Difficulty with Sim Patients

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MedStudent219

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hi all. We had some SPs come in and my history was very short. It was really hard since the patient had been instructed to give really short answers. I feel like I did poorly and even when I used copen questions got about 5 or so words. Any tips on approaching this? Thanks! :)

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Best tip: Practice!

You’ll have a hard time, and that is the point of these sims! You’ll get better over time. I wouldn’t stress, keep doing your best!
 
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How would I ask more open questions if the patient is giving me very short responses? It's not difficult to ask open questions in patients who talk more. Any tips on how to approach these kinds of patients? thanks!!!
 
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Meet them in the middle. Maybe they are miffed that they drove 2 hours, and sat in your ED for 2 hours, got asked the same questions one thousand times, and are in front of you after a whole day of not getting help for the problem they are having.

Let them warm up on their own terms. Just be friendly and they always come around. Even the grumpiest lumps lol. You don’t need to be perfect, just be there.

How would I ask more open questions if the patient is giving me very short responses? It's not difficult to ask open questions in patients who talk more. Any tips on how to approach these kinds of patients? thanks!!!
 
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In my experience, those SPs are trying to make a point to you by acting that way - which is that there's some underlying issue that's leading to that terseness which you're supposed to suss out.
I remember one we had where the cc was headache, and the SP was terse to the point of hostility. After getting nowhere in the first few questions, I put my old carts list down, looked him in the eye, and asked point blank what else was worrying him and why he didn't trust me, at which point he was allowed to fill in the whole back story of his father who had died from a brain aneurysm, which was making him terrified of these headaches. After that he opened up and we got the rest of the checklist done.
The point is to get you to learn to pick up on cues and connect with the patient, rather than just hammering away with your standardized questions.
Remember that if someone you've never met before is upset or hostile to you right off the bat, there's something else that they're upset about, not you. Doubly so for patients, because they've sought you out for help, but may react less than politely because they're concerned about other things that you are unaware of and so get edgy with whoever's in front of them.
So get off script for a second with those folks and ask what's bothering them, and then you'll probably have more luck getting your regular questions answered.
 
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How would I ask more open questions if the patient is giving me very short responses? It's not difficult to ask open questions in patients who talk more. Any tips on how to approach these kinds of patients? thanks!!!

As kraskadva said, SPs act that way for a reason. Either 1) the whole point of the encounter is to teach you handle to handle a difficult patient (possible but doubt), or 2) you're supposed to find something "deeper" and have been missing the point (and it's the SPs way of trying to lead you).
 
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I assumed this thread would be about actual SimMan encounters.
 
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It’s pretty sad that SP encountered can be boiled down to 1) normal sp, proceed as normal 2) weird acting sp, weird Fanily or social or sexual history incoming, proceed delicately, fish it out from them with eye contact, open questions, and fake empathy.


Maybe cs is different but I feel like after a year of sp encounters, literally everyone one falls into 1 or 2, with zero in between or nuance or attempt at authenticity
 
On my exam many years ago, the cc was "trying to lose weight." When I entered the room, it was a petite 21 yo female. As soon as I saw that it changed my perspective to what is actually going on (emotional, social, psych) vs I'm overweight and diabetic.
 
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