Palliative Medicine Extended Standardized
Patient Scenario (ESPS)

Important Message for UB Students and Residents Currently on Palliative Medicine Elective

This website includes all of the material for the standardized patient project you are currently doing. Please do not read ahead beyond the visits assigned each week. There is nothing in subsequent visits that will aid your performance, but reading ahead will certainly disrupt the flow of the patient encounter in your mind.
In 1999 the University at Buffalo initiated a month long Palliative Medicine elective for residents and 4th year medical students that included a new teaching modality we have labeled the Extended Standardized Patient Scenario (ESPS). The ESPS was designed to incorporate elements of end-of-life communications and decision making into the matrix of an ongoing doctor-patient relationship. Over the course of the month, the student engaged in 6 sessions with a single SP, whose clinical course demonstrated a 6-month time period with a fatal illness. The extended scenario took the patient from diagnosis, through anti-neoplastic treatment, to end-of-life care. The sessions were supplemented with an evolving (and enlarging) ambulatory medical record that included progress notes as well as laboratory, radiology, pathology reports.

We welcome other institutions to use all or part of this site in the development of their own programs. We request that appropriate acknowledgements be provided when this occurs. Send your reactions and feedback to Jack P. Freer MD, Dept. of Medicine, e-mail: A full description of the program is found in: Freer. J.P., Zinnerstrom, K.L.: "The Palliative Medicine Extended Standardized Patient Scenario: A Preliminary Report". Journal of Palliative Medicine. 2001, 4: 49-56.

Elements of ESPS

ESPS Staff:
Jack P. Freer, MD : Palliative Medicine Course Coordinator
Karen H. Zinnerstrom, PhD :Coordinator for Research and Evaluation, Standardized Patient Program
Diana R. Anderson, EdM :Coordinator for Training and Evaluation, Standardized Patient Program.
Don Pearce, MSE

updated 01/20/06