More Information about Being a Standardized Patient
What is a DO?
In the United States, there are two types of physicians. There are those who have earned the Doctor of Osteopathic Medicine (DO) degree and those who have earned the Doctor of Medicine (MD) degree. Both DOs and MDs are fully qualified physicians licensed to prescribe medication and perform surgery. But there are differences.
A DO practices a "whole person" approach to medicine. There is an emphasis on learning about the person who has the disease, rather than just the disease itself. There is also an emphasis on the neuromusculoskeletal system and its influence on health. DOs are taught to emphasize prevention of injury or illness, in addition to treating the current medical problem.
A DO receives training in osteopathic manipulative treatment (OMT). According to the American Osteopathic Association: "Osteopathic Manipulative Treatment (OMT) is hands-on care. It involves using the hands to diagnose, treat and prevent illness or injury. Using OMT, your osteopathic physician (DO) will move your muscles and joints using techniques including stretching, gentle pressure and resistance."
Because OMT is part of DO training it is an essential part of the COMLEX-USA Level 2-Performance Evaluation clinical skills examination. During training, NBOME Standardized Patients receive detailed information about OMT and how it specifically relates to a given medical case being portrayed.
What is a Standardized Patient?
A Standardized Patient (SP) is a person who has been carefully coached to simulate an actual medical patient so accurately that the simulation cannot be detected by a skilled clinician. SPs are used in a variety of ways in medical education. NBOME SPs are essential to assessing the clinical skills of medical students who wish to be licensed as osteopathic physicians.
What does an SP do?
In your role as an SP, you will be interacting with third- and fourth-year osteopathic medical students. You will portray a patient, and you will have memorized and rehearsed the details of a specific medical case. SPs are assigned cases based on what demographics they can portray (e.g., 45-year-old Caucasian woman, 50-year-old African American man, etc.).
You will undergo the same common examinations that you might have as a real patient in a doctor's office. For example, candidates may: listen to your heart and lungs with a stethoscope; press on your abdomen to look for tenderness or swelling; look into your eyes, ears, and throat; take your blood pressure; assess your muscle strength; check your reflexes; or check your pulses.
You will NOT have to undergo any invasive physical exam procedures; i.e. breast, genital, pelvic, rectal, corneal reflex. None of the examinations will require you to give blood or other samples, and you will not be required to take any drugs.
Female SPs may need to shift (but not remove) their bras so that the student doctors may listen to their heart. Student doctors are urged to use a drape to protect the SP's modesty during the physical examinations.
You will document the events in the doctor-patient encounter and evaluate the student doctor's interpersonal skills as you have been trained. You will not give direct feedback to the student doctor on his or her performance.
Challenges of Being an SP
This job is not easy, and it is not for everyone. The attire for an SP is a hospital gown and robe. Smoking is not permitted in the building, and you must remain in the building throughout your shift, including during lunch and breaks.
This job requires intense concentration while you are being interviewed and examined by the student doctors. You must be able to respond exactly as the real patient would, and only as that patient would. You must be able to maintain not only the patient's character but also simulate his/her physical condition during the encounter with the student doctors. You must be able to do this many times in succession without any changes.
After the doctor-patient encounter, you must be able to remember and record what the student doctor did. You must be able to respond quickly to feedback from training staff who give you guidance about improving your job performance.
Being an SP is hard work, and it demands a high level of job performance.
What makes an effective SP?
There are certain qualities we look for in selecting SPs for our program:
- Superb recall
- Ability to follow direction
- Ability to think quickly
- Ability to portray a patient
Some further points to consider
- Accuracy - It is always important to give the facts of a medical case correctly. This way we ensure each student doctor enjoys fair and equal treatment.
- Consistency - A major goal for the doctor-patient encounters is to ensure consistency (i.e. standardization) and quality for the student doctors interviewing and performing the physical examination. Therefore, it is important for you to be consistent both with information you give to each candidate and the way you give it
- Confidentiality - Your ability to maintain confidentiality and not discuss case information or student doctor performance with other SPs and those outside of NBOME is essential.
- Conflicts of Interest - Because the NBOME's National Center for Clinical Skills Testing is a high-stakes examination center with confidential testing information, we cannot employ individuals who work at an osteopathic medical school or a test prep center (e.g., ETS, Kaplan).
- Attire - SPs are dressed in hospital gowns while in the examination. A robe will be available for to you to wear between encounters or when leaving the examination room. You are required to bring and wear white crew socks and clean, appropriate (non-revealing) undergarments. No T-shirts, tights or pantyhose.
Starting pay for training is $18 per hour. Once you have successfully completed the full training and are scheduled for an examination, the rate increases to $20 per hour.
All SPs are evaluated annually and eligible for salary increases based on performance, professional and personal standards met throughout the year.
How often do SPs work?
The work is part-time, as needed. While there is no guarantee of minimum hours per week, you will be scheduled to portray your case often enough to remain sharp.
How much availability do I need to provide?
An SP is required to be available for at least twelve days per month, and will be scheduled based on the needs of the exam. NBOME does not guarantee a fixed minimum or maximum number of hours. SPs who are repeatedly unavailable for the required twelve days per month may be dismissed.
All SPs are expected to work at least some weekend and evening work when needed, and priority is given to applicants who have full availability on a regular basis.
An online scheduling system is used to schedule SP shifts. After logging onto the webpage, you can indicate your availability for future examinations, and also see what examinations you are currently scheduled to work.
What hours do SPs work?
The morning examination hours are from 8:00 AM to 3:30 PM.
The evening examination hours are from 2:00 PM to 9:30 PM.
Standardized Patients may arrive 15 minutes prior to the start of the shift. Lockers are supplied for you to store personal items and clothing.
Public Transportation to NBOME
The NBOME's National Center for Clinical Skills Testing (NCCST) is very accessible by public transportation.
Free onsite parking is available to employees.
How to Apply to Be an SP
The best way to apply to be an NBOME SP is to complete the online application. (See link below.) Be sure to upload a recent photo of yourself, which will be useful in determining the most appropriate medical case/s for you to portray. Your information will be entered into the potential SP database, and depending on our current needs, you may be invited to attend an onsite recruitment session.
Complete the online application via the following link:
If you are not able to submit your application online you may print it and send a recent photo to one of the mailing addresses below:
NBOME National Center for Clinical Skills Testing (NCCST-Philadelphia)
101 West Elm Street
Conshohocken, PA 19428
Attn: SP Recruitment
NBOME National Center for Clinical Skills Testing (NCCST-Chicago)
8765 W. Higgins Road
Chicago, IL 60631-4174
Attn: SP Recruitment