What happens when the Theatre program and Occupational Therapy department join forces? The result is the use of standardized patients in a high-fidelity experiential learning experience at UM-Flint. Standardized patients are people trained to take on characteristics of a real patient, affording the student the opportunity to learn and to be evaluated in a simulated clinical environment. For the Spring 2021 semester, the UM-Flint Theatre program and Practice Integration in Occupational Therapy course collaborated to bring in-person standardized patient scenarios to its labs.
Occupational Therapy Professor
Dr. Jillian Woodworth, a Clinical Assistant Professor for Occupational Therapy, first pursued the Theatre and Occupational Therapy collaboration with a Catalyst Course Collaborative Grant through the Thompson Center for Learning and Teaching in April 2021. This grant proposed resources to support learning strategies for students, which included the incorporation of standardized patients into the OT labs. Since her Practice Integration in Occupational Therapy course is the final didactic course for students before they go to their clinical rotations, standardized patient simulations expose students to a variety of conditions before they embark on field work.
"As an instructor, I've always revolved my teaching around hands-on experiences in order to enhance the students' learning and clinical reasoning skills. Because of our current environment, it isn't ideal to work with medically complex cases. That's kind of how the idea of simulating these experiences was introduced," Woodworth said. "This provides that opportunity to expose our OT students to real life patient scenarios, establish those interpersonal skills, practice clinical reasoning, perform evaluations and interventions in the best environment we can at this time."
These environments consist of a functional living lab and pediatric lab OT at the William S. White Building on campus. The spaces mimic a real clinic, and include a bedroom, kitchen, bathroom setup, and sensory equipment. A two-way mirror ensures that Dr. Jillian Woodworth and lab instructor Kevin De Bear can take notes and provide feedback without distracting the students.
The performance of the standardized patients translates well to real clinical experiences, according to Woodworth.
"The standardized patients have been spot on with not just the physical mannerisms of the disability that they are portraying, but the social-emotional part as well," Woodworth said. "One of the standardized patients, Stephanie Dean, was crying in bed to one of our students, which happens all the time with those dealing with new disabilities. These are all things that you have to work with when you're working with a patient."
Due to the success of this experience, Woodworth hopes the collaboration can continue in the future. Woodworth also believes that this experience has made her even more confident for when her students embark on their clinicals.
"I have loved seeing these students problem solve, collaborate and grow during these simulated experiences," Woodworth said. "It makes me confident that they'll thrive in their clinicals when the time comes, and be really good occupational therapists in the future."
As the standardized patients for the simulation, Associate Professors of Theatre Stephanie Dean and William Irwin use acting and improvisation skills to facilitate real-person scenarios. Irwin and Dean helped create case scripts and played the roles of patients and caregivers. These performances captured physical and vocal details, emotional depth, and believability for Occupational Therapy students.
Stephanie Dean was not only given the medical background for her role as a C6 injury victim, but also information about the patient's life, including the patient's age, house type, children, and spouse. This ensured emotional depth, and also gave Dean new perspectives.
"Playing a quadriplegic for a day reminded me that just being able to move my limbs is such a gift that can be gone overnight," Dean said. "Knowing that these OT students and professors devote their lives to taking care of these patients and making life better for them is extremely moving. This experience reinforced my appreciation both for the work that occupational therapists do, and for the many blessings in life that I have," Dean said.
According to Irwin, these simulations are key for those in theatre to improve their skills.
"Patient simulations are excellent for theatre students to keep their skills sharp and learn new ones in character development, emotional vulnerability, improvisation, listening, physical/vocal dexterity, creativity, storytelling, collaboration, script writing, partnering, empathizing, while also exploring an alternative means of employment and creative expression in the realm of the performing arts field," Irwin said.
Dean recognizes that this collaboration shows a new side of theatre and how it can teach the audience.
"Theatre is certainly a form of entertainment. But, it also can be used to create social change," Dean said. "Theatre can be used as a tool to expose audiences to new ideas and situations they may have never experienced in the past. This fosters the abilities to relate to and empathize with others in new ways."
In the future, Irwin hopes to involve theatre students and create more collaborations on campus.
"It's been incredibly invigorating, marrying the skills we possess as professional actors with occupational therapy in effort to provide a meaningful educational experience for their students," Irwin said. "I look forward to future collaborations like this with Occupational Therapy and other programs on our campus."
Occupational Therapy Students
As Occupational Therapy students cared for the standardized patients, they were randomly assigned to one of about six tasks in the simulation, such as specific assessment, an occupational profile, and a debrief of the session with the client.
Occupational Therapy student Courtney Humphrey says that the experience built the students' therapeutic use of self, which enhances their abilities as future practitioners. Therapeutic use of self is how occupational therapists use their personality, insights, and communication style to establish a meaningful therapeutic relationship, according to Humphrey.
"We have been learning all the signs, the symptoms, the diagnoses, all of that. And these actors who present with these signs, symptoms, and complex medical cases are more than just their diagnosis," Humphrey said. "They're a person, too. We have to remember that the person comes first before whatever the diagnosis is."
Occupational Therapy student Erick Sustaita also appreciated the actors' performance and how it helped build his therapeutic use of self, especially after standardized patient Stephanie Dean began to cry.
"I'm not the kind of person who wants to give someone a hug, so I had to find a new way to comfort the patient. I looked at [Dean] and I said, 'I understand that you're frustrated, but you and I are going to work together. And we're going to get you back to doing some of the things that you can do independently,'" Sustaita said. "That was really difficult for me, but I was able to talk to her as a human being. Just being able to comfort patients is a big thing."
After taking part in the simulations, Humphrey and Sustaita feel more prepared for their career as occupational therapists.
"These simulations are such a safe space for us to make any mistakes and be provided with constructive feedback in a way that's non-judgmental," Humphrey said.