Standardized patient experience

I would like to know more about the standardized patient experience. Specifically I'm interested in the interview and selection process, training, exact details of a teaching session, and any experiences that standardize patients have seen each other in a teaching situation and in a mentoring situation.

First, you have to break this down into multiple possible job descriptions.

Under the description of SP are a few different jobs. Most are about acting. You're given a case that includes age, demographics and complaint. Your job is to act the part through the student interaction. This could be communication only or might include a focused exam. The exam doesn't commonly include genitals or female breasts. These one-on-one sessions are recorded and sometimes a checklist is used. The students are supplied with vital signs and demographic data about the 'patient.' Occasionally, faculty is present to evaluate the student.

Less common are the classroom sessions. Here, the SP might act or might just be a body for class guided practice. Once again, no genitals or breasts are involved.

SPs rarely received more training that shadowing an experienced SP for a few hours.

Less common are the Genital Teaching Assistants. These are trained individuals who teach pelvic and breast exams following the school's curriculum. In the 1.5 hour or so encounter, the GTA will teach about 4 students how to do a gender appropriate exam using themselves as the demo and critiquing the student's performance.

Occasionally, there are jobs to simply be a body for something more invasive. Once, I was the body for students to practice rectal swabs. Others are used as bodies for ultrasound exams or the like.

How do you get these jobs? Most people are brought into the program via individual recommendation from a current SP/GTA. People who use the position to entertain their kink don't usually last. If you're serious about the job, the kink is incidental.

So I guess what I'm interested in knowing more about is the genital teaching assistant position.

GTA training is essentially being shown first then demonstrating the exam techniques with a senior GTA as trainer. In my case, there were three of us newbies and the trainer, all of us in gowns. Each section of the exam was demonstrated by the trainer, then each of us would do the same.

While each center has their own standards and idiosyncrasies, the basics are:

Students enter the exam room to find the GTA in the gown with a sheet over lap and legs, on the exam table.

After an introduction and explanation of the process, the GTA will begin the demo. I change my presentation depending on what kind of students they are. Nurse practitioners, for example, don't need instructions on hand washing and draping, 2nd year med students do.

The exam is shown systematically. First is the examination of the pubic hair, supra pubic area and inguinal lymph nodes.

After that, the exam of the penis and testicles is shown.

Each student practices those techniques.

Next the GTA stands for the hernia exam. Each student practices.

Last is the rectal/prostate exam. Where I work, we teach the exam standing, bent over the table. After explaining the process using a fist as a demo anus, each student practices.

All through the process, the students are guided and corrected as necessary.

For women they have a standardized patient job called a gynecologic teaching assistant. I'm assuming whoever applies for that gets right into exposed exams, as they know what they're getting into; but who knows, and perhaps they were just a standardized patient first. That would be win-win if they enjoyed the exams and could really help educate students at the same time. I'd love to hear more about it from a woman who's a GTA.

There are various titles in various schools.

The female training is very similar, but gender specific. Assuming that untrained women understand the gynecology exam is simply false - the same with the untrained male. Having experienced the exam and understanding its intricacies for teaching are two wholly different things.

What about someone with a medical background? An MD, DO, RN, PA, or NP who wanted to be a standardized patient would really be in demand.

Jds4med,

Could you describe the exam of the penis and testes as you would to a student?

What about someone with a medical background? An MD, DO, RN, PA, or NP who wanted to be a standardized patient would really be in demand.

No, they're not. First, the money isn't that good,. Second, they come with too many preconceived notions. It's easier to train laypeople.

Jds4med,

Could you describe the exam of the penis and testes as you would to a student?

First, always tell the patient what you're going to do BEFORE you do it. Tell the patient and move the drape to expose the genitals.

Next, examine with your eyes. When you look, is anything unexpected. Make mental note of circumcision status - it's always charted.

Tell the patient that you're going to touch his penis. If necessary, retract the foreskin. Grasp the glans and traction the penis away from the body. Observe all sides of the penis for abnormalities. Gently palpate all 3 chambers from base to tip while maintaining traction. After palpation, relax traction and spread the meatus to observe for discharge. If the foreskin was retracted, return it to it's natural position.

Now, stretch the scrotum and move it to observe all surfaces. Roll the skin between your fingers to feel for abnormalities.

Next, trap one testicle between thumb and fingers and palpate all surfaces for lumps and bumps with the other hand. Locate the epididimus and palpate gently. Traction the testicle away from the body and palpate the spermatic cord, trying to identify the vas. Repeat on the other side.

Be sure to reassure the patient that nothing is wrong at each stage, as long as nothing IS wrong.