For Standardized Patients
Standardized Patients (SPs) are people who have been carefully coached and trained to simulate an actual patient. They portray the entire patient -- not just the history, but also the body language, physical findings, emotions, and personality characteristics of the patient. Standardized Patients may not have any prior medical knowledge, come from all backgrounds, and represent ages and physical types. Some SPs are actors, but most are not. They share an interest in helping others and are especially interested in helping students learn to be doctors. Through their patient portrayals, SPs help in teaching new skills, refining old skills, and evaluating learners, further enabling medical school to assess where to focus a student’s education and to verify that students are ready to begin practice.
Standardized Patients are used to help students learn interpersonal and communication skills as well as how to examine patients and solve medical problems in a safe environment. For example, students can practice challenging situations such as ethical dilemmas, delivering bad news, communicating with angry or upset patients, and dealing with medical emergencies. At the end of each encounter when the student is most ready to learn, both the SP and the faculty members give the student feedback on how to improve. The students also can watch video recordings of their performances.
To be successful, each case must be:
- As close to reality as possible
- Able to be scored (have items the SP can recognize as being important like the student asking a specific question)
- Allow testing of several student skills during one session (how they ask questions, examine a part of the body, or recommend a specific medication)
- The same performance for every student so students can be compared
Training to become a Standardized Patient typically involves one or two coaching sessions, each lasting approximately one hour. The actual student encounters can take place during the week or on weekends based on the type of event. Most Standardized Patients perform their encounters about once a month. If you are trained for more than one role, you may be asked to commit more time. Typical sessions last three 3-4 hours, though occasional sessions are as short as an hour as long as a full day.
Standardized Patients are trained to portray a particular patient. The SP learns a complete history, including the patient’s reasons to see the doctor as well as details about the patient's past health, job, social life, family, and daily activities. The training also includes the patient's emotional state, behavior, and concerns. The SP can learn to become that patient and speak to the doctor just as that real patient would. The training also covers how to move like the patient and how to react to any medical exam. For example, if the case is someone with back pain, the SP will learn where it hurts, how the patient could move, and what the patient can and cannot do because of the pain.
After introducing themselves, the first thing that students do is discuss with the patient the reasons for seeing a physician. Then they ask questions to obtain more details and collect background information about previous health, family, and other issues. Standardized Patients are trained to be prepared to answer these questions. The case may also require a physical examination, which typically includes listening to the heart and lungs with a stethoscope; pressing on the abdomen; looking into the eyes; ears and throat; taking blood pressure; assessing muscle strength; checking reflexes; and/or checking pulses. No blood or tissue samples will be taken and “sensitive” exams requiring you to undress completely are not performed. If a case requires additional information, SPs give the students a card, saying “I just had that test done, and here are the results.” After performing the physical exam, students should discuss the medical problem and its potential solutions with the patient. Once the discussion is over, the student leaves the room to write the medical record and the SP fills out an evaluation form about the student.
You will be involved in educating future physicians and will work with people who share your interests. You will be paid for the time you spend in training and in student encounters (typically $12-15/hour).
If you are interested in becoming a Standardized Patient or have further questions, call 316-293-3519.
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What is a Standardized Patient?
A Standardized Patient (SP) is a person who has been trained to simulate accurately and consistently the medical condition of an actual patient. This is accomplished by recreating the medical and family history, the physical findings, and the personality of that patient.
The University of Kansas School of Medicine utilizes Standardized Patients in the training and evaluation of medical students and residents. As a Standardized Patient, you will be interviewed and examined by medical students or residents, just as you would by your family doctor. However, instead of disclosing your personal medical, family and bio-social history, you will answer questions based on the "facts" of the "patient case" that you have learned.The idea of using SPs was developed by Dr. Howard S. Barrows, a neurologist, in 1963. Currently, most medical schools in the United States are utilize SPs for teaching and testing medical students. Although SPs do not replace real patients in the curriculum, they do provide a realistic learning resource for students.
How will I know what to say when the students interview me?
You will be given "SP facts," or a script, detailing the current medical problem, past medical history, family and bio-social situation, and emotional state of the patient that you will need to portray. You will learn to appear as the patient by using specific body language, movement, and responses to physical examination. You will also be trained to look for specific student responses and skills, to record them, and to give feedback to the student on their performance.
Do students and residents know that an SP is not a real patient?
All students and residents are aware that they are seeing a Standardized Patient. However, they are instructed to treat the SP as if they are a real patient. Thus, the students' and residents' interviewing and physical examination techniques and skills, are, in all respects, the same as if they were seeing a real patient who was presenting them with a real medical condition.
Will I have to grade the student?
You will not be asked to give any student or resident a grade. You will be asked to complete a checklist as a record of the encounter. Some of our programs also require SPs to provide both positive and constructive feedback to the students or residents based on their performance.
What type of physical examination should I expect?
This will depend on the type of patient case. A focused physical examination may include: listening to the heart and lungs with a stethoscope; pressing on your abdomen, neck, face, and limbs to assess tenderness; using a scope to look in your ears, eyes, nose, and throat; taking your pulse, respiration, and blood pressure; checking muscle strength, reflexes, range of motion, and gait. Breast, pelvic, genital or rectal examinations will not be performed. Invasive procedures (blood draw, X-ray, throat cultures) will not be performed.
Will I have to remove my clothing?
Hospital gowns might be worn for a particular patient case. If so, we will provide the gown and you will always be permitted to wear underclothing underneath.
Is an SP's personal health history relevant?
Maybe. Since an SP is hired and trained to portray a patient with a certain medical condition, someone who has had an appendectomy probably cannot portray a patient with appendicitis. But that same person could play the role of a patient with chest pain or someone with a back problem. In addition, an individual who has had a great deal of experience with health care providers, either personally or on behalf of a friend or relative, is not necessarily "more qualified" to be an SP than someone who simply gets a routine check-up now and then. Having had certain kinds of medical conditions or particularly "good" or ""bad" experiences with health care, are not measures of a potentially effective SP.
What characteristics make an effective SP?
If you are someone who:
- Has a strong in interest in education;
- Possesses strong written and verbal communication skills;
- Can maintain a strong level of concentration;
- Is comfortable with others touching and examining you;
- Values punctuality and commitment; and
- Has a flexible schedule
Then you can be an SP!
SP work is part-time and very rewarding. People of all demographics are always needed.
Is acting experience a prerequisite to working as an SP?
No. While actors work as SPs, the focus is on providing the student or resident with an educational opportunity, not on performance or dramatic interpretation. Playing a patient case is extremely repetitive because the same portrayal must be done for every student during a specific event.
What are SPs paid?
Compensation ranges from $15 to $25 an hour depending on the program. Standardized Patients are hired as part-time employees of KU.
How often might I be called to be an SP?
We schedule standardized patient events for medical students year round, although the months of July and December are typically slow. An event can last one day or up to 7 days, and the work is usually in the afternoon and early evening in order to accommodate students' class schedule. Occasionally, we have an event on a weekday morning, and once in a while on a Saturday. If we do not contact you immediately for work, that doesn't mean we are not interested in utilizing your talents. Rather, it may indicate we are not scheduled in the near future to do an event that matches your particular demographics, skills, experience, etc.
What can I expect if I am hired as an SP?
Each SP for a particular event is carefully screened to determine how to best use their skills or attributes. As an SP you are expected to learn "Facts" about the case that you will be portraying. These "Facts" are just like the facts in your own personal situation, except they are not about you; they are about the fictitious person that you are portraying. You will be expected to memorize these "Facts." Your portrayal of the case will be much like when you visit your own health care provider, except you will respond to a student's questions with the "Facts" that you have memorized.
Training time for individual roles is typically one hour, which includes training sessions led by center staff and clinical faculty. During the training sessions, SPs study the learning objectives developed by the faculty, practice their role, receive instruction on feedback skills, and may undergo a "dry run" with clinical faculty.
Although this job is very rewarding, it is not easy nor is it for everybody. It requires intense concentration while being interviewed and examined. You must be able to maintain not only the patient's character but also simulate their physical condition during an encounter. After the encounter, recall the student's performance is necessary in order to fill out a computerized checklist. You may also be required to provide verbal feedback directly to the student. In order to provide every student with the same experience, you will perform these steps repeatedly throughout the entire event. Being an SP takes energy, memorization, discipline, attention to detail, and excellent communication skills.
How do I apply to become an SP?
If you are interested in becoming a Standardized Patient or have further questions,call 316-293-3519.