The Sunday Magazine

How standardized patients are helping a new generation of doctors by acting out ailments

The health care system is full of unsung heroes, but standardized patients may be among the most obscure. These are medical role players who pretend to have certain ailments, diseases, life histories and personality types so doctors in training can practice dealing with real people in real situations. Three standardized patients — Penny Tucker and Fred Hoeber in Edmonton and Laura Ellis in Hamilton, Ontario — talk about their work and some of their most memorable roles.
Standardized patients perform a range of situations that can be sad, or sometimes just plain strange. Working with standardized patients gives medical students a chance to practice an important skill: how to suspend judgment. (Photographs courtesy of MacEwan University)

It all started with Seinfeld. Cosmo Kramer, to be exact.

Fred Hoeber is a retired psychologist, who operates a bison and elk ranch near Riviére Qui Barre, Alberta. Some 10 years ago, he was looking for some part-time work that would get him off the ranch. 

Then Hoeber saw an episode of the hit TV show Seinfeld, the one where Kramer gets a gig as a standardized patient at a local medical school. The job? Act out illnesses, ailments and crises for health care professionals who are learning to navigate difficult situations and give diagnoses. 

"I thought if Kramer can do it, I can do it," said Hoeber, who now works as a standardized patient at the University of Alberta, the Northern Alberta Institute of Technology and Grant MacEwan University.

Hoeber was one of three standardized patients who spoke recently with The Sunday Edition host Michael Enright about the ins and outs of their job. 

Laura Ellis is a standardized patient at McMaster University, where she's also a part-time trainer in the program. Like Hoeber, she said she was introduced to the job by a friend who referenced Seinfeld

"Now, that's how I present it to other people," she said. 

Penny Tucker is a standardized patient at the University of Alberta, the Northern Alberta Institute of Technology and Grant MacEwan University. She also works as a standardized patient trainer for licensing exams at the University of Alberta. 

Tucker said the job works well for actors, who are going in and out of auditions and need to keep up their skills. 

Ellis has a background in theatre and she agreed. 

"This is kind of the dream part-time job for an actor," she said. "You're really honing your craft."  

Standardized patients perform a range of situations that can be sad, or sometimes just plain strange. 

"Anything you can think of, standardized patients will play that's real to life," said Tucker.

Ellis remembered having to act out a scenario where a family was arguing over end of life care for a loved one. 

These are situations that "can tear families apart," she said.

Meanwhile, Hoeber, who also works for veterinary students, recalled one episode where he pretended he needed help for his imaginary dog.

"My dog was bit by another dog and I'm really showing a lot of emotion. I'm upset and there are people in front of me and I don't give a damn, I want my dog looked after right now," said Hoeber. "That's what the role sometimes demands, that I act like a jerk."

Tucker said working with standardized patients gives medical students a chance to practice an important skill: how to suspend judgment.

She recalled playing roles where the patient was smoking marijuana or drinking too much alcohol.

"You'd get the odd student who would frown upon that," she said. "You know, you're really struggling with addiction. You might have the occasional health care professional who is learning not to be judgmental. I think that's one of the great values of this whole exercise that we engage in." 

Ellis added that in addition to practicing their bedside manners and how to be empathetic, students learn the importance of getting to know the patient so they can understand the full scope of the issue.

"It's really getting to know that person, and building that rapport will be the only thing that gets you that information," she said.

Tucker agreed.

"What makes a health care professional a really good one is to think of the person as a whole being, not just as a medical specimen," she said. 

Click 'listen' above to hear the full conversation.

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