With the help of actors, this UK medical program helps future doctors learn to interact with patients
An actor portraying an illness is commonplace on television and in movies that aim to provide a realistic view of the emotions and physical pain that patients endure. But what many may not realize is how valuable actors can be to aspiring medical professionals in real life.
The Standardized Patient Program, a national program that was introduced to the University of Kentucky’s College of Medicine in the mid 1990s, has become a vital way to train and assess medical students on how they communicate with patients.
“We primarily focus on communication skills – how to talk and get information from a patient, and how to improve their listening skills by not interrupting or being judgmental,” explained Joe Gatton, who has served as coordinator of the standardized patient, or “SP” program, for nearly seven years.
Gatton, who has a background in show business, served as a SP himself for nearly a decade before taking on the role of coordinator. His responsibilities include training the SPs to portray various illnesses in order to evaluate the skills of the students in all of UK’s major health colleges, including pharmacy, nursing, dentistry and the physician’s assistant programs.
The SP program begins during a medical student’s first year at UK, with the scenarios the SPs portray and the skill levels progressing as the student shows advancement.
Medical students are aware the SPs that assess their skills are actors. The goal is to give them a way to practice their craft before venturing out into real-life situations.
“For first- and second-year students, we’re teaching them how to assess a patient’s ailments based on how they verbally describe what’s going on,” Gatton said. “(The student) learns how to ask the right kinds of questions in the right kind of way. Sometimes even silence draws more information out – just being patient enough to listen instead of going to the next question, and learning how to respond.”
Besides UK medical students, the SP program also occasionally works offsite with interns, pharmacists and other medical professionals within competency training workshops.
UK’s SP staff is made up of about 35 to 40 people, ages 20 to 75, that evaluate medical students based on a specific checklist of skills. The position is considered part-time and temporary, although Gatton said he knows people that have worked as SPs for more than 10 years.
When hiring SPs, Gatton said communication skills and a teaching background are a plus, but not required. Over the years, he has employed many retired teachers, actors and other individuals involved in the communications field.
One of Gatton’s goals through the SP program is to teach medical students “how to have a conversation and ask questions that don’t treat someone like they’re a germ underneath a microscope.
“Because we’re in this great age of technology, we think it’s going to save us,” he explained. “But if you ask the right kind of questions, you’ll know the correct technology to use may be less expensive. If (the patient) doesn’t need an MRI, don’t give an MRI. Sometimes the tendency is, ‘Well, we’ll just do some tests,’ as opposed to ‘does this patient really need this?’”
Gatton explained how some of the scenarios SPs act out are straightforward, while others may take some investigating on the part of the student in order to discover the root of the problem. Regardless of the situation, the student must keep the SP comfortable and stay sensitive to his or her needs – especially if it involves a sexual issue or a battle with addiction.
“A patient may come in presenting one thing, but the case is basically training these students to listen and realize that what’s on the chart isn’t actually their issue,” Gatton said.
For example, a SP may present a case where the actor simply wants get a prescription refill, when in fact it turns out she is a victim of domestic violence and needs more medication because her partner stole it.
“Another scenario may involve an elderly person coming to have their blood pressure medicine adjusted and the student has to figure out that it actually doesn’t need to be adjusted; (the patient) hasn’t been taking it correctly,” Gatton said. “If (the student) takes the cue correctly, they realize they may be dealing with a case of early dementia and need to do some other types of tests.”
For Gatton, he believes communication skills are just as important as the sciences involved in a medical profession.
“Just because something’s on a chart, don’t come in with your mind made up,” he said. “Start out with an open-ended question, and then slowly start narrowing it down and eliminating things.”
Considering how long Gatton has been involved with the SP program, it’s clear he sees many benefits in the process.
“Sometimes you get cynical and think nobody cares, but then you see someone (communicating with patients) the right way and is still passionate about it – to see how great it is when it works, it’s inspiring,” Gatton said.
Kenda Wright, who has worked as a SP for more than six years, said she enjoys her career because it combines her love of acting with her interest in education. She also feels she is helping to make a difference in the medical field.
“I believe the Standardized Patient Program allows the students to become better health-care professionals,” said Wright, who minored in theatre in college and has held past jobs as a banker and a high school business teacher.
“(The students) are able to practice interviewing and counseling skills in a safe environment that allows them opportunities for constructive feedback and chances to improve their communication skills through repeated simulations,” she added. “In turn, the increased opportunities help them develop better relationships with their patients.”