Standardized patients essential to NOSM University

By The Sudbury Star
Local Journalism Initiative

Brenda Barrett has played an important if less-known role in helping train and shape Northern Ontario’s future doctors and other health-care professionals.

For the past seven years, Barrett, of Sudbury, has been a so-called standardized patient for NOSM University – Northern Ontario’s school of medicine based in Sudbury and Thunder Bay.

“I saw an ad on a social media platform and thought it would be neat to help develop future doctors,” she recalled. “After a phone interview, I was asked to come in for formal training with other new hires. It was quite the process and I’m thankful for that.”

Barrett said being a standardized patient has been satisfying.

“I really get a sense that the medical students take a lot from their experiences with standardized patients. On more than one occasion, I’ve been stopped in the hallway by a student – once I am out of character – and told how helpful and real our interaction was.”

Barrett reflected on how it feels to act as a standardized patient.

“It’s not easy to slip into a role as someone else when it involves something traumatic or grief-related. In fact, it’s exhausting, but when I can successfully be that patient for the student and give them exposure to uncomfortable situations in a safe learning environment, it’s very satisfying.

“Not every encounter is so profound, or impactful, but they all have value in one sense or another.”

The Standardized Patient Program at NOSM University relies on volunteers such as Barrett. For medical students, working with mannequins is static; live humans are the dynamic component that puts our doctors of the future at the ready.

“The Standardized Patient Program helps train medical learners at all stages of their education and strengthens their clinical skills,” said Kelly Merla, the Standardized Patient Program coordinator in Undergraduate Medical Education for the medical school.

Merla works closely with the Standardized Patient trainer to recruit, hire, schedule and train standardized patients, “who act as real patients for the learners. The standardized patients simulate a set of symptoms or medical conditions to help medical learners become more skilled at the proper techniques for taking patient histories and performing physical exams.”

Standardized patients are required to learn a case and attend a training session with other standardized patients portraying the same case. It ensures the same message and responses are level and faithful to the process.

“During the training session, the Standardized Patient Program works with the standardized patients to standardize their portrayals, review any physical exam findings, and practise providing effective feedback on their experience,” Merla said.

“Standardized patients then attend the clinical skills session where they portray their case and provide verbal feedback to the medical learner. The clinical skills sessions are small group sessions facilitated by a community physician who provides all the medical teaching content. Standardized patients are expected to be punctual, professional, and open-minded.”

Merla would know as she was herself a trainer.

She said acting skills are not required. Instead, standardized patients learn the case content and portray that role during their encounters. They need to be able to follow instructions and be willing to take on a role that is standardized.

Like actors, standardized patients need to know their lines. There can be some improvisation, but clear, core statements of fact need to be communicated to the medical students.

“Standardized patients receive case notes to review in advance of their training session,” Merla said. “During the training session with other standardized patients who are playing the same role, the standardized patient trainer reviews the case content, affect and mannerisms of the role, as well as any physical exam findings that may need to be portrayed.”

In real life, standardized patient Patrick Bélec is a Sudbury nurse.

“In nursing school, a fellow student encouraged me to join. I always wanted to be involved. I openly talk about the program at work to recruit others.”

He has been a standardized patient since 2021.

“It gives me an idea on how doctors are formed and I get to see the other side of the gurney. I have always been involved in education and I love teaching. I deliver reliable, good quality feedback.”

Bélec said it is a great opportunity to get involved in the essential formation of doctors who must be competent and help them build on therapeutic communication, which is so vital in health care.

“It’s a great way to give back to the community and to help future physicians develop their skills fostering positive patient interactions,” he said.

Doctors Sarah Clark and Anne Robinson, co-chairs of the Introduction to Clinical Medicine Committee at NOSM University, said standardized patients play a key role in training future doctors. They provide a safe and supportive learning environment for medical learners to practise their physical exam and history-taking skills, and to develop the ability to effectively communicate with patients.

They also said NOSM University is committed to recruiting standardized patients who reflect Canada’s diverse population and Northern Ontario’s rural and remote character.

NOSM encourages all healthy people aged 18 and over to participate. To make it real, from time to time, the university requires newborns, children and youth. They also need a diverse pool of standardized patients who enjoy being a part of training our future physicians.

To apply, go to tinyurl.com/yn423huz.