I have a few minutes before going to sleep, and again, I want to keep blogging on a regular basis, so here's a post about my first standardized patient.

Yesterday, I had my first one-on-one standardized patient interview (SPI). At Michigan, SPIs are used to teach students how to communicate effectively as physicians, and how to do physical exams. (These brave souls volunteer their time and bodies to teach students how to conduct proper rectal and pelvic exams, believe it or not.) Oftentimes, we are told that our anatomy cadavers are our "first patients," but as you can imagine, SPI volunteers are a bit more engaging. At this stage of our education, we aren't expected to create a differential diagnosis based on our interviews, per se; these rounds of SPIs are designed to simply evaluate communication skills and rapport-building ability. Luckily, we've had plenty of lessons on how to structure and guide a medical interview, in order to create a natural flow of conversation. This was the first time we were able to practice these skills on trained actors, who would evaluate what impressions we made on them, and how well we were able to navigate and transition between different parts of a medical interview.

I was definitely a bit nervous, but certainly not anxious. In fact, I was looking forward to conducting an interview on my own for the first time. We've had SPI sessions before, but those were in group settings, where my classmates and I often had to piggyback our questions off of previous lines of investigation. This time around, my classmates and I were allowed to bring in our own notes, so I prepared a brief outline of questions I wanted to ask, and had a rough idea of where I wanted to take the conversation.

The interview went really well, I think. My patient was a Ms. Taylor, complaining of abdominal pain and constipation. The details are probably boring to my blog readers, so I won't dwell on them (though I can try getting a copy of the video recording, if you want :-p). The biggest lesson I got out of my SPI was confirming my love of medicine. In all honesty, I kind of want to do another SPI. I was pleased that the interview was very conversational, yet informative and productive. At the end of the session when we broke role, the debriefing with my patient (now the instructor) was extremely encouraging and helpful. Apparently she felt at ease, thought I was professional, and felt that I was engaged with her throughout the session. I especially appreciated her picking up on subtle mannerisms I could improve (apparently, saying, "Interesting" after every answer can make a patient uneasy) and offering some examples of lines I can use to transition from topic to topic.

Overall, I felt great about the experience. This was exactly why I'm in med school, to connect with people. The best part was how natural it felt. I felt like I naturally legitimized my patient's concerns and picked up on subtle conversational cues. I'm not exactly eager to practice the rectal or pelvic exam on actual SPI patients, but at least this SPI left me wanting more. Out of everything I've experienced in med school so far, this session has me looking forward to practicing real medicine.

P.S. To all M1 classmates who still need to do their SPIs, it's a really straightforward venture. Be yourself, be aware of your patient, and pursue parts of the interview that might not necessarily be medically related. I imagine the other SPI patient instructors are as friendly and encouraging as the one I had yesterday. You all are going to do great!