University of Pittsburgh

Standardized Patients Frequently Asked Questions

What is a Standardized Patient?

A Standardized Patient is someone who has been trained to portray, in a consistent, uniform, reproducible manner, a patient in a health care setting. Standardized Patients, or SPs, are used by the University of Pittsburgh School of Medicine (UPSOM) and other institutions to assess and evaluate learners. SPs learn a case based on an assigned patient (other than themselves) and are interviewed and/or examined by students as though they were that person in the doctor’s office or other professional setting. SPs are asked to realistically provide the patient’s history and simulate physical or emotional symptoms as required by the teaching or testing activity.

Why do you use the term standardized instead of simulated?

The mission of the SP Program is to have an SP realistically convey an illness to a
student and to do it in a consistent and sometimes measurable way. Ten SPs can be trained to do the same clinical case. No matter which SP interacts with the student, he or she would receive the same information and similar responses while still being unique with each student. This way, we accurately teach and assess students according to one standard per case. Each case can be altered or revised as needed. We strive to set standards that can be accurately reproduced.

I do not have a background in acting. Do I have to be an actor to succeed as an SP?

No. Some SPs are trained and experienced actors, but many are not. Many successful SPs have never had any formal acting experience. There are some similarities between the work that SPs perform and what actors do, but there are differences, too. Sensitivity, self-awareness, and the ability to communicate clearly are qualities equally as important in being a successful SP.

I am an actor. This should be easy for me and good experience, too.

Perhaps. Some find SP work to be more difficult than working from a script or within common improvisational outlines. This work has nothing to do with finding dramatic moments, providing entertainment, or playing to an audience. It can be repetitive, as the same materials must be presented for every student. In addition to portraying the case, you will need to observe the behavior of the learner, provide balanced and objective feedback and stay flexible to the needs of the faculty in each situation. This work also is confidential, and you will not be permitted to share this material or use it in any public or private performance.

Is working as an SP safe?

Yes. SPs are simply portraying someone who has a medical condition. The examinations are very basic and do not cause any harm to the SP. At most, there might be some brief discomfort that would be involved with any basic physical examination. For example, SPs may have their blood pressure taken multiple times in one day. If you have any concern, you do not need to participate in activities that involve physical examination.

Do the students know we are not real patients?

Yes. We aren’t trying to deceive the learners. Learners are told they will be working with SPs but are told to behave as though they are with real patients.

Will I need to wear a hospital gown?

It depends. Some encounters involve an interview-only, and in those activities, there are no physical examinations involved. Other sessions do involve a physical exam. For those, SPs are dressed in a hospital gown and wear undergarments (sports bra, and modest underwear) beneath the gown. SPs always know beforehand if there is to be a physical examination. Also, it is important to note that SPs can elect to participate in sessions that are interview-only, or in physical examination encounters.

What would be involved in a physical examination?

Most of the sessions involve very common examinations. For example, students may: listen to the heart and lungs with a stethoscope; press on the abdomen looking for tenderness or swelling; look into the eyes, ears, and throat; take blood pressure; assess muscle strength; check reflexes; check pulses, etc. None of the examinations involve taking any blood or other samples, and SPs are never given any drugs. Occasionally learners may listen or touch beneath the undergarments. This can happen during the lung exam or while checking for a femoral pulse.

Would I have to take part in genital or rectal examinations?

Only if you elect to participate in those specific sessions; if you are comfortable in this role, you would undergo training and participate in examinations by faculty and trainees. Exams taught with SPs include female pelvic and breast exams, male genitourinary and rectal (prostate) exams. We train SPs for these exams in a small group setting with an experienced faculty member.

How do I know what to say when the student interviews me?

We spend a lot of time on this question in training when we discuss basic “rules” that will direct SPs in most settings. For any activity, SPs will receive a specific case that contains a complete history of the patient. It includes the reason for which he/she comes to see the doctor, his/her past medical history, and details about his/her life such as employment, family, and activities. We also describe the emotional state of the patient during the encounter. By learning that history, the SP will know how to respond to the questions asked by the learner. We also train SPs to move like the patient and how to react to the physical examination. For example, for a back pain case, we would show you where it hurts and what the patient could or could not do because of the back problem.

I’ve had a couple of health problems in the past. Can I still be a standardized patient?

If you possess the communication and other skills required for the position yet have a physical limitation, it’s possible to still be an SP depending on the health issue. Sometimes an individual has a condition that would be a learning opportunity for students. Other times, the condition could prohibit students from learning the desired outcome for the encounter. For example, visible scars in specific areas that will be addressed during a focused physical exam may exclude SPs participating in a particular event. There are no guarantees about the types of cases that are available, and some individuals are not suited for certain roles. Past or present medical conditions will not necessarily exclude you from participating in the program.

Why do you need Standardized Patients? I thought medical students learned with real patients.

By using SPs, students have the opportunity to practice the skills they are taught before they work with real patients. These encounters provide a safe setting where students can make mistakes and learn from those errors without doing any harm to a real patient such as counseling them poorly or taking an incomplete history. SP work is not intended to replace the experience they will need with real patients, but rather to add to their training. SPs can be more consistent, more objective, and more flexible than real patients.

What types of people do you need?

We are looking for men and women of all ages, physical types, ethnic groups, and professional backgrounds to represent the various types of patients in any community. We need individuals who are strong communicators, can learn quickly, accept direction, and adapt easily to a range of different situations.

How am I trained and prepared to be a standardized patient?

Once candidates are hired, they will meet with the SP Program Director and members of our SP Training Team and spend a minimum of 16 hours in training sessions. The amount of time needed for further training will depend on the complexity of the case and the SP’s experience. Trainings focus on how to realistically portray a patient case, how to provide effective verbal feedback, and how to identify and score student skills. Before encountering students, SPs are required to successfully present or demonstrate their knowledge. Please note that training is mandatory; you cannot work unless you attend training.

How often would I work and when?

That is difficult to say. SPs are considered temporary employees of the University of Pittsburgh. We schedule SPs according to the needs of the School of Medicine curriculum and the case being portrayed. Most of the student sessions take place on weekdays, so SPs have to be available during those times. There also may be some weekend or evening work, though this is not very common. The SP Scheduling Specialist focuses first on the skillsets and demographics that are required for the cases and from there will align schedules with SP availability. Please note that once SPs agree to work on a particular day, it is absolutely essential that they meet that work commitment, arriving prepared and on time.

How much does the job pay?

We will discuss pay with you if we choose to invite you to an interview. SPs are paid a competitive hourly rate.

How do you choose who will become an SP?

We conduct individual interviews to find out who is suitable for the job and assess the applicant’s comfort level in this environment by participating in role-play activities. We also conduct reference and background checks to see if an individual is a good fit before an offer is made. Characteristics we look for in the interview are a positive attitude; no biases toward gender, race, religion, national origin, or physical characteristics; reliability and punctuality; someone who understands confidential matters; and someone who is comfortable with their own health and in dealing with health professionals.

I’ve been an SP for other organizations. Would I be able to work for The University of Pittsburgh School of Medicine (UPSOM)?

Your previous experience could certainly be useful, but we cannot automatically say we would be able to hire you. Some aspects of the work may be different from what you are used to, and you would have to work as instructed for UPSOM’s needs. If you work as an SP elsewhere, you certainly are welcome to work for UPSOM as well, but remember that you cannot fail to meet your obligations to UPSOM at any time because of other work.

I think I could do this job. It sounds easy enough.

The position is actually quite complex, as it requires SPs to tap into various skillsets simultaneously. It requires intense concentration while being interviewed and examined by up to 10 learners in succession. SPs must be able to respond as the real patient would and maintain not only the patient’s character but also simulate a physical condition during the interview and examination, and do so repeatedly in a consistent manner. SPs are required to describe the encounter afterward recalling skills precisely, and how the student’s behaviors impacted the SP as the patient. The job requires energy, memorization, discipline, maturity, concentration, excellent communication skills, and a high level of comfort with your own body and health. Being a Standardized Patient is rewarding but hard work and we demand a high level of performance from our SPs.

I’m still interested. What do I do next?

Please apply via Pittsource to the Simulation Support Specialist position. If you do not have an account created in Pittsource, you will have to create an account prior to applying for the position. We typically conduct a recruitment cycle twice per year depending on the needs of the program. Once you apply, we will keep your application on file and review it during our next recruitment cycle.

If you have further questions, please call Adam Kukic, SP Program Administrator at 412-383-5893, or e-mail him at akukic@medschool.pitt.edu.