does anyone know if barry has a simulated patient or going to have one in the new building?
Our current curriculum doesn't have simulated patients. I have no idea if the new building will when it's done, but I'd hope they will not.
As you probably know, simulated patients just consists of someone, sometimes an actor or theatre student, pretending to have an illness. The basic goals of simulated patients in medical education was to give the students a chance to practice communication and clinical skills on someone. Also, an instructor could monitor the students rapport with the "patient" and not have to worry about making a real patient know that the student was inexperienced. Also, the simulated interaction could be videotaped - unlike recording a real encounter, which might breach patient confidentiality. Seems like a good idea, huh? Well... it depends how you want to use funding.
In my opinion, simulated patients does have its place: difficult portions of the exam: pelvic exam, rectal, opposite gender chest/groin, psychotic patients, etc. In podiatry, you really don't see very many of those patients. Hysterical, scared, or frustrated patients are encountered from time to time in podiatry, but that's about it. The majority of pod patients are fairly straight forward and easy to deal with, and "could you please remove your shoes and socks" just isn't going to make patients very uncomfortable.
I think students learn how to deal with patients in their physical diagnosis lab or when they get into clinic with real patients. In reality, you learn by trial and error. Some people are good communicators and some others need work, but a handful of actors isn't going to change that. It's hard to take it seriously when you know it's just an excercise and practice. You really have to get into the clinic or hospital and just apply what you know and use the communication skills you've been polishing for your entire life. No matter how many patients you see, you will keep learning. Some people will be pretty good at communicating with patients, thinking on the fly, and reaching accurate diagnosis even as a 3rd or 4th year student, and other people will still struggle even when they've been done with residency.
In other applications, such as surgery, practicing over and over with saw bones, models, or cadavers makes complete sense. If students or residents screw up in surgery, the patient gets hurt - sometimes irreversibly. However, if student doctors screw up in the H&P, the worst that really happens is that the student or patient (usually the student) gets embarrased, uncomfortable, or anxious. Even if the student screws up the H&P, the senior student, resident, or attendings will realize the error (and eventually learn to look over the shoulder of students who repeatedly make diagnostic errors from bad H&Ps). I think the time and money it'd take for a pod program to do simulated patients would be much better used to just get the students more supplies to practice their procedures. Procedures are hard for everyone and will cause hard for everyone, and you can't have too much practice; why do you think surgical residencies are so dang long lol?
Physical diagnosis at Barry consists of a semester of lecture (Bates as text and main test material), a lab (practice H&P on classmates with instructor supervision). Some labs and the exams in that class consist of one student pretending they have a certain pathology (unknown to examining student), so I guess that is simulated patients in a sense. They don't currently hire actors or anything like that, though.
