The University of San Francisco: School of Nursing

The Bridge - USF School of Nursing Newsletter

The Bridge - USF School of Nursing Newsletter

Summer 2009 - Vol IV Issue 1

Student Actors Play Standardized Patients for Nursing School

Mr. Smith, 78, sat on his hospital bed, but he didn’t want to be there. He didn’t know where he was, no one was answering his questions, and he didn’t understand why nurses were examining him. Determined to get out of bed, he got himself to the edge of the bed and promptly fell to the floor. The nurses—USF nursing students—were stunned.

nursing acting Nursing sophomore Rita Miles (left) tends to "Mrs. Green," a 38-year-old hospital patient played by Kelley Greer, a junior studying acting and dance.

Thankfully, the “patient” was a student actor and the entire scenario was a simulation designed to teach nursing students about the risk and prevention of patient falls. The scenario came about because of an innovative partnership between the School of Nursing and the performing arts and social justice department that uses acting students to play “standardized patients” during part of nursing students’ clinical training.

Long a staple of medical schools, the use of standardized patients is relatively new in nursing education. The School of Nursing uses mannequins throughout students’ clinical training, but the presence of a live person can make the situation seem more credible and give the future nurses the chance interact with patients in ways not possible when practicing on mannequins. The nursing students learn that nursing is about more than having good technical skills; it also means attending to patients’ non-medical needs and displaying empathy.

“I think this is a perfect embodiment of why you go to a 4-year liberal arts Jesuit university to become a nurse,” said Susan Prion, assistant professor of nursing. Prion and Judith Lambton, associate professor of nursing, worked with the performing arts and social justice department to create the partnership, which began last year.

But it’s not just the nursing students learning from the experience. Acting students such as senior Rochelle Lozano also have the chance to work on their craft.

“The overall experience was fun, exciting, and made me realize that I am capable of fully engaging as a character in a hospital scene with extreme medical conditions,” Lozano said. “I actually felt like the real patient and thought like one also, such as how I am actually feeling with pain throughout my body, not being able to see my family and friends and being confined.”

Lozano and other students in Ken Sonkin’s second-year acting class, which focuses on character development, received three character briefs, each one describing a particular patient’s situation (including Mr. Smith’s). The acting students then had several weeks to fully develop the characters using a variety of acting methodologies, including studying people of different genders, social classes, and ages. About 10 students were selected to play the characters for the nursing students, combining their research with their improvisation skills to focus on one goal—getting out of bed.

The nursing students, by contrast, were given relatively little information. As in a real hospital situation, they simply knew the patients’ basic medical information. And while they knew they needed to prevent the patients from falling, the nursing students often were so focused on performing necessary head-to-toe assessments, they missed patients’ efforts to get out of bed until it was too late.

The nursing students had studied falls prevention in the classroom and, in theory, knew what to do, but putting it into practice was a very different experience—one that is likely to stick with them. Before the simulation, students took a pre-test about their knowledge of falls prevention. Afterwards, they took the same test and scored dramatically higher. What’s more, Prion said, comments from the nursing students highlight the impact of using standardized patients.

“A lot of information was simply backed up for me,” a student wrote in an evaluation. “I had learned it in theory, but had yet to apply it to the clinical setting…Most of all, I learned that I still have a lot more to learn.” Another student wrote that the most helpful part of the experience was “the live acting because it made the experience very real, forcing us to ‘act out’ what we would do rather than say what we would do. Doing it is harder than saying you’ll do it!”

For the actors, the experience has also been an opportunity to do more than entertain.

“Not only did the actors feel like they were truly serving another department on campus, but they also saw how their acting skills could be put to use other than for mere entertainment,” Sonkin said.

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