Our school periodically has Standardized Patient Encounters where we go and practice taking histories and doing physical exams or focused physicals. Sometimes our task is to handle an ethical issue: breaking bad news, behavior change counseling for smoking/alcohol/diet, difficult patient, drug-seeking behavior. Sometimes they have a "complaint" to act out: chest pain, hypertension, cough, headache, back pain. Sometimes the patients are grumpy. Some are really nice. Some are pretending to be mad at us for "being late" or for "making a medical error."
We, as students, don't know what our task will be until we're handed a clipboard a few moments before we walk into the room.
We are videotaped and rated by both the patient and a physician preceptor. We give an oral presentation and turn in a write-up based on the encounter. They grade us off of a checklist (that we have never seen) that covers everything from professional behavior to technical skill.
Well, I had mine this week and just got the preceptor's feedback today. I got a rave review!! :-D The patient gave me all high ratings in every category, and the preceptor said I only missed one thing from the checklist AND that I had covered several things of importance that weren't on the checklist!! His comment was that "you're naturally intuitive and have good clinical reasoning skills." Sure, I have to work on my terminology and how I present orally, but it's SO unbelievable how motivating a positive comment can be.
Having a fake patient tell you after the encounter is over that "You were nicer to me than my actual doctor is" somehow makes the light at the end of this very long, very dark tunnel of med school just a little bit brighter. One day I will be someone's "actual doctor." And while that thought is a tiny bit terrifying still, it's also exhilarating because it just drives home the realization that right now I am acquiring knowledge and learning skills that I will be able to use one day to help real people that are suffering and in need of care.
It just makes it feel like this is worth it.