Tuesday afternoon, I had my first encounter with a standardized patient (SP) as part of the PPS I HX/PE exam. I was responsible for taking the patient’s complete history and vital signs as well as conducting a cardio, respiratory, and abdominal exam. Though this encounter was purely for practice, I learned a great deal about my bedside manner and ability to draw out personal/private information.
Going into the exam, I was confident about my interviewing skills. I’ve always enjoyed interacting with people who I don’t see on a daily basis (one of the reasons I love participating on interview days), but this was a slightly different kind of interaction. Patients have an entire life’s worth of information at their disposal – the trouble is eliciting the facts and concerns which are most relevant to the chief complaint. As part of the exam, we had to learn about our patient’s chief complaint, history of present illness (HPI), past medical history, social history, and family history. Whew, quite a bit of information. 🙂
While taking the history, my SP maintained her character throughout, but the physical examination was more interactive. Beginning with the vital signs, I carefully walked through what I thought would be a straight forward and structured physical examination. Vital signs were good, breath sounds were clear to auscultation, liver was easily palpable, bowel sounds were discernible, etc. The SP also had plenty of helpful tips as I went along.
After finishing the exam, I left the room, answered a few survey questions about how the encounter went, and then listened to my SP’s feedback. Now in the past I’ve been told I have a “story teller’s” voice, but this time I was told that I’ve been blessed with two gifts: 1.) warm hands and 2.) a demeanor (both in voice and body language) which is inviting, warm, and honest. She proceeded to say that if she actually had a medical secret, I had already established enough credibility in the short patient history to warrant hearing about it. Yeah, I’m sure most of my classmates received similar feedback, but it made me feel unusually happy at that moment. 😛
All in all, the experience was fantastic! I’m looking forward to getting the video of my encounter to analyze nonverbal cues and how well the interview flowed.