By Ritisha K. Chhaganlal, J.D.
Standardized patients (SPs) are an integral part of learning at the University of Central Florida (UCF) College of Medicine. The “patients” are treated as if they are suffering from actual illnesses and ailments. Medical students poke and prod and question such patients on symptoms and medical histories, and are even assigned the opportunity to break bad news in certain situations.
By doing so, the medical professionals in training are offered experience not always able to be acquired through routine hospital rotations. SPs can also offer assessments of students’ performance, providing constructive criticism and further growth throughout their training. Additionally, some medical students have actually assisted SPs in discovering unknown medical conditions that have gone previously undiagnosed.
The win-win of the long accepted and utilized concept in medical training has pushed UCF to expand on its current roster of more than 60 SPs.
The Role of a Standardized Patient.
It would seem that SPs are simply actors, however, Victor Changsan, a UCF student who doubles as an SP, said, “[…] it’s more than that. I’m a facilitator or an assistant instructor.”
Neurologist and medical educator, and the creator of the first SP in the 1960’s, the late Dr. Howard S. Barrows, M.D., said, “The [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.”
SPs are given scripts and act out (similar to an actor) different medical and social situations. Also not unlike actors, most SPs are required to undergo an audition prior to selection. As reported by the Orlando Sentinel, Rebecca Beiler, an SP educator at UCF College of Medicine, said, “We give them a simple case. They review it and come in and portray it.” This simple scenario is played out once in front of a top performing medical student and once again to a less organized medical student. Beiler says the reasoning behind 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 it. They have to make it believable.”
However, according to the University of Pittsburgh School of Medicine, unlike acting, “[t]his work has nothing to do with finding dramatic moments, entertaining, or playing to an audience. It can be very repetitive; the same patient must be presented for every student.” For FAQ’s regarding SPs issued by the University of Pittsburgh Office of Medical Education, click here. Furthermore, SPs must undergo training and practice scenarios with one another before being seen by medical students. SPs have the opportunity to become more advanced in their role as well, even becoming SP educators such as Beiler.
Changsan said, “I don’t give them [medical students] the medical stuff, but I give them the human aspect.”
Benefits of the Utilization of Standardized Patients.
Dr. Barrows’ innovative teaching and assessment conceptualizations derived from a need for a more extensive methodology of evaluating the clinical skills of third-year medical students. While his concepts were not widely accepted when initially developed, Dr. Barrows’ persistence gradually assisted in shaping present-day medical school curriculums across the United States. To read more on the origin of SPs in the U.S., click here.
The utilization of SPs complements medical education by rounding out the following areas: demonstration and instruction, practice and experience, and evaluation and assessment. Medical students are able to gain valuable skills in bedside manners, medical history documentation and critical thinking skills through the use of SPs in their training.
Dr. Barrows noted, “This examination simulates the entire encounter with a patient from beginning to end and allows us to assess students’ clinical skills in a valid, comprehensive, and powerful way.” He further explained that SPs add significant value to medical students by: preparing them for actual clinical problems in a less threatening environment; allowing for interruption and immediate, consistent and corrective feedback; and making it possible for students to practice communication skills with sometimes difficult patients or emotionally-charged situations. To read more on Dr. Barrows’ overview of the utilization of SPs, click here.
Does/did your medical school utilize standardized patients? Do you believe it was a helpful addition to the curriculum? Please leave any thoughtful comments below.
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Miller, Naseem S. “Fake Patient Help Teach UCF Students.” Orlando Sentinel: 6 Nov. 2015. Web. 28 Dec. 2015
“Standardized Patient Frequently Asked Questions.” School of Medicine Office of Medical Education. University of Pittsburgh: 13 Jan. 2012. Web. 21 Jan. 2016.
Stratton, Terry D., Ph.D. “Origin of Standardized Patients in the United States.” Office of Medical Education, UK HealthCare. University of Kentucky College of Medicine: 2015. Web. 21 Jan. 2016.
“Using Standardized Patients in Teaching & Assessment.” School of Medicine Office of Medical Education. University of Pittsburgh: 28 Oct. 2014. Web. 21 Jan. 2016.
About the Author: Ritisha K. Chhaganlal, J.D., is an attorney with The Health Law Firm, which has a national practice. Its main office is in the Orlando, Florida area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Ave., Altamonte Springs, FL 32714, Phone (407) 331-6620.
KeyWords: Graduate medical education (GME), medical graduate attorney, Association of American Medical Colleges (AAMC), Accreditation Council for Graduate Medical Education (ACGME), graduate medical education attorney, lawyer for medical students, medical resident attorney, use of standardized patients (SPs) in medical school, standardized patients in medical training, medical graduate evaluations and assessments, residency program legal dispute, residency program litigation, medical school litigation, legal representation for medical residents, medical students legal counsel, United States Medical Examiners (NBME) lawyer, health law attorney, The Health Law Firm, UCF College of Medicine applicants, UCF College of Medicine enrollees
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