Simulated Patient Program

In order for students to develop patient-centred, evidenced based and reflective medical practice, Graduate School of Medicine (GSM) 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, GSM 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 – GSM Simulated Patient Program

As GSM 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:

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

Three different groups of GSM 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.

Scenario role plays allow students to practice interviewing (history taking) skills, learning how to ask the right questions related to the different bodily systems (e.g. cardiovascular history taking). 

Learning and practicing physical examination techniques  allows a student to become proficient in carrying out  different types of  physical examinations. 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 a Session Specific SP?

Session Specific SPs are individuals that bring specific skills or knowledge to particular sessions throughout the year to benefit student learning. This knowledge is gained from additional training sessions made available to existing SPs. For example, Mental Health role plays assist with “Psychiatric History Taking” or “Managing Challenging Behaviours” sessions.

‘Session Specific’ SPs are also utilised for sessions requiring specific training scenarios, such as our ‘Sexual History Taking sessions. 

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. TAs are required to undergo additional training and a physical examination (to ascertain physical suitability) before taking part in any TA session.

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

1. What is the Graduate School of Medicine (GSM)?

   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.

   Now known as the Graduate School of Medicine, GSM's aim 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 GSM graduates will have a commitment to patient-centred, evidence-based, reflective and cost-effective medical practice.

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

   GSM 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, GSM 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 GSM Simulated Patient?

   You will initially be required to undergo some training and be inducted to the Program. 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 Scenario, and “role play” a medical condition. This gives the medical student an opportunity to ask questions of the SP  to discover the signs and symptoms they describe, 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 always be informed of the nature of the activity and the level of commitment required in advance. You can choose to be involved in either communication (role-play) or physical examination sessions, or both, whichever suits you best.

4. Do I have to be trained?

   Yes. Every SP will be required to complete some interactive online training modules that will familiarise you with the process and expectations of GSM. You will also be required to attend a campus specific Induction session that will familiarise you with GSM’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, and GSM will provide all necessary training and information for you.

5. Does it cost anything?

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

6. When would I start?

   GSM conducts inductions at various times throughout the year. After you have completed the online 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 Wollongong, Shoalhaven and Southern Highlands campuses.

7. Where would I go to volunteer?

   GSM has three sites, Wollongong, Shoalhaven (west Nowra) and Southern Highlands (Moss Vale). SPs could volunteer at any or all of those sites. (All training sessions and activities will take place at GSM’s Clinical Skills Centres which have purpose-built facilities in all locations.

8. How available would I have to be?

   While there is no set time commitment and participation is entirely at the discretion of the SP, It is hoped SPs can make themselves available for sessions at least a few times per month. SPs can make themselves available more frequently, however, availability may not always result in participation.

   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. GSM is seeking a diverse group of SPs which can include different cultural groups, ages, genders, ethnicities and medical histories. We generally hope our volunteers are fairly active and mobile, as we need to present ‘typical’ bodies rather than ‘atypical’. SPs do not need to have any existing illnesses, conditions or symptoms to participate, nor should any pre-existing conditions prevent you from participating in the SPProgram.

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

    As a GSM 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 does allow us to better accommodate your needs, as well as the needs of the students. We aim to have a large pool of SPs with a database identifying different circumstances, needs and availability of volunteers 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.

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 a physical 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 GSM 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. Your personal information will not be shared outside the SP Program without your express permission.

14. What if I change my mind or my circumstances change?
    
    If you have submitted your EOI or you begin in the program but decide that you no longer wish to participate, please discuss with GSM 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 GSM Simulated Patient?

    Ask them to contact GSM's SP Program staff at their nearest campus. Refer to the Contact Us section for more details.  

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

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

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

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

    You will be contacted by the SP Program staff of your nominated campus to arrange next steps.

    Before participating in the SP Program, you will need to complete:

    • SP online training modules, available through UOW Open Learning platform
    • SP Consent form
    • SP Code of Conduct form
    • Consent for Sharing of Medical Information form
    • Unpaid Work Engagement form
    • Campus specific SP Induction
    • Clinical Skills Centre Orientation form

    GSM staff will contact you to advise of when suitable sessions are available, 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 the Graduate School of 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 GSM 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 GSM ’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 GSM by “UOW’s Voluntary Workers Personal Accident Policy”.

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 the Graduate School of 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 the Graduate School of 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 GSM 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 the Graduate School of 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 GSM 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 GSM by “UOW’s Voluntary Workers Personal Accident Policy”.

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 School of 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 the Graduate School of 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 GSM 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 School of Medicine
University of Wollongong
Northfields Avenue
WOLLONGONG NSW 2522

P: (02) 4221 5627 or (02) 4221 5505
E: simulated-patients-wollongong@uow.edu.au

Shoalhaven Campus

Clinical Skills Support Officer
Graduate School of Medicine
University of Wollongong – Shoalhaven Campus
George Evans Drive
MUNDAMIA NSW 2540

P: (02) 4429 1501
E: simulated-patients-shoalhaven@uow.edu.au

Southern Highlands Campus

Clinical Skills Support Officer
Graduate School of Medicine
University of Wollongong – Southern Highlands Campus
Kirkham Street
MOSS VALE NSW 2577

P: (02) 4221 5505
E: simulated-patients-southernhighlands@uow.edu.au