Wacky Job Alert: Fake Patient

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In the morning, Neva Krauss listened to medical students tell her she’s got an incurable disease. Then she went home, took some Tylenol (and a nap) before returning to Johns Hopkins to hear the bad news all over again. That’s because Krauss doesn’t actually have any terminal illnesses — she just gets paid to act like she does. Krauss is one of 150 standardized patients working at the Johns Hopkins School of Medicine’s Simulation Center, and charged with helping medical students get as-close-to-real-life-as-possible experience dealing with the emotionally fraught situations that doctors have to face on a daily basis.

In SP simulations, medical students practice some of the most awkward or uncomfortable situations they may have to someday face — admitting medical mistakes, asking distraught loved ones about organ donation, dealing with patients who appear to be physically abused. Faculty members observe the interactions through two-way mirrors, and discuss them with students afterward. And it’s hardly fun and games for those involved:  the SPs may have to fake horrible physical pain, or emotional devastation, or psychiatric issues, or drunkenness. “Not only do I have to constantly grimace and groan, but I have to remember what the med student is saying so I can grade how they do,” Tom Wyatt told the Johns Hopkins Magazine.

Ideally, the program helps medical students resolve communication issues before they’re faced with a real-life scenario. There are plenty of SP legends of inept or insensitive students, like the one who ended every sentence with “…okay?” When instructed to give bad news to a SP, she said, “Your son has just died, okay?” prompting the SP to sputter, “No, it’s not okay!” Which is exactly why these trainings are necessary.



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  1. This sort of program should be part of any professional training system; whether for doctors, lawyers, pilots, teachers, or police. Learning, in a safe environment, how to deal with those difficult situations is – or should be – an essential part of such training. It sounds like Hopkins is doing it right.
    One small problem with the article: I had to go back and re-read the first paragraph three times to figure out that SP stands for Standardized Patient. That should have been indicated at the first mention.

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