University of Pittsburgh

Standardized Patient Frequently Asked Questions

What is a Standardized Patient?

A Standardized Patient is someone who has been trained to portray, in a consistent, standardized manner, a patient in a medical situation. Standardized Patients, or SPs, are used by the University of Pittsburgh School of Medicine (UPSOM) and other institutions to teach and evaluate students. SPs learn a case based on a real patient other than themselves and are interviewed and / or examined by students as though they were that person in the doctor’s office or clinic, giving the patient’s history and simulating their physical signs such as pain or difficulty walking.

Why do you use the term standardized instead of simulated?

The mission of the SP Program is not to have an SP realistically convey an illness to a student but to do it in a consistent and 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 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.

That sounds like acting. Do I have to be an actor?

No. Some SPs are trained and experienced actors, but most are not. You can be a very good SP without ever having been on stage or in a movie. There are some similarities to what actors do, but there are differences, too.

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

Perhaps. You may find it much more difficult than working from a script or within common improvisational outlines, and you may find it very frustrating. This work has nothing to do with finding dramatic moments, entertaining, or playing to an audience. It can be very repetitive; the same patient 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 it safe?

Yes. There is no reason for anyone to do anything that might be harmful. You are just 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. If you had cause for concern, you would be entitled to stop any examination.

Do the students know we are not real patients?

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

Will I need to take off my clothes?

Sometimes. If the students are only required to interview the patient, then you will not need to. In some situations, you will be undergoing a physical examination, and for that you would be dressed in a hospital gown, open at the back, with underwear on underneath. You would know beforehand when this would be expected. In some cases, certain pulses should be checked at locations underneath the underwear, but the underwear does not need to be removed.

What would be involved in a physical examination?

You would take part in very common examinations. For example, students may: listen to your heart and lungs with a stethoscope; press on your abdomen looking for tenderness or swellings; look into your eyes, ears, and throat; take your blood pressure; assess your muscle strength; check your reflexes; check your pulses, etc. None of the examinations involve taking any blood or other samples, and you would not be given any drugs. For female SPs, the breasts may be partially exposed or touched as necessary parts of other examinations, for example, listening to the heart.

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

Genital and rectal examinations are performed, but only when the Standardized Patient has expressed an interest in being involved in those teaching sessions. Gynecological, breast, and genitourinary exams are always monitored by a faculty member.

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

We create a complete history for you to learn. It includes the patient’s complaint 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 he/she is in during the encounter. By learning that history, you can learn to portray the patient and speak to the doctor. We also would show you how to move like the patient and how to react to the physical examination. For example, you may be portraying someone with a bad back. 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?

Probably, if you are suitable in every other way. Sometimes an individual has a condition that would be very helpful to the student during the encounter. Other times, the condition could prohibit the student from learning the desired outcome for the encounter. 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 exclude you from participating in the program. However, you will need to be suitable in other ways.

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 to make mistakes and learn from those mistakes without doing any harm to a real patient such as counseling them badly or taking a poor history. This is not intended to replace the experience they will need with real patients but rather to add to their training so that they can do a better job. 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 various backgrounds to represent the various types of patients they will be portraying. We need individuals who are strong communicators, who can learn quickly, accept direction, and adapt easily to a variety of different situations.

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

Once candidates are hired, they will meet with the SP Trainer and spend a minimum of 15 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. Certain cases require the SP to provide feedback and/or score student performance so they will need to be trained on that as well. Before encountering students, SPs are required to successfully present or demonstrate their character. Please note that training is mandatory; you cannot work unless you attend training.

Do I need to know a lot about medicine?

No. We will teach you what you need to know to accurately portray a case.

How often would I work and when?

That is very difficult to say. You are considered a temporary employee of the University of Pittsburgh. You will be scheduled according to the needs of the School of Medicine curriculum and the case being portrayed. Initially, you might work only a few hours during the course of months or none at all. Most of the student sessions take place on weekdays, so you would have to be available during those times. There also may be some weekend or evening work. We match your abilities as closely as possible with the current projects and then match schedule needs to your availability. Please note that once you agree to work on a particular day, it is absolutely essential that you meet that work commitment.

How much does the job pay?

We will discuss pay with you if we choose to invite you to be interviewed. SPs are paid an hourly stipend.

How do you choose who will become an SP?

We will conduct individual interviews to find out if you are suitable for the job and assess your 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 due to the repeated examinations; 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. We are not looking for individuals who want to pursue their own agenda with doctors or the medical system.

I’ve been an SP for other organizations. Would I be able to work for UPSOM?

Your previous experience could certainly be useful, but we cannot automatically say we would be able to hire you. You should also remember that 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 are continuing to 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 nor should you let down any other SP program or other employer.

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

Think carefully before you decide. This job is not easy, and it is not for everyone. It requires intense concentration while you are at times being interviewed and examined by up to 10 students in succession. You must be able to respond exactly as the real patient would, and only as that patient, never as yourself. You must be able to maintain not only the patient’s character but also simulate his or her physical condition during the interview and examination, and do so repeatedly in a consistent manner. You may be required to discuss the encounter afterward with the student, and for that you would have to recall the encounter precisely and describe carefully how the student’s behaviors impacted you as the patient. The job requires energy, memorization, discipline, concentration, excellent communication skills, and a high level of comfort with your own health and in dealing with doctors. Being a Standardized Patient is rewarding but hard work, and we demand a high level of job performance from our SPs.

This all sounds very unusual and interesting, but it is so unusual I’m not sure whether I would be able to do it well or whether I would like it.

It is unusual and interesting! Most SPs report great satisfaction with this work, but it is understandable that you would be concerned. That’s why we want you to understand completely what is involved.

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

Please go to the SP application page for further instructions and details. We hire one time a year depending on the needs of the program. Even if we do not use you right away, we will keep your application on file for future needs.

If you have further questions, please call the Advanced Clinical Education Center at 412-648-8702, or e-mail us at acec@medschool.pitt.edu.