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What is a Standardized Patient?
"The Standardized Patient (SP) is a person who has been carefully coached to simulate an actual patient so accurately that the simulation cannot be detected by a skilled clinician. In performing the simulation, the SP presents the gestalt of the patient being simulated; not just the history, but the body language, the physical findings and the emotional and personality characteristics as well." - Howard S. Barrows, 1987
Is this like being a research subject?
No. This is very different. We use standardized patients (SPs) to simulate a real patient in a real healthcare setting - allowing students to have the opportunity to practice taking a history and performing a physical examination on a patient in a safe and controlled environment.
What types of physical examinations would be done?
They would be very common types of examinations – similar to the type you would have in a doctor's office. For example, the student may take your blood pressure; listen to your heart and lungs with a stethoscope; press on your abdomen; look into your eyes, ears and throat; check your reflexes, etc. The students never perform any invasive exams or procedures. None of the examinations ever involve taking blood or other types of samples.
How do I know what to say when the medical student interviews me?
SPs are given a patient case/script to memorize weeks in advance of seeing students. The case contains all of the facts of that particular "patient's" medical history and social history. The SPs will be trained in the facts of the case and how to portray the symptoms by an SP Educator, as well as the Medical Director. This will assure the accuracy and standardization of your portrayal.
That sounds like acting. Do I have to be an actor?
No. Some SPs are trained and experienced actors, but many are not. You can be a very good SP without ever having been on stage. There are similarities to what actors do, but there are many differences too. If you are appropriate for the patient case, we can train you to do the job properly regardless of your experience.
I am an actor. This should be easy for me and a good experience, too.
Perhaps. But you may find it much more difficult than you think. This work has nothing to do with finding dramatic moments, finding your "motivation," or playing to an audience. It has everything to do with disciplining yourself within in the needs of the case you are portraying and the exam, itself. It can be very repetitive, as exactly the same simulation must be done for every student who sees you.
Is it safe?
Yes. There is no reason for anyone to do anything to you that might be harmful. You are not really sick, just simulating someone who is sick. The examinations are very basic and do not cause harm to a patient. At most, there may be some discomfort portraying the symptoms of the case several times a day. All patient encounters are digitally recorded and may be observed by faculty and EEC staff as they happen. This is, in part, for the safety of the standardized patient.
Do the students know that we aren't real patients?
Yes. We aren't trying to deceive anyone. Students know they are going to be seeing standardized patients in simulations of clinical encounters. They are told to treat the SPs as they would real patients in a real health care setting.
How often would I work?
It varies. It depends on what exams or educational workshops the different departments want to coordinate for their students. There are some SPs who will work for us most weeks of the academic year and then there are some that we can only use for one or two projects a year. It will depend on two things:
- whether or not you physically fit the case criteria
- whether or not you performed satisfactorily on the last project for which you were hired. SPs who have done satisfactory work for us before are given the opportunity to work more often, depending on the need.
I've had a couple of health problems in the past. Can I still be used as a Standardized Patient?
Probably. Everyone has had some sort of medical history. Sometimes it doesn't matter if the SP has a medical problem that the patient in the case they are portraying has not had. But, sometimes it does matter. For example, if you have surgical scars on, for instance, your chest or abdomen, then we could not use you for a chest pain or abdominal pain case. Also, it is important to note that this work can be very tiring. If, because of your medical condition, you tire easily, then this work may not be suitable for you.
Why do you need Standardized Patients? I thought students learned on real patients?
Some things are better done using SPs. For example, an SP may be seen by a large number of students and is expected to portray the case in a precise and consistent manner up to ten times a day. Every student sees that case portrayed in the exact same way. That is why we use the term "standardized" patient. This is a fair way to assess the students' skills. A real patient often varies in the telling of their history. And, as stated above, a real patient would not have the stamina to be seen by ten students a day for 10 or 20 days in a row.
Will I need to know a lot about medicine?
No. We will teach you what you need to know about the case you will be portraying. Most standardized patients find they learn quite a lot from doing this work and they enjoy it very much.
Will I need to take my clothes off?
At times, yes. If the patient case requires the students to perform a physical examination, then the SP is asked to wear a hospital gown with varying amounts of undergarments. In some cases which require no physical examination, SPs wear their own street clothing. You have the option of telling us if you would prefer not to portray cases which involve physical exams.
I think I could do this job - it sounds easy enough.
Although this work may sound straightforward and easy, it can be quite challenging and is not for everybody. It requires good concentration and memory, as well as the ability to interact with many different types of people. This job takes energy, discipline, excellent communication skills and a certain level of comfort with your own body and health. Being a standardized patient is hard work.
I'm interested! What do I do next?
Apply to the Standardized Patient Program by completing our online form and uploading the relevant files. You will be contacted by the department after your application has been received.
We host an Open House for prospective SPs twice a year. This gives you the opportunity to meet our staff and learn more about the work we do.