“Mrs. Jones” sits in an exam room and explains to a medical student how she has been suffering from lower abdominal pain for several days. The student takes the patient’s history and does a thorough physical evaluation.
Sounds pretty routine, right? Well, not exactly. “Mrs. Jones” is not really sick, but it is her job to pretend like she is.
“Mrs. Jones” is a standardized patient, or role-playing patient, who is specifically trained to present the medical history, simulate the physical symptoms and portray the emotions of a real patient.
This fall, there will be more “Mrs. Joneses” being seen as the James H. Quillen College of Medicine at East Tennessee State University expands the use of standardized patients in its medical education curriculum.
“Standardized patients are becoming more of a permanent fixture in medical training,” said Dr. Martin Eason, an assistant professor of medical education at ETSU.
“They don’t replace the one-on-one interaction with real-world patients. Rather, they supplement the medical students’ training.”
Men and women of all ages from the Tri-Cities are being recruited as standardized patients. After being selected, they undergo intensive training in which they are taught how to present as actual patients with various medical conditions.
In the past, standardized patients have been used specifically at ETSU in the health communications courses. But this fall, the Quillen College will begin using standardized patients in other courses and clinical clerkships for teaching exam skills and diagnosing disease states.
“We know that practice makes perfect, and this gives medical students real-world experience in a controlled, non-threatening environment,” Eason said. “The students must think in real time and use their clinical skills to recommend how the patient should be managed. So, when they begin seeing actual patients in the hospitals and clinic settings, they will already have had significant experience.”
In addition to practice, another important benefit of standardized patients is that they provide good feedback, which, according to the medical school’s Executive Associate Dean Dr. Philip Bagnell, doesn’t just come from the instructors.
“The standardized patients also participate in the feedback process,” Bagnell said. “For example, immediately after an exam is finished, the patient will then share his or her own perspectives with the medical student as to how they felt during the exam. Did the student ask the right questions? Did the patient feel rushed? Was there enough eye contact?”
Bagnell described this as “excellent preparation for the actual patient care setting.” He added that the Standardized Patient Program will complement the training medical students are also receiving in the new Human Patient Simulation Laboratory, which was unveiled last February.
Eason said this hands-on experience will also be beneficial to medical students as they prepare to obtain their licensure. Beginning with the Class of 2005, all medical school graduates in the United States must undergo a standardized patient experience as part of their national licensure exam.
He added that the College of Medicine plans to create a Virtual Clinic in the future where the students would see standardized patients.

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