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How Standardized Patients Work

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I'm Not a Patient, but I Play One in the Exam Room
Can you think on your feet? Do you like helping people learn? Do you think your acting ability goes unheralded? This could be the gig for you.
Can you think on your feet? Do you like helping people learn? Do you think your acting ability goes unheralded? This could be the gig for you.
Image courtesy University of Pittsburgh

The process goes like this: A standardized patient is assigned a case. That case may be based on an actual patient, or it may be a carefully developed fictional situation [source: ASPE]. The patient may be suffering anything from mysterious back pain to an itchy rash or, well, burning during urination. He may be dying of cancer. The case documents include everything an SP might need to know to accurately portray the patient in question – medical history, symptoms, personality quirks, demeanor and physical limitations [source: GVSU]. If a patient with back pain can't stand without hunching over, neither can the SP.

SPs receive assignments anywhere from two weeks to three months in advance of the interactions, depending on the complexity of the case [sources: Fulmer, Lewis]. They study, memorize and internalize. They train with SP educators on the educational context and goal; on how to accurately portray the patient's condition and personality; and on what exactly will be required of them during the interaction [source: Lewis]. For physical exams, they learn what students should be doing during the exam, and why. If feedback is involved, they learn which types of feedback are most helpful in the given context [source: Lewis].

Interactions are basically unscripted: The SP has his or her answers planned in advance, but there's no telling what a student is going to ask during an interview. A good standardized patient can answer questions on the fly and do it accurately.

"We had a second-year medical student who was assessing a patient for chest pain," recalls Lewis. "The student should have asked the SP if she ever woke up in the middle of the night feeling like she couldn't breathe ... Instead, the student asked, 'Do you ever wake up in the middle of the night breathing?' Without missing a beat, the SP replied, 'To the best of my knowledge, I breathe all night, every night.'"

Many standardized patients have acting backgrounds, for obvious reasons [source: University of Pittsburgh]. Being a good actor doesn't guarantee success, though. Not by a long shot.