December 1, 2023 • 38 mins
Do you want to peek behind the curtain of the medical world? You're in the right place. We've got a special treat for you today in the form of our guest, Katie Culligan, a professional actor turned standardized patient. Katie brings to light how she and her colleagues play a crucial role in shaping medical practitioners' skills through simulating various medical conditions and cases. She shares her unique journey and the impact she's made in the medical education sphere.
Katie isn't just an actor; she's an educator and innovator. She's breaking ground and challenging norms playing different genders and ages in medical simulations. Katie explains how she convincingly depicts medical symptoms she doesn't have through various tools and techniques. From using props to mimicking complex medical procedures - she's done it all. Katie's wealth of experience provides an illuminating perspective on the complexities and nuances of medical simulation training, particularly for women.
But that's not all. Katie's role extends beyond mere acting; she is also instrumental in providing feedback that shapes the future caregivers. She unpacks how she leverages her experiences to offer valuable feedback to medical students, contributing to their growth in this demanding field. This episode is a goldmine of insights for anyone curious about the intersections between medicine and performance art, and the transformative learning experience standardized patients offer to future doctors. Join us for this fascinating conversation with Katie Culligan and discover how she's making an impact in the world of medical education. Tune in now!
Here are the links for my Katie and Standardized Patients podcasts and content :
Katie isn't just an actor; she's an educator and innovator. She's breaking ground and challenging norms playing different genders and ages in medical simulations. Katie explains how she convincingly depicts medical symptoms she doesn't have through various tools and techniques. From using props to mimicking complex medical procedures - she's done it all. Katie's wealth of experience provides an illuminating perspective on the complexities and nuances of medical simulation training, particularly for women.
But that's not all. Katie's role extends beyond mere acting; she is also instrumental in providing feedback that shapes the future caregivers. She unpacks how she leverages her experiences to offer valuable feedback to medical students, contributing to their growth in this demanding field. This episode is a goldmine of insights for anyone curious about the intersections between medicine and performance art, and the transformative learning experience standardized patients offer to future doctors. Join us for this fascinating conversation with Katie Culligan and discover how she's making an impact in the world of medical education. Tune in now!
Here are the links for my Katie and Standardized Patients podcasts and content :
- Show website: https://www.standardizedpatientspodcast.com/
- Instagram: https://www.instagram.com/standardizedpatientspodcast/
- TikTok: https://www.tiktok.com/@standardizedpatientspod
- Twitter: https://twitter.com/thestandardize1?s=11 (we don't use this this actively these days, but if people like twitter, they can find us there too)
- Conan O'Brien Needs a Friend/Fan Episode "The Professional Patient": https://podcasts.apple.com/us/podcast/conan-obrien-needs-a-friend/id1438054347?i=1000544389665
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:10):
Hello and welcome to the Wellness Musketeers podcast,
where we discuss and inform onmatters relating to health,
wellness, fitness topics andeven some current events as well
.
I'm your host, aussie MikeJames, a freelance writer and
speaker with over 30 years ofinternational experience
managing leading corporatefitness centers in Australia and
(00:32):
in Washington DC with the WorldBank Group.
Joining me today is my fellowMusketeer, dr Richard Kennedy.
Welcome, richard.
Thank you, michael.
Dr Kennedy is an internist whohas over 36 years of clinical
experience, including the WorldBank clinical services and
private practice.
Now, a very special guest todayis professional actor and
(00:56):
standardized patient, KatieCulligan.
Since 2008, katie has simulatedhundreds of medical conditions
and cases to help medicalstudents learn how to diagnose
and communicate effectively withpatients Think about the
importance of bedside manner byyour doctor.
Katie and her colleagues helpdoctors learn how to be better
(01:17):
doctors.
So today we're going to diveinto the who, what, where and
why of this quirky industry thatnot many people have heard of
standardized patients.
In fact, my only realrecollection, if I can call it
that, was a fine-filed episodecalled the Burning, and I'm sure
(01:38):
Katie's been reminded of thisover the years, and in this
episode, cramer and his friendMickey Abbott get an acting gig
playing sick patients formedical students and they're
assigned a gonorrhea andbacterial metatitis respectively
only on SineCop.
So again, I'm pretty sureKatie's been reminded of that
episode over the years.
Now Katie's on the staff atJordan Medical School and has
(02:01):
worked at seven differentmedical schools and several
other simulation programs.
She's a James MadisonUniversity alumni, stage and
film actor, certified fitnesstrainer, hip exercise instructor
, wife and, most importantly,mother to a toddler.
Welcome, katie.
Speaker 2 (02:19):
Thank you so much for having me Hi.
Speaker 3 (02:23):
Okay, katie, we're going to start, and first
question I'd like to ask you iscan you explain to our audience
what exactly it means to be astandardized patient and how you
came to be a standardizedpatient practitioner.
Speaker 2 (02:38):
Sure, yeah, what it means to be a standardized
patient is basically med schoolshire actors, or some semblance
of actors often, who are paid,typically, sometimes volunteer
to be portraying patients withcertain ailments.
(02:59):
So it could be anything from owmy stomach hurts to I'm getting
some bad news and I oh mygoodness, you're telling me I
have cancer, so anything thatruns the gamut of that to med
students all over the country,depending on the simulation
program, and we, as standardizedpatients, basically evaluate
(03:20):
those med students and give themfeedback, sometimes verbal
feedback, sometimes writtenfeedback.
But we are here to help themunderstand how it feels what
they did in their encounter withus, how it feels to be in our
shoes as their patient.
That's great.
Speaker 3 (03:36):
That's great that is a great answer and a little side
note to this I went to medicalschool in Pittsburgh and one of
the interesting things wasinitially they had us while we
were learning to interviewpatients and things like that,
they did have I called themodels and then portray a
(03:59):
patient at a particularcondition and we were all
evaluated based on that.
So this actually is refreshingto see that the one is still
doing it.
Yeah, that's awesome.
And also, for the same, themain reason and we'll probably
talk about it a little bit lateris that bedside manner is
(04:21):
critical.
Speaker 2 (04:23):
Yeah.
Speaker 3 (04:25):
It's critical.
But, moving on, how manydifferent types of cases or
encounters have you beeninvolved with and what is the
range of the medical conditionsthat a practice of standardized
patients includes?
And what does a typicalencounter consist of?
Speaker 2 (04:43):
So that I could.
Just the question is like, howmany different types of cases
have I been involved with?
So many?
I don't think I could actuallyquantify that because I've just,
over the years, done so many.
Some it feels like a milliontimes.
Some I've only done once.
But, like I had mentionedearlier, it runs the gamut.
(05:06):
I've played patients who haveit's more about what's going on
in their head how are theyinteracting with the world
around them the med student orthe doctor versus patients that
are literally just I'm in pain,please help me, like I'm coming
in because I have this pain andit's all about the physical
(05:26):
ailment.
I want you to treat me well,but also please help me because
I'm in acute pain, so that I'vejust done so many and the range
truly is, if you can think of it, I'm.
There's a chance.
I portrayed something in therealm of that and I realized I
didn't answer your questionearlier how I got into it.
(05:47):
So just a backtrack.
I was in a show with awonderful actor and she said I
hope to never have a day jobagain, meaning like a non acting
job, and I said how do you dothat?
And she was just out of collegeand she was like I do these
role playing things and some ofthem are a lot of them are
standardized patient work, andso she and another castmate sent
(06:09):
me some resources and saidthese are the ones I work with.
Remember, if you go and auditionor reach out to them, remember
I'm reflected in this too.
So please be professional,please show up, do that, of
course, and ever since then I'venever looked back at such a
cool industry that, like intheir right, it doesn't feel
(06:32):
like a day job, because you're,you do get paid to act and you
also get to learn a lot aboutmed school and I know so much
more from doing it.
So, anyway, just wanted totouch base on that.
Yeah, it sounds like anexciting endeavor.
Speaker 3 (06:47):
If I was younger, I'd consider doing it myself.
Hey, you could do it now.
Speaker 2 (06:55):
That's the best part is, if you wanted to, you would
bring a lot to the table.
You don't have to be a young.
It's not a young person's game.
They need people from all walksof life.
A person who's not a youngperson Walks of life ages
everything.
Yeah, yeah, though I knowyou're a doctor, so you're
probably busy.
Speaker 3 (07:10):
Well, we'll have to talk about that.
But how do you prepare for atypical encounter?
What kind of information anddetail are you given and what
kind of feedback do you givephysicians, medical students,
afterwards?
Speaker 2 (07:30):
Yes.
So preparation for thisencounter or any encounter, it
can be very different dependingon the encounter or the school
or who you're portraying.
Sometimes it is literally I geta paragraph this is like the
most like hands off.
It'll be like you are this name, this age, you're upset because
(07:51):
you're having this pain or theshortness of breath and
something in that nature, whereit's very much like we have to
improv a lot of it.
But some, and I would say a lotof encounters that I've done are
very highly trained and detailoriented.
It might be a packet of like 20pages of information that we.
(08:12):
It can be overwhelming.
But then not only do we have toread it ahead of time, and
sometimes we get paid to read itat home and prepare for it, if
we're lucky but then we go intoa training that can be hours
long, with a group ofstandardized patients, sometimes
online, a lot of times inperson, and we ask questions and
(08:32):
we go through it.
And then we even do a mockencounter like just a little bit
so people can put it on thefeed, ask questions, and then we
go into the encounter and we doit a bunch of times, maybe on a
different day or different week.
So it really depends on a lotof factors of how much work we
(08:54):
put into it, which can be.
It can be awesome and it can bechallenging, depending on your
personality and skill set of howthey're different.
Speaker 3 (09:04):
Yeah, it sounds.
It actually sounds like a lot.
Speaker 2 (09:08):
Yeah, it is.
It is a lot, a lot.
And you asked also about whatkind of information and detail
are you given and what kind offeedback do you give to
physicians, med studentsafterwards?
This is our favorite parttypically about standardized
patient work is being able togive feedback to people who are
(09:29):
ideally open to hearing it, andso we often, very often, we have
the ability and opportunity togive feedback in some way.
So whether it's written, as Imentioned earlier, like online,
they get to read it later or, myfavorite is verbal, where the
encounter ends, the patientsorry, the med student leaves
(09:52):
the room and then they come backand I say hey, so my name is
actually Katie and would you beopen to hearing some feedback
from my perspective as yourpatient, and that way we get to
really have a nice rapport.
So when you said this thing, itmade me feel a little unsure of
where the encounter was going.
(10:12):
Perhaps if you had done thisthing, I might have felt a
little bit more reassured, andoftentimes we often sandwiched
that with positive feedback.
When you shook my hand, whenyou walked into the room and
gave me strong eye contact, Ifelt confident.
So we try to make sure that ourfeedback is specific and
(10:34):
measurable, so meaning that,rather than just being like that
was great, you did great, itwas cool.
But how can we tell them?
Like when you did the specificbehavior, it made me feel
generally good in some way,shape or form, or generally bad,
and here's how it made me feelbad, and here's how what might
have made me feel better, orjust I don't even know the
(10:55):
answer to what might have madeit better, but I do know that
this is how it affected me.
So that's the cool thing aboutfeedback that we get to be
specific and we are often askedto give them feedback.
Speaker 3 (11:09):
Oh great, that's actually really good.
And that leads to this nextquestion, which is to me
interesting Do you play patientsof all ages and had
simultaneously?
Because you're a woman, do theyalso ask you to play the role
(11:29):
of an older man, maybe, or ayounger man in a particular
condition?
And if so, well, if the answeris yes, what does that do to the
encounter?
Speaker 2 (11:41):
Yeah, that's a great question.
So, yes, the answer to that isI've played all different types
of ages and a few differenttypes of genders.
Honestly, like very rare thatI'm asked to play a man.
But for some types, forformative meaning, like learning
opportunities, not a, not anexamination Typically I wouldn't
(12:01):
be playing someone that's soout of my, my role, but for
something that's you're helpingteach these students.
So right now we're going to dothis example case and you're
going to be playing this 58 yearold man who's coming in with
chest pain because he just atefive guys burgers.
But it might be somethingdifferent.
So then the students have todifferentiate.
(12:21):
Is okay, is it Harper, or is heactually have?
He has some, has medicalhistory of like heart issues.
Should we take it seriously andis he having a heart attack?
So that type of thing can bejust more used as a tool rather
than we don't believe you thatthis woman is playing the 58
year old man, like they justhave to get over it.
(12:42):
And that's often the case withall the things.
It's like we we can only do andlook like what we look like.
Sometimes we put on certainword robes that make us lean
into a certain thing.
But I have played a lot offemale characters, for sure, and
but I've played different ageranges.
I once played like a 86 yearold who and again this was a
(13:05):
formative event where they'relearning and the students walk
out of the room and when theycome back into the room, like
they typically know me as Katie,and all of a sudden I'm like
this woman who can barelyfunction, like they have to move
my body to get because she'sall out of it, and so those can
be fun because it throws thestudents for a loop.
However, I will say that justregarding type, if I am being
(13:31):
asked to do an examination, I amoften asked to do something
close to my type.
It may not, I might.
I might be like, ok, you're 50years old, ok, I am not 50 years
old, but I'm, if I could enoughportray a 50 year old woman, or
like you're 20 years old, I'mnot 20 years old, wish I was,
but I could still somewhatbelievably be that, whereas,
(13:55):
like when I've been asked toplay a 14 year old girl, that's
a little bit, I've done it.
Or a three year old done it.
That's a huge stretch, but theyjust have to understand that
we're not here for thebelievability, because you're
not going to get the same typeof education.
If you actually had a three yearold, or real three year old,
they wouldn't be able tocommunicate Feedback.
(14:16):
You can understand the processof what we're doing.
So the last thing to yourquestion, though, is specific
symptoms, visible conditionsthat I don't have.
This is a huge, great question,because if there are fluid in
the lungs, let's say and ofcourse I would be very lucky to
say I wouldn't have fluid in mylungs typically- but, I portray
(14:37):
a case that day that, let's say,my character has fluid in her
lungs.
What would happen is if they say, okay, I'm going to listen to
your lungs now and they do it.
And then, after they've done it, I will give them a card that
says fluid and right lung onback or whatever.
Or we've even had theopportunity sometimes to use a
thing called ventrilo-scopeSorry, ventrilo-scope, yeah,
(15:01):
yeah, they can like and we wouldsay this is what you would hear
when you do that.
Or even without the card or theventrilo-scope, it would say I
would just say and you wouldhear there's fluid in my left
lower base of the lung,something like that.
That's the least common onethat we have to verbalize it,
(15:22):
but that can be on the table.
So basically we have to setaside, like just it's almost a
little time out without totallybreaking character, and we say
and this is what you would hear.
And then we go back in thecharacter oh yeah, yeah, I know
Wild, right.
Speaker 3 (15:38):
Oh, good, that's it.
Yeah, yeah, when you think it,and it makes you think of,
because you could pretty muchpick any health condition, be it
mental or physical, and Isuspect you can make it very
basic or it could be relativelycomplex.
And I had asked what was, inyour experience, what has been
(16:00):
the most complex patientexperience you've had to portray
?
Speaker 2 (16:06):
Oh my goodness, that's a really good and
challenging question because itdepends on what type of
complexity.
I've done a case that was verymuch like I was barely acting in
it, like it was all about.
The students had to come in andthey had to use a bunch of
(16:27):
tools and there was a fake armsitting in the room.
We're sitting there, but wehave a checklist and they have
to learn how to Drill an IV orsomething into the arm.
Yeah, I'm sure you know what I'mtalking about.
Of course we're not using ourreal arm because, ouch.
Speaker 3 (16:44):
Yeah.
Speaker 2 (16:46):
But that is a very complex thing that we had to
learn and be, but at the sametime we're sitting there being
like I'm crashing, go and dothey do the thing.
Okay, they brought the thingover, they did it.
Yeah, we did the blood spurtout, Okay.
So we're checking the boxes ofthat.
So that's complex in one way.
But there's also been complex,more character based cases, and
(17:09):
some of them the complexity is Ithink I mentioned earlier the
some of the cases are like 20pages long and they have such a
really detailed excuse me,detailed backstory and we have a
lot of lines that we have tosay verbatim, word for word, so
it'll be like a paragraph, andthen, if they ask this question,
(17:30):
I have to say this line, and sothat can be complex and just as
an actor or person memorizingand making sure that I say it.
So it's standardized.
Speaker 3 (17:40):
Okay.
Speaker 2 (17:40):
And we can give our own flavor to how we say those
things.
But the more we are expected tosay specific things in a case
like if it's a quantity, that'sjust that can be really complex,
and sometimes it's.
I, my hobby is to read to readAgatha Christie novels or
(18:01):
something like that, and it's.
Do we need to know thisinformation, like when we're
trying to learn everything else?
In this case, do we really needto know that is the type of
novel that we're reading, whenmost likely is not going to come
up.
Yeah, yeah, it's just funny, butyeah it's.
And once again, some people aregoing to like those complex
(18:22):
cases more.
Some like it where we don'thave to memorize as much.
But that means you got to use alot more improv skills of
bringing your whatever to thetable and having that, being
neutral when you need to, butthen also being just off the
cuff, really there and presentin the moment so you don't Go
(18:43):
the wrong route or send them thewrong route.
Speaker 3 (18:47):
Yeah, yeah, I know that's a long answer to your
question, but yeah, but itsounds like what it needs to be,
because it medicine ischallenging it.
You have to be able to think,and you have to be able to think
on your feet.
Yeah, and you cannot.
(19:07):
I Learned very early in mycareer the best doctors are the
ones who, by the time you havefinished your interview with the
patient before you've put yourhands on them, 95% of the time
you should have a pretty goodidea what's going on.
(19:28):
If you haven't, you didn'tlisten, ah, which means in
didn't ask the right questionsbased on what they were telling
you.
Speaker 2 (19:38):
That makes complete sense, and I love hearing that
from a doctor's perspective.
So that's really wonderful.
Did you ever work withstandardized patients?
Speaker 3 (19:47):
Oh, yeah, mm-hmm.
When I was in in Pittsburgh andthen when I was in New York at
Columbia, yeah, and you, whatyou found was that some people
are very believable of the rolesthey were playing yeah that you
will, I remember, distinctlyremember this.
(20:11):
She was actually 67 in real lifeand she was playing someone who
was 25 who ended up having ashoot of appendicitis, and we
were the questions she was.
She then the emergency room andshe's trying to describe her
pain, which, of course, at thattime was very atypical.
(20:35):
It wasn't a classic pain.
It wasn't in the right place ofthe abdomen that you typically
expect to see it, mm-hmm and butshe kept giving clues to the
students and it was fascinatingto see only One of the three
picked up on it.
Oh yeah question, which meantthat person was listening and it
(20:59):
had a lot to do with it, so shewas very believable, because a
lot of people you get people getconfused when they see,
physically, a person who looksone way right but we're training
something else.
It's hard for them to thedisconnect that what's in front
of them and Put in place whatthey would expect to see if it
(21:22):
was a person who reallypresented that way.
Speaker 2 (21:25):
Yeah, absolutely.
I believe that a huge thing andhelps teach students first of
all that to get a poker face andto come across as
non-judgmental.
But also, I imagine out in thereal world that you may not see
that exactly, but you mightstill expect to see one thing,
and then you're encounteringsomething else in the room and
(21:45):
it's probably really importantto Keep a neutral face right to
not let that throw you.
So then they don't say hey.
I Felt judged by this doctor.
I'm not going back to thisdoctor.
I don't trust them now, oh yeah.
Speaker 3 (22:01):
And you said something very early on.
But when you just said, whenyou mentioned walking in the
room and shaking the hand of theperson who's gonna be provided
here to you, if that person wasshaking your hand and looking
down at the floor or lookingover to the right or the left
(22:21):
Gives a totally differentimpression to the patient.
Yeah, I mean for something.
Yeah, whatever it is, they'recoming for something.
And if you're not there, Ialways say this is something I
learned from my mom.
She used to say when you're inthe room with people, be present
.
Speaker 2 (22:41):
So true, so true.
Speaker 3 (22:44):
And that's true in real life, but even more so in
medicine.
Speaker 2 (22:50):
Oh, yeah, yeah, absolutely.
I love hearing that.
Thank you for sharing and I'mcurious.
So because you work withstandardized patients I have.
Has that helped you, like as adoctor?
Was that something that broughtanything to your skills?
I?
Speaker 3 (23:07):
Think it has more because you, as you observe and
watch, you learn to look back onyour own experiences, because
medicine is pretty basic thesame diseases that existed 2,000
years ago or the same onestoday.
(23:29):
The only difference is we havemore tools to get access to the
answers.
Speaker 2 (23:36):
Yeah.
Speaker 3 (23:38):
But the history and the physical are still the most
important and it gets reinforcedwith that Standardized patient
has been.
Now you need people who are,have a willingness and, just
like in every other disciplinein life, you have some people
who are all into what they'redoing and there are people who,
(24:00):
basically, are talented enough,smart enough, gifted enough that
they can skate the surface andit works until you get that.
And I always say Other dilemmais it works until you get that
one patient who really needs youto be present and you something
(24:21):
, and it has dire consequencesfor that individual.
Yeah, you know, the one thingis it's one thing to To miss to
miss a pitch in the baseballgame and and it's another thing
to miss an important point thatleads to someone's demise that
(24:44):
could have been a.
Speaker 2 (24:46):
Yeah, life or death.
Speaker 3 (24:47):
Yeah much.
Speaker 2 (24:48):
Yeah, big deal.
Yeah, that's, so true, hmm.
Speaker 3 (24:52):
Yeah, so that do.
And when you're giving thefeedback to them, do you Do you
give them critiques on the bestway to go forward?
In other words, you can givepositive criticism, but it
(25:17):
should always be a learningexperience, something because
technically, none of us everdoes it perfect.
Sure, no matter what people say, we never really do it
perfectly.
What role does thisstandardized patient play in
helping them?
Speaker 2 (25:35):
Yeah, I think it's so cool that we do play a huge
role because even standardizedpatients of course we can be
standardized in how we're taughtand we portray the case but as
humans and when we're givingfeedback, we're saying me as
this patient, monica, I felt,katie felt, and my experience
(26:00):
might be very different than,let's say, if you were
portraying that same case, thatyou might have preferences or
things that you don't like thathappen.
That I was like actually thatwas perfectly fine, it didn't
bother me one way or the other.
What's really cool is we get togive not only general feedback
of when you ask this open-endedquestion it allowed me to give
(26:25):
you an open-ended, a lot ofinformation.
That's more kind of likechecklist, but communication
style feedback.
But then to be like when yousaid this one thing, I felt XYZ,
and that again that's from myexperience as Katie, as the
patient, rather than DrKennedy's experience as the
(26:48):
patient.
You might have been like no, Iactually felt it didn't make me
feel one way or the other orvice versa.
So I think that's what's socool is that we get to bring a
human, subjective perspective ofhow it went in that moment,
because the same student, medstudent could do the same exact
(27:08):
case to another person and maybebecause they were able to learn
from me or take something away,now they can do it a little bit
better or a little bit stronger.
Maybe better is not the rightword, but for the next patient
and be more present might be oneof it, because that certainly
is feedback we give, but we alsodo try to give, as I mentioned
before, specific feedback.
(27:30):
So it's very much like one ofmy favorite things to ask my
students after feedback sessionin verbally is, I'll say, the
things that I felt were good orspecifically, and then something
that they could work on,sometimes a few things that they
could work on.
I try to be tactful.
I do try to be tactful andprofessional about it.
But I often say okay, so beforeyou leave, after you have any
(27:54):
questions about it, anythingelse and then I'll say what's
something that you learned fromour feedback session today that
you would like to put into yournext encounter.
And it helps them say thisspecific thing I would like or
plan on trying for the next one,and that's really cool because
you can see them put it togetherand you hope that they use it
(28:15):
and who knows if they do havethe next encounter.
But it's that, yeah, yeah.
So that's one of my favoriteparts about it.
Speaker 3 (28:22):
Oh, that's good.
Do they, do you videotape?
Are you videotaped?
And then do they have access tothe videotapes going forward?
Speaker 2 (28:33):
Yeah, so we are often videotaped in the encounter
rooms, off not all the time, butin the encounter rooms there
are several cameras all around,there are microphones, not like
in our faces, but they pick upand oftentimes we are recorded.
Therefore, people such as thestudents or preceptors, doctors,
(28:56):
mentors, professors, can watchit either in real time from an
observation room or after thefact, so they can then see their
work there.
Okay, so see, when you did thisone thing, that's why they you
missed asking this question, butthat's why they, when they feel
about this evaluation you were,you didn't get credit, that it
(29:16):
can be that type of a thing to abackup to be like, because
again, we a standardized patientor simulated patients we are
not perfect either, of courselike we can work really hard to
be present and remembereverything, but in an
examination scenario, which iswhere this comes into play,
there are times where we did.
They ask if I have a familyhistory of heart disease.
Oh my gosh, this is my sixthencounter today.
(29:39):
And did they ask it?
Or did the last person ask it?
So, those were the times whenit's really beneficial to we can
go back and rewatch therecording after the fact and
have that backup.
But a lot of times it's reallyjust for that.
It's not.
They don't show it to the world.
It's not public or it's veryprivate, secure, but it is often
(30:02):
recorded, yeah.
Speaker 3 (30:04):
Yeah, it should be a learning experience on both ends
actually.
Speaker 2 (30:08):
Absolutely.
Speaker 3 (30:10):
It's, and part of it is, I think, for a lot of,
particularly those going intomedicine who've never really had
any experience as a patientthemselves and really have not.
They're now all of a sudden.
You go from being a student towhere someone, one day after you
(30:31):
graduated, on July one,basically someone's going to
call you Dr, so and you're the,you walk in the room and the
person in front of you expectsyou to be that doctor, and so it
can be somewhat nerve wrackingif you're not prepared.
That's why, as they like it,almost everything else, practice
(30:53):
does make us better Me, notmake us perfect, because there's
nobody on the planet that way,but we should be able to close.
Speaker 2 (31:02):
As they always say, practice makes progress right.
Speaker 3 (31:04):
There, you go.
Speaker 2 (31:06):
I love that thing.
Speaker 1 (31:06):
It's so true.
Speaker 3 (31:07):
It's so true that is how has your experience as a
standard.
That patient helped you to be abetter actor 100%.
Yeah, and and what would yousay?
That these encounters arebasically a form of work.
Is it an improvisation exercise?
(31:27):
Is it?
It's real world, in the sensethat you can make the actual
conditions that people mighthave and so therefore be a
learned experience.
So when that medical student,soon to be doctor, actually is
on the other side, where itreally counts, it will make a
difference.
Speaker 2 (31:48):
Yeah, it's definitely made me a better actor, because
you're it's almost like filmacting a little bit, because
it's a little more nuanced.
You're not making this sweetthing, but it's not huge, it's
all very intimate one one.
Sometimes a couple of differentdoctors are in there, a couple
of different patients, but it'svery specific and nuanced and we
have to be realistic.
(32:08):
That's the goal we, even ifwe're not playing someone who we
are exactly like, we still wantto be as realistic as possible
so they can then treat usrealistically too.
So, it's helped me definitelywith my improv skills, but also,
just, yeah, as an actor.
It's definitely helped me tieinto my emotions, like of when
(32:30):
we do challenging cases where wehave to get upset or cry, we're
getting bad news To go withwhat we're feeling.
Rather than pushing tears orpushing we have to figure out,
oh, the doctor or the way thatthe med student is talking to me
is making it's making me feelso supported and heard that
actually I'm getting more upsetin a good way, like it's helping
me release, rather than, oh,they're very detached and cold
(32:52):
and how they're delivering thisnews, I'm just going to shut
down and I'm going to be angry.
So, like it and you feel it,and so that has been a huge
emotional exercise when I'vedone those cases and also
sometimes just learning how tobe neutral and do no harm.
Don't as I mentioned earlier,don't send them down a detour
where they're going to spend thenext 20 minutes asking about
(33:13):
your drinking, when it's no,this person doesn't have a
drinking problem, like if theycame in because they have
stomach pain, whereas astandardized patient they were
just improving and said, yeah, Idrink five drinks every single
night, I'll liquor.
Obviously the doctor's going tobe like okay, why don't we talk
about that when it's that's notimportant to that?
(33:34):
Like like, why did you that'syeah.
So I hope that answers thequestion.
Speaker 3 (33:38):
Oh, yeah, yeah.
So, katie, you've created apodcast series called the
standardized patients podcast.
I understand that, as a guest,you have been featured on Conan
O'Brien's podcast.
What made you decide to startthis podcast, and what topics do
you cover?
Speaker 2 (33:55):
So we my podcast partner, catherine Bublack and I
decided to start this podcast,called the standardized patients
podcast, before I was featuredon Conan O'Brien's podcast.
Believe it or not, that wasjust a happy, wonderful surprise
, but we started the podcast Ithink we recorded almost all of
(34:19):
our season one in late summerfall of 2021.
And the reason that we decidedto do it is because I had this
big experience being astandardized patient and we
realized that there were noother podcasts about
standardized patient work.
There were a couple episodes ofpodcasts here and there that
(34:42):
focused on some standardizedpatient work, but in a very
oversaturated market as podcastsare these days, it was really
refreshing to realize wait,there is not a podcast that is
just about standardized patients.
That is currently happening,and I have a lot of experience
as a standardized patient.
I have a large network ofstandardized patients and etc.
(35:06):
That I have not only workedwith a lot but also are friends
with, and so we reached out todifferent people and garnered
interest in seeing if they'd bewilling to come on our podcast
and, if so, what would they bewilling to talk about?
And we had so many subjectsthat we wanted to cover that we
realized we needed a season two.
So we're doing season two rightnow and who knows if there'll
(35:31):
be a season three, but therereally is so much to talk about
that we haven't even covered yet.
That's where we decided it wasworth making a podcast.
So we knew it would be a nicheaudience.
But we figured between otherstandardized patients, people
that want to get into the work,people that want to learn about
(35:51):
standardized patient work,people that are curious about
odd jobs, day jobs as an actoror med students, doctors, etc.
People in the health, medicalfield.
I thought it would be a reallygood hub for people to come
learn about this line of workbecause it is fascinating, and I
think it's fascinating andwhich is a good thing,
considering I'm the host of it.
(36:12):
But to just touch on the ConanO'Brien podcast, I had reached
out to them because they wereopen to hearing from fans and I
told them a little bit aboutmyself and I put in that I was a
standardized patient and Ithought that might be a cool
thing if they were interested.
(36:32):
And they were interested and soI was really excited to get an
email from Team Coco to ask whatI'd be interested for a
pre-interview and then got me onfor an actual interview and it
was just wild and exciting thatthat brought standardized
patient work to a whole notherplatform, because his audience
is huge and people that don'teven care about what we do, they
(36:57):
still will listen to thatpodcast because he's funny and
they like what he brings to thetable.
So it was a really coolopportunity and I'm still
pinching myself that it happened.
But it's just funny that afterthat, the following March was
when we released our podcast andit had nothing to do with that
podcast that I was on.
It just happened to be a reallycool coincidence.
(37:18):
So long-winded answer, but thatis the answer to those
questions.
Speaker 1 (37:24):
Thank you, katie and Dr Kennedy, for such a very
informative discussion onstandardized patients, and
hopefully we now all have muchmore information on the area of
standardized patients than anold Seinfeld episode.
And thank you for joining us atWellness Musketeers.
Tune in for upcoming episodesto gain the tools to improve
(37:45):
your health, work performanceand live with a greater
understanding of the world weexperience together.
Please subscribe, give us afive-star review and share this
recording with your family,friends and colleagues.
You can make a contributionthrough a link provided in our
program Nats, to allow thispodcast to grow.
Let us know what you need tolearn to help you live your best
(38:08):
life.
Send your questions and ideasfor future episodes to davilis
at davidmless at gmailcom.
Hello and welcome to the Wellness Musketeers podcast,
where we discuss and inform onmatters relating to health,
wellness, fitness topics andeven some current events as well
.
I'm your host, aussie MikeJames, a freelance writer and
speaker with over 30 years ofinternational experience
managing leading corporatefitness centers in Australia and
(00:32):
in Washington DC with the WorldBank Group.
Joining me today is my fellowMusketeer, dr Richard Kennedy.
Welcome, richard.
Thank you, michael.
Dr Kennedy is an internist whohas over 36 years of clinical
experience, including the WorldBank clinical services and
private practice.
Now, a very special guest todayis professional actor and
(00:56):
standardized patient, KatieCulligan.
Since 2008, katie has simulatedhundreds of medical conditions
and cases to help medicalstudents learn how to diagnose
and communicate effectively withpatients Think about the
importance of bedside manner byyour doctor.
Katie and her colleagues helpdoctors learn how to be better
(01:17):
doctors.
So today we're going to diveinto the who, what, where and
why of this quirky industry thatnot many people have heard of
standardized patients.
In fact, my only realrecollection, if I can call it
that, was a fine-filed episodecalled the Burning, and I'm sure
(01:38):
Katie's been reminded of thisover the years, and in this
episode, cramer and his friendMickey Abbott get an acting gig
playing sick patients formedical students and they're
assigned a gonorrhea andbacterial metatitis respectively
only on SineCop.
So again, I'm pretty sureKatie's been reminded of that
episode over the years.
Now Katie's on the staff atJordan Medical School and has
(02:01):
worked at seven differentmedical schools and several
other simulation programs.
She's a James MadisonUniversity alumni, stage and
film actor, certified fitnesstrainer, hip exercise instructor
, wife and, most importantly,mother to a toddler.
Welcome, katie.
Speaker 2 (02:19):
Thank you so much for having me Hi.
Speaker 3 (02:23):
Okay, katie, we're going to start, and first
question I'd like to ask you iscan you explain to our audience
what exactly it means to be astandardized patient and how you
came to be a standardizedpatient practitioner.
Speaker 2 (02:38):
Sure, yeah, what it means to be a standardized
patient is basically med schoolshire actors, or some semblance
of actors often, who are paid,typically, sometimes volunteer
to be portraying patients withcertain ailments.
(02:59):
So it could be anything from owmy stomach hurts to I'm getting
some bad news and I oh mygoodness, you're telling me I
have cancer, so anything thatruns the gamut of that to med
students all over the country,depending on the simulation
program, and we, as standardizedpatients, basically evaluate
(03:20):
those med students and give themfeedback, sometimes verbal
feedback, sometimes writtenfeedback.
But we are here to help themunderstand how it feels what
they did in their encounter withus, how it feels to be in our
shoes as their patient.
That's great.
Speaker 3 (03:36):
That's great that is a great answer and a little side
note to this I went to medicalschool in Pittsburgh and one of
the interesting things wasinitially they had us while we
were learning to interviewpatients and things like that,
they did have I called themodels and then portray a
(03:59):
patient at a particularcondition and we were all
evaluated based on that.
So this actually is refreshingto see that the one is still
doing it.
Yeah, that's awesome.
And also, for the same, themain reason and we'll probably
talk about it a little bit lateris that bedside manner is
(04:21):
critical.
Speaker 2 (04:23):
Yeah.
Speaker 3 (04:25):
It's critical.
But, moving on, how manydifferent types of cases or
encounters have you beeninvolved with and what is the
range of the medical conditionsthat a practice of standardized
patients includes?
And what does a typicalencounter consist of?
Speaker 2 (04:43):
So that I could.
Just the question is like, howmany different types of cases
have I been involved with?
So many?
I don't think I could actuallyquantify that because I've just,
over the years, done so many.
Some it feels like a milliontimes.
Some I've only done once.
But, like I had mentionedearlier, it runs the gamut.
(05:06):
I've played patients who haveit's more about what's going on
in their head how are theyinteracting with the world
around them the med student orthe doctor versus patients that
are literally just I'm in pain,please help me, like I'm coming
in because I have this pain andit's all about the physical
(05:26):
ailment.
I want you to treat me well,but also please help me because
I'm in acute pain, so that I'vejust done so many and the range
truly is, if you can think of it, I'm.
There's a chance.
I portrayed something in therealm of that and I realized I
didn't answer your questionearlier how I got into it.
(05:47):
So just a backtrack.
I was in a show with awonderful actor and she said I
hope to never have a day jobagain, meaning like a non acting
job, and I said how do you dothat?
And she was just out of collegeand she was like I do these
role playing things and some ofthem are a lot of them are
standardized patient work, andso she and another castmate sent
(06:09):
me some resources and saidthese are the ones I work with.
Remember, if you go and auditionor reach out to them, remember
I'm reflected in this too.
So please be professional,please show up, do that, of
course, and ever since then I'venever looked back at such a
cool industry that, like intheir right, it doesn't feel
(06:32):
like a day job, because you're,you do get paid to act and you
also get to learn a lot aboutmed school and I know so much
more from doing it.
So, anyway, just wanted totouch base on that.
Yeah, it sounds like anexciting endeavor.
Speaker 3 (06:47):
If I was younger, I'd consider doing it myself.
Hey, you could do it now.
Speaker 2 (06:55):
That's the best part is, if you wanted to, you would
bring a lot to the table.
You don't have to be a young.
It's not a young person's game.
They need people from all walksof life.
A person who's not a youngperson Walks of life ages
everything.
Yeah, yeah, though I knowyou're a doctor, so you're
probably busy.
Speaker 3 (07:10):
Well, we'll have to talk about that.
But how do you prepare for atypical encounter?
What kind of information anddetail are you given and what
kind of feedback do you givephysicians, medical students,
afterwards?
Speaker 2 (07:30):
Yes.
So preparation for thisencounter or any encounter, it
can be very different dependingon the encounter or the school
or who you're portraying.
Sometimes it is literally I geta paragraph this is like the
most like hands off.
It'll be like you are this name, this age, you're upset because
(07:51):
you're having this pain or theshortness of breath and
something in that nature, whereit's very much like we have to
improv a lot of it.
But some, and I would say a lotof encounters that I've done are
very highly trained and detailoriented.
It might be a packet of like 20pages of information that we.
(08:12):
It can be overwhelming.
But then not only do we have toread it ahead of time, and
sometimes we get paid to read itat home and prepare for it, if
we're lucky but then we go intoa training that can be hours
long, with a group ofstandardized patients, sometimes
online, a lot of times inperson, and we ask questions and
(08:32):
we go through it.
And then we even do a mockencounter like just a little bit
so people can put it on thefeed, ask questions, and then we
go into the encounter and we doit a bunch of times, maybe on a
different day or different week.
So it really depends on a lotof factors of how much work we
(08:54):
put into it, which can be.
It can be awesome and it can bechallenging, depending on your
personality and skill set of howthey're different.
Speaker 3 (09:04):
Yeah, it sounds.
It actually sounds like a lot.
Speaker 2 (09:08):
Yeah, it is.
It is a lot, a lot.
And you asked also about whatkind of information and detail
are you given and what kind offeedback do you give to
physicians, med studentsafterwards?
This is our favorite parttypically about standardized
patient work is being able togive feedback to people who are
(09:29):
ideally open to hearing it, andso we often, very often, we have
the ability and opportunity togive feedback in some way.
So whether it's written, as Imentioned earlier, like online,
they get to read it later or, myfavorite is verbal, where the
encounter ends, the patientsorry, the med student leaves
(09:52):
the room and then they come backand I say hey, so my name is
actually Katie and would you beopen to hearing some feedback
from my perspective as yourpatient, and that way we get to
really have a nice rapport.
So when you said this thing, itmade me feel a little unsure of
where the encounter was going.
(10:12):
Perhaps if you had done thisthing, I might have felt a
little bit more reassured, andoftentimes we often sandwiched
that with positive feedback.
When you shook my hand, whenyou walked into the room and
gave me strong eye contact, Ifelt confident.
So we try to make sure that ourfeedback is specific and
(10:34):
measurable, so meaning that,rather than just being like that
was great, you did great, itwas cool.
But how can we tell them?
Like when you did the specificbehavior, it made me feel
generally good in some way,shape or form, or generally bad,
and here's how it made me feelbad, and here's how what might
have made me feel better, orjust I don't even know the
(10:55):
answer to what might have madeit better, but I do know that
this is how it affected me.
So that's the cool thing aboutfeedback that we get to be
specific and we are often askedto give them feedback.
Speaker 3 (11:09):
Oh great, that's actually really good.
And that leads to this nextquestion, which is to me
interesting Do you play patientsof all ages and had
simultaneously?
Because you're a woman, do theyalso ask you to play the role
(11:29):
of an older man, maybe, or ayounger man in a particular
condition?
And if so, well, if the answeris yes, what does that do to the
encounter?
Speaker 2 (11:41):
Yeah, that's a great question.
So, yes, the answer to that isI've played all different types
of ages and a few differenttypes of genders.
Honestly, like very rare thatI'm asked to play a man.
But for some types, forformative meaning, like learning
opportunities, not a, not anexamination Typically I wouldn't
(12:01):
be playing someone that's soout of my, my role, but for
something that's you're helpingteach these students.
So right now we're going to dothis example case and you're
going to be playing this 58 yearold man who's coming in with
chest pain because he just atefive guys burgers.
But it might be somethingdifferent.
So then the students have todifferentiate.
(12:21):
Is okay, is it Harper, or is heactually have?
He has some, has medicalhistory of like heart issues.
Should we take it seriously andis he having a heart attack?
So that type of thing can bejust more used as a tool rather
than we don't believe you thatthis woman is playing the 58
year old man, like they justhave to get over it.
(12:42):
And that's often the case withall the things.
It's like we we can only do andlook like what we look like.
Sometimes we put on certainword robes that make us lean
into a certain thing.
But I have played a lot offemale characters, for sure, and
but I've played different ageranges.
I once played like a 86 yearold who and again this was a
(13:05):
formative event where they'relearning and the students walk
out of the room and when theycome back into the room, like
they typically know me as Katie,and all of a sudden I'm like
this woman who can barelyfunction, like they have to move
my body to get because she'sall out of it, and so those can
be fun because it throws thestudents for a loop.
However, I will say that justregarding type, if I am being
(13:31):
asked to do an examination, I amoften asked to do something
close to my type.
It may not, I might.
I might be like, ok, you're 50years old, ok, I am not 50 years
old, but I'm, if I could enoughportray a 50 year old woman, or
like you're 20 years old, I'mnot 20 years old, wish I was,
but I could still somewhatbelievably be that, whereas,
(13:55):
like when I've been asked toplay a 14 year old girl, that's
a little bit, I've done it.
Or a three year old done it.
That's a huge stretch, but theyjust have to understand that
we're not here for thebelievability, because you're
not going to get the same typeof education.
If you actually had a three yearold, or real three year old,
they wouldn't be able tocommunicate Feedback.
(14:16):
You can understand the processof what we're doing.
So the last thing to yourquestion, though, is specific
symptoms, visible conditionsthat I don't have.
This is a huge, great question,because if there are fluid in
the lungs, let's say and ofcourse I would be very lucky to
say I wouldn't have fluid in mylungs typically- but, I portray
(14:37):
a case that day that, let's say,my character has fluid in her
lungs.
What would happen is if they say, okay, I'm going to listen to
your lungs now and they do it.
And then, after they've done it, I will give them a card that
says fluid and right lung onback or whatever.
Or we've even had theopportunity sometimes to use a
thing called ventrilo-scopeSorry, ventrilo-scope, yeah,
(15:01):
yeah, they can like and we wouldsay this is what you would hear
when you do that.
Or even without the card or theventrilo-scope, it would say I
would just say and you wouldhear there's fluid in my left
lower base of the lung,something like that.
That's the least common onethat we have to verbalize it,
(15:22):
but that can be on the table.
So basically we have to setaside, like just it's almost a
little time out without totallybreaking character, and we say
and this is what you would hear.
And then we go back in thecharacter oh yeah, yeah, I know
Wild, right.
Speaker 3 (15:38):
Oh, good, that's it.
Yeah, yeah, when you think it,and it makes you think of,
because you could pretty muchpick any health condition, be it
mental or physical, and Isuspect you can make it very
basic or it could be relativelycomplex.
And I had asked what was, inyour experience, what has been
(16:00):
the most complex patientexperience you've had to portray
?
Speaker 2 (16:06):
Oh my goodness, that's a really good and
challenging question because itdepends on what type of
complexity.
I've done a case that was verymuch like I was barely acting in
it, like it was all about.
The students had to come in andthey had to use a bunch of
(16:27):
tools and there was a fake armsitting in the room.
We're sitting there, but wehave a checklist and they have
to learn how to Drill an IV orsomething into the arm.
Yeah, I'm sure you know what I'mtalking about.
Of course we're not using ourreal arm because, ouch.
Speaker 3 (16:44):
Yeah.
Speaker 2 (16:46):
But that is a very complex thing that we had to
learn and be, but at the sametime we're sitting there being
like I'm crashing, go and dothey do the thing.
Okay, they brought the thingover, they did it.
Yeah, we did the blood spurtout, Okay.
So we're checking the boxes ofthat.
So that's complex in one way.
But there's also been complex,more character based cases, and
(17:09):
some of them the complexity is Ithink I mentioned earlier the
some of the cases are like 20pages long and they have such a
really detailed excuse me,detailed backstory and we have a
lot of lines that we have tosay verbatim, word for word, so
it'll be like a paragraph, andthen, if they ask this question,
(17:30):
I have to say this line, and sothat can be complex and just as
an actor or person memorizingand making sure that I say it.
So it's standardized.
Speaker 3 (17:40):
Okay.
Speaker 2 (17:40):
And we can give our own flavor to how we say those
things.
But the more we are expected tosay specific things in a case
like if it's a quantity, that'sjust that can be really complex,
and sometimes it's.
I, my hobby is to read to readAgatha Christie novels or
(18:01):
something like that, and it's.
Do we need to know thisinformation, like when we're
trying to learn everything else?
In this case, do we really needto know that is the type of
novel that we're reading, whenmost likely is not going to come
up.
Yeah, yeah, it's just funny, butyeah it's.
And once again, some people aregoing to like those complex
(18:22):
cases more.
Some like it where we don'thave to memorize as much.
But that means you got to use alot more improv skills of
bringing your whatever to thetable and having that, being
neutral when you need to, butthen also being just off the
cuff, really there and presentin the moment so you don't Go
(18:43):
the wrong route or send them thewrong route.
Speaker 3 (18:47):
Yeah, yeah, I know that's a long answer to your
question, but yeah, but itsounds like what it needs to be,
because it medicine ischallenging it.
You have to be able to think,and you have to be able to think
on your feet.
Yeah, and you cannot.
(19:07):
I Learned very early in mycareer the best doctors are the
ones who, by the time you havefinished your interview with the
patient before you've put yourhands on them, 95% of the time
you should have a pretty goodidea what's going on.
(19:28):
If you haven't, you didn'tlisten, ah, which means in
didn't ask the right questionsbased on what they were telling
you.
Speaker 2 (19:38):
That makes complete sense, and I love hearing that
from a doctor's perspective.
So that's really wonderful.
Did you ever work withstandardized patients?
Speaker 3 (19:47):
Oh, yeah, mm-hmm.
When I was in in Pittsburgh andthen when I was in New York at
Columbia, yeah, and you, whatyou found was that some people
are very believable of the rolesthey were playing yeah that you
will, I remember, distinctlyremember this.
(20:11):
She was actually 67 in real lifeand she was playing someone who
was 25 who ended up having ashoot of appendicitis, and we
were the questions she was.
She then the emergency room andshe's trying to describe her
pain, which, of course, at thattime was very atypical.
(20:35):
It wasn't a classic pain.
It wasn't in the right place ofthe abdomen that you typically
expect to see it, mm-hmm and butshe kept giving clues to the
students and it was fascinatingto see only One of the three
picked up on it.
Oh yeah question, which meantthat person was listening and it
(20:59):
had a lot to do with it, so shewas very believable, because a
lot of people you get people getconfused when they see,
physically, a person who looksone way right but we're training
something else.
It's hard for them to thedisconnect that what's in front
of them and Put in place whatthey would expect to see if it
(21:22):
was a person who reallypresented that way.
Speaker 2 (21:25):
Yeah, absolutely.
I believe that a huge thing andhelps teach students first of
all that to get a poker face andto come across as
non-judgmental.
But also, I imagine out in thereal world that you may not see
that exactly, but you mightstill expect to see one thing,
and then you're encounteringsomething else in the room and
(21:45):
it's probably really importantto Keep a neutral face right to
not let that throw you.
So then they don't say hey.
I Felt judged by this doctor.
I'm not going back to thisdoctor.
I don't trust them now, oh yeah.
Speaker 3 (22:01):
And you said something very early on.
But when you just said, whenyou mentioned walking in the
room and shaking the hand of theperson who's gonna be provided
here to you, if that person wasshaking your hand and looking
down at the floor or lookingover to the right or the left
(22:21):
Gives a totally differentimpression to the patient.
Yeah, I mean for something.
Yeah, whatever it is, they'recoming for something.
And if you're not there, Ialways say this is something I
learned from my mom.
She used to say when you're inthe room with people, be present
.
Speaker 2 (22:41):
So true, so true.
Speaker 3 (22:44):
And that's true in real life, but even more so in
medicine.
Speaker 2 (22:50):
Oh, yeah, yeah, absolutely.
I love hearing that.
Thank you for sharing and I'mcurious.
So because you work withstandardized patients I have.
Has that helped you, like as adoctor?
Was that something that broughtanything to your skills?
I?
Speaker 3 (23:07):
Think it has more because you, as you observe and
watch, you learn to look back onyour own experiences, because
medicine is pretty basic thesame diseases that existed 2,000
years ago or the same onestoday.
(23:29):
The only difference is we havemore tools to get access to the
answers.
Speaker 2 (23:36):
Yeah.
Speaker 3 (23:38):
But the history and the physical are still the most
important and it gets reinforcedwith that Standardized patient
has been.
Now you need people who are,have a willingness and, just
like in every other disciplinein life, you have some people
who are all into what they'redoing and there are people who,
(24:00):
basically, are talented enough,smart enough, gifted enough that
they can skate the surface andit works until you get that.
And I always say Other dilemmais it works until you get that
one patient who really needs youto be present and you something
(24:21):
, and it has dire consequencesfor that individual.
Yeah, you know, the one thingis it's one thing to To miss to
miss a pitch in the baseballgame and and it's another thing
to miss an important point thatleads to someone's demise that
(24:44):
could have been a.
Speaker 2 (24:46):
Yeah, life or death.
Speaker 3 (24:47):
Yeah much.
Speaker 2 (24:48):
Yeah, big deal.
Yeah, that's, so true, hmm.
Speaker 3 (24:52):
Yeah, so that do.
And when you're giving thefeedback to them, do you Do you
give them critiques on the bestway to go forward?
In other words, you can givepositive criticism, but it
(25:17):
should always be a learningexperience, something because
technically, none of us everdoes it perfect.
Sure, no matter what people say, we never really do it
perfectly.
What role does thisstandardized patient play in
helping them?
Speaker 2 (25:35):
Yeah, I think it's so cool that we do play a huge
role because even standardizedpatients of course we can be
standardized in how we're taughtand we portray the case but as
humans and when we're givingfeedback, we're saying me as
this patient, monica, I felt,katie felt, and my experience
(26:00):
might be very different than,let's say, if you were
portraying that same case, thatyou might have preferences or
things that you don't like thathappen.
That I was like actually thatwas perfectly fine, it didn't
bother me one way or the other.
What's really cool is we get togive not only general feedback
of when you ask this open-endedquestion it allowed me to give
(26:25):
you an open-ended, a lot ofinformation.
That's more kind of likechecklist, but communication
style feedback.
But then to be like when yousaid this one thing, I felt XYZ,
and that again that's from myexperience as Katie, as the
patient, rather than DrKennedy's experience as the
(26:48):
patient.
You might have been like no, Iactually felt it didn't make me
feel one way or the other orvice versa.
So I think that's what's socool is that we get to bring a
human, subjective perspective ofhow it went in that moment,
because the same student, medstudent could do the same exact
(27:08):
case to another person and maybebecause they were able to learn
from me or take something away,now they can do it a little bit
better or a little bit stronger.
Maybe better is not the rightword, but for the next patient
and be more present might be oneof it, because that certainly
is feedback we give, but we alsodo try to give, as I mentioned
before, specific feedback.
(27:30):
So it's very much like one ofmy favorite things to ask my
students after feedback sessionin verbally is, I'll say, the
things that I felt were good orspecifically, and then something
that they could work on,sometimes a few things that they
could work on.
I try to be tactful.
I do try to be tactful andprofessional about it.
But I often say okay, so beforeyou leave, after you have any
(27:54):
questions about it, anythingelse and then I'll say what's
something that you learned fromour feedback session today that
you would like to put into yournext encounter.
And it helps them say thisspecific thing I would like or
plan on trying for the next one,and that's really cool because
you can see them put it togetherand you hope that they use it
(28:15):
and who knows if they do havethe next encounter.
But it's that, yeah, yeah.
So that's one of my favoriteparts about it.
Speaker 3 (28:22):
Oh, that's good.
Do they, do you videotape?
Are you videotaped?
And then do they have access tothe videotapes going forward?
Speaker 2 (28:33):
Yeah, so we are often videotaped in the encounter
rooms, off not all the time, butin the encounter rooms there
are several cameras all around,there are microphones, not like
in our faces, but they pick upand oftentimes we are recorded.
Therefore, people such as thestudents or preceptors, doctors,
(28:56):
mentors, professors, can watchit either in real time from an
observation room or after thefact, so they can then see their
work there.
Okay, so see, when you did thisone thing, that's why they you
missed asking this question, butthat's why they, when they feel
about this evaluation you were,you didn't get credit, that it
(29:16):
can be that type of a thing to abackup to be like, because
again, we a standardized patientor simulated patients we are
not perfect either, of courselike we can work really hard to
be present and remembereverything, but in an
examination scenario, which iswhere this comes into play,
there are times where we did.
They ask if I have a familyhistory of heart disease.
Oh my gosh, this is my sixthencounter today.
(29:39):
And did they ask it?
Or did the last person ask it?
So, those were the times whenit's really beneficial to we can
go back and rewatch therecording after the fact and
have that backup.
But a lot of times it's reallyjust for that.
It's not.
They don't show it to the world.
It's not public or it's veryprivate, secure, but it is often
(30:02):
recorded, yeah.
Speaker 3 (30:04):
Yeah, it should be a learning experience on both ends
actually.
Speaker 2 (30:08):
Absolutely.
Speaker 3 (30:10):
It's, and part of it is, I think, for a lot of,
particularly those going intomedicine who've never really had
any experience as a patientthemselves and really have not.
They're now all of a sudden.
You go from being a student towhere someone, one day after you
(30:31):
graduated, on July one,basically someone's going to
call you Dr, so and you're the,you walk in the room and the
person in front of you expectsyou to be that doctor, and so it
can be somewhat nerve wrackingif you're not prepared.
That's why, as they like it,almost everything else, practice
(30:53):
does make us better Me, notmake us perfect, because there's
nobody on the planet that way,but we should be able to close.
Speaker 2 (31:02):
As they always say, practice makes progress right.
Speaker 3 (31:04):
There, you go.
Speaker 2 (31:06):
I love that thing.
Speaker 1 (31:06):
It's so true.
Speaker 3 (31:07):
It's so true that is how has your experience as a
standard.
That patient helped you to be abetter actor 100%.
Yeah, and and what would yousay?
That these encounters arebasically a form of work.
Is it an improvisation exercise?
(31:27):
Is it?
It's real world, in the sensethat you can make the actual
conditions that people mighthave and so therefore be a
learned experience.
So when that medical student,soon to be doctor, actually is
on the other side, where itreally counts, it will make a
difference.
Speaker 2 (31:48):
Yeah, it's definitely made me a better actor, because
you're it's almost like filmacting a little bit, because
it's a little more nuanced.
You're not making this sweetthing, but it's not huge, it's
all very intimate one one.
Sometimes a couple of differentdoctors are in there, a couple
of different patients, but it'svery specific and nuanced and we
have to be realistic.
(32:08):
That's the goal we, even ifwe're not playing someone who we
are exactly like, we still wantto be as realistic as possible
so they can then treat usrealistically too.
So, it's helped me definitelywith my improv skills, but also,
just, yeah, as an actor.
It's definitely helped me tieinto my emotions, like of when
(32:30):
we do challenging cases where wehave to get upset or cry, we're
getting bad news To go withwhat we're feeling.
Rather than pushing tears orpushing we have to figure out,
oh, the doctor or the way thatthe med student is talking to me
is making it's making me feelso supported and heard that
actually I'm getting more upsetin a good way, like it's helping
me release, rather than, oh,they're very detached and cold
(32:52):
and how they're delivering thisnews, I'm just going to shut
down and I'm going to be angry.
So, like it and you feel it,and so that has been a huge
emotional exercise when I'vedone those cases and also
sometimes just learning how tobe neutral and do no harm.
Don't as I mentioned earlier,don't send them down a detour
where they're going to spend thenext 20 minutes asking about
(33:13):
your drinking, when it's no,this person doesn't have a
drinking problem, like if theycame in because they have
stomach pain, whereas astandardized patient they were
just improving and said, yeah, Idrink five drinks every single
night, I'll liquor.
Obviously the doctor's going tobe like okay, why don't we talk
about that when it's that's notimportant to that?
(33:34):
Like like, why did you that'syeah.
So I hope that answers thequestion.
Speaker 3 (33:38):
Oh, yeah, yeah.
So, katie, you've created apodcast series called the
standardized patients podcast.
I understand that, as a guest,you have been featured on Conan
O'Brien's podcast.
What made you decide to startthis podcast, and what topics do
you cover?
Speaker 2 (33:55):
So we my podcast partner, catherine Bublack and I
decided to start this podcast,called the standardized patients
podcast, before I was featuredon Conan O'Brien's podcast.
Believe it or not, that wasjust a happy, wonderful surprise
, but we started the podcast Ithink we recorded almost all of
(34:19):
our season one in late summerfall of 2021.
And the reason that we decidedto do it is because I had this
big experience being astandardized patient and we
realized that there were noother podcasts about
standardized patient work.
There were a couple episodes ofpodcasts here and there that
(34:42):
focused on some standardizedpatient work, but in a very
oversaturated market as podcastsare these days, it was really
refreshing to realize wait,there is not a podcast that is
just about standardized patients.
That is currently happening,and I have a lot of experience
as a standardized patient.
I have a large network ofstandardized patients and etc.
(35:06):
That I have not only workedwith a lot but also are friends
with, and so we reached out todifferent people and garnered
interest in seeing if they'd bewilling to come on our podcast
and, if so, what would they bewilling to talk about?
And we had so many subjectsthat we wanted to cover that we
realized we needed a season two.
So we're doing season two rightnow and who knows if there'll
(35:31):
be a season three, but therereally is so much to talk about
that we haven't even covered yet.
That's where we decided it wasworth making a podcast.
So we knew it would be a nicheaudience.
But we figured between otherstandardized patients, people
that want to get into the work,people that want to learn about
(35:51):
standardized patient work,people that are curious about
odd jobs, day jobs as an actoror med students, doctors, etc.
People in the health, medicalfield.
I thought it would be a reallygood hub for people to come
learn about this line of workbecause it is fascinating, and I
think it's fascinating andwhich is a good thing,
considering I'm the host of it.
(36:12):
But to just touch on the ConanO'Brien podcast, I had reached
out to them because they wereopen to hearing from fans and I
told them a little bit aboutmyself and I put in that I was a
standardized patient and Ithought that might be a cool
thing if they were interested.
(36:32):
And they were interested and soI was really excited to get an
email from Team Coco to ask whatI'd be interested for a
pre-interview and then got me onfor an actual interview and it
was just wild and exciting thatthat brought standardized
patient work to a whole notherplatform, because his audience
is huge and people that don'teven care about what we do, they
(36:57):
still will listen to thatpodcast because he's funny and
they like what he brings to thetable.
So it was a really coolopportunity and I'm still
pinching myself that it happened.
But it's just funny that afterthat, the following March was
when we released our podcast andit had nothing to do with that
podcast that I was on.
It just happened to be a reallycool coincidence.
(37:18):
So long-winded answer, but thatis the answer to those
questions.
Speaker 1 (37:24):
Thank you, katie and Dr Kennedy, for such a very
informative discussion onstandardized patients, and
hopefully we now all have muchmore information on the area of
standardized patients than anold Seinfeld episode.
And thank you for joining us atWellness Musketeers.
Tune in for upcoming episodesto gain the tools to improve
(37:45):
your health, work performanceand live with a greater
understanding of the world weexperience together.
Please subscribe, give us afive-star review and share this
recording with your family,friends and colleagues.
You can make a contributionthrough a link provided in our
program Nats, to allow thispodcast to grow.
Let us know what you need tolearn to help you live your best
(38:08):
life.
Send your questions and ideasfor future episodes to davilis
at davidmless at gmailcom.
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