Relaying an HIV Diagnosis: A Standardized Patient Case

Abstract Receiving a new diagnosis of HIV is a traumatic experience for patients, who commonly exhibit shock, denial, anger, or despair as initial reactions. This brief standardized patient case assesses a resident's ability to disclose a new diagnosis of HIV to a patient, to provide counseling to a patient with limited medical knowledge, and to select appropriate laboratory tests following a new diagnosis of HIV. This resource contains examiner instructions, resident instructions, a standardized patient script, an examiner checklist, and a standardized patient checklist. This case was used in the context of an objective structured clinical exam (OSCE) for internal medicine residents in a 3-year program for HIV primary care training. However, the case can be utilized as a “giving bad news” scenario or as an educational experience. The resource was piloted using a medical resident not involved in the HIV primary care track. This provided a good opportunity to clarify any confusion about the station, trouble-shoot any logistical problems, and fine-tune any aspects of the standardized patient performance. Focus groups conducted immediately after the resource, as well as 2 months afterwards, demonstrated that residents felt the case was very realistic, including the dramatic emotional reaction of the standardized patient. The participants also felt that the case was central to the skills expected of an HIV primary care provider. Overall, the residents enjoyed the resource as a formative experience