- What is a Standardized Patient?
- How are SPs used?
- Why do you need SPs? Don’t nursing and medical students learn on real patients?
- Will the students know I am not a real patient?
- Will I have to grade the student?
- Is this like being a research subject?
- What types of physical examinations would be done?
- How do I know what to say when I’m being interviewed?
- That sounds like acting. Do I have to be an actor?
- I am an actor. Will this be easy for me?
- Is it safe?
- Will I need to know a lot about medicine or nursing?
- Will I need to take my clothes off?
- I have had health problems in the past. Can I still be an SP?
- How do you choose who will be hired?
- How often would I work?
- I am interested. What do I do next?
1) What is a Standardized Patient?
A Standardized Patient (SP), also called a Simulated Patient, is a person who has been carefully coached and trained to simulate an actual patient; not just the history, but the body language, the physical findings, and the emotions and personality characteristics as well. SPs are lay people who may or may not have any medical knowledge. Some SPs are actors, but most are not. SPs are from all walks of life, of all ages and education. The common thread among all our SPs is an interest in helping others.
The University of Windsor employs SPs in the training and evaluation of health care professionals, including nursing and medical students. As an SP, you will be interviewed and may or may not be examined (depending on the scenario) by the nursing/medical students. In the patient role, you may see several students on a one-to-one basis during an evaluation session or there may be a groups of students (2-8) working with you in a teaching session.
2) How are SPs used?
SPs are used in a number of ways - primarily to teach and evaluate health care students and professionals, including nursing/medical students and physicians. Students can perfect interpersonal skills by practicing on SPs, as performance is monitored by colleagues and faculty; history taking and physical exam skills are learned through guided practice and feedback. SPs offer repeated practice opportunity and the ability to describe, from the standpoint of the patient, how the encounter felt. SPs can also provide valid, standardized evaluation of the student’s clinical performance and provide opportunity for “hands on” experiences with patient problems that may not appear spontaneously in the clinic, hospital or community setting.
3) Why do you need SPs? Don’t nursing and medical students learn on real patients?
Yes, nursing and medical students DO learn on real patients, but there are several reasons why they see SPs too, not the least of which is that patients do not stay in hospital very long anymore. Additional reasons why SPs are used include:
- Availability: A particular patient problem needed for education or evaluation is available at any time. The SP is available almost anywhere and examination is not dependent on hospital or clinic. The SP can be arranged in advance to be available at the point in time when the experience is important for the learner. It also allows all students to be able to experience a certain situation that cannot be controlled in a hospital or community setting.
- Repeatability: The patient problem is standardized, meaning that it will be the same problem to all students. This promotes fair and reliable assessment of performance. The symptoms, signs, emotions and complexity of the patient is fixed and known ahead of time.
- Safety: Students can learn to interview and examine a patient without being concerned that they may do or say something harmful to the patient. A safe, constructive environment is created by using “a patient” who cannot be harmed, tired or upset.
- Controllability: A simulation can be adjusted to the level of the learner and the educational goals of the educator. SPs also offer practice with difficult patients, sensitive subjects and areas of risk. Students can be confronted with hostile or demanding patients in a controlled setting.
- Flexibility: SPs are a flexible educational tool. During an encounter with an SP, there can be interruptions, discussions and repetitions.
- Immediacy: The SP can be trained to provide feedback on the learner’s professional manner, attitude and interpersonal skills. Feedback is immediate and from the patient’s point of view.
4) Will the students know I am not a real patient?
All students are aware that they are seeing SPs, and are asked to perform health histories and physical examinations just as professionally as they would if you were real patients.
5) Will I have to grade the student?
No. However you may be asked to complete a checklist as a record of the teaching session. Additionally you may also be asked to provide feedback – both positive and constructive – to students, based on their performance. When significant feedback is requested, training sessions will be provided to you as the standardized patient on how to effectively provide constructive feedback.
6) Is this like being a research subject?
No. We use SPs to simulate realistic patient situations for nursing and medical students.
7) What types of physical examinations would be done?
They are very common exams such as those you might have in a nurse practitioner/doctor’s office/clinic, hospital or community setting. For example, listening to the heart and lungs with a stethoscope, pressing on the abdomen looking for tenderness or swelling, looking into the eyes, ears and throat, taking blood pressure, assessing muscle strength, checking reflexes, pulses, etc. None of these exams involve the taking of blood or other samples. We consider all of these “non-invasive” physical exams. You are not required to do physical exam roles if you prefer not to.
8) How do I know what to say when I’m being interviewed?
You will be given a script and/or trained to portray “the patient”. We will create a complete history for you to learn, which includes not only the patient’s “presenting concern” - i.e. the reason the patient is seeking care - but also details about the patient’s past medical history, job, social life, family, activities etc. We also describe the patient’s emotional state, behaviour and affect - i.e. how to play the role. By learning that history you can learn to become that patient and speak to the interviewer just as that patient would. When required, we will also train you on how to move like the patient and how to react to the physical exam. For example, if you are portraying someone with back pain, we will show you where it hurts and what you could and could not do because of your pain.
9) That sounds like acting. Do I have to be an actor?
No. Some SPs are trained and experienced actors, but most are not. If you are the right sort of person, we can train you to do the job regardless of your experience.
10) I am an actor. Will this be easy for me?
Perhaps! While it can be very “dramatic”, this work has nothing to do with entertaining or playing to an audience. It has everything to do with disciplining yourself to the needs of the case or exam, and the needs of the learner. It can be very repetitive, as in an exam situation when you must repeat exactly the same situation for each student. Some actors may find it more difficult than working from a script or within dramatic improvisational outlines, and may find it frustrating. Others find it very fulfilling and challenging work. Remember also that the cases must remain confidential. You cannot use any of the material in public or private performance.
11) Is it safe?
Yes. There is no reason for anyone to do anything that might be harmful. You are not really sick, just simulating someone who is sick.
12) Will I need to know a lot about medicine or nursing?
No. We will teach you what you need to know. Your scenario will contain all of the information that is relevant for you to know to portray the patient role. Most SPs find that they can learn a lot from the work and enjoy that very much.
13) Will I need to take my clothes off?
No. However, if you are participating in a non-invasive physical exam you may be required to wear a hospital gown. You may wear underclothing under the gowns, and if appropriate to the patient case, shorts or sweatpants. You must be comfortable, however, with the possibility that the hospital gown may slide off or that their may be the possibility of poor draping in these situations. You can choose not to do these kinds of roles. In cases where there is no physical examination, SPs wear street clothing appropriate to the role.
14) I have had health problems in the past. Can I still be an SP?
Normally yes. It is your reponsibility to disclose to the appropriate personnel if you have a medical condition or injury that may potentially cause risk or further injury to you in a particular scenario or case. Everyone has some sort of medical history. Most times it does not matter if you have a health issue/condition that the patient you are portraying has not had. It does become an issue at times; for instance, if you have had your appendix out and you are portraying someone with acute appendicitis, your appendix scar would be really confusing! Also, we will do our best (based on your disclosure) not put SPs in situations which might cause them discomfort. For instance if you have arthritis or tendonitis, and you were portraying someone whose joint movement is being examined, you could potentially be hurt. If you do have a medical problem, all it means is that you cannot portray that particular case, but you can do other cases.
15) How do you choose who will be hired?
We interview people to find out if they are suitable. We need people who understand the unusual requirements of this program. You should able to take an interest in the work beyond it simply being a job. You will use a wide range of skills and will need to role-play and work with a number of different people. It is important that you are comfortable with your own health and in your dealings with health professionals. Good reading and verbal communication skills are very important. It will be essential that anyone hired as an SP not have any biases against anyone based on their gender, race, religion, national origin, physical characteristics, etc. Reliability, punctuality and flexibility are very important.
16) How often would I work?
The work is irregular - and may vary from 0 to 24 hours/week maximum. We will approach you on a project-by-project basis, as our needs and your profile match. We use some SPs only once a year, and some much more often based on their availability, experience, etc. Once you have performed satisfactorily in the program, you will be offered future positions based on the program's needs.
17) I am interested. What do I do next?
Complete the application form provided on the main webpage and submit as instructed. If you wish, please attach a resume and/or photo. We will be in contact with you to arrange an information session dependent on the program needs. Your application will be kept on file for one year upon receipt, and you may contact us at any time to update the information.
Thank you for your interest in the University of Windsor Standardized Patient Program!