Simulated Patient Program

In order for students to develop patient-centred, evidenced based and reflective medical practice, Graduate Medicine (GM) has adopted a wide range of learning and educational approaches as well as state of the art technologies to assist in the facilitation of such learning. One of the key learning activities for medical students is the interaction between students and the community. In establishing a Simulated Patient Program, GM is ensuring students are able to learn and continually practice appropriate communications with real people, make diagnoses and have immediate access to feedback. To do this successfully we need to involve people from our local communities.

Community Involvement – GM Simulated Patient Program

As GM has progressed and developed so too has our teaching and involvement of community members. The Simulated Patient Program requires volunteers for many aspects of Clinical Skills teaching program.

Currently, community members are involved in a variety of ways:

• Simulated Patient Program
• Expert / Session Specific Simulated Patients
• Male and Female Teaching Associates (TAs)

Three different groups of GM Simulated Patients

What would I have to do in the Simulated Program?

As a regular Simulated Patient (SP), you will need to be available to participate in scripted role-plays and/ or physical examinations with our 1st and 2nd Year Students. This allows students to practice communication skills and physical examination techniques.

For example: to allow a student to become proficient in carrying out a cardiovascular examination; or taking a neurological history from an SP. This does not involve intimate examinations and there is always consultation with you in advance about the nature of the activity and the level of commitment required.

Many SPs continue to participate in the program over a period of time, accessing more training and becoming more skilled as they progress.

What would I do as an expert or session-specific SP?

‘Expert’ SPs are individuals that bring specific skills or knowledge to particular sessions throughout the year to benefit student learning. For example Mental Health professionals (Mental Health nurses, drug & alcohol counsellors, psychologists) assist with “Psychiatric History Taking” or “Managing Challenging Behaviours” sessions.

‘Session Specific’ SPs are utilised for sessions requiring specific demographics such as our ‘Teen Health and Communication’ or ‘Communicating with the Geriatric Patient and Assessment of Higher Function’ sessions. 

We also need to recruit SPs for specific sessions who have particular health conditions our students are studying.  For example our ‘Abnormal Heart’ session requires SPs with existing heart conditions.  This gives medical students the opportunity to listen and understand different heart sounds and murmurs.

What would I do as a Teaching Associate (TA)?

The Teaching Associate Program provides opportunities for medical students to practise a variety of intimate examinations with male/female Teaching Associates (TAs) in a safe and controlled educational setting. In recognition of the high level of contribution to the teaching of our students TAs receive a gift for their involvement in the program. This is in the form of a gift card to a well-established retail group and is offered for physical examination and training sessions.

The TA Program is designed for medical students to:

1. Gain confidence in both the fine technical and sensitive communication skills required to undertake intimate examinations. For men, this would involve examination of the groin, genital area and digital rectal examinations. For women, this includes pelvic and speculum examination.

Learn to perform these examinations in a non-threatening environment with immediate feedback and guidance from the TA.

1. What is Graduate Medicine (GM)?

   In July 2004, the Australian Government approved the development of a Graduate Medicine at the University of Wollongong. The Government provided funds to help finance the purpose-built medical school buildings on the Wollongong and Shoalhaven campuses.
   
   In January 2007, the first eighty students began their Bachelor of Medicine and Bachelor of Surgery (MBBS). Fifty-six new students were based at the Wollongong campus and twenty-four at the Shoalhaven campus in Nowra. Each January since then, approximately 2/3 of the total student cohort begin their MBBS degree at Wollongong and the other 1/3 at Shoalhaven.
   
   The aim of GM is to produce excellent medical practitioners who are able to contribute to the enhancement of health care for patients in all geographic settings but particularly in regional, rural and remote communities. It is also expected that GM graduates will have a commitment to patient-centred, evidence-based, reflective and cost-effective medical practice.

2. Why does Graduate Medicine need Simulated Patients (SPs)?

   GM has adopted a wide range of learning and educational approaches as well as state of the art technologies to assist in the facilitation of such learning. One of the key learning activities for medical students will be the interaction between students and patients. In establishing a Simulated Patient Program, GM is ensuring that students are able to learn and continually practice appropriate communications with real people, make diagnoses and have immediate access to feedback in the simulated environment of the Clinical Skills Centre.

3. What would I have to do as a GM Simulated Patient?

   If you are recruited as a GM SP you will initially be required to undergo some basic training. Once that has occurred, you will be asked to participate in scripted role-play sessions. Typically, an SP would be asked to familiarise themselves with a script, and “role play” a medical condition. This gives the medical student an opportunity to discuss and advise the SP according to what signs and symptoms he/she describes, while in a simulated environment.
   
   SPs will also be needed for students to practise their physical examination skills - this will not include intimate examinations. All SPs will need to give informed consent to take part in any learning and teaching activities. SPs will also always be informed of the nature of the activity and the level of commitment required in advance. You can choose to be involved in role-play or physical examination sessions, or both, whichever suits you best.
   
   Many GM SPs continue to participate in the program over a period of time, accessing more training and becoming more skilled as they progress.

4. Do I have to be trained?

   Yes. Every SP will be required to attend some basic complete some web-based training that familiarises you with the process and expectations of GM and attend an Induction session that will familiarise you with GM’s facilities. This is to ensure that as an SP you are comfortable and familiar with your role which in turn will make for a better experience for the medical student. You will not need any particular experience or qualification to participate, GM will provide all necessary training and information for you.

5. Does it cost anything?

   Training will be provided by GM at no cost to the SP. When SPs are required to attend training and/or activities at the Clinical Skills Centre, GM can provide some parking (limited), and in exceptional circumstances, assist in transportation to and from the venue. Refreshments will also be provided on these occasions.

6. When would I start?

   GM conducts training and inductions at various times throughout the year.  After you have completed the Expression of Interest Form (please refer to point 17) and the SP training modules, you will be notified when the next available Inductions are being held.  Inductions are held at both Wollongong and Shoalhaven campuses.

7. Where would I go to work?

   GM has two sites, Wollongong and Shoalhaven. SPs could work at either of those sites (or both). All training sessions and activities will take place at GM’s Clinical Skills Centres which have purpose-built facilities in both locations.

8. How available would I have to be?

   GM prefers that SPs be able to make a commitment for a length of time to participate in the program. This is not a full-time commitment but may initially be training sessions, and availability to participate in clinical role-plays or examinations. This is to ensure that SPs who are trained are able to utilise and practise the knowledge and skills developed. GM aims to establish a pool of skilled and experienced SPs who will be available on an ongoing basis to work with GM students.

   If you are interested but have limited availabilities please indicate as such on your Expression of Interest Form (please refer to point 17).

9. Do I need to have an illness or a particular medical history?

   No. GM is seeking a diverse group of SPs which can include different cultural groups, ages, ethnicities and medical histories. We encourage everyone to apply via the Expression of Interest Form (please refer to point 17). SPs do not need to have any existing illnesses, conditions or symptoms to participate as SPs with GM.

10. Do I have to provide my whole medical history and/or health records?

    As a GM SP, you do not need to provide any existing personal medical or health records if you don’t want to. However, if you are able to provide a brief medical history of any existing conditions, it may allow us to better accommodate your needs, as well as the needs of the students. We aim to have a large pool of GM SPs with a database identifying different circumstances, needs and availability of Simulated Patients to match the annual curriculum needs.

11. Do I receive treatment for my existing (or new) illnesses?

    No. The role of a Simulated Patient is to assist students in the development of their communication and examination skills. The medical students will not be treating SPs, prescribing medication or making diagnoses outside the simulated role-play situation.

    After completion of their role-play session, all SPs will attend a debriefing prior to leaving GM:

    De-briefing Objectives

    • To ensure SPs ‘de-role’ prior to their departure from GM
    • To allow SP to provide and receive feedback about the session
    • For the Program to identify and record issues that may need to be addressed for SPs
    • To ensure that the SP is aware that they have participated in a role-play situation only and that they have not relied upon or do not intend to act on any assessment or diagnosis mentioned in the simulation
    • To make referrals for actual medical assessment and treatment by a proper medical practitioner if required

12. What would happen if an abnormality was found or I became unwell during a session?

    In the event of any abnormalities being detected during participation in an examination session, you will be notified that you may need to seek medical advice. This will be privately discussed with you and if you agree, an appropriate letter to your own GP will be provided by the tutor. You will also receive a copy for your own records.
    
    A consent form will be completed on joining the program which allows appropriate contact with your own local GP in the unlikely event that this situation occurs. This is optional however and you may choose to follow up any findings yourself - a letter will be given to you from the tutor of the session.
    
    If the situation involves an injury or is of a more urgent nature, you will receive first aid, then an ambulance will be called as per UOW Emergency Response Procedures, a copy of which can be made available to you if you wish.
    
    

13. What happens to my personal details?

    All personal details and information that is provided by GM SPs remain confidential and is handled in accordance with the Privacy and Personal Information Protection Act (NSW) 1998 and Health Records and Information Privacy Act (NSW) 2002. It will only be used by the Simulated Patient Program Coordinator to determine and assist your initial and ongoing participation in the Program.

14. What if I change my mind or my circumstances change?

    If you have put in your EOI or you begin the program but decide that you no longer wish to participate, please discuss with GM SP Program Coordinator. There may be a minimum commitment you can make or you may need more flexible arrangements. We will do our best to consider and accommodate your needs.

15. How do I benefit from being a Simulated Patient?

    There are a number of benefits in volunteering to contribute to the development of medical students. Participants in similar programs around the world have commonly identified:

    • Meeting new people and making new friends
    • Contributing to the education and skill development of future medical practitioners
    • Having an opportunity to give something back to the community
    • Developing new personal skills
    • Being involved in new and growing areas of health education

16. What if I know someone else who is interested in being a GM Simulated Patient?

    Ask them to contact the GM's SP Program Coordinator directly.

17. How do I sign up to be a GM Simulated Patient?

    If you decide you would like to apply to become an SP, you need to:

    • Read all necessary information provided by GM
    • If you are a UOW student, complete Expression of Interest Form (EOI)
    • If you are a community member from outside the University, please access the Expression of Interest Form (EOI)
    • Return it to the SP Program Coordinator

18. What happens after I have signed up to be a GM Simulated Patient?

    You will be contacted by the SP Program Coordinator.

    Once you have received notification of acceptance into the SP Program you will need to:

    • Complete – GM SP Code of Conduct
    • Complete – Informed Consent
    • Complete – Consent for Sharing of Medical Information
    • Your details will be kept at GM, and you will receive regular information regarding the program
    • Prior to any participation in student learning activities, you will attend an initial training session
    • GM staff will contact you to advise of when you are needed, in accordance with your availabilities

19. How do I find out more?

    If you have read all the provided information and would like to find out more please contact the Simulated Patient Program Coordinator at the campus nearest you.

What is the Female Teaching Associate (TA) Program?

Participants in Graduate Medicine’s SP Program provide an opportunity for students to practice their physical examination and communication skills in a supervised setting in the Clinical Skills Laboratories. The Female TAs is an extension of that program where we recruit and train women from the community to provide teaching and feedback to medical students while undergoing intimate examinations. The program has been successfully running at GM since 2008.

Purpose

The FTA Program provides an opportunity for medical students to practice intimate physical examinations with women in a controlled, safe, educational setting. By receiving immediate feedback from the FTAs, the students can learn the skills required in a sensitive and professional environment.

Female TA sessions are taught when medical students are in Phase 2 of their training.

The FTA Program enables medical students to:

• Gain confidence in both the fine technical skills and the sensitive communication skills required to undertake a pelvic examination; and
• Learn to perform pelvic examinations in a non-threatening environment with immediate feedback and guidance from an experienced, trained Teaching Associate
• Maximise learning via a small group setting and standardised method of instruction

Volunteer Status

As an extension of GM’s Simulated Patient Program, the status for Teaching Associates at the University is “volunteer”. This means that Teaching Associates are covered during their time at GM by “UOW’s Voluntary Workers Personal Accident Policy”.

Each session will last up to two hours and participants receive a gift in appreciation of the high level of contribution to the teaching of our students. This is in the form of a gift card to a well-established retail group for training and physical examination sessions.

Examinations

The intimate examinations include:

• Bimanual pelvic examination – The student would feel the position and consistency of the uterus and the ovaries and any abnormalities in the pelvic cavity and lower abdomen
• Introduction of a speculum to locate and view the cervix – The speculum is introduced to the vagina, opened and locked and the cervix viewed

Recruitment

FTA sessions are usually taught in the 2nd half of the year. The FTA recruitment process includes an interview with the Coordinator: Volunteers and an initial examination by a Graduate Medicine doctor. The examination after interview serves a number of purposes:

• To give the women the experience of what an examination should feel like and familiarise both FTA and doctor with the woman’s individual anatomy
• To ascertain the woman’s suitability for the program
• To ensure there is no pathology present before taking part in examination sessions with students

Training for Participants

To ensure a quality program, after interview and assessment examination, FTAs must complete a comprehensive training package. This training must be attended before any sessions with students and includes anatomy of the pelvis, terminology and constructive feedback techniques.

All sessions and training of FTAs will be supervised by Graduate Medicine aligned doctors. Discussion on any potential risks will be covered during the training session e.g. discomfort, tenderness. No medical advice will be given and no treatment given for any condition. If however, any problems are identified during a session, this will be discussed with you in private and appropriate referral will be made.

Further Information

These sessions will be carried out at both GM campus locations in Wollongong and Shoalhaven. If you are interested in the FTA program, you will need to complete an Expression of Interest form. For more information and a copy of the form, please speak to either of the Simulated Patient Program Coordinators.

What is the Male Teaching Associate (TA) Program?

Participants in Graduate Medicine’s SP Program provide an opportunity for students to practice their physical examination and communication skills in a supervised setting in the Clinical Skills Laboratories. Male TAs is an extension of that program where we recruit and train men from the community to provide teaching and feedback to medical students while undergoing intimate examinations. The program has been successfully running at GM since 2010.

Purpose

The MTA program provides an opportunity for medical students to practice intimate physical examinations with men in a controlled, safe, educational setting. By receiving immediate feedback from the MTAs, the students can learn the skills required in a sensitive and professional environment.

Male TA sessions are taught when medical students are in Phase 2 of their training.

The MTA Program enables medical students to:

• Gain confidence in both the fine technical skills and the sensitive communication skills required to undertake a genital or rectal examination; and
• Learn to perform genital and rectal examinations in a non-threatening environment with immediate feedback and guidance from an experienced, trained ‘patient’
• Maximise learning via a small group setting and standardised method of instruction

Volunteer Status

As an extension of the Simulated Patient Program, the status for Teaching Associates at the University is “volunteer”. This means that Teaching Associates can be covered during their time at GM by “UOW’s Voluntary Workers Personal Accident Policy”.

Each session will last up to two hours and participants will receive a gift in appreciation of the high level of contribution to the teaching of our students. This is made in the form of a gift card to a well-established retail group at the relevant rates for training and physical examination sessions.

Examinations

The intimate examinations include:

• Examination of the groin, penis and scrotum
• Examinations of the groin and pelvic region & lower abdomen to identify any abnormalities including hernias
• Digital rectal examination (DRE) – where the student or doctor uses a gloved finger to examine the rectum and prostate, feeling for enlargement and abnormalities

Recruitment

MTA sessions are usually taught in the 1st half of the year. The MTA recruitment process includes an interview with the Coordinator: Volunteers and an initial examination by a Graduate Medicine doctor. The examination after interview serves a number of purposes: To give the men the experience of what an examination should feel like and familiarise both MTA and doctor with the man’s individual anatomy

• To ascertain the man’s suitability for the program
• To ensure there is no pathology present before taking part in examination sessions with students

Training for Participants

To ensure a quality program, after interview and assessment examination, MTAs must complete a comprehensive training package. This training must be attended before any sessions with students and includes anatomy of the male pelvis, terminology and constructive feedback techniques.

All sessions and training of MTAs will be supervised by Graduate Medicine aligned doctors. Discussion on any potential risks will be covered during the training session e.g. discomfort, tenderness. No medical advice will be given and no treatment given for any condition. If however, any problems are identified during a session, this will be discussed with you in private and appropriate referral will be made.

Further Information

These sessions will be carried out at both GM campus locations in Wollongong and Shoalhaven. If you are interested in the MTA Program, you will need to complete an Expression of Interest form. For more information and a copy of the form, please speak to either of the Simulated Patient Program Coordinators.

Wollongong Campus

Shawn Tyler

Simulated Patient Program Coordinator
Graduate Medicine
University of Wollongong
Northfields Avenue
WOLLONGONG NSW 2522

P: (02) 4221 5627
F: (02) 4221 4341
E: styler@uow.edu.au

Shoalhaven Campus

Judy Hayes

Simulated Patient Program Coordinator
Graduate Medicine
University of Wollongong - Shoalhaven
George Evans Drive
WEST NOWRA NSW 2540

P: (02) 4429 1506
F: (02) 4429 1505
E: judyh@uow.edu.au