"Choose Your Own Adventure" in medical school




Standardized patients (or "simulated patients", as Wikipedia would have it) are incredibly important, as medical schools are full of students who may be very bright, but occasionally lacking in empathy or a reasonable facsimile thereof. I've known some talented amateur actors who have moonlit as SPs.


I did this for many years at Michigan State University, at both their DO and MD schools. The scenario I portrayed most frequently was a married woman in her 40s who had an unplanned pregnancy. There were two phases to the interviews. The first was to inform me of the risks associated with being older and pregnant and what amniocentesis testing involved. This half I mostly had to keep the students from getting too technical. The second interview (usually with different students) was to inform me that I was indeed carrying a child with Downs Syndrome. There were some students that I trusted the moment they walked through the door, others I sat there thinking "oh please dear lord go into something like pathology or forensics, something where you don't have to deal with patients". One time as I sat there getting nauseous listening to the student I realized how some people throw up when getting bad news. Some had heard that I cried so they handed me tissue before I cried. Ooops. I clammed up on them and made them squirm. Very very few ever so much as reached out to touch me. The best student was one who said "you have to allow yourself to grieve for the normal child you're no longer going to have". I burst into tears and she hugged me. At the end of that interview I broke character and let her know that was the perfect response and asked her how did she know what do say. She simply told me she had two severely retarded children and her doctor has merely walked into her hospital room and said your child has "xyz" and walked out and left her alone. I believe the video of her interview was used in the future of an example of what to do.


My daughter did this for a while. She was acting a patient with a diagnosable condition, and she found that if she didn't put enough make-up on, the doctors were more likely to diagnose her as an abused woman.


I live near a teaching hospital and go their clinic because it has excellent hours. I like the student docs - they have a lot of new information that older doctors don't - and they are always overseen by more experienced physicians.

I can tell when the interns are really new to the clinic practice; sometimes it will take them a very long time to perform a basic exam and they will struggle to come up with a diagnosis even when I walk in basically telling them what the diagnosis is (pretty much every visit is for asthma).

Some doctors definitely have people skills off the bat and others you can see them mentally turning the pages on their text books as they are speaking to you.

It's hard to translate all book learning into an actual patient experience.


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