Innovations in Standardized Patient Methodology — Professionalizing SPs

One of the things I most often hear when I attend the ASPE conference is: “Where is the nearest Starbucks?” Oh wait, that’s what I most often ask.

What I most often hear is “We just started our own SP program! How do we [Insert Common SP Program Hurdle]?” Fortunately, the novice Program Director is surrounded by outgoing experts who are eager to share their wealth of experience.

But one need not wait for the ASPE conference to tap into this knowledge base. The ASPE Newsletter Archives is chock-full of useful information on SP Programs, including this piece from Kris Slawinski, “Innovations in Standardized Patient Methodology — Professionalizing SPs.”

Whether you consider yourself a “start up” or an “old hand”, you too will find something of interest in this article from 2003.  So grab a coffee, get comfy and give it a read. There’s a Starbucks around here somewhere.

 – Don Montrey (Coordinator for SP Training, NBOME)

ASPE Quarterly
Volume 2 Issue 1
Winter 2003

Innovations in Standardized Patient Methodology — Professionalizing SPs

By Kris Slawinski, Pritzker School of Medicine
If you’re like most SP trainers, you expect your SPs to arrive for work on time, prepared, dressed appropriately, smelling clean, friendly, happy to be there and interested in doing a good job. And, like most SP trainers, you’ve experienced SPs who do not meet even these basic expectations.

Frustrated with assuming that SPs would know not to wear ratty jeans, sneak off to the fire escape to smoke a cigarette, and solicit appointments for paid psychic readings on the job, I recalled something Jane Banning of the University of Wisconsin at Madison had told me. She hoped to eventually incorporate SP in-services to promote a more professional view of the work, and subsequently raise their performance standards and the seriousness with which they viewed what they did.

Using a draft of objectives of the UW SP program Jane shared with me, I developed introductory guidelines for behavior and job performance which have proved helpful in initial orientations with a new hire to help disperse early misunderstandings. In it I outline my general expectations of the SPs, many of which are aimed at protecting the students. It states that the sessions are not set up as opportunities to socialize, to “get even” with the medical profession, nor to hone acting skills, and mentions dress code, responsibilities, among other items.

In fact, the word ‘actor’ is a dirty word in my facility, as it is clear to me—and eventually becomes clear to faculty when they refrain from using the word in discussing the sessions with students—that students do better with SPs when they are focused on encountering a patient, rather than meeting with an actor who is playing a patient.

But the guidelines aren’t unilateral: I also outline what the SP can expect from me and from the Pritzker School of Medicine. This includes full disclosure of the pay scale, competitive wages, thorough trainings, and a safe forum to ask questions, as well as to report discomfort with the task or uncomfortable situations with students, faculty, or other SPs. I make it clear to the SPs that their input is valuable in honing the training materials, sniffing out undeveloped elements and details that don’t ring true to the scenario, and keeping it as real as possible.

As with students, repetition helps, so I tailor these guidelines to be more detailed and specific to each project and reintroduce them into each training. This underscores my expectations further, gives them a clear idea of what the project entails, and eliminates the ability for anyone to say they weren’t informed.

Initially I feared that the SPs would find the guidelines too restrictive, but their reaction was quite positive. “You have to show me the way, you have to tell me what you want me to do,” says Connie Trumble, SP for University of Chicago’s Pritzker School of Medicine. “Preparing professionally for the job is important, and there have to be guidelines.”

It’s not just my SPs who find professional guidelines helpful. “It validates SPs as a profession, and with a profession comes standards of quality,” says Jeretta Scott, SP for University of Washington for four years. “Standards enhance the profession—we’re not just health care professionals or actors, we’re more of a defined profession.” Scott assisted UW in hosting an SP retreat in 2000 with the focus on feedback skills with the senior SPs sharing their experiences and solutions. “SPs need to be professional in their encounters with medical students,” agrees Trumble. “I do a lot of studying to do this work right. I don’t do this as a hobby.”

Not only do I get more serious attitudes and better job performance from my SPs now, but students and faculty take the encounters more seriously when the SPs communicate this through their earnestness, facility and pride in what they do.

Of course, it may be asking a lot to expect a professional attitude from part time help, many of whom would rather be onstage in a different kind of spotlight (and, of course, many actors don’t make it as SPs because they cannot sublimate their need to be the center of attention instead of surrendering that position to the student). But they keep returning, usually because, along with a usually handsome hourly wage, they find the work “beyond fulfilling,” as Scott puts it. “It’s a better job than anything I’ve ever had. To feel learning is taking place in an individual who is going to be helping people, in a safe environment, is so powerful.”

For a copy of the guidelines used at UC, direct email to


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