Earn up to $20 an hour while educating students

I’m a familiar face around my city’s medical center, where some know me as that closeted gay man who infected his wife with HIV or the hostile employee who physically threatened a co-worker in an act of road rage or the bipolar cocaine addict.

Students in the center’s M.D., nursing, pharmaceutical and social work programs try to help me with my various “problems.” Some days my appointments go pretty well; other times things go off the rails. I’m what’s known as a Standardized Patient, or an SP. I’m paid to portray people with a variety of mental and/or physical afflictions. Some are age- or gender-specific; others aren’t. I’ve acted out all the scenarios described above and been paid for it. Students learn while I earn. It’s a win-win.

You can earn money as a pretend patient, too

Academic medical centers across the country hire local people like me to give their health science students a taste of real-world patient care, so you may be able to do it, too.

When the students see the SPs, they get to work on their procedural, deductive and people skills under the watchful eye of an instructor. These sessions are often the first experiences the students have with patient care (other than conducting practice exams on family members or fellow students) and they frequently represent a significant portion of their current semester’s grade.

I generally get my SP assignments several weeks in advance. My “ailments” are outlined and sometimes supplemented with background materials including YouTube videos. Each scenario — whether something dramatic, like acting out inappropriately in public, or simply preparing to check out of the hospital — sets the stage for the student/SP interaction.

All of the “caregiver-patient” encounters are held in examination rooms. A session facilitator may sit in or simply knock on the door when it’s time to wrap things up. Cameras videotape the proceedings for subsequent critiquing and class discussion.

Like a continuing theater production

During a typical day, an SP may go through four to eight exam rotations with different students. It’s kind of like a continuing theater production. The SP can refine his or her character with each successive “performance.” Each student/patient experience differs, based on the curriculum level, skills and personality of the young caregiver.

SPs are generally allowed some latitude in personifying the patient in their own manner, as long as the key scenario points are covered and students aren’t personally ridiculed or threatened. As a one-time improv performer in Chicago, I enjoy flexing those old muscles and responding to whatever the students bring.

And if my character is dealing with a substance abuse problem or mental health issue, I have permission to rant and rave a little more. As the instructors explain to students, anything can happen once they step into an examination room.

What the students get out of this

In our SP program, we are often encouraged to give students immediate feedback on their performance while the experience is fresh. By doing so, the SP soon learns that a spoonful of sugar (“You had good questions and quickly made sense of my symptoms”) helps the medicine go down (“You might want to work more on patient eye contact and spend less time looking at your checklist.”). This lets the instructors devote more time to critiquing the technical aspects of the students’ work.

How the students got it wrong

During one particularly busy SP assignment, several students in succession took my vital signs under an instructor’s supervision. In reality, my pulse rate is a bit slower than the average person’s (something I attribute to doing Transcendental Meditation), and all the students noted this. When the instructor asked the students what this suggested to them, they all expressed concern, barely took their eyes off their clipboards and suggested additional tests.

“Look at the patient,” said the instructor. “Does he appear to be in distress? Is his breathing labored? Look at his complexion. Is it pale or discolored? [The answer to each question was “No.”] Not all patients fall within the norm. That’s why you must evaluate them individually based on what you see as well as what the numbers tell you.”

Why older adults make great standardized patients

Older adults, it turns out, make ideal SPs. We offer our future caregivers a seasoned perspective on health care delivery. Many of us can also commit to the irregular hours an SP works, which may range from a few weekday hours to an occasional weekend assignment. The SP dress code alternates between street clothes and hospital gowns as required.

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