'Standardized patients' help providers-in-training learn bedside manners, medical-history documentation and critical-thinking skills.
The “patients” wear hospital gowns, are poked and prodded and quizzed on their ailments.
It’s all for a good cause: helping students in medicine, nursing and other health professions gain experience.
“Standardized patients,” as these patients are called, are given scripts and act out different medical and social situations. They help providers-in-training learn bedside manners, medical-history documentation and critical-thinking skills.
“They have many advantages that real patients don’t have,” says Dr. Analia Castiglioni, medical director of University of Central Florida’s College of Medicine’s Clinical Skills and Simulation Center.
They can expose students to cases that may not take place during hospital rotations, such as breaking bad news to someone. Standardized patients also provide assessment of students’ performance after the sessions.
“They’ve become, over time, a crucial part of our competency-based assessments,” Castiglioni says.
The simulated-patient concept entered the health-education field in the 1960s, and the demand for them has remained steady.
“Medical education has always counted on patient exposure,” says Castiglioni. “That’s how you learn, but our health-care system has evolved so it’s hard to teach everything in the real environment.”
The University of Central Florida’s medical school currently has more than 60 SPs on its roster, but it’s looking to hire more. They are paid $15 or more an hour. The University of Washington also hires SPs; visit depts.washington.edu/hsasf/clinical/becomessp for more information.
“Being an SP gives members of the community a chance to give back. You can be anyone, and we’ll work with you,” says Rebecca Beiler, a standardized-patient educator at UCF College of Medicine.
UCF applicants are first screened via an online form. If selected, they go in for an audition.
“We give them a simple case. They review it and come in and portray it,” once to an excellent medical student and once to an unorganized student, Beiler says. “This allows us to see if they follow direction and don’t interject and how well they do in acting, because the students have to buy into it. They have to make it believable.”
SPs who are selected go through training and practice with one another first before being seen by medical students. Standardized patients can also become more advanced and teach students how to find the pulse or listen to lung sounds, or even become SP educators such as Beiler.
She started off as a standardized patient about five years ago and stuck with it until it became her profession after she got her master’s degree in higher education.
On a typical day, SPs arrive at UCF’s clinical-skills lab and, based on the day’s script, they wear their own clothes or hospital gowns or sometimes themed outfits, such as farmers.
They form a special bond. They hang out with each other in the hallway during their breaks, share tips and tricks, and do potlucks every once in a while.
“We’re all from different walks of life,” says Victor Changsan, 23, a UCF student who comes in as an SP three to five days a week. “We share our hobbies and experiences. It would seem that we’re just acting, but it’s more than that.”
Kathy Hale, 59, has been an SP at UCF since the medical school opened.
“I have multiple sclerosis, and I’ve seen multiple doctors. And this is something that really piqued my interest,” says Hale.
She comes in based on the school’s schedule and her availability — sometimes as many times as five times a week.
“It’s so rewarding to see the students grow from the first few weeks of medical school to their fourth year,” Hale says.
And it’s a two-way street. On occasion, students have been able to find a disease or condition in the SPs that was not previously diagnosed, Castiglioni says.
The only tricky part of the job is explaining it to others.
“I try to explain to them that I’m more than an actor,” says Changsan. “I’m a facilitator or an assistant instructor. I don’t give them the medical stuff, but I give them the human aspect.”