Annoyed at standardized patient :(

[ocean11]

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Hi everyone,

MAN I just have to vent. I am so annoyed at this one standardized patient today, she was so critical and negative. I had 2 on my exam today, which is worth 20% of my grade. One of them had mostly nice things to say, the other pretty muched touched on all the negatives and no positives, she looked depressed to start with and I got a bad vibe from the start.

Anyhow, I think its so stupid that they call this test 'standardized' because clearly EVERY patient is different and its all luck of the draw on who you get! Some are more picky than others, some are in bad moods, I think we should have to see ALL the standardized patients (8 of them per day) and take our 'average' instead of just 2. Some people have said the same thing about this particular 'standartized patient' so I'm not alone... should I complain?!?!? arghhhhhhhhhhhhhhhhhhhh 🙁 🙁 🙁 🙁 🙁 🙁 🙁 😡 😡 😡

 

[tigershark]

The patient is probably supposed to be critical and negative. We had all kinds of "difficult" standardized patients.

Everything they do is for a reason.

 

[ocean11]

The patient is probably supposed to be critical and negative. We had all kinds of "difficult" standardized patients.

Everything they do is for a reason.

yeah thats true.... but this can REALLY affect my grade! I think I might end up with a C or something...... which could screw up my final grade which is worth TONS of points --> which could drop my average --> drop my class rank and thus screw up my chances of EVER obtaining a decent residency!!!!!!!!!!

 

[QofQuimica]

yeah thats true.... but this can REALLY affect my grade! I think I might end up with a C or something...... which could screw up my final grade which is worth TONS of points --> which could drop my average --> drop my class rank and thus screw up my chances of EVER obtaining a decent residency!!!!!!!!!!

I think tigershark is right. Do you KNOW for sure that you got a bad grade from this patient, or do you just feel bad because she was kind of mean? Maybe she just wanted to test how you stood up to her criticism, and your grade is fine.

 

[UCLAstudent]

The same thing happened to me on my final last block, except that I only got to interview one standardized patient. The interview was videotaped, and I felt really good about it. Even the faculty member who reviewed my tape said that I established good rapport, etc. Well, the standardized patient gave me a bad score. I look young, and the patient interpreted this as nervousness and inexperience. I was a little nervous (it was a final exam, after all), but not to the degree that the patient described in her comments. When I got my score, I felt like I had been punched in the stomach. You just have to move on, try to improve, and hope for a better patient next time. 🙂

 

[Gut Shot]

This is exactly why such encounters should be given zero weight, and why Step 2 BS should be destroyed.

 

[matthew45]

SPs at all schools should be watched like hawks by the faculty. The good ones are invaluable, especially in giving CONSTRUCTIVE criticism on things like personal mannerisms, tone, approach to sensitive issues etc. The bad ones do nothing but make students feel inadequate.

I had one experience where I sat down with an SP (in a regular exercise designed to make sure we had the entire History memorized) who thought it would be fun to be a difficult patient....

me: "so what brought you in today?"
sp: (looking at me skeptically and with annoyance): "ummm, what do you mean?"
it deteriorated rapidly from there, she accused me of "failing to establish a rapport" because I didn't ask her how she was doing when she told me her fictitious children had all left for fictitious universities.

This was M1 year, give me a break.

 

[beary]

I got a comment once from an SP that she didn't like how thoroughly I washed my hands because it seemed like I thought patients were dirty. 🙄

 

[deuist]

I once got a comment during an exam that I did not properly cover the patient, meaning that I did not put a sheet over the patient's genitals to keep them from being exposed. The patient was wearing pants! There was nothing to expose!

 

[DW3843]

this is a good one....

After a focused H&P on my standardized patient with abdominal pain we were going over the checklist of things that I was "supposed" to ask or perform, including things like auscultate the abdomen, palpate adbominal aorta, etc.

This ***** actually asked me, "So what exactly is the abdomen?"

To his credit he seemed to know that adbomen had a relative synonymity with "belly." However, he genuinely did not know what exactly the word abdomen referred to.
By the way, I was the last of 6 students to do the same H&P on the guy.

I wonder how much they get paid???

 

[ocean11]

this is a good one....

After a focused H&P on my standardized patient with abdominal pain we were going over the checklist of things that I was "supposed" to ask or perform, including things like auscultate the abdomen, palpate adbominal aorta, etc.

This ***** actually asked me, "So what exactly is the abdomen?"

To his credit he seemed to know that adbomen had a relative synonymity with "belly." However, he genuinely did not know what exactly the word abdomen referred to.
By the way, I was the last of 6 students to do the same H&P on the guy.

I wonder how much they get paid???

LOL that is soooo funny, I don't think they should get paid more than $20/hour HOWEVER, the ones that do the rectal/GU deserve MUCH MORE! it sucks to have to do that..... but I honestly sometimes feel that they have something AGAINST future doctors and want to make our life tough because we're going to have it 'better than them' later on..... or they have had a $hitty experience with some doctor and are taking it out on us.

However, I have to credit many that I've been with and say that they have been great.... its just a few that have a chip on their shoulder.

UCLA: yeah I don't know my grade yet, but once I do I'll post it on this forum for all to see....

 

[tigershark]

this is a good one....

After a focused H&P on my standardized patient with abdominal pain we were going over the checklist of things that I was "supposed" to ask or perform, including things like auscultate the abdomen, palpate adbominal aorta, etc.

This ***** actually asked me, "So what exactly is the abdomen?"

To his credit he seemed to know that adbomen had a relative synonymity with "belly." However, he genuinely did not know what exactly the word abdomen referred to.
By the way, I was the last of 6 students to do the same H&P on the guy.

I wonder how much they get paid???

Are you people really this dense?

The SP's are trained to test your patience/compassion/empathy etc.

Do you really believe that they didnt know what the abdomen is? Or maybe, just maybe, they were supposed to ask a "stupid question" to test how you deal with it.

SPs dont say or do anything they arent trained to do.

 

[akpete]

Are you people really this dense?

The SP's are trained to test your patience/compassion/empathy etc.

Do you really believe that they didnt know what the abdomen is? Or maybe, just maybe, they were supposed to ask a "stupid question" to test how you deal with it.

SPs dont say or do anything they arent trained to do.

If they were going over the checklist, was this even during the "patient encounter." I took this to mean that it was a question asked afterwards.

By the way, not all SP's follow the book exactly. Maybe at your school, but not all...

 

[Tiki]

yeah thats true.... but this can REALLY affect my grade! I think I might end up with a C or something...... which could screw up my final grade which is worth TONS of points --> which could drop my average --> drop my class rank and thus screw up my chances of EVER obtaining a decent residency!!!!!!!!!!

Don't you think you are being a bit overdramatic? 😉

One grade is not going to destroy your career.

 

[TypeA]

I used to be a standardized patient for (unnamed med school). The ONLY time I was told to be difficult was when I was doing the psychiatric stuff. I always wanted my students to succeed. I will never forget this one MS who was obviously terrified. There was a faculty member looking on and she was in for the long program. I had been through the routine so much that I knew what they were to be looking for. She forgot capillary refill and got sidetracked on draping. So, as the faculty was directed elsewhere, I whispered it to her. She quit sweating after that. There is NO reason why SPs have to be jerks. I agree, there is a HUGE purpose in the position, but a nice person can help out just as much as a jerk (probably more).

That stinks that an SP can't see the big picture and get off their soapbox to perform their function.

 

[Nikki2002]

I got a comment once from an SP that she didn't like how thoroughly I washed my hands because it seemed like I thought patients were dirty. 🙄

oh lord

 

[DW3843]

Are you people really this dense?

The SP's are trained to test your patience/compassion/empathy etc.

Do you really believe that they didnt know what the abdomen is? Or maybe, just maybe, they were supposed to ask a "stupid question" to test how you deal with it.

SPs dont say or do anything they arent trained to do.

nope. I really am not that dense but thanks anyway.

The abdomen question was after the H&P when both of us were "out of character" during the checlist grading. The real person was the one who asked the question.

 

[sga814]

i have no complaints about the uic sp's..... we'll see if that changes when i start doing gyne exams

 

[ocean11]

I used to be a standardized patient for (unnamed med school). The ONLY time I was told to be difficult was when I was doing the psychiatric stuff. I always wanted my students to succeed. I will never forget this one MS who was obviously terrified. There was a faculty member looking on and she was in for the long program. I had been through the routine so much that I knew what they were to be looking for. She forgot capillary refill and got sidetracked on draping. So, as the faculty was directed elsewhere, I whispered it to her. She quit sweating after that. There is NO reason why SPs have to be jerks. I agree, there is a HUGE purpose in the position, but a nice person can help out just as much as a jerk (probably more).

That stinks that an SP can't see the big picture and get off their soapbox to perform their function.

Thats awsome dude! I wish I had you as my SP yesterday,

anyhow..... I'm feeling better and realize that 'life goes on' and that even if I end up in Family practice in Kentucky or Alaska, I'll still be a physian 😉

But see thats my point...... it's not REALLY a standardized test if the patients are ALL different..... because they have diff attitudes and personalities..... so I don't think we should be graded on it I thing it should be a pass/fail component of our class!!! instead its worth 20%?!?!?!?!!!!!!!!

Too subjective for me..... oh well 7 more weeks and second yr is over YEY!!!

 

[sga814]

usmle step II CS (SPs) is graded p/f!!!

 

[CANES2006]

Wait till you get REAL patients. Then you'll see how difficult some of them can be. 😀

 

[DoctorFunk]

Too subjective for me..... oh well 7 more weeks and second yr is over YEY!!!

And then you enter 2 years of little more than subjective grading. Enjoy 😉

 

[USCTex]

Are you people really this dense?

The SP's are trained to test your patience/compassion/empathy etc.

Do you really believe that they didnt know what the abdomen is? Or maybe, just maybe, they were supposed to ask a "stupid question" to test how you deal with it.

SPs dont say or do anything they arent trained to do.

No way, there are plenty of befuddled SPs, and I'm sure it is not just my school. I walked into my first ever graded SP encounter and the sheet on the door had told me to take a sexual history.

Me: "So what brings you in today, Mr. X?"

There is a good pause from the SP.

SP: "Uh...I don't know."
Me: "So, you don't have any specific concerns?"
SP: "I'm just here for an insurance physical."

I'm thinking, what? An insurance physical? I mean I'm silent for a long pause, it is my first graded SP encounter and I'm scared as hell.

SP: "Did you even read the sheet outisde? I think you're suppose to take some sort of sexual history."

Granted I screwed up and I should've come in and just stated I was there to do a sexual history but the guy fumbled a fine improv oppurtunity. He had a very specific complaint of ED that he was suppose to have come in for. And it wasn't like he was supposed to be embarassed to talk about it and I had to work my way to his complaint; our course director had specifically promised no such tricks. As soon as I started the sexual history he was chirpy as all get up talking about his inability to perform.

 

[CanIMakeIt]

For me the SP experience was good for the mid terms.....hopefully for the finals it will be ok too since I will be mostly doing physical exam this time around..... 2 more weeks 🙂

 

[DIVA01]

this is a good one....

After a focused H&P on my standardized patient with abdominal pain we were going over the checklist of things that I was "supposed" to ask or perform, including things like auscultate the abdomen, palpate adbominal aorta, etc.

This ***** actually asked me, "So what exactly is the abdomen?"

To his credit he seemed to know that adbomen had a relative synonymity with "belly." However, he genuinely did not know what exactly the word abdomen referred to.
By the way, I was the last of 6 students to do the same H&P on the guy.

I wonder how much they get paid???

actually a real patient I interviewed asked me what the abdomen was as well. she said "what's the adbomen?" so, i think your SP might have known exactly what he was doing-- they say that the average literacy level is about 4th grade. so-- maybe the SP was just being a real patient.

 

[cdql]

actually a real patient I interviewed asked me what the abdomen was as well. she said "what's the adbomen?" so, i think your SP might have known exactly what he was doing-- they say that the average literacy level is about 4th grade. so-- maybe the SP was just being a real patient.

We were also taught the same thing. We always refer to everything in the simplest terms possible.

Now if the SP asks me what a belly is, I'll have to reach out and slap em

 

[MacGyver]

SPs should NOT be playing stupid psychological games trying to simulate real patients.

Their ONLY goal should be to mimic the symptoms and history of a real medical condition.

Im sick and tired of this liberal ass feel good bull**** that has invaded med schools. Teach us how to diagnose and treat, i'm sick of tuition being wasted on this "i feel your pain" bull**** that they ram down our throats.

If I go out into the world and all my patients hate me because I'm like Dr. House and treat patients rude, then I will lose all my patients and go out of business. Quit wasting our time with that BS and teach us IMPORTANT MATTERS that we cant learn outside of medical school.

Its a total waste of freaking time to pay an MD or PhD thousands of dollars in tuition so they can tell us to be "nice to our patients." Teach us the finer intricacies of carbohydrate metabolism, or the nuances involved with heart murmurs. If I want to learn how to be a nice person, I can go down the street to Joe Blow and ask him and his opinion will be just as valid as the MDs. Furthermore I dont have to waste thousands of dollars just for somebody to tell me how to "feel patient's pain"