Standardized patients play crucial role in medical training
Program uses real people to simulate scenarios that help students take their skills from the classroom to the exam room.
Standardized patients like Mara Levin, right, help fourth-year medical students Joey Ghotmi, left, and Chloe Eckert, center, polish their skills before experiencing real-life patients.
Photo by Noelle Haro-Gomez, U of A Health Sciences Office of Communications
As a retired history professor, John Heyl doesn’t exactly have the resume needed to teach medicine. Yet he’s been educating medical students for more than a decade.
John Heyl has been a standardized patient for more than a decade. He said he loves knowing that he’s making a difference for future health care workers.
Photo by Noelle Haro-Gomez, U of A Health Sciences Office of Communications
Heyl is one of about 140 standardized patients with the University of Arizona Interprofessional Clinical & Professional Skills Center’s Standardized Patient Program. The community members range in age from 19 to 92 and assist in the training of U of A health sciences students by acting as patients in specific scenarios that allow future health care professionals to practice taking medical histories, performing basic exams and test-driving their compassion along with their skills.
“The students are just so very appreciative of what we do for them and the kind of feedback we give,” said Heyl, who’s been part of the program for 16 years. “It's terrifically rewarding. Those of us involved in it really feel we’re doing something important.”
A booming program
When the standardized patient program started more than 50 years ago, it served primarily College of Medicine – Tucson students. When the program moved into its new, bigger home with 30 exam rooms on the eighth floor of the U of A Health Sciences Innovation Building in 2019, it opened up to students across all health professions, including veterinary medicine. Animals don’t pop in for check-ups, though. Instead, cases focus on how to deal with the humans who accompany their pets.
The standardized patient program gives students the chance to test their classroom knowledge in a real-life setting where there’s no risk.
“Our mission is that this is a safe place for students to practice their skills, make mistakes and learn from those mistakes before seeing actual patients,” said Colette Scott, MEd, director of the center.
The program has grown dramatically over the years, said Heyl, whose wife, Kathy, worked in academic affairs at the U of A College of Medicine – Tucson and introduced him to his postretirement job. And it is a job — standardized patients earn $22 an hour, with those portraying reproductive health issues earning more.
For the pseudopatients, though, it’s a labor of love. It offers them a chance to give back to the community as well as enjoy social connections. That’s what enticed Karen and Wayne Lane, recent retirees who are new to Tucson, to apply for the program last summer. Plus, it gave Karen, who was an art director for an ad agency, the chance to live out a childhood dream.
Colette Scott, MEd, oversees the standardized patient program, which is utilized by the health sciences colleges.
Photo by U of A Health Sciences BioCommunications
“I grew up in Los Angeles, so I always wanted to be an actress, but my mother talked me out of that,” she said, laughing.
Colleges come to the standardized patient program with requests that patients simulate specific medical issues. Heyl, for example, recently came to clinic with a swollen, red knee made all the more realistic by theatrical makeup. Sometimes, the colleges want patients to help students navigate tricky emotional situations.
Karen Lane recently portrayed an overly flirtatious patient with diabetes, trying to coerce her physician-in-training to have a coffee date or meet up at the gym.
“I probably could have been hammier,” she said, “but I saw how uncomfortable he was. I started feeling bad for him because he didn’t really know how to react.”
Students have limited time to prepare before seeing the standardized patients and learning what the cases are. Some of the scenarios can be pretty tough, both for the students and patients, which is why they can retreat to special areas to unwind.
“We just thought that was a really good idea for both our students and our standardized patients,” Scott said. “So, whenever we have high-emotion cases or our reproductive health activities, we set up a lavender room in case anyone’s triggered or just needs time to decompress.”
Kathy Heyl is in charge of making sure the space is stocked with adult coloring books, soft music, pillows, blankets and chocolate. A retired social worker, she also provides support for whoever needs it.
Specialized training
Fourth-year medical student Chloe Eckert has logged a lot of hours in the standardized patient program clinic. Eckert, who has applied to be an ob-gyn resident, is such a fan of the program that she talked her father into becoming a standardized patient, and this semester she’s mentoring fellow students.
U of A medical student Chloe Eckert, center, loves the standardized patient program so much that she suggested her father become one.
Photo by Noelle Haro-Gomez, U of A Health Sciences Office of Communications
“I remember one of my first standardized patients told me she couldn’t even feel my stethoscope because I wouldn’t push on her chest hard enough,” Eckert recalled. “She said, ‘I’m not going to break if you push it on me.’ You need that kind of feedback that a real patient might not give you, but our experienced, trained standardized patients can. It’s been a really awesome part of school.”
Despite all the classroom training, it’s still hard to fully prepare for being in an exam room with someone. That’s why an opportunity to practice building rapport with patients is so important,
Eckert said.
“In real life, patients are going to be different than our standardized patients on a script, but it’s important that we feel comfortable enough with our own flow, our own selves, in a room with somebody at the most basic level,” she said.
Eckert recalled a time when she was beating herself up over forgetting to ask about drug use, a basic and important piece of a patient’s medical history.
“All I could think about was that I was going to fail this practical,” she said. “But the feedback I got from the patient was that she said she loved how engaged I was. She said, ‘It felt like you actually cared what my answers were.’
“That changed my mindset with how we interact with patients because we’re so nervous about all these very specific details, and they care about the interaction. That’s the whole point of the standardized patient program. You want the standardized patient to feel like this is somebody I want to see when they graduate in four years.”