students are responsible for the teaching of these modules and lead the discussion within the group along with a faculty moderator/proctor. We use both web-based anatomy illustrations as well as fresh cadaver dissections to teach surgical procedure-based anatomy to the students.
- Post-training Assessment and Testing The students undergo final testing on last day of the clerkship/rotation. They undergo the same three surgical skills tests and seven cognitive exams they received on day one of the clerkship/rotation.
Allied Health Professions
Physician Assistant Students
- Skills sessions and Problem Oriented Physical Exams (POPEs)
- Comprehensive skills examinations
- Year II OSCEs
- Physical exam and communications skills practice
- Practical Exams
Residents/Fellows OSCEs to assess ACGME competencies, including communication and interpersonal skills, professionalism, and systems-based practice. High Fidelity Simulation.
Faculty & Clients
- Wayne State University School of Medicine
- Wayne State University Genetics Counseling Program
- Wayne State University Physician Assistant Studies
- Wayne State University Pharmacy Program
- Wayne State University Graduate Medical Education Sole-Sponsored Programs
- Beaumont Hospital
- Children’s Hospital of Michigan
- DMC – Harper Hospital
- DMC – Sinai Grace Hospital
- Henry Ford Hospital
- Southeast Michigan Center for Medical Education
- St. John Hospital and Medical Center
- St. John Providence Hospital
- St. Joseph Mercy Ann Arbor
- St. Joseph Mercy Oakland
- University of Detroit Mercy School of Dentistry
- Highly customized services are offered to clients and stakeholders to clearly identify training and assessment needs. The Assistant Director of Clinical Evaluation and Director of Operations work closely with faculty to design and implement comprehensive teaching and testing in a variety of clinical areas.
- Interested in a quote for services? Please contact DeShaun D. Harris (firstname.lastname@example.org) for additional information.
- Video records of learner performance, available streaming online or in hard-copy.
- Learner performance reports, delineated individually and/or customized aggregate/cohort reports.
Available Simulation Modalities
The Standardized Patient (SP) Program within the Kado Clinical Skills Center provides hands-on training and assessment in physical exam skills, communication, and patient-centered care. This program trains lay people to present specific medical ailments and medical histories for the purposes of teaching and testing medical students, residents, fellows, and other health professionals.
The success of this program is built upon a commitment to excellence and a rigorous approach to recruitment and training of SPs. The SP program is integrated into all four years of medical school education as well as resident training for internal medicine, surgery, emergency medicine, pediatric, neurology, and multiple subspecialty trainees from over seven different hospital systems.
High-Fidelity Mannequin Simulation
Wayne State University has been engaged in high fidelity simulation for over a decade. Our medical students participate in simulation during their clerkship rotations. We have also trained residents in the follow specialties: anesthesia, critical care, emergency medicine, pediatric emergency medicine internal medicine and pediatric dentistry. The director of simulation, Trifun Dimitrijevski, MD, works with faculty instructors to develop curriculum that is appropriate for the learner’s interests and level of experience. Within a single encounter learners work as a team to take a history, obtain a differential diagnosis, and provide appropriate clinical management for their patient.
Our faculty and staff strive to provide a psychologically safe environment where our learners can be trained on all core competencies using evidenced-based practice in a realistic learning environment. Faculty facilitated peer-debriefing follows each encounter where learners are encouraged to develop self-debriefing techniques in an effort to foster lifelong learning practices. Faculty and learners are able to review the encounter immediately by reviewing the session recording complete with audio. Below you will find a list of our high fidelity mannequins.
- CAE Healthcare (formerly METI, Inc.)
- Human Patient Simulator (HPS)
- Emergency Care Simulator (ECS)
- Pediatric Emergency Care Simulator (PECS)
- Laerdal SimBaby
- Noelle with Neonatal HAL
- Baby HAL
- UMedic Harvey Cardiopulmonary Simulator
- CAE Healthcare (formerly Blue Phantom)
- Central venous catheter trainer (ultrasound compatible)
- Thoracentesis trainer (ultrasound compatible)
- Paracentesis trainer (ultrasound compatible)
- Kyoto Kagaku
- Lumbar puncture trainer
- Limbs & Things
- Arthrocentesis of the knee trainer
- Advanced Injection Arm
Surgical Skills Training
- CAE Healthcare (formerly METI, Inc.)
- LAPSim with haptic feedback
- Fundamentals of Laparascopic Surgery (FLS) Trainers
Standardized Patient Information
What is a standardized patient?
A Standardized Patient, or SP is a layperson trained to present a clinical scenario or illness just like a “real” patient, for teaching or testing
Standardized Patient Brochure and Form.
What are the benefits of using SPs versus “real” patients?
- The Standardized Patient is not actually “sick” and worried about their care. The SP can focus on the student’s actions.
- Standardized Patients provide a “safe” environment for students to practice and perfect skills they will use with actual patients.
- Students can practice their approach to a patient without the fear that making a mistake or saying something “wrong” may upset the patient.
- The Standardized Patient is trained to portray a scenario identically every time, allowing each student the same learning opportunity.
- Testing students’ “patient” skills using Standardized Patients ensures a more predictable and fair assessment.
What does a standardized patient do?
What Are SPs Used For?
Here are a few examples.
- Students learn to interview a patient and gather information needed to help diagnose their problem.
- Students practice effective interpersonal skills to better communicate with patients.
- Students learn appropriate techniques and approaches for physical examination of patients.
- Students learn techniques to counsel patients in a variety of circumstances on a variety of issues.
- Students gain experience with challenging issues such as breaking bad news.
- Testing any of the above.
What happens during an encounter with a student?
- A typical encounter with a student may involve the SP being interviewed, counseled, or examined in the same manner as would occur during a regular doctor visit.
- For certain sessions the SP is trained to provide constructive feedback to the student from the patient’s point of view.
- In certain cases SPs are trained to score student performances, and provide a score.
Standardized Patients Do NOT:
- Replace students’ experiences with real patients
- Undergo invasive or potentially harmful examinations or procedures, e.g. rectal/pelvic exams, injections, etc.
How do I become a standardized patient
What qualifications do I need?
We look for people:
- From all walks of life
- Of all shapes and sizes
- Of all ages and both sexes
- With good communication skills
- With a genuine interest in helping students learn
- With reasonably flexible hours
- Who can devote an occasional half day
How does becoming a standardized patient benefit me?
- Gain awareness that you are making a significant contribution to the training of our future physicians and health care providers.
- Help further develop and fine-tune your own interpersonal communication skills.
- Better understand how our health care system works.
- Meet new people with a common interest.
- Gain modest financial compensation.
Interested In Learning More About Becoming A Standardized Patient?
Leadership & Personnel
|DeShaun D. Harris
Director of Operations
|Joel Appel, DO
Clinical Medicine Course Director
|Chih J. Chuang, MD
Director, Physical Diagnosis Program
Office Services Clerk Senior
|Trifun Dimitrijevski, MD
Director of Simulation
Clinical Medicine Course Coordinator
|Christopher Guyer, MD
Assistant Director, Physical Diagnosis Program
Simulation Technology Administrator
|Sonal C. Patel
Assistant Director of Clinical Evaluations
|Kimberly J. Snell
Supervisor, Standardized Patient Education
Chih J. Chuang, M.D.
Dr. Chih Chuang is an assistant professor in the department of Academic and Student Programs at Wayne State University School of Medicine. He received his M.D. from Wayne State University Class of 2006 and then completed a combined residency in Internal Medicine and Pediatrics at the Detroit Medical Center/Wayne State University. He then reserved as a chief resident for his residency to develop his teaching and leadership skills. He then went on to complete a fellowship in Palliative Care Medicine and Hospice. Dr. Chuang joined the faculty of Wayne State in 2012 to be Director of the Office of Global Health and Education. In 2013, he also became Director of the Physical Diagnosis Program. Clinically, Dr. Chuang sees Palliative Care and Hospice patients at the John D. Dingell VA Medical Center. Dr. Chuang is a member and recipient of the Leonard Tow Humanism in Medicine Award of the Gold Humanism Honor Society. He has a passion for teaching and learning as well as mentoring the next generation of health care professionals. His research interests include education, global health and palliative care. He is married to his wife Dr. Ginger Chuang, a WSU Class of 2006 alumna, and they reside with their dog, Dakota.
Christopher Guyer, M.D.
Dr. Guyer graduated from Wayne State Medical School in 2006. He completed residency in Emergency Medicine at Detroit Receiving Hospital/Wayne State University in 2009 and completed fellowship in Sports Medicine at Henry Ford Hospital in 2010. He came to us from Henry Ford Health System as a Senior Staff Physician, practicing in the Division of Emergency Medicine and Division of Orthopedics. He is currently an Assistant Professor at the Wayne State University School of Medicine and an Adjunct Physician Instructor for the University of Michigan School of Medicine. His research interests include the use of ECGs for cardiovascular screening in athletes and using simulation for medical education. He is a team physician for the Detroit City FC, a Visiting Team Medical Liaison for the Detroit Lions, and a team physician with the US Ski and Snowboard Association.
Gini has been the coordinator for the Clinical Medicine course since 2011. She received her Bachelor’s Degree in Accounting from University of Phoenix Online in 2012. She enjoys working with the local medical community towards training better physicians for the future.
Lowery is a retired paramedic from the Detroit Fire Department. She is a Professional Technician for Wayne State Medical School. She is currently a member of the Support Staff for the Kado Clinical Skills Center, working as a Logistician and Exam Proctor. She is pursuing a Bachelor of Science in nursing with a minor in anthropology.