We trained 19 volunteers to be simulated patients. Volunteers lived across three time zones and ranged in age, from about ten years old to their mid-70's. A total of 58 scholar students, across four time zones, completed the exam with a simulated patient using BlueJeans, which is HIPAA-compliant and had the capacity for simultaneous sessions. A series of storms the night before the exam took out the wifi and power for a number of students and volunteers, which necessitated the use of phone for some sessions. All exams were either video- or audio-recorded and reviewed by the course instructors to assess the final grade for each student. Each simulated patient completed a brief rating form for their sessions that provided feedback related to the student clinician's rapport, therapeutic approach, and ability to address the goals of the referral. Students were further assessed by the instructors using a rubric that included the nine competency domains of integrated health (SAMHSA, 2014) and standards of clinical documentation.
The use of the simulated patient final exam has been a core component of this course in years previous but relied on in-person implementation. However, this project "flipped" the exam for remote implementation due to the COVID-19 pandemic. Many students taking the course had limited experience providing tele-therapy and tele-health services to clients; this project provided a concrete method to train students for remote-based social work practice, which has become a standard of care within the pandemic context. Completing this project demonstrated to students that it is totally viable to engage all aspects of their learning and demonstrate the ability to apply and reflect on their clinical skills and knowledge - even if they are not seeing clients in real life. This project demonstrated to the instructor team that a remote-based simulated exam is able to facilitate the same learning objectives as an in-person exam, while also providing additional learning related to the use of technology in the delivery of clinical care.