Bad standardized patient interview

[DoctorofDelight]

Hey guys, I'm an M1 and I need to vent. I just got back from a standardized patient interview and the "patient" pretty much ripped my head off after it was done. He basically said I didn't make a good impression on him because I didn't ask him enough about one of his major symptoms and didn't shake his hand at the beginning (I had sanitizer and shook his hand at the end of the interview) even though I kept giving him reassurance like "I'm glad you came in and we will do everything we can to help you". I understand the criticism about not delving deep enough but it's the criticism that I didn't make a good impression that's messing with me.

He had pretty much nothing good to say about my performance and it's screwing with my confidence. This is the second interview I've had that I've pretty much heard only negative things. I am trying to use this information to improve but at the same time I'm beginning to feel like there is something seriously wrong with my personality and I will never be able to establish rapport with patients (meaning I will never be a good doctor). My classmates said they did better than expected and that makes me feel worse about myself. How do I deal with this? I'm seriously frustrated and scared. Is this something I should be this concerned about?

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[Pacna]

Hey guys, I'm an M1 and I need to vent. I just got back from a standardized patient interview and the "patient" pretty much ripped my head off after it was done. He basically said I didn't make a good impression on him because I didn't ask him enough about one of his major symptoms and didn't shake his hand at the beginning (I had sanitizer and shook his hand at the end of the interview) even though I kept giving him reassurance like "I'm glad you came in and we will do everything we can to help you". I understand the criticism about not delving deep enough but it's the criticism that I didn't make a good impression that's messing with me.

He had pretty much nothing good to say about my performance and it's screwing with my confidence. This is the second interview I've had that I've pretty much heard only negative things. I am trying to use this information to improve but at the same time I'm beginning to feel like there is something seriously wrong with my personality and I will never be able to establish rapport with patients (meaning I will never be a good doctor). My classmates said they did better than expected and that makes me feel worse about myself. How do I deal with this? I'm seriously frustrated and scared. Is this something I should be this concerned about?

First of all, just breathe. You'll hardly remember this in a week.

I think he was right about the hand-shaking thing. Every doc I've seen shakes hands, sometimes even with unresponsive patients just out of habit. If they have hand sanitizer on them, they'll rub as best they can and apologize for the wetness, saying it's just hand sanitizer.

I think the rest of the encounter was colored by that handshake for him. After that, you could do nothing right. This is typical of people in general. That's why first impressions matter so much! You could have done perfectly the rest of the time (probably very comparable to your classmates) and he still would have hated you.

This is why we have standardized patients. It's good that you're rattled. It's good that you care. You'll do better next time. 🙂

 

[Mad Jack]

He sounds like he was right. We all suck at SPs at first, you don't just go in on your second encounter ever and perform like a pro. Relax, take the criticism, and use it to improve. You'll have to do this literally thousands of times by the end of residency, and by then it'll be second nature. It's like you just picked up a guitar for the second time and you're pissed you don't sound like a rock star- it doesn't work that way, it takes a lot of time.

 

[Psai]

You have to shake hands at the beginning. Hi I'm dr of delight, a first year med student how may I address you blah blah blah

If he said you sucked, you probably sucked. Just have to deal with it. Did you expect to be a pro at talking to patients when you've just started? It's not easy to have someone tell you that you're not as good as you thought you were. I've been doing this for a little bit now and I'm still not very good. If it makes you feel better, standardized patients don't know what they're talking about half the time. Look at it as an opportunity to improve. You'll get little feedback in third year and you'll wish you had

 

[DoctorofDelight]

You have to shake hands at the beginning. Hi I'm dr of delight, a first year med student how may I address you blah blah blah

If he said you sucked, you probably sucked. Just have to deal with it. Did you expect to be a pro at talking to patients when you've just started? It's not easy to have someone tell you that you're not as good as you thought you were. I've been doing this for a little bit now and I'm still not very good. If it makes you feel better, standardized patients don't know what they're talking about half the time. Look at it as an opportunity to improve. You'll get little feedback in third year and you'll wish you had

This is my 4th interview. My first 2 were fine but the last 2 I didn't get any positive feedback.

 

[Psai]

People who don't care give you lukewarm feedback. "Fine" is a waste of time. If they didn't give you any details, that feedback isn't worth your time. Many of my comments are "good to work with, smart, etc." Useless. The real comments were 3-4 lines with specifics about what I did that was good. One guy wrote two paragraphs detailing a specific surgery where I made a useful contribution. That's the kind of comment that shows that you made an impression on someone. If they are critiquing your performance, that's the real deal. Take it to heart and use it to improve

 

[SouthernSurgeon]

If they are critiquing your performance, that's the real deal.

Agreed. They are called standardized for a reason. Occasionally you get some bad egg SPs who are just jerks. But for the most part they've done this hundreds of times, so if you stood out to them negatively that means something.

You don't need to beat yourself up over it, but you should take the feedback and use it to improve.

 

[notbobtrustme]

literally the only person that cares is your mom.

standardized patients are there for your own personal growth. I got some feedback that I took to heart and haven't repeated since even in 3rd year.

 

[AlmostAnMD]

I never shake hands and still do well on OSCEs. I don't shake hands with real patients either. Not a fan.

 

[DoctorofDelight]

Agreed. They are called standardized for a reason. Occasionally you get some bad egg SPs who are just jerks. But for the most part they've done this hundreds of times, so if you stood out to them negatively that means something.

You don't need to beat yourself up over it, but you should take the feedback and use it to improve.

I plan to use the feedback to improve, but this one just stings. I can't redeem myself until the next interview which isn't for another couple months so I am left having to feel like I'm a disrespectful POS until then. I just wish I were more like everybody else in my class.

 

[EMDO2018]

Hey guys, I'm an M1 and I need to vent. I just got back from a standardized patient interview and the "patient" pretty much ripped my head off after it was done. He basically said I didn't make a good impression on him because I didn't ask him enough about one of his major symptoms and didn't shake his hand at the beginning (I had sanitizer and shook his hand at the end of the interview) even though I kept giving him reassurance like "I'm glad you came in and we will do everything we can to help you". I understand the criticism about not delving deep enough but it's the criticism that I didn't make a good impression that's messing with me.

He had pretty much nothing good to say about my performance and it's screwing with my confidence. This is the second interview I've had that I've pretty much heard only negative things. I am trying to use this information to improve but at the same time I'm beginning to feel like there is something seriously wrong with my personality and I will never be able to establish rapport with patients (meaning I will never be a good doctor). My classmates said they did better than expected and that makes me feel worse about myself. How do I deal with this? I'm seriously frustrated and scared. Is this something I should be this concerned about?

Just a lay person on an ego trip. We actually had a SP tell everyone she knows she "helps train doctors" right betty, now go back to flipping burgers or wipping butt or whatever you do.

 

[D4C]

I plan to use the feedback to improve, but this one just stings. I can't redeem myself until the next interview which isn't for another couple months so I am left having to feel like I'm a disrespectful POS until then. I just wish I were more like everybody else in my class.

I bet you're more like them than you know. For most of them also suck at SPs at this point - I promise. Relax and don't let a poor evaluation from a SP fracture your confidence.

And practice practice practice.

 

[Psai]

Just a lay person on an ego trip. We actually had a SP tell everyone she knows she "helps train doctors" right betty, now go back to flipping burgers or wipping butt or whatever you do.

They actually do help train doctors, that's their job
For someone who thinks that their classmates are elitist, you're pretty much the same but worse because you're a hypocrite and you don't even know
btw I flipped burgers and wiped butts. You should try it some time, build some character

 

[DoctorofDelight]

I bet you're more like them than you know. For most of them also suck at SPs at this point - I promise. Relax and don't let a poor evaluation from a SP fracture your confidence.

And practice practice practice.

Thing is, they did fine on their interviews. Everyone I talked to did better than I did. That's what's rattling me. I almost feel like I'm the bad apple who slipped through the cracks during the app cycle. But whatever, like you said I need to relax and do better next time.

 

[tiedyeddog]

I hate to say this but get used to it. You'll get the same or worse in third year and even more in residency. Don't let a stupid standardized patient get under your skin.

 

[Donald Juan]

You shouldn't let it rattle you that your classmates did better. Some people are gonna be better initially than others. I can tell you if I hadn't waited tables for about 5 years I would suck balls at interviewing people and talking to strangers. Some people will act like talking with strangers and interviewing skills are things that you either have or don't, but it is a skill you can improve on like anything else. Take the criticism constructively, work on improving, and with time and practice you'll have more confidence in your skills and it will make you a better doctor.

 

[Ismet]

I plan to use the feedback to improve, but this one just stings. I can't redeem myself until the next interview which isn't for another couple months so I am left having to feel like I'm a disrespectful POS until then. I just wish I were more like everybody else in my class.

If that stings, 3rd year will hit you like a ton of bricks.

You're not disrespectful just because you didn't shake his hand. Just make note to shake hands with every SP from now on and there you go, you're done with that part of the feedback. Stop comparing yourself to your classmates too. You're an MS1 who just completed their 4th SP interview. You'll get better each time. That's why they start us on SP's after all.

 

[TraumaLlamaMD]

Bet some of your classmates got similar feedback but aren't letting it make them anxious. Unless you were in the room watching them, you have no idea how your performance compares to theirs, regardless of what they say. Figure out how to take the advice to heart and then let it go.

 

[Roxas]

Just a lay person on an ego trip. We actually had a SP tell everyone she knows she "helps train doctors" right betty, now go back to flipping burgers or wipping butt or whatever you do.

"The only thing that can be below you is to not have a job"
-Ashton Kutcher

 

[hmockingbird]

On the other hand, I've had a decent number of standardized patient interviews go poorly, while I have had mostly good interactions with patients so far in third year. I've received specific feedback at building good rapport/making patients comfortable, that I am good at helping defuse problem situations, and tons of patients who have complimented me and wished me good luck. I think there is something about it being standardized and a "test" that can sometimes make me trip up, so I do suck more in those interviews, but it's not always, totally a reflection of my actual clinical skills. (I could feel the difference third year with real patients - it just seemed way more natural.) I still have to do well enough to pass (I have never failed an interview) but my point is to be encouraging that this is not the end of the road and might not totally reflect on your third year clinical skills. I have gotten so much better with standardized patients now because I am used to doing that type of thing every day now, even though I still know it is a "test" (whether it's actually graded or not) it still feels more routine/natural to me.

But still my advice would be take from the experience what you can because you can only go up from here. There are some things schools harp on, often because they are on CS, and I think shaking hands is one of them. There's other feedback you may get that's more of a "personal style" (like different SPs feel different ways about touching their hand/shoulder). So you don't have to take everything they say as a rule, but I would honestly just be open to suggestions and try everything, especially on your next OSCE. That will help you do what you need to do on the OSCEs AND eventually find things that fit your own personality when you are developing your bedside manner with real patients. If you are particularly concerned, maybe talk with the prof who directs the OSCEs? But I think you will be fine!

This too:

You shouldn't let it rattle you that your classmates did better. Some people are gonna be better initially than others. I can tell you if I hadn't waited tables for about 5 years I would suck balls at interviewing people and talking to strangers. Some people will act like talking with strangers and interviewing skills are things that you either have or don't, but it is a skill you can improve on like anything else. Take the criticism constructively, work on improving, and with time and practice you'll have more confidence in your skills and it will make you a better doctor.

 

[Kaustikos]

So... This sounds familiar. Let me tell you about this one actor. This actor I've had for the past three years for our patient interviews. The first time I had him was him acting like a patient with a cough. I don't know the specifics, but he tore me a new anus with his review. Talking about how I wasn't sympathetic or didn't care or whatever. The next year? I had him again as a patient coming for a follow-up from an ED visit for acute pancreatitis from alcohol. Guess what? He gave me honors in everything. He was pretty much giving me an unnecessary glowing review about how amazing I was. I didn't change anything in my approach. It just goes to show you how variable interactions are.
All I can say is don't let that one moment ruin your perception of what you'll become. You'll learn. You'll get better. Take it in stride and don't let it get to you. You're a first year... You don't even know how the hell you're supposed to deal with patients. The only reason I did well is because I was comfortable talking to people. I made jokes/made patients smile/etc, but I was **** for other things. I didn't (still don't) know how to use the bp cuff. JK. But seriously, you'll get it.

 

[ACSurgeon]

SPs are valuable but some have a certain philosophy that they take too far (like making the initial handshake a big deal). In real life, if you mean well, it comes across and patients/families appreciate it. Also, depending on the circumstance, some patients/families will love you, and some will be so upset about the situation that they'll be upset with anyone they encounter. Most people [in my small midwestern city] are reasonable and appreciate the interaction and focus more on getting their questions answered and getting reassurance if possible, rather than caring about a handshake.

All that aside, until you've passed ALL of your OSCEs and step 2 CS, you'll have to learn to perform to the SP's satisfaction, otherwise you'll run into problems. Show humility, try to learn from their feedback, and if that isn't working, go to your course director and explain what feedback you've received, and how you've tried to implement it, and see what other feedback they have for you.

 

[ACSurgeon]

So... This sounds familiar. Let me tell you about this one actor. This actor I've had for the past three years for our patient interviews. The first time I had him was him acting like a patient with a cough. I don't know the specifics, but he tore me a new anus with his review. Talking about how I wasn't sympathetic or didn't care or whatever. The next year? I had him again as a patient coming for a follow-up from an ED visit for acute pancreatitis from alcohol. Guess what? He gave me honors in everything. He was pretty much giving me an unnecessary glowing review about how amazing I was. I didn't change anything in my approach. It just goes to show you how variable interactions are.
All I can say is don't let that one moment ruin your perception of what you'll become. You'll learn. You'll get better. Take it in stride and don't let it get to you. You're a first year... You don't even know how the hell you're supposed to deal with patients. The only reason I did well is because I was comfortable talking to people. I made jokes/made patients smile/etc, but I was **** for other things. I didn't (still don't) know how to use the bp cuff. JK. But seriously, you'll get it.

The most important thing is showing compassion. Some OSCE cases will be a SP with a social problem (domestic violence, for example) but come with a generic complaint (cough, leg pain, etc). A good SP will make it obvious that the focus is the social issue. Sometimes the social/mental/substance abuse issues are of equal importance, so while you have to workup their medical complaint, you have to at least address the "other" problem to show that you care and didn't blow them off. It can be as simple as at the end of the interaction saying that you want to set a follow up to discuss said issue (if not urgent).

 

[Frazier]

Hey guys, I'm an M1 and I need to vent. I just got back from a standardized patient interview and the "patient" pretty much ripped my head off after it was done. He basically said I didn't make a good impression on him because I didn't ask him enough about one of his major symptoms and didn't shake his hand at the beginning (I had sanitizer and shook his hand at the end of the interview) even though I kept giving him reassurance like "I'm glad you came in and we will do everything we can to help you". I understand the criticism about not delving deep enough but it's the criticism that I didn't make a good impression that's messing with me.

He had pretty much nothing good to say about my performance and it's screwing with my confidence. This is the second interview I've had that I've pretty much heard only negative things. I am trying to use this information to improve but at the same time I'm beginning to feel like there is something seriously wrong with my personality and I will never be able to establish rapport with patients (meaning I will never be a good doctor). My classmates said they did better than expected and that makes me feel worse about myself. How do I deal with this? I'm seriously frustrated and scared. Is this something I should be this concerned about?

You'll get over it. Work on thickening that skin -- good quality to have.

 

[qw098]

I never handshake.

 

[Dires]

Don't worry. This is why schools have SPs. Other then the grade (that may or may not be) associated with it these are largely learning experiences so that you can get a glimpse of what 3rd year will be like. And guess what, in third year you will still have a patient here or there that will rip you. In fact, it will happen throughout your career. Stay calm, keep learning from your mistakes, and try to keep your chin up.

 

[touchpause13]

Thing is, they did fine on their interviews. Everyone I talked to did better than I did. That's what's rattling me. I almost feel like I'm the bad apple who slipped through the cracks during the app cycle. But whatever, like you said I need to relax and do better next time.

That's what I feel like for a lot of the hard science stuff we learn

everyone has strengths and weaknesses. Here's the thing though, you were given detailed feedback on how to improve! We are all in med school to learn, congrats you were just given a great learning experience. I know it sucks to feel like you messed up, but it's not worth beating yourself up over. You made a mistake, and now you know how to fix it. So fix it.

 

[TooMuchResearch]

First of all, just breathe. You'll hardly remember this in a week.

I think he was right about the hand-shaking thing. Every doc I've seen shakes hands, sometimes even with unresponsive patients just out of habit. If they have hand sanitizer on them, they'll rub as best they can and apologize for the wetness, saying it's just hand sanitizer.

I think the rest of the encounter was colored by that handshake for him. After that, you could do nothing right. This is typical of people in general. That's why first impressions matter so much! You could have done perfectly the rest of the time (probably very comparable to your classmates) and he still would have hated you.

This is why we have standardized patients. It's good that you're rattled. It's good that you care. You'll do better next time. 🙂

I don't offer my hand. I touch lots of gross stuff, patients are sick, some patients lack functional immune systems, etc. You don't want me to shake your hand.

Always shake the standardized patient's hand, though.

OP, you are expected to suck at this stuff right now. Keep practicing and get used to not letting some unjustified criticism get you down. Always listen to the justified criticism.

 

[Winged Scapula]

Closing as its cross posted in Osteo