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The Great Pretender: Tips from a Standardized Patient

We asked a Standardized Patient who has more than 12 years of experience under his belt to share some pointers on how to make the most of your SP encounters. Because he works in many different SP programs, we’ve kept his identity under wraps.

Hello med students. I’m a Standardized Patient. As an SP, I’ve seen you during different stages of your medical education — whether you were in your first year trying to overcome your nerve-wracking anxiety dealing with an “actual” patient, or as a seasoned post-graduate trying to figure out how seeing an SP is going to help you considering that you’re already taking care of real patients who need real help.  

As SPs we’re here to help you on your journey to becoming the best medical practitioner you can be, and if you let us, we can be a huge asset to you. Below are six things to keep in mind when you’re in a standardized patient encounter:

1. We’re not out to get you or trick you.

If it feels that sometimes we’re not that elaborate or forthcoming in our responses, it’s because the faculty want you to ask us questions in very specific ways. There are no “gotchas” or traps. It’s a process designed to help you think critically and organize your thoughts. If you ask a general question, you’ll usually get a general answer. If you ask a specific question, you’ll get a specific answer.

2. We sincerely want you to succeed.

We dedicate a lot of time to preparing for each case, fine-tuning the way we answer specific questions so that we can give you practical feedback that will help enhance your clinical skills. Backstories are created for our characters and meticulously outlined on the off chance that it may come up during an encounter. I’ve even been part of some cases where we (the SPs and the program coordinator) have spent multiple days poring over a case — analyzing it and trying to identify any loopholes or questions that might arise. 

3. Yes, we are actors, but please suspend your disbelief and take these encounters seriously.

Please treat your SPs as though they are actual patients. Don’t ask your SPs about the format, or to repeat the announcement that was just made over the loudspeaker, or what it’s like being an actor. It makes things awkward and pulls focus from the goals of the encounter and the program.

4. We’re not crash test dummies or lab animals.

Be gentle. Examine us the way you would examine someone you care about: with kindness, patience, and warmth (even if your hands are cold). That said, don’t be too cautious! You don’t want to look like you’re handling a rare artifact from the Smithsonian.

5. Connect and everything else will fall into place.

Often when I’m giving feedback after an encounter, I feel a greater connection with med students and residents because they’re more relaxed and present. I often wonder to myself, “Where was this person during the encounter?”  The more you can show up to an encounter as a whole person — not someone in a white coat on a pedestal — and engage with me on a personal level, the more I (and your actual patients) will open up, and the more rewarded and fulfilled we’ll all feel by the encounter.

6. Have fun.

It’s not brain surgery … yet. It’s a safe place to try things. It’s okay to not know something and it’s okay if you mess up — especially in an SP encounter. Why?  Because it’s an exercise. And hopefully you can take what you learn from these exercises, build upon it, and apply it to your medical practice.  You’re constantly evolving as a doctor, and with every patient — whether it’s real or standardized — you’re getting better and better.