How Standardized Patients Work

Because There's No Crying, or Eye-rolling, in Medicine

Standardized patients play a wide range of roles in clinical simulation. They participate in interviews, answering questions about medical history and symptoms; they receive counseling regarding their assigned diseases or physical states; and they undergo physical exams [source: GVSU]. Depending on the case, they may need to get undressed [source: University of Pittsburgh]. Even then, exposure is pretty minimal: The SP is in a hospital gown, and a student may touch the bare back or partially expose the chest while applying a stethoscope [source: University of Pittsburgh]. If they're open to it, though, SPs can be assigned cases involving more sensitive interactions, like breast, pelvic or prostate exams [source: University of Pittsburgh]. In those cases, the student's instructor is always in the room [source: University of Pittsburgh]. In all cases, the SP's instructor might be there to evaluate the "patient's" performance [source: CU Denver].

More than diagnostic skills and proper speculum placement, SP interactions are about learning to communicate with patients. "Even though it is called a 'soft skill,' it is one of the hardest to master," says Valerie Fulmer, director of the Standardized Patient Program at the University of Pittsburgh School of Medicine. "Communication is at the root of proper diagnosis, patient safety and patient satisfaction, and miscommunication can lead to medical error."

And you can't develop a bedside manner in a lecture hall. "Students may be great in the classroom, but that doesn't automatically translate into being a good health care provider," says Karen Lewis, Ph.D., administrative director of the Clinical Learning and Simulation Skills Center at the George Washington University School of Medicine and Health Sciences. "They have to be compassionate caregivers with superior communication skills to be great doctors [and] nurses."

For some students, it takes practice to approach a patient with sensitivity. For others, the hard part is maintaining a professional distance, or getting out of their own heads. Fulmer tells of one student who was overcome with emotion while interviewing an SP portraying a homeless patient.

"[He] had to take a timeout," she recalls. "He had a brother who was homeless ... and the interview was difficult for him. He reported that it was good to practice an interview such as this in a safe place where he could deal with his own emotion without having to worry about dealing with a real patient at the same time."

SPs provide that safe place; students know the patients are "patients." They also provide a pretty realistic clinical simulation, though they needn't have a medical or acting background to do it. That's what SP training is for.