Merck Manuals Student Stories Reblog: Fake Patients with Fake Symptoms: the Standardized Patient Experience

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Originally posted on Merck Manuals Student Stories.


Palms sweaty, heart racing, and after what I hope comes across as a poised knock on the door, I walk into the mock exam room at our school’s Patient Simulation and Clinical Competency Center. It looks like the generic doctor’s office I have been to a million times for the flu, my athletic physical, and several sprained ankles, but something is off.

There’s a microphone hanging over my head, video cameras in two corners, and, perhaps the most bizarre of all, I am the one with the stethoscope in my white coat pocket. And the patient in there? She’s waiting for me.

I hover my hand under the hand sanitizer dispenser and nothing comes out. BUT THIS WAS THE ONE THING I KNOW HOW TO DO! I silently freak out in my head taking it as a sign of how the entire forty-five minute practice history and physical would go, while a little voice in my head whispered to stay calm and relax…oh wait, is that a Purell dispenser right in front of me? I sheepishly smile at the standardized patient.

I take a deep breath and as I settle into the rolling chair in front of her, we begin to talk. At first I am strongly aware that this is not a real patient, this entire fake scenario is fabricated and being acted out by ten other standardized patients and medical students in the rooms around me, and that somewhere in a nearby control room a fourth year medical student is watching and cringing at every awkward phrase that slips past my lips and accessory movement my body makes.

Yet, as soon as she opens her mouth, I am deeply involved and committed to helping relieve her complaints of chest pain. I ask her questions, and she answers them. I make a joke, and she laughs. But it’s more than a one-sided interrogation. She tells me about her job as a teacher, and I ask her about her students. She tells me of her concerns, and I remind her we are going to help her.

Before I know it we’ve moved past her history of present illness, past medical history, family history, social history, and review of systems, and I am taking her vital signs. During the physical exam, I explain why I am percussing and palpating and using those weird looking tuning forks, and she follows my instructions. As I walk out of the exam room, I shake her hand and tell her I will see her soon with a game plan about how we are going to help her feel better again.

After, the standardized patient and the observing fourth year student give me feedback that involves the words, “excellent,” “good rapport,” “you made me feel comforted,” and “I felt confident in what you were doing.” For the first time in a long time, I see the light at the end of this long and information-filled second year tunnel. I can and will get through the mountains of seemingly insurmountable work to see my God-given gifts and talents of really connecting to people in action. Because even though it wasn’t a real patient, for a moment I remember that this is why I came to medical school: to comfort and heal.