Posted By Michelle On Sunday, July 29, 2012, 10:34 PM in Blog

Standardized Patient Rationale

By Guest Blogger Nicole Zylstra

Often as an SP I am asked to do something that is more challenging than the traditional “my spleen’s over here” scenario. Sometimes I might be given a case that involves more than just my physical body parts – it requires an emotional as well as a physical response. Maybe you as a student doctor have to tell me that I have inoperable cancer, or that I’ve just had a miscarriage, or that my spouse has been declared brain-dead, or that I’ve had a serious stroke that requires emergency surgery. Unfortunately in medicine there are plenty of “bad news” scenarios that require more than just medical knowledge, they require a degree of tact and sensitivity on the part of the doctor. Good news is easy for patients to take and so I suppose that’s why we don’t get to practice those cases very often; just the hard ones.

These cases can be rewarding, in that it gives the student doctor an opportunity to go through a simulation involving real people and highly charged emotions while still in the confines of a safe environment. If the student doctor doesn’t handle the situation as well as he/she might be capable of, there are no hard feelings. That doctor hasn’t “lost my business” as a patient, no one is traumatized, everyone gets to go home at the end of the day. We are happy as SPs to be able to do this work. It makes us feel like we are valuable members of the community with a real skill to offer that has more real world benefits than a lot of the other more commercial work that we might do the rest of the time.

That being said, it doesn’t mean that it’s easy. As performers, we are naturally sensitive human beings. It is our sensitivity, and our ability to access our genuine human emotions, that makes us good at what we do. Sure, the situations we are put into aren’t technically “real” but they feel real to us. That’s our skill at work. It’s our job to treat the situation as if it was real, and to allow ourselves to respond in real ways. This is an actor’s job in any situation; the bonus in these SP models is that we get to give you real feedback on what you did and how it made us feel.

Because we do feel real things. In fact a lot of brain research would probably back us up on this – the memory of something can produce as strong emotions as if you were going through it the first time. So there is no real difference sometimes between imagining a situation and experiencing it. And so allowing yourself to be put into a situation - to live in it fully, without stepping outside to analyze yourself in the moment – and to allow yourself to respond in the moment to what is happening, feels as real to us as anything else that might happen during the day. The only difference is that while in a real life situation I might only have to deal with receiving a certain piece of bad news once only, as an SP I may have to let go of everything I’ve experienced in one situation, start at an emotional “zero” and go in there again and go through it all again. And again. And again. It produces real stress, and it can make for a very long hard day that often takes a while to shake off. Imagine you had a traumatic experience at work – you may try to put it behind you as quickly as possible, but odds are it will linger just a little bit. That’s what it feels like to us.

Whenever I go into an SP situation where the case clearly has an emotional component, I always tell myself, “I’m not gonna cry.” Because in that moment I don’t feel like it. But inevitably, if the doctor is fully engaged in the situation, I am too, and pretty much every time the tears come just by themselves. I’m not acting, per se. I’m just allowing myself to feel something very real. You deal it, we feel it.

Thanks to all the really wonderful student doctors we’ve worked with over the years who have seen these opportunities not as “fake situations,” but as very special teaching opportunities that have the benefit of being “real” but without the consequences.

Comments (0)

No comment posted.