Inside the World of UVA's Play-Acting Patients

About half the class watches the birthing simulation, observing what their classmates do well and where they could improve.

“I get really into it. It’s really fulfilling to participate in medical education,” Collins said. “Before that, they interacted exclusively with mannequins,” not real people.

Each standardized patient receives a “case” with the patient’s symptoms and medical history. Sometimes, the case tells the standardized patient what attitude they need to have – perhaps they’re anxious about the appointment, high-strung, or dismissive of a medical professional’s advice. From there, these standardized patients get to decide how they act in a simulation.

The nursing students play their own different roles in simulations. During the obstetrics simulation, for example, some students tend the laboring mother; others play Collins’ partner; and still others are assigned to be the chief nurse alongside faculty members who often “deliver” the “infant” as the chief provider. Afterward, they take assessments to see what they learned and debrief with professors and peers about what went well in the simulation, and how their care and decision-making might be improved in the future.

Twins Grace and Ellie Boitnott agreed that the simulations were fun. The 19-year-olds have been standardized patients since they were in middle school, when their mother, nursing professor Amy Boitnott, asked them to help prepare nursing students for their first clinical rotations. Since then, the sisters have played everything from moody adolescents with asthma to teen moms.

“Neither of us has acting experience, so this is like our little taste of that,” Ellie said.

One of the students acts as Collins’ partner, there to hold her hand or bring her ice chips if needed.

The two are in college now (Grace is a rising second-year student at UVA), but continue to act in the simulations a couple times a year. The experience nudged Grace to study biomedical engineering; she still looks forward to each simulation in which she takes part.

Though standardized patients are instructed as to how to answer students’ questions about their maladies, they also must improvise and rely on body language to communicate their symptoms. Grace is one of the few people to say she’s had fun with meningitis.

“You have to do exactly what you would do if you actually had the sickness. We have to keep that in mind, but also not give it away,” Grace said.

Bob Hammel, who participates in simulations with his infant daughter, likes to throw the students he works with for a loop.

“It’s my mission to get my daughter in the arms of the students,” he said.

It’s not just a test for the students, though, who often cycle through multiple simulations in one day. By the time they get to Hammel, some of the students’ nerves are so fried that holding a cute baby is just what they need to feel grounded. That’s especially true since he sometimes plays a difficult patient: a man who wants to leave the hospital against medical advice, for example, or a vaccine-hesitant father.

He gets into character for each simulation, which is sometimes easier than others. During the check-up simulations with his daughter, he often answers questions the same way he does at their actual check-ups.

It’s rewarding for Hammel. He gets to help nursing students practice caring for patients, and it’s a special way to spend time with his daughter.

“I get a kick out of it,” he said. “I get to hang out with her all day and show her off to the students.”