Actors play patients to train medical students for real-life work

Students from the SIT occupational therapy degree course (from left) Lydia Tham, 20, Cheryl Lee, 20, and Lim Jiayi, 21, interacting with 29-year-old Aidil Khalip, who lost a leg in a motorcycle accident four years ago and now plays wheelchair rugby.
Students from the SIT occupational therapy degree course (from left) Lydia Tham, 20, Cheryl Lee, 20, and Lim Jiayi, 21, interacting with 29-year-old Aidil Khalip, who lost a leg in a motorcycle accident four years ago and now plays wheelchair rugby.ST PHOTO: CHEW SENG KIM

They also serve as live models for anatomy lessons; some even teach students how to do physical examinations

Medical schools are turning to part-time actors to help students polish their bedside manners, long before they reach a real patient's bedside.

The actors take part in elaborate role plays, simulating patients to help mimic the challenges of hospital work.

This could mean playing a distraught family member, a patient who cannot speak English or a senior doctor.

"I'm driven very much by the fact that it gives me a chance to help put the doctors' hearts into medicine," said Mr Davin Boo, who used to be a bit-part actor and is now self- employed.

The 48-year-old has been part of the National University of Singapore (NUS) Yong Loo Lin School of Medicine's programme for the past three years.

Even with acting experience, he said that working as a simulated patient can be challenging as it requires improvisation.

CHANGING ROLES

I've been lectured by doctors or felt judged, or just treated as a figure in a ward. It's wonderfully satisfying to be able to help change that.

DAPHNE ONG, a professional actress, on what she hopes to achieve by working as a simulated patient.

"As an actor, you just go by the script," he said. "As a simulated patient, you may be able to pre- empt responses, but it's not a fixed script on the other end."

Retired teacher Eugene Eu, 58, said that he likes the ability to interact with young people and - a personal bonus - understand what his daughter has to deal with.

"My daughter has just started doing her nursing diploma and, with this experience that I have, I'm able to empathise with her," he said. "We have this thing in common."

NUS has around 160 such actors, while the new Lee Kong Chian School of Medicine at Nanyang Technological University (NTU) has around 100.

Apart from helping students work on their soft skills, this group of people serve as live models for anatomy lessons. Some of them have also been trained to teach students how to carry out physical examinations, using their own bodies to demonstrate.

Dr Tanya Tierney, assistant dean of clinical communication training and student welfare at the NTU school of medicine, said the sessions make students more aware of what they say and how they say it.

"Whether you smile at the patient, whether you make eye contact, how you listen to someone - all these things can help develop trust and build rapport," she said.

Sessions are recorded on video for students to see if they have nervous tics that they are unaware of, such as clicking a pen while talking to patients.

"This is practice in a safe environment," said Dr Nicola Ngiam, who directs the standardised patient programme at the NUS Centre for Healthcare Simulation.

"In the old days, students would go straight to the wards and that was not ideal. Now, patients can feel assured that their doctor has done this before."

The Singapore Institute of Technology (SIT), which offers the only degree course for occupational therapy here, is planning to start such a programme later this year - but with a different set of simulated patients.

It will pair students with people who have disabilities, who will give feedback on how well students do when it comes to technical proficiencies such as transferring them from the bed to a wheelchair.

They will also take part in role play and give students an idea of their communication skills.

Occupational therapists aim to help people live normal lives and learn to look after themselves independently.

Currently, the school is working with 21 people who have disabilities such as muscular dystrophy or visual impairment.

Students have to tag along with a simulated patient on three separate occasions to understand what the patient's daily life is like.

Associate Professor May Lim, who is programme director for occupational therapy at SIT, said: "We decided it's very important for students to learn from the people they will be treating, through interaction in the community and beyond a clinical setting."

One of the people the students will be interacting with is Mr Aidil Khalip, 29, who lost a leg in a motorcycle accident four years ago and now plays wheelchair rugby.

He said: "For me, doing this was to create awareness of what handicapped people do. Not everyone of us stays at home all the time."

First-year student Lydia Tham, who was paired to work with Mr Aidil along with two other coursemates, said the experience really gave her pause for thought.

"When you get to know them as a person and know what they are able to achieve, you see things from their point of view - they are not just a case file."

This is what professional actress Daphne Ong hopes to achieve by working as a simulated patient.

"I've been lectured by doctors or felt judged, or just treated as a figure in a ward," said the 37-year-old. "It's wonderfully satisfying to be able to help change that."

A version of this article appeared in the print edition of The Straits Times on January 17, 2017, with the headline 'Actors play patients to train medical students for real-life work'. Print Edition | Subscribe