Transcripts

A Medical Role-Reversal: Patients As Teachers

MS. REBECCA SHEIR

00:00:09
I'm Rebecca Sheir and welcome back to "Metro Connection." Today, we're talking about health and wellness and in order to keep ourselves healthy and well, what's one of the things we might do?

MS. ALICIA WHITE

00:00:17
We're going to test your acuity. So if you just want to stand near the door here, we're going to be using this chart on the wall...

SHEIR

00:00:24
Why, go to the doctor, of course, for our regular exam or checkup, like say for our vision.

WHITE

00:00:30
Can you cover your eye and read the smallest line of print that's visible to you?

MS. JESSICA RODRIGUEZ

00:00:37
F-D-P-L-T-C-E-L, maybe.

SHEIR

00:00:42
But unlike the eye exam we heard before the break during Justin Purvis' story, the eye exam you're hearing now...

WHITE

00:00:48
Okay, can you cover the other eye now and if you can see the same line, can you try to read it backwards this time?

SHEIR

00:00:53
Well, this exam has an instructor.

MR. RAY ALCALA

00:00:55
So the part about the read the same line backward, so why backward?

RODRIGUEZ

00:00:59
Because I might have memorized it from the first time and, like, will recognize the letters so they saw it. So try to change it up a bit.

SHEIR

00:01:05
But not just any instructor. We're in a mock examination room at the George Washington University School of Medicine and Health Sciences. The doctor and patient you're hearing are actually first year medical students and the guy asking about reading the same line backward, isn't a physician on GW's faculty nor is he a fellow med student. No, this guy...

ALCALA

00:01:24
My name is Ray Alcala.

SHEIR

00:01:26
...is a standardized patient instructor or SPI. How do you describe to people what it is you do?

ALCALA

00:01:32
Basically, I explain that I instruct medical students, usually first, second year medical students on physical exam systems. So, you know, HENT or pulmonary cardiovascular, abdominal, musco-skeletal, neurology.

SHEIR

00:01:47
So that explains the eye part of SPI as for the SP, you might've heard how medical schools often use people, actors as well as others to play the role of a patient and act out various conditions and situations for medical students to practice on, well these people are known as standardized patients.

ALCALA

00:02:04
I started out as a standardized patient, simulating roles and then these programs starting cropping up where standardized patients became instructors. And I just found that fascinating to learn what it was that all these students were performing on me all these years and to be able to give them feedback on what they were doing.

SHEIR

00:02:21
G.W.'s standardized patient instructor program cropped up pretty recently. It's just in its second year now.

MS. JENNIFER OWENS

00:02:27
Questions, concerns, issues, fears, gripes, feedback? Um-hum.

SHEIR

00:02:32
And Jennifer Owens...

OWENS

00:02:33
I'm one of the SP educators here at the George Washington University School of Medicine and Health Sciences.

SHEIR

00:02:38
...who I met recently in a busy classroom, is kind of the standardized patient instructor, instructor, I guess you could say. She trains SPI's like Ray Alcala on G.W.'s physical diagnosis checklist.

OWENS

00:02:50
Basically what we feel needs to be incorporated into a head to toe physical exam...

SHEIR

00:02:55
With a focus on technique. So in a mock exam room like the one we were just in, a fourth year student helps first years with the more nitty gritty medical details.

OWENS

00:03:04
So if a student has a question like where is the specific lymph node located or why am I doing this? The fourth year is there to give that information.

SHEIR

00:03:12
But if a student has a question like, for instance...

OWENS

00:03:15
How do I use the otoscope? More of a technique question. Well, that's what the SPI is there for.

SHEIR

00:03:19
And as Ray Alcala explained to me after his session with the students, the SPI is there for something else too. I also got the feeling that you were sort of bringing in a patients perspective. You mentioned something about don't forget, everyone has a different eye level.

ALCALA

00:03:33
Yeah, that's very true. I mean, because a lot of times, students as doctors don't really realize the different issues they have to deal with and we were just covering a visual fields are checking their peripheral vision. And I have had really tall students checking vision fields but they're thinking of where their fields would be for them, that they'll do the maneuver and they're not getting the results that they're expecting and I can say, oh, and by the way when you notice the results were a little off, consider the fact that we only have a height differential. And I think that they appreciate that perspective.

SHEIR

00:04:04
Between his stints as a standardized patient and standardized instructor, Alcala says he's managed to create a fulltime gig, for others, though?

MR. JOSH DRUMRIGHT

00:04:12
I'm Josh Drumright.

SHEIR

00:04:14
He's more of a part time thing.

DRUMRIGHT

00:04:15
Yeah, so I come in for these things because they're in the evening and easy for me to do around my day job.

SHEIR

00:04:20
What is your day job?

DRUMRIGHT

00:04:22
I do background investigations for a federal agency.

SHEIR

00:04:27
But part time or no, just like Alcala, Drumright says he relishes the opportunity to teach medical students.

DRUMRIGHT

00:04:33
You feel like you have a hands on, interactive important role in medical school and it's a growing part of medical school. More and more medical schools are doing programs like this. It's fairly new for G.W. to have just regular people have such a large influence on the teaching process.

SHEIR

00:04:49
And while Ray Alcala agrees, this involvement of what lay people, I guess you could say, is a positive thing, he says it's not without its challenges, such as gaining the students trust.

ALCALA

00:05:00
I think a lot of students will look at, oh, well, you know, he's not a doctor, he's not a fourth year medical student, why should I believe what he has to say? But I think that if you demonstrate that you're confident and you speak the language they speak, all of a sudden, they open up to you.

SHEIR

00:05:16
But Alcala says it kind of works the other way too, being an SPI helps him look at these budding physicians in a whole other way.

ALCALA

00:05:23
You know how many years and how much training they go through but when you work with the students, the way that we get to work with the students, you know that they're real people and they're great people and I just have such great appreciation for what they do and what they have to go through to be able to care for all of us.

SHEIR

00:05:56
You can learn more about standardized patients, standardized patient instructors and the National Association dedicated to educating them on our website, metroconnection.org.
Transcripts of WAMU programs are available for personal use. Transcripts are provided "As Is" without warranties of any kind, either express or implied. WAMU does not warrant that the transcript is error-free. For all WAMU programs, the broadcast audio should be considered the authoritative version. Transcripts are owned by WAMU 88.5 FM American University Radio and are protected by laws in both the United States and international law. You may not sell or modify transcripts or reproduce, display, distribute, or otherwise use the transcript, in whole or in part, in any way for any public or commercial purpose without the express written permission of WAMU. All requests for uses beyond personal and noncommercial use should be referred to (202) 885-1200.