“ We need to give the student actionable feedback.”
Paula Goldberg, a standardized patient at Brown and other local institutions.
sionally catches their gaze veering off to the side as they try to remember their next question— a behavior he has also observed among fellow actors trying to remember lines— or hears them exclaim happily not due to what he says as an SP but rather out of jubilation over their own progress in an encounter.
Goldberg and Oakes consider the role an opportunity to learn as well as to teach. They believe it carries into their experiences as real patients who are able to expect specific parts of exams or request that various medical providers change how they perform an exam, like not listening for heart sounds over clothing— a mistake that typically costs students points in their clinical tests. Oakes has even had medical students point out a new, real diagnosis through their examination skills.“ I have often wished that my health care practitioner [ were ] a fourth-year Brown medical student” due to students’ thoroughness, he says.
ACT VII: THE EPILOGUE While working through a series of SP encounters as part of the Internship Preparatory Course during my final year of medical school, I could not help but enter the feedback session afterward wondering if I had asked all the right questions or prescribed the correct medications. But the SPs commented minimally on these aspects. Instead, they appreciated the moments when they felt consideration and
empathy in the words we shared.
Now that I am familiar with the hospital workload and patient volume that naturally enforces time limitations on every patient encounter, my SP’ s comments served as an important reminder that those thoughtful exchanges are not wasteful. They are not embellishments that can be easily forsaken in the absence of endless time. To the patient, those words matter.
As physicians, we will not always have the correct answer; sometimes, we won’ t even have an answer. Sometimes, knowledge and skill will not be enough to save our patients. The quality of our conversation becomes the extent of our medication.
When we find those physicians whom we feel comfortable and safe around, the ones who seem to know what to ask, what not to say, when to listen, and how to place their tools, including the clinical trainees who we suspect are seeing their first patients, those soft skills may have been shaped in part by the standardized patients who were part of their education. All of us— performers, teachers, learners, and their future patients— are key players on the medical stage. HD @ B
Emilija Sagaityte graduated from The Warren Alpert Medical School in May and is now a pediatrics resident in Washington, DC.
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