There are more than 600 simulated patients at Dalhousie’s Centre for Collaborative Clinical Learning and Research (CCCLR), helping to educate the next generation of health-care professionals.
I’m one of them. I’m an amateur actor and first took the gig because I was interested in acting more after being in a play at Theatre Arts Guild.
For many actors in Halifax, the program provides a steady if modest source of income. This helps support a vibrant arts community, which took a hit after the province modified the film tax credit and knocked the industry off balance.
I’ve been a simulated patient for two years. It’s a fair wage and I love getting paid to act but that’s not why I still do it. The greater benefit for me, which I never expected, was how much I have learned about illnesses, health-care, professional communication, and how to provide feedback.
The health-care students who attend the skills development sessions and then do exams become better doctors, physiotherapists, social workers, and pharmacists. This happens because they’ve practised on people who are trained to provide a lifelike experience for them in a low-stakes learning environment.
Tanya Dutton is the managing director of the CCCLR. She chats with simulated patients about the work. “The call to make health care better is a very powerful call and some simulated patients have experienced that … a bit of a calling to serve these students,” she says.
Simulated patients also play an important role in providing standardized test subjects for licensing exams. “From a safety and licensure perspective, that is a profound responsibility,” Dutton explains. “When you consider the public concerns about having a safe practitioner, that’s a significant contribution to society.”
The CCCLR has grown considerably since its modest beginning. It began in a small room in Fenwick Tower in the 1990s and moved to the Thompson Building on Barrington Street, where it was called the Learning Resource Centre. In the summer of 2016, it moved into the new Collaborative Health Education Building at the corner of Summer Street and University Avenue took a new name.
In this setting, more faculties can take advantage of the service it provides and realizing the benefits that can be achieved through collaboration. For example, teaching interdisciplinary communication could save money in the future. When health-care practitioners learn what other professions can do, it helps avoid duplication. “This leads to efficiencies in health care because having more than one person do something is not sustainable,” Dutton says. “There are not enough health-care dollars and providers.”
After a recent simulation in which medical students had to examine simulated stroke patients, somebody commented on how astonished they were that the CCCLR was able to find 27 stroke patients willing to participate, Dutton says. Then, they saw one of them hop off the bed table and realized they were all just actors.
“This kind of magic that happens when you have talented simulated patients and excellent training from the educators,” Dutton said.
In addition to providing a live human to practice on, this setting provides simulated patients a chance to give feedback to the students, who will eventually become health-care practitioners. This is also an important learning tool for the students because the power differential that exists once they are licensed doesn’t exist here.
“In this setting, it’s a safe environment for people to make mistakes and we know that people will make mistakes and that’s where you’ll learn,” Dutton says. “Being able to correct them and learn them here certainly serves society.”
After practising, students do an OSCE, which stands for objective structured clinical examination. While the risks are lower in a standardized exam, the students are still anxious about going in with a simulated patient.
“There’s something about coming and talking to a complete stranger that gets your adrenaline going,” she says. “It gives them confidence to do it in the real world.”