Frequently Asked Questions by Prospective Standardized/Simulated Patients

What will I do as a Standardized/Simulated Patient?

An SP is someone who is hired from the community and trained to participate in educational role play with our learners. SPs are trained to portray, in a consistent, reproducible manner, a patient in a health care setting. SPs, are employed by the University of Pittsburgh School of Medicine (UPSOM) to provide opportunites for  students across campus to learn to communicate by connumicating. SPs are trained to be keen observervers for the purpose of feedback and sometimes evaluation.  SPs pretend to be patients based on case materials we provide that describe a person . These " case" materials are based on the experience of real patients (we don't ask you to portray yourself)  The SP is interviewed and/or examined by students as though they were that person in the doctor’s office or other professional setting. You will be extensively trained and have ample time to ask questions before participating. 

SPs are asked to realistically provide the patient’s history and simulate physical or emotional symptoms as required by the activity. Our program mission is to help our learners improve their interpersonal, communication , empathy and physical exam skills. 

What's the difference between a "standardized" patient and a "simulated" patient?

These two terms describe approaches to the work any SP in our program will do. There are many different terms used in the simulation community to describe the role of an SP.  Simulated Participant, Standardized Colleague, Simulated Family member, Standardized Client, Fake Patient.....are all other names for SPs that are common.  Essentially the difference is in the training SPs receive , the materials used and the objectives of the event itself. The objectives of the learning event are what drive the training and expectations of the SP.

One SP can be trained to wear many hats and do many things.

Some events, particularly those that involve testing, need a more "standardized " approach to training SPs in consistency of portrayal and scoring. Mulitple SPs can be trained to do the same clinical case, and score a checklist in a consistent way, which is essential to fairness in scoring our learners.  

Many teaching events involve a more organic presentation of materials and need the SPs to be flexible in adjusting some case details, emotions and responses to the students according to the skills used by individual learners. Some groups, particularly in Canada and Europe, call this being more "simulated ".  

There are times that we ask our SPs to be more " standardized "  in how they respond to students, and times we ask folks to be more "flexible" , or simulate an organic conversation that rewards a student for skills used. 
We always train SPs to be educationally minded, believable and realistic....no matter the event.  

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, clear communication, reliability and awareness of the educational needs of the program are all qualities equally as important in being a successful SP. We have SPs who are also writers, cartoonists, retail workers, caregivers, artists , restaurant workers, musicians or retirees. 

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

Perhaps. Some find SP work to be more difficult than stage work or improvisation work.  This work has less to do with exploring a "character" ,  providing entertainment, or playing to an audience and more to do with the educational needs of each individual learner. It requires an eye for consistency , and an ability to bring life to each encounter based on how the student approaches you. You study a case and make judgements about how to respond to students based on the case, rather than  memorizing a script.. You will be trained to observe the behavior of the learner, and respond appropriately by providing information , emotions, and flexing your approach with each learner. We will also train you to provide balanced and objective feedback specific to each situation.

This work also is confidential, and you will not be permitted to share materials or stories of things that happen in any public or online forum,. We tell our students that what happens in simulation is confidential so that they can feel safe to try new things without fear of shame or recrimination. 

Is working as an SP safe?

Yes. SPs are well trained regarding what will happen in any environment. We will support your emotional safety and your physical safety through this training. We limit numbers of encounters, so that SPs are not overly taxed emotionally or physcially. If you have any concern, we will discuss it in training and you can always choose not to participate in activities for which you have a concern. 

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 trained SPs and 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 will be a physical examination at an event. Also, it is important to note that SPs can choose to participate in sessions that are interview-only, or in sessions that include physical examination encounters.

What would be involved in a physical examination?

Most physical exam session include basic exam items upon which you will be trained. 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 for sounds or pulses. This can happen during ultrasound exams, the lung exam or while checking for a femoral pulse, which is at the base of the thigh.

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

This is 100% up to you! Only if you choose to participate in those specific sessions would we train you for these exams. If you are comfortable in this role, you would participate in extensive training and in teaching examinations by faculty and senior SPs . These exams are taught by SPs across the city and are some of the most impactful sessions we do , based on reports from our learners. Sensetive Exams include pelvic and breast exams, genitourinary, hernia and rectal (prostate) exams. We train SPs for these exams in a small group setting with experienced trainers and faculty members.

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 interview settings.After our 16 hours of basic training, SPs will receive a specific case when they sign up for an event , that contains a complete history of the patient. It includes the reason for which they are coming to see the doctor, their past medical history, and details about their 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. If the case stated that you are " in pain",  we will train you  to move like the patient and  react to the physical examination. For example, if you have a back pain case, we will 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. We will ask you about visible or audible conditions during your training so that we can address your particular needs during a focused physical exam. Some surgeries or scars may exclude you from 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, more flexible , and able to provide informed feedback unlike most real patients.

What types of people do you need?

We are looking for all ages, physical types, ethnic groups, and professional backgrounds to represent the various types of patients present in any community. We need individuals who are self aware, reliable, strong communicators, quick learners, and open to accepting direction. We look for people that can empathize with the human experience of others and adapt easily to a range of different situations.

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

Candidates will be screened via phone , and then will meet with staff and members of our SP Training Team to do some role play in an interview format. You will be given some basic training materials to study before coming into the interview. If you are selected, you will spend a minimum of 16 hours in paid training and observation sessions. The amount of time needed for further training will depend on you ! We watch carefully and expect each new SP to ask questions and participate fully in the training in order to get the practice they need to feel comfortable. The complexity and needs of the case or event will also factor into when you will begin actual work. In training we focus on the difference between being an SP and a "real patient", 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 demonstrate their understanding and skill through role play practice . 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 , the needs of our client partners, and the case being portrayed. Most 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  will train you to use our schedule " sign up " system called Better IMPACT. You can sign up for events on our online calendar according to your skill ,  demographics and other requirements of the cases and events. From there, we will align schedules with availability of those that signed up and confirm you through Better Impact.

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. The more skilled and reliable you are, the more work we will trust you to do! 

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 and we also pay for training.

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; willingness to take instruction, attention to detail, inclusive of 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 apply at UPSOM's program 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 skill sets simultaneously. It requires intense concentration and situational awareness . 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 when required.  SPs will recalling skills precisely, and understand 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 and gratifying  work and expect  a high level of dependability from our SPs.

How do I apply?

Please apply via Talent Center to the Simulation Specialist position. If you do not have an account created in Talent Center, 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 Valerie Fulmer, Director, SP Program at 412-648-8702, or e-mail her at  vlf2@pitt.edu